Their work takes place in different countries, from Brazil to Pakistan and beyond, but for a group of researchers at the University of Virginia School of Medicine, the mission is the same: to stop the crisis of malnutrition that plagues children around the world.

The problem is epidemic: One in five children worldwide suffers the devastating effects of malnutrition and diarrhea; in developing countries, that number is one in three. And when children are malnourished in their first years of life, the effects can last a lifetime, affecting their development, stunting their growth, even reducing their IQs.

The causes go far beyond whether there is food on the table. It’s a matter of infrastructure, of sanitation, of vaccination, of a complex series of variables that contribute to a global problem. And so the U.Va. researchers are taking a multi-pronged approach, working independently and collaboratively on efforts to tackle fundamental challenges that transcend national boundaries.

The approaches are different, but the goal is shared: to allow children to lead healthy lives and develop to their fullest potential.

The importance of the work has been recognized by the Bill & Melinda Gates Foundation, which has backed U.Va.’s efforts with several grants in the past few months. Recipient projects include:

• An academic-industry partnership led by U.Va.’s Dr. William Petri that is developing a fast, simple test to measure antibody response to the tetanus vaccine. This will provide hard data allowing scientists to gauge the success of vaccination programs in areas where accurate assessment is effectively impossible. U.Va.’s Carol Gilchrist is spearheading the work at U.Va. in conjunction with Dr. Rashidul Haque in Bangladesh. “Malnutrition, immune failure and disease are a natural consequence of each other,” Gilchrist said. “We’re trying to measure immune failure and identify the children most at risk.”
• A project led by Dr. Richard Guerrant, the founder of U.Va.’s Center for Global Health, who is working to discover biomarkers of intestinal dysfunction, or enteropathy, caused by the environment. This will allow researchers to create interventions to improve children’s health and development, benefiting the poorest fifth of children – at least 170 million worldwide. “We hope that the ‘win-win’ synergies of working with world-class colleagues here and abroad on such major global health problems as diarrhea and malnutrition can help us recognize, understand and find innovative solutions to reduce their devastating costs,” Guerrant said.
• A collaboration between U.Va.’s Dr. Molly Hughes; Dr. Asad Ali, a pediatrician at Pakistan’s Aga Khan University; and Dr. Anita Zaidi, chair of that university’s Department of Pediatrics, to test a small group of biomarkers in children’s blood and stool using mRNA sequencing. Her efforts attest to her belief, shared by her colleagues at U.Va., that work in the developing world must be led by scientists in the developing world. “Our collaborators are just absolutely outstanding,” Hughes said. “They have a very long history of conducting studies on infectious disease as well as malnutrition. … That really gives us a lot of strength to build upon, because we don’t have to go back and start all over again.”

It is notable, Petri says, that U.Va. and its collaborators are receiving such generous support from the Gates Foundation. “It’s so unusual, I think, to have multiple grants awarded at the same time that involve multiple developing country sites and multiple professors from one institution,” Petri said. “That one university would receive so many grants at once speaks to the importance of the work under way.”

Gilchrist agreed. “The problem of malnutrition is too big for any one lab,” she said. “It’s not just a failure of food at the borderlines. You can have a family with one child who’s obviously thriving and another child who is not. There are other components to the situation, and our job is to identify the factors that cause the imbalance and find ways to solve these global challenges.”