British Heart Foundation
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The Big Beat Challenge: British Heart Foundation invests GBP 30 million to transform cardiovascular disease

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Cardiovascular researchers are encouraged to apply for The Big Beat Challenge from the British Heart Foundation

Less than a generation ago, a major cardiovascular event, such as a heart attack or a stroke, was a death sentence for more than two-thirds of those who experienced one. In the last 40 years, those odds have been flipped. But even with such gains in understanding, diagnosing, and treating cardiovascular diseases (CVD), they remain the number one global killer, causing 18 million deaths each year. And, according to the World Health Organization, annual deaths are predicted to rise to almost 24 million by 2030.

To tackle this globe-spanning problem, the British Heart Foundation (BHF) has launched a worldwide competition called “The Big Beat Challenge,” which will award up to GBP 30 million (USD 39 million) to a team of researchers who propose a transformational solution to any cardiovascular disease. What makes The Big Beat Challenge different from other grand challenges is its open-ended design, meant to foster the highest levels of innovation.

“The BHF is largely a ‘response-mode’ funder of research,” says Sir Nilesh Samani, cardiologist and medical director of the charity. “We ask people to come to us with their best ideas and we fund the best of those.”

Now the BHF is putting that concept on steroids. That means those who qualify as the best people may come from any country, from any scientific or medical background, and with any idea to take on an unmet medical need in cardiovascular disease, Samani says.

“We want people to come forward with a problem in any area of cardiovascular research and propose a game-changing solution to it,” Samani says. Also, the charity decided that the winning team could come from any part of the world—there’s no requirement to include a UK-based partner. “That is a big change for an organization with ‘British’ in its name,” Samani says, noting that potential applicants have double-checked the lack of a geography requirement with him. “And, yes, we are sure that’s what we mean,” he jokes.  

Sir Nilesh Samani

British Heart Foundation

Betting big, without borders

The BHF is betting that the open-minded design of The Big Beat Challenge will return their investment in a big way. Founded in 1961, the charity funds about GBP 100 million (USD 131 million) in CVD research per year, making it one of the world’s largest independent funders in this area. Reliant entirely on charitable donations, it has funded research that established successful protocols for heart transplants, discovered that coronary thrombosis acts as a major cause of heart attacks, carried out clinical trials for aspirin as well as crucial clot-busting and cholesterol-reducing drugs, and identified gene mutations that lead to inherited heart diseases, such as hypertrophic cardiomyopathy.

Until now, the BHF’s funding has taken the conventional form of supporting individual doctoral students, postdoctoral fellows, and professors through project and program grants. These grants tend to be three-to-five-year awards of around GBP 1.5–2 million (USD 2–2.6 million) maximum, and focus on incremental research that builds on previous knowledge.

The Big Beat Challenge is an attempt to do something different. “To tackle big problems, we need to get the best minds to come together and to provide both disruption and progress,” says Sir Patrick Vallance, chief scientific adviser to the UK government in London and scientific chair of the Big Beat Challenge’s International Advisory Panel. “Heart disease is now a growing scourge across most countries and will continue to cause premature death and suffering. This is why we need a Grand Challenge—to turn discovery into creative development.”

The BHF expects interdisciplinary research teams from various domains to apply for the challenge’s four-to-seven-year award. These teams might include people in industry or technology as well as academic partners or collaborators from unexpected fields, such as electrical engineers or microbiologists who have an idea about how to revolutionize cardiovascular health. No area of research in the cardiovascular space is off-limits, and the research can involve clinicians, innovators, and entrepreneurs. Also, the winning team does not have to develop an immediate clinical application or therapy, but must demonstrate an obvious path to patient relevance.

Applications deemed intriguing and compelling by both a special panel of BHF research-funding committee members and a public and patient group will be evaluated by the International Advisory Panel. A shortlist from that group will be awarded agreed-upon seed funding to further develop their team and application. The charity expects to choose the challenge’s winning team around May 2020.

Sir Patrick Vallance

Government Office for Science

Changing the cardiovascular landscape

Samani says that despite the progress that has been made in identifying and modifying risk factors for heart disease, one in nine people in the UK still die from heart attacks and the coronary artery disease that leads to them. “We haven’t eliminated it or found good ways to prevent it from happening,” he says.

In addition, debilitating hardening of the arteries represents a huge global health burden, strokes cause devastating disability, and arrhythmias and heart failure continue to be intractable problems to treat. Vallance, who was the former president of research and development at GlaxoSmithKline, adds that promising projects could be aimed at reducing individual cardiovascular risk, harnessing the role of the immune system in cardiovascular disease, or finding true cures through regeneration and repair of heart tissues or vessels.

“For me, a key issue is whether there is a ‘big problem’ that is ripe for tackling and then whether the right team has been put in place to tackle it,” says Vallance. “That team is likely to be diverse, bring unexpected science to the table, and include scientists and groups who have never thought of themselves as ‘cardiovascular’ researchers.”

The environment is primed for a large investment, because advances in data science, artificial intelligence, and genome editing have brought enormous potential to reshape the research landscape. Global connectivity also allows a richer level of international collaboration between scientists than ever before. The Big Beat Challenge is deliberately designed to spark creativity and bold ideas across the broadest array of innovators using the most diverse technologies and approaches. The end result may represent an enormous advance for a small subset of patients, or smaller yet still significant changes for large swathes of the global population—the bottom line is that a winning proposal will make a transformational impact on one or more cardiovascular diseases.

Samani can envision such grand ideas as a vaccine for atherosclerosis, one of the most common causes of early death, or genome editing that could correct an inherited heart disease. Or—and here he admits his own bias because he sees these patients daily—a method to prevent an arrhythmia called atrial fibrillation that affects 33 million globally, has inadequate treatment options, and can lead to stroke, heart failure, and even sudden cardiac arrest.

Samani says he’s most excited to hear the ideas that the challenge will bring in, especially from researchers outside of the cardiovascular space, who might have fantastic, even radical ideas for changing CVD outcomes. “We want to capture the imagination of scientists,” he says. “There’s still time before we hit the outline application deadline, and we want to reach the broadest community out there.”

What will be the key ingredient in the proposal that wins the GBP 30 million (USD 39 million)? It will need to be bold and transformative.

“We are prepared to take a high risk, to yield a high gain,” says Samani. “A great application will hit us in the face—there will be something uniquely different in the way they are approaching the problem.”

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