Uzima Puts $100M Behind Stillbirth Prevention — But It Will Not Be Awarded as Grants
October 15, 2026 · 7 min read
Granted Research Team · Editorial policy
At the World Health Summit in Berlin on October 12, 2026, the Gates Foundation and Wellcome Leap announced Uzima: A Stillbirth Prevention Program — $50 million from each funder across the program's first three years, for a $100 million total commitment.
The stated goal is to demonstrate that stillbirth rates in selected countries can be cut in half within a decade. Work begins with partners in sub-Saharan Africa, and an initial package of validated innovations is expected by early 2027.
For anyone who works in maternal and newborn health, the number is the headline. For anyone who intends to be funded by it, the number is the least important fact in the announcement. The important fact is who is administering it — because Wellcome Leap does not make grants, and the difference determines whether your organization can participate at all.
The problem, in the numbers Uzima is built around
| Metric | Figure |
|---|---|
| Stillbirths globally, per year | ~2,000,000 |
| Frequency | One roughly every 17 seconds |
| Share occurring in sub-Saharan Africa | Almost half |
| Share occurring during labor | Over 40% |
| Projected cumulative stillbirths, 2020–2030 | 15.9 million |
| Cases that remain medically unexplained | 25–50% |
| Nigeria's rate vs. Germany's | Roughly 7x |
| Nigeria's rate vs. Japan's | Roughly 14x |
Two of these rows explain the entire program design.
The first is that over 40% of stillbirths occur during labor — intrapartum, in a window measured in hours, often with a health worker physically present. That is not primarily a drug-discovery problem or a vaccine problem. It is a detection and decision problem: recognizing deterioration in time and acting on it. This is why the technology list reads the way it does.
The second is that 25% to 50% of cases remain unexplained. A program cannot reduce by half a cause of death it cannot characterize. Hence the three-year framing as a validation phase rather than a delivery phase.
The technology package expected by early 2027
The initial innovation package is specific, and it is heavily instrumentation-weighted:
- AI-enabled ultrasound and screening tools
- Labor monitoring sensors and technologies
- Biomarker-based and imaging-based diagnostics, including fundoscopy
- Automated clinical decision-support systems
- Integrated patient navigation and support systems
Anita Zaidi of the Gates Foundation framed the thesis bluntly: "In most parts of the world, pregnancy care remains in the dark ages, and AI will be transformative."
The AI-ultrasound line is the one to watch. The underlying bet is that gestational-age estimation and risk stratification can be performed by a non-specialist operator with a handheld probe and a model doing the interpretation — which converts a scarce-radiologist problem into a device-distribution problem. If that holds, it is the single highest-leverage intervention on the list, because it moves risk detection to the point of first antenatal contact.
Note what is not prominent: facility construction, workforce expansion, or supply-chain strengthening. Uzima is a technology validation program, not a health-systems-strengthening program. Proposals built around training and infrastructure will likely find a poor fit here, however important that work is.
The mechanism: contracts, not grants
Here is the part most coverage has skipped.
Uzima is anchored on Wellcome Leap's existing In Utero program — a $50 million effort directed by Sarah Stock, MD, PhD, a professor and consultant in maternal and fetal health — paired with the Gates Foundation's Maternal, Newborn, Child Nutrition and Health program.
Wellcome Leap is a US-based 501(c)(3) subsidiary of Wellcome that runs an ARPA-style model. Its funding mechanics differ from conventional philanthropy on nearly every axis that matters operationally:
1. There is no rolling application. Leap does not accept unsolicited concept notes. Prospective participants respond to individual program calls, each with its own guidelines, abstract requirements, and cost-and-schedule summary. Abstracts and proposals are not accepted by email. Monitoring the program page is the entire discovery mechanism.
2. Funding is milestone-gated. Funded teams — Leap calls them performers, not grantees — must hit defined technical milestones at set checkpoints to keep receiving money. This is a go/no-go structure borrowed from DARPA, not a budget period with a continuation report. A performer that misses a milestone is off the program.
3. The legal instrument is a contract. To participate, your organization must become a signatory to either a MARFA (Master Academic Research Funding Agreement) or a CORFA (Commercial Research Funding Agreement). These are contracts, not grants. Intellectual property, publication rights, data obligations, and termination provisions all come from the agreement rather than from 2 CFR 200 or a foundation grant letter.
4. Eligibility is genuinely global and genuinely sector-agnostic. Leap accepts proposals from any legal entity in any legal jurisdiction — universities and research institutions, small, medium, and large companies including venture-backed firms, and government or nonprofit research organizations. For a maternal-health program targeting sub-Saharan Africa, this matters: an African medical-device company and a European university hospital compete through the same door.
What this means for your timeline
The operative deadline for Uzima is not a proposal due date. It is institutional readiness, and it has a long lead time.
Getting a MARFA or CORFA executed is a legal-office exercise involving IP terms, indemnification, and data-rights negotiation. At a university with a sponsored-programs office accustomed to federal grants and standard foundation agreements, an ARPA-style research funding agreement is an unfamiliar document, and unfamiliar documents sit in queues. Organizations that wait for a call to open and then begin legal review routinely discover that the abstract deadline arrives before the agreement clears.
If you intend to compete for Uzima work:
- Check whether your institution is already a MARFA or CORFA signatory. Many research universities are, from prior Leap programs — Q4Bio, VISIBLE, Resistance Networks, Dynamic Resilience, FORM. If so, you have skipped the longest step.
- If not, start the agreement now, independent of any specific call. It is reusable across every future Leap program.
- Build the cost-and-schedule discipline before you need it. Milestone-gated funding requires you to commit to measurable technical checkpoints with dates. Teams accustomed to aim-based grant narratives find this conversion genuinely hard, and it is better done without a deadline.
The country dimension, and the real bottleneck
Uzima's announcement included an open invitation: ministers of health are invited to help shape the program and explore country participation, with the first official country partner to be announced in the coming months. Additional investors, philanthropies, and governments are being asked to join.
This is the clearest signal about where the program's critical path actually runs. A technology validation program needs validation sites — antenatal clinics and labor wards with ethics approval, data governance, and willingness to run a device trial in routine care. The country partnership decisions will determine which performers are fundable, because a diagnostic validated nowhere is not a diagnostic.
The practical implication for a prospective performer: a proposal with a named, committed clinical site in a high-burden country is categorically stronger than one proposing to find sites after award. If you have existing facility relationships in Nigeria, Ethiopia, Tanzania, the DRC, or any high-burden sub-Saharan setting, that relationship is your single most valuable asset in this competition — more valuable than the algorithm.
Honest assessment of the ambition
Halving stillbirth rates in selected countries within a decade is a very aggressive target, and it is worth being clear about why.
The 40%-intrapartum figure cuts both ways. It means a large share of these deaths are addressable in principle through better monitoring and faster escalation. It also means the intervention has to work inside a labor ward during an emergency — the least forgiving deployment environment in clinical medicine, where staff are overcommitted, power and connectivity are unreliable, and a false alarm rate that would be tolerable in screening becomes an actively harmful distraction.
The unexplained-cause share compounds this. If a quarter to half of stillbirths lack a characterized mechanism, the fraction that any detection-and-escalation package can reach is unknown at the outset. A three-year validation phase before an implementation phase is the right structure for that uncertainty, and the funders have described it as exactly that rather than overselling the timeline.
The $100 million should be read as the largest coordinated commitment ever made to this specific cause of death, aimed at a problem that has been chronically under-measured rather than at one that is well understood and merely unfunded. Both of those things can be true, and the honest version of the opportunity is that it is a measurement-and-validation program dressed in an outcome target.
The short version
If you build maternal-health diagnostics or monitoring technology: the money is real, the eligibility is global and includes for-profits, and the gating item is a MARFA or CORFA signature you should start now rather than when a call opens.
If you run or partner with clinical sites in high-burden countries: your site access is the scarce input. Expect to be courted, and position accordingly before the first country partner is named.
If you are a ministry of health: the invitation to shape the program is explicit and the first country partner has not been announced. That window is open now and will not stay open.
If you work in conventional foundation fundraising: treat this as a worked example of a broader shift. ARPA-style, milestone-gated, contract-based funding is expanding across health philanthropy, and the organizations that win in it are the ones whose legal and project-management infrastructure was ready before the call.