Lifebox Awarded Bill & Melinda Gates Foundation Grand Challenges Initiative  

ADDIS ABABA//LONDON/NEW YORK, 10 December 2020 – Today the Bill & Melinda Gates Foundation announced the award of a Grand Challenges initiative to Lifebox – the safe surgery and anesthesia non-profit co-founded and chaired by Dr. Atul Gawande – to improve the safety of cesarean-sections in Ethiopia.

“Surgical site infections from C-sections are a leading cause of harm for mothers in Ethiopia,” said Dr. Tihitena Negussie Mammo, Lifebox Global Clinical Director and a surgeon based in Addis Ababa. “By supporting Lifebox to adapt ‘Clean Cut’ – a proven program to reduce surgical infections – for C-sections, this grant funded by UBS Optimus Foundation as part of the Bill & Melinda Gates Foundation’s Grand Challenges initiative will enable Lifebox and partners to drive lasting improvements in maternal health across the country and, we hope, beyond.” 

A mother giving birth in Ethiopia is 23 times more likely to die than a mother giving birth in the United States. C-sections are the most common surgical procedure performed in Ethiopia and the majority of these operations are considered essential surgical procedures. The overall surgical site infection (SSI) rate following a C-section in Ethiopia is estimated at 9% and infections and complications following C-sections are estimated to cause 15% of maternal deaths in the country. 

This work is part of the Bill & Melinda Gates Foundation‘s Grand Challenges initiative, funded by UBS Optimus Foundation to enable Lifebox and its partners to adapt and implement “Clean Cut” – Lifebox’s surgical site infection reduction program – specifically for C-sections. Piloted in Ethiopia in partnership with the Federal Ministry of Health (FMoH), Clean Cut saw a 35% reduction in infections for all surgical patients. The British Journal of Surgery published these results in September 2020. 

“Clean Cut leveraged surgical teamwork to dramatically improve compliance with essential perioperative infection prevention standards,” said Dr. Thomas Weiser, Principal Investigator, Consulting Medical Officer of Lifebox and an Associate Professor of Surgery at Stanford University. “This Grand Challenge Initiative allows for a rigorous study of Clean Cut and its impact on the safety of C-sections.”

“The Ethiopian Society of Obstetricians and Gynecologists is delighted to partner with Lifebox to tackle the morbidity and mortality faced by Ethiopian mothers from complications arising from cesarean sections,” said Dr. Mekdes Daba, President of the Ethiopian Society of Obstetricians and Gynecologists (ESOG). “We see firsthand the toll this takes on families across our country and we look forward to implementing change.”

Working with partners ESOG, FMoH, and Ariadne Labs – a joint center for health systems innovation at Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health – Lifebox aims to implement Clean Cut at ten maternity hospitals in Ethiopia. The outcomes of more than 6,000 patients will be analyzed over the coming two years to demonstrate impact ahead of scaling across Ethiopia and other resource-limited contexts to improve the safety of emergency obstetric care. 

For more information about Lifebox visit and its Clean Cut program. 



For further information or to arrange interviews: Kitty Jenkin, +447803425743

About Lifebox: 

Lifebox is a nonprofit organization working to improve the safety of surgery and anesthesia in low- and middle-income countries. Co-founded and chaired by Dr. Atul Gawande, Lifebox works to improve anesthesia safety, reduce surgical infection rates, and strengthen operating room teamwork through tools, training, and partnerships. Since its founding in 2011 Lifebox has worked in over 116 countries and trained more than 10,000 healthcare providers. 

About Grand Challenges: 

Grand Challenges is an initiative of the Bill & Melinda Gates Foundation where funders are invited to support innovations to solve key global health and development problems.  Lifebox’s project to improve the safety of C-sections in Ethiopia is funded by UBS Optimus Foundation, which has also supported Lifebox’s COVID-19 response and the development of a low-cost high-quality surgical headlight.