Kochon Prize Nomination Form

TO ALL THE INNOVATORS IN TB

Nominee Information
Nominee Type:
Organization / Network / Programme Name:
Salutation:
First name:
Last name:
Mailing address:
Country:
Phone number:
Email address:

1. Describe the innovation and the key barriers that were overcome to successfully scale the approach and ensure wide access. (10,000 characters or less)

2. Provide evidence of the intervention's impact, potential for lasting systematic change by building local capacity, empowering communities, and creating replicable models that expand access to TB interventions. (10,000 characters or less)

3. Describe how the nominee plans to use the 2025 Kochon Prize award to further their work in scaling up use or improving the new tool or approach. (10,000 characters or less)

CHARACTER COUNT LIMIT WILL BE STRICTLY ENFORCED.

Criteria 1: Demonstration of a creative approach to introducing and scaling new TB tools, emphasizing improved access and overcoming implementation barriers.
Criteria 2: Provision of clear evidence of scale-up, impact, and potential for lasting systemic change
Criteria 3: The extent to which the prize money can contribute towards efforts to further scale-up or improve the new tool or approach

Nominator Information:
Type of nominator:
Individual Organization Group of individuals
Organization name:
Salutation:
First name:
Last name:
Mailing address:
Country:
Phone number:
Email address:
Website (if applicable):
Nominator Information: Additional Details
Are you a Stop TB partner?
No Yes
Nominator code:
 
This code will allow you to return to your nomination to edit it.