Anurag Mairal, director of technology solutions at PATH Health Technologies, says that it's time to start looking at low-cost innovations in healthcare differently. What should the road map be for an innovation? Should the product debut in a developing country first and then, evolve for the developed market or vice versa?
"We're at a point now, that companies cannot just keep adding bells and whistles to the same product to garner sales," Mairal told me.
So, given the increasing costs of healthcare in the U.S. and in Europe, companies are looking increasingly at simpler solutions that have the capacity to criss-cross border with a few tweaks.
PATH is a Seattle-based non-profit. But it's working with the commercial sector to scale, distribute, and market its innovations. That's Mairal's task. He's a new addition to the PATH team, after a noted career with Johnson & Johnson companies. He is symbolic of this merger between social impact and commercial viability.
His approach includes disruptive innovation (disrupt the global health system by changing the cost equation, moving away from a grants-based approach to a commercial-approach) and developing a market for said innovations. It's not enough to innovate. Must build a system to introduce these innovations to the market, advertise them, create distribution chains, and get them to the end-user.
PATH was started in the 1970s by three researchers: Gordon Duncan, Rich Mahoney, and Gordon Perkin. Their aim was quite the same: bring together public health and the private sector. Their focus, though, was slightly different: population control. So, their first innovations addressed population overload -- interventions to curb birth rates -- and were focused on Asia.
Since then, they've expanded their focus, looking at nutrition, water, sanitation, vaccinations, and reproductive health. Here are some of the innovations that PATH has piloted:
River blindness tests
It looks like a pregnancy test but it's designed to identify river blindness (or a tropical disease, "onchocerciasis"), which is a preventable condition that has affected 37 million people globally, many in poor, rural communities situated near a water source. With a grant from the Gates Foundation for $1.8 million, PATH created this device. Traditionally, a health worker would have have to draw a vial blood, take it to a clinic where it can be processed, and then report the results several days later. The later strip, however, requires just one drop of blood from a finger prick and results are available in 20 minutes. Ideal for rural health workers.
Rice is a popular grain, eaten by half the world's population. Fortified rice includes micronutrients such as iron, thiamin, zinc, vitamin A, and folic acid. PATH partnered with food purveyors in India, Brazil, and Colombia to produce the fortified grains to combat iron deficiencies, malnourishment, and anemia. Now, the grains are being coupled with school meal programs, such as in Burundi, to ensure that they reach school kids in low-income communities.
Mobile-phone milk pasteurization
Still in the works, FoneAstra is a system that uses mobile phones to monitor flash-heat pasteurization of donor breast milk. When a mother's milk is not safe to consume or is simply not available, human milk banks (HMB) fill the need; WHO supports the use of HMBs to address malnourished infants. However, the pasteurization process is tricky and healthcare facilities are hesitant to use this donor milk, unsure of its safety. By having a cell phone attached to the pasteurization device, FoneAstra enables these health clinics to monitor data on pasteurization, assuring them that the milk is safe to use. A pilot is under way in South Africa with the Human Milk Banking Association.
PATH created this design after consulting with women globally (in the US, South Africa, Thailand, and Dominican Republic) to ensure that they had single-size solution. It's more "discreet" than the condom, is easier to use than hormonal contraception, and enables women to protect themselves from unwanted pregnancy and some sexually-transmitted diseases. Now, PATH is commercializing this for sale with Germany-based health company, Kessel. But, it's also trying to figure out how the diaphragm could be integrated into family planning programs, given that it's a reusable product and would eliminate trips to a local health clinic. Those projects are under way in Uganda, India, and South Africa.
Vaccine vial monitors
Vaccine temperatures are critical - if too hot, they lose their potency. One of PATH's earliest innovations (1996) included the vaccine vial monitor- a square indicator on the label that lets health workers know if the vaccine is still safe to use. Modeled after a technology used in the food industry, it prevented WHO from dumping massive quantities of vaccines whose potency would be "unknown" after a day in the sun or in the hands of a health worker. UNICEF and WHO claim that this innovation saves the global health community $5 million every year.
The opposite problem of vaccines getting too hot -- they freeze in the carriers. Coupled with ice packs, the vaccines can be at the risk of freezing which diminish their potency as well. Solution? PATH discovered a new way to use nontoxic, biodegradable phase-change material with ice packs to prevent freezing.
Here's a product that debuted in the developed world but is being refined, and considered for the developing world as well. While you can find a female condom in drug stores, Mairal explains that they're not popular. Why? They're not always easy to use and can be uncomfortable. A more refined version, developed by PATH, has higher quality materials (i.e. 0.03 mm thin polyurathane film that allows for heat transfer), claims to be easier to use and feels more natural.
Rather than showcasing pre-made videos on maternal and neonatal health, PATH's Digital Public Health Platform -- basically, video and projector equipment- is enabling rural women in Rajasthan, India to create videos, showcase their films, and answer questions. The community-driven approach includes teams of health workers for local solutions and storytelling.
According to Franklin, what mattered in business was humility, restraint, and discipline. But today’s Type-A MBAs would find him qualified for little more than a career in middle management.
When he retired from the printing business at the age of 42, Benjamin Franklin set his sights on becoming what he called a “Man of Leisure.” To modern ears, that title might suggest Franklin aimed to spend his autumn years sleeping in or stopping by the tavern, but to colonial contemporaries, it would have intimated aristocratic pretension. A “Man of Leisure” was typically a member of the landed elite, someone who spent his days fox hunting and affecting boredom. He didn’t have to work for a living, and, frankly, he wouldn’t dream of doing so.
Having worked as a successful shopkeeper with a keen eye for investments, Franklin had earned his leisure, but rather than cultivate the fine arts of indolence, retirement, he said, was “time for doing something useful.” Hence, the many activities of Franklin’s retirement: scientist, statesman, and sage, as well as one-man civic society for the city of Philadelphia. His post-employment accomplishments earned him the sobriquet of “The First American” in his own lifetime, and yet, for succeeding generations, the endeavor that was considered his most “useful” was the working life he left behind when he embarked on a life of leisure.
The brash Manhattan billionaire would seem to stand for values they despise—yet conservative Christian voters are flocking to his campaign.
Donald Trump is immodest, arrogant, foul-mouthed, money-obsessed, thrice-married, and until recently, pro-choice. By conventional standards, evangelical Christians should despise him. Yet somehow, the Manhattan billionaire has attracted their support.
According to the most recent polls, Trump is one of the top picks for president among evangelical Christians. One Washington Post poll even had him as the group’s favorite by a margin of six points. His first major rally in the Bible-belt fortress town of Mobile, Alabama, drew an estimated 18,000 attendees. And on September 28, prominent televangelist Paula White will reportedly lead a delegation of evangelical leaders to meet with the mogul in Trump Tower.
Climate change means the end of our world, but the beginning of another—one with a new set of species and ecosystems.
A few years ago in a lab in Panama, Klaus Winter tried to conjure the future. A plant physiologist at the Smithsonian Tropical Research Institute, he planted seedlings of 10 tropical tree species in small, geodesic greenhouses. Some he allowed to grow in the kind of environment they were used to out in the forest, around 79 degrees Fahrenheit. Others, he subjected to uncomfortably high temperatures. Still others, unbearably high temperatures—up to a daily average temperature of 95 degrees and a peak of 102 degrees. That’s about as hot as Earth has ever been.
It’s also the kind of environment tropical trees have a good chance of living in by the end of this century, thanks to climate change. Winter wanted to see how they would do.
I traveled to every country on earth. In some cases, the adventure started before I could get there.
Last summer, my Royal Air Maroc flight from Casablanca landed at Malabo International Airport in Equatorial Guinea, and I completed a 50-year mission: I had officially, and legally, visited every recognized country on earth.
This means 196 countries: the 193 members of the United Nations, plus Taiwan, Vatican City, and Kosovo, which are not members but are, to varying degrees, recognized as independent countries by other international actors.
In five decades of traveling, I’ve crossed countries by rickshaw, pedicab, bus, car, minivan, and bush taxi; a handful by train (Italy, Switzerland, Moldova, Belarus, Ukraine, Romania, and Greece); two by riverboat (Gabon and Germany); Norway by coastal steamer; Gambia and the Amazonian parts of Peru and Ecuador by motorized canoe; and half of Burma by motor scooter. I rode completely around Jamaica on a motorcycle and Nauru on a bicycle. I’ve also crossed three small countries on foot (Vatican City, San Marino, and Liechtenstein), and parts of others by horse, camel, elephant, llama, and donkey. I confess that I have not visited every one of the 7,107 islands in the Philippine archipelago or most of the more than 17,000 islands constituting Indonesia, but I’ve made my share of risky voyages on the rickety inter-island rustbuckets you read about in the back pages of the Times under headlines like “Ship Sinks in Sulu Sea, 400 Presumed Lost.”
A tattooed, profanity-loving Lutheran pastor believes young people are drawn to Jesus, tradition, and brokenness.
“When Christians really critique me for using salty language, I literally don’t give a shit.”
This is what it’s like to talk to Nadia Bolz-Weber, the tattooed Lutheran pastor, former addict, and head of a Denver church that’s 250 members strong. She’s frank and charming, and yes, she tends to cuss—colorful words pepper her new book, Accidental Saints. But she also doesn’t put a lot of stock in her own schtick.
“Oh, here’s this tattooed pastor who is a recovering alcoholic who used to be a stand-up comic—that’s interesting for like five minutes,” she said. “The fact that people want to hear from me—that, I really feel, has less to do with me and more to do with a Zeitgeist issue.”
Massive hurricanes striking Miami or Houston. Earthquakes leveling Los Angeles or Seattle. Deadly epidemics. Meet the “maximums of maximums” that keep emergency planners up at night.
For years before Hurricane Katrina, storm experts warned that a big hurricane would inundate the Big Easy. Reporters noted that the levees were unstable and could fail. Yet hardly anyone paid attention to these Cassandras until after the levees had broken, the Gulf Coast had been blown to pieces, and New Orleans sat beneath feet of water.
The wall-to-wall coverage afforded to the anniversary of Hurricane Katrina reveals the sway that a deadly act of God or man can hold on people, even 10 years later. But it also raises uncomfortable questions about how effectively the nation is prepared for the next catastrophe, whether that be a hurricane or something else. There are plenty of people warning about the dangers that lie ahead, but that doesn’t mean that the average citizen or most levels of the government are anywhere near ready for them.
In the name of emotional well-being, college students are increasingly demanding protection from words and ideas they don’t like. Here’s why that’s disastrous for education—and mental health.
Something strange is happening at America’s colleges and universities. A movement is arising, undirected and driven largely by students, to scrub campuses clean of words, ideas, and subjects that might cause discomfort or give offense. Last December, Jeannie Suk wrote in an online article for The New Yorker about law students asking her fellow professors at Harvard not to teach rape law—or, in one case, even use the word violate (as in “that violates the law”) lest it cause students distress. In February, Laura Kipnis, a professor at Northwestern University, wrote an essay in The Chronicle of Higher Education describing a new campus politics of sexual paranoia—and was then subjected to a long investigation after students who were offended by the article and by a tweet she’d sent filed Title IX complaints against her. In June, a professor protecting himself with a pseudonym wrote an essay for Vox describing how gingerly he now has to teach. “I’m a Liberal Professor, and My Liberal Students Terrify Me,” the headline said. A number of popular comedians, including Chris Rock, have stopped performing on college campuses (see Caitlin Flanagan’s article in this month’s issue). Jerry Seinfeld and Bill Maher have publicly condemned the oversensitivity of college students, saying too many of them can’t take a joke.
The tension between religious liberty and same-sex marriage may eventually come to a head in the courts, but probably not through the Kentucky clerk’s case.
As Rowan County clerk Kim Davis crawls further and further out on a limb, Supreme Court experts agree that she has little chance of prevailing. District Judge David Bunning, on August 12 ordered Davis, in her capacity as county clerk, to issue marriage licenses to all couples who meet the statutory criteria for marriage in Kentucky—a definition that, since the Court’s landmark decision in Obergefell v. Hodges, includes same-sex couples.
Davis has refused, citing “the authority of God.” The U.S. Supreme Court, without comment, denied her emergency request for a stay. This throws the case back to the Sixth Circuit, which will hear the appeal of Judge Bunning’s order. Assuming she loses in the Sixth Circuit—a fairly good assumption—she would then have the alternative of petitioning the Supreme Court to hear her religious freedom claim. The Court will eventually hear a case about religious freedom and same-sex marriage, but I don’t think it will be this one.
How the Islamic State uses economic persecution as a recruitment tactic
Before Islamic State militants overran her hometown of Mosul in June 2014, Fahima Omar ran a hairdressing salon. But ISIS gunmen made Omar close her business—and lose her only source of income. Salons like hers encouraged “debauchery,” the militants said.
Omar is one of many business owners—male and female—who say ISIS has forced them to shut up shop and lose their livelihoods in the process. The extremist group has also prevented those who refuse to join it from finding jobs, and has imposed heavy taxes on civilians.
“ISIS controls every detail of the economy,” says Abu Mujahed, who fled with his family from ISIS-controlled Deir al-Zor in eastern Syria. “Only their people or those who swear allegiance to them have a good life.” When they took over Deir al-Zor, ISIS gunmen systematically took control of the local economy, looting factories and confiscating properties, says Mujahed. Then they moved in, taking over local business networks.
Understanding social norms for the phone means accepting the fact that the things we call "phones" are actually computers.
When the telephone was new, it was a sensation. And not an altogether positive one. Sure, it was a machine that enabled a person to speak—as if by magic—to another person in another place in real time. But also, what if ghosts were sneaking through the line? This was a real concern.
Another panic point: What if the telephone created an entire “race of left-eared people,” as The New York Timesreported in 1904. “Watch a telephone for half a day, and it will be seen that almost every person that uses the instrument will place the receiver to the left ear.”
Along with questions about the physical and supernatural effects of the telephone came deliberations about etiquette. What was the proper greeting? (“Ahoy hoy,” was Alexander Graham Bell’s pick. Thomas Edison preferred “Hello.”)