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.
Without the financial support that many white families can provide, minority young people have to continually make sacrifices that set them back.
He died on a Saturday.
My mother and I had planned to pick my dad up from the hospital for a trip to the park. He loved to sit and watch families stroll by as we chatted about oak trees, Kona coffee, and the mysteries of God. This time, the park would miss him.
His skin, smooth and brown like the outside of an avocado seed, glistened with sweat as he struggled to take his last breaths.
In that next year, I graduated from grad school, got a new job, and looked forward to saving for a down payment on my first home, a dream I had always had, but found lofty. I pulled up a blank spreadsheet and made a line item called “House Fund.”
The Islamic State is no mere collection of psychopaths. It is a religious group with carefully considered beliefs, among them that it is a key agent of the coming apocalypse. Here’s what that means for its strategy—and for how to stop it.
What is the Islamic State?
Where did it come from, and what are its intentions? The simplicity of these questions can be deceiving, and few Western leaders seem to know the answers. In December, The New York Times published confidential comments by Major General Michael K. Nagata, the Special Operations commander for the United States in the Middle East, admitting that he had hardly begun figuring out the Islamic State’s appeal. “We have not defeated the idea,” he said. “We do not even understand the idea.” In the past year, President Obama has referred to the Islamic State, variously, as “not Islamic” and as al-Qaeda’s “jayvee team,” statements that reflected confusion about the group, and may have contributed to significant strategic errors.
Neuroscientist James Fallon discovered through his work that he has the brain of a psychopath, and subsequently learned a lot about the role of genes in personality and how his brain affects his life.
In 2005, James Fallon's life started to resemble the plot of a well-honed joke or big-screen thriller: A neuroscientist is working in his laboratory one day when he thinks he has stumbled upon a big mistake. He is researching Alzheimer's and using his healthy family members' brain scans as a control, while simultaneously reviewing the fMRIs of murderous psychopaths for a side project. It appears, though, that one of the killers' scans has been shuffled into the wrong batch.
The scans are anonymously labeled, so the researcher has a technician break the code to identify the individual in his family, and place his or her scan in its proper place. When he sees the results, however, Fallon immediately orders the technician to double check the code. But no mistake has been made: The brain scan that mirrors those of the psychopaths is his own.
Why are so many kids with bright prospects killing themselves in Palo Alto?
The air shrieks, and life stops. First, from far away, comes a high whine like angry insects swarming, and then a trampling, like a herd moving through. The kids on their bikes who pass by the Caltrain crossing are eager to get home from school, but they know the drill. Brake. Wait for the train to pass. Five cars, double-decker, tearing past at 50 miles an hour. Too fast to see the faces of the Silicon Valley commuters on board, only a long silver thing with black teeth. A Caltrain coming into a station slows, invites you in. But a Caltrain at a crossing registers more like an ambulance, warning you fiercely out of its way.
The kids wait until the passing train forces a gust you can feel on your skin. The alarms ring and the red lights flash for a few seconds more, just in case. Then the gate lifts up, signaling that it’s safe to cross. All at once life revives: a rush of bikes, skateboards, helmets, backpacks, basketball shorts, boisterous conversation. “Ew, how old is that gum?” “The quiz is next week, dipshit.” On the road, a minivan makes a left a little too fast—nothing ominous, just a mom late for pickup. The air is again still, like it usually is in spring in Palo Alto. A woodpecker does its work nearby. A bee goes in search of jasmine, stinging no one.
Places like St. Louis and New York City were once similarly prosperous. Then, 30 years ago, the United States turned its back on the policies that had been encouraging parity.
Despite all the attention focused these days on the fortunes of the “1 percent,” debates over inequality still tend to ignore one of its most politically destabilizing and economically destructive forms. This is the growing, and historically unprecedented, economic divide that has emerged in recent decades among the different regions of the United States.
Until the early 1980s, a long-running feature of American history was the gradual convergence of income across regions. The trend goes back to at least the 1840s, but grew particularly strong during the middle decades of the 20th century. This was, in part, a result of the South catching up with the North in its economic development. As late as 1940, per-capita income in Mississippi, for example, was still less than one-quarter that of Connecticut. Over the next 40 years, Mississippians saw their incomes rise much faster than did residents of Connecticut, until by 1980 the gap in income had shrunk to 58 percent.
Nuts-and-bolts Washington coverage has shifted to subscription-based publications, while the capitol’s traditional outlets have shrunk.
Back in 2009, I had a job with a Washington, D.C.-based newsletter called Water Policy Report. It wasn’t exactly a household name, but I was covering Congress, the federal courts, and the Environmental Protection Agency—a definite step up from the greased-pig-catching contests and crime-blotter stories I had chased at a community newspaper on Maryland’s Eastern Shore, my first job out of college.
One of my responsibilities at the newsletter was to check the Federal Register—the official portal that government agencies use to inform the public about regulatory actions. In December of that year I noticed an item that said that the Environmental Protection Agency had decided that existing pollution controls for offshore oil-drilling platforms in the Gulf of Mexico were adequate, and that there wasn’t enough pollution coming from those platforms to warrant further review or action.
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.
“Wanting and not wanting the same thing at the same time is a baseline condition of human consciousness.”
Gary Noesner is a former FBI hostage negotiator. For part of the 51-day standoff outside the Branch Davidian religious compound in Waco, Texas, in 1993, he was the strategic coordinator for negotiations with the compound’s leader, David Koresh. This siege ended in infamous tragedy: The FBI launched a tear-gas attack on the compound, which burned to the ground, killing 76 people inside. But before Noesner was rotated out of his position as the siege’s head negotiator, he and his team secured the release of 35 people.
Jamie Holmes, a Future Tense Fellow at New America, spoke to Noesner for his new book Nonsense: The Power of Not Knowing. “My experience suggests,” Noesner told Holmes, “that in the overwhelming majority of these cases, people are confused and ambivalent. Part of them wants to die, part of them wants to live. Part of them wants to surrender, part of them doesn’t want to surrender.” And good negotiators, Noesner says, are “people who can dwell fairly effectively in the areas of gray, in the uncertainties and ambiguities of life.”
The sport is becoming an enterprise where underprivileged young men risk their health for the financial benefit of the wealthy.
Football can be a force for good. The University of Missouri’s football team proved it earlier this month when student athletes took a facet of campus life that’s often decried—the cultural and economic dominance of college football—and turned it into a powerful leverage point in the pursuit of social justice. Football can build a sense of community for players and fans alike, and serve as a welcome escape from the pressures of ordinary life. The sport cuts across distinctions of race, class, geography, and religion in a way few other U.S. institutions do, and everyone who participates reaps the benefits.
But not everyone—particularly at the amateur level—takes on an equal share of the risk. College football in particular seems headed toward a future in which it’s consumed by people born into privilege while the sport consumes people born without it. In a 2010 piece in The Awl, Cord Jefferson wrote, “Where some see the Super Bowl, I see young black men risking their bodies, minds, and futures for the joy and wealth of old white men.” This vision sounds dystopian but is quickly becoming an undeniable reality, given new statistics about how education affects awareness about brain-injury risk, as well as the racial makeup of Division I rosters and coaching staffs. The future of college football indeed looks a lot like what Jefferson called “glorified servitude,” and even as information comes to light about the dangers and injustices of football, nothing is currently being done to steer the sport away from that path.
A Chicago cop now faces murder charges—but will anyone hold his colleagues, his superiors, and elected officials accountable for their failures?
Thanks to clear video evidence, Chicago police officer Jason Van Dyke was charged this week with first-degree murder for shooting 17-year-old Laquan McDonald. Nevertheless, thousands of people took to the city’s streets on Friday in protest. And that is as it should be.
The needlessness of the killing is clear and unambiguous:
Yet that dash-cam footage was suppressed for more than a year by authorities citing an investigation. “There was no mystery, no dead-end leads to pursue, no ambiguity about who fired the shots,” Eric Zorn wrote in The Chicago Tribune. “Who was pursuing justice and the truth? What were they doing? Who were they talking to? With whom were they meeting? What were they trying to figure out for 400 days?”