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.
Freddie Gray's death on April 19 leaves many unanswered questions. But it is clear that when Gray was arrested in West Baltimore on the morning of April 12, he was struggling to walk. By the time he arrived at the police station a half hour later, he was unable to breathe or talk, suffering from wounds that would kill him.*
Gray died Sunday from spinal injuries. Baltimore authorities say they're investigating how the 25-year-old was hurt—a somewhat perverse notion, given that it was while he was in police custody, and hidden from public view, that he apparently suffered injury. How it happened remains unknown. It's even difficult to understand why officers arrested Gray in the first place. But with protestors taking to the streets of Baltimore since Gray's death on Sunday, the incident falls into a line of highly publicized, fatal encounters between black men and the police. Meanwhile, on Tuesday, a reserve sheriff's deputy in Tulsa, Oklahoma, pleaded not guilty to a second-degree manslaughter charge in the death of a man he shot. The deputy says the shooting happened while he was trying to tase the man. Black men dying at the hands of the police is of course nothing new, but the nation is now paying attention and getting outraged.
After a five-month delay, Loretta Lynch made history last week. On Thursday, the Senate confirmed Lynch as the next U.S. attorney general, the first African American woman ever to hold this Cabinet position. Her long-stalled nomination sometimes seemed in doubt, held hostage to partisan jockeying between Democrats and Republicans. But one political bloc never gave up, relentlessly rallying its support behind Lynch: the black sorority.
During her initial hearing, the seats behind Lynch were filled with more than two dozen of her Delta Sigma Theta Sorority sisters arrayed in crimson-and-cream blazers and blouses, ensuring their visibility on the national stage. These Delta women—U.S. Representatives Marcia Fudge and Joyce Beatty among them—were there to lend moral support and show the committee that they meant business. The Deltas were not alone. The Lynch nomination also drew support from congressional representatives from other black sororities: Alpha Kappa Alpha members Terri Sewell and Sheila Jackson Lee took to the House floor to advocate for a vote while Sigma Gamma Rho members Corinne Brown and Robin Kelly and Zeta Phi Beta member Donna Edwards used social media and press conferences to campaign on Lynch’s behalf.
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.
I’m not a dog person. I prefer cats. Cats make you work to have a relationship with them, and I like that. But I have adopted several dogs, caving in to pressure from my kids. The first was Teddy, a rottweiler-chow mix whose bushy hair was cut into a lion mane. Kids loved him, and he grew on me, too. Teddy was probably ten years when we adopted him. Five years later he had multiple organs failing and it was time to put him to sleep.
When I arrived at the vet, he said I could drop him off. I was aghast. No. I needed to stay with Teddy.As the vet prepped the syringe to put him to sleep, I started sobbing. The vet gave me a couple minutes to collect myself and say goodbye. I held Teddy's paw until he died. Honestly, I didn't think I was that attached.
This week we have images of a Chilean volcano, migrants shipwrecked in the Mediterranean, the "Blue Forest" in Belgium, Kim Jong Un atop Mt Paektu, the Boston Marathon, Orcas hunting on a Patagonian beach, Saudi attacks on Yemen, tule elk along California's coastline, and much more.
In her new book No One Understands You and What To Do About It, Heidi Grant Halvorson tells readers a story about her friend, Tim. When Tim started a new job as a manager, one of his top priorities was communicating to his team that he valued each member’s input. So at team meetings, as each member spoke up about whatever project they were working on, Tim made sure he put on his “active-listening face” to signal that he cared about what each person was saying.
But after meeting with him a few times, Tim’s team got a very different message from the one he intended to send. “After a few weeks of meetings,” Halvorson explains, “one team member finally summoned up the courage to ask him the question that had been on everyone’s mind.” That question was: “Tim, are you angry with us right now?” When Tim explained that he wasn’t at all angry—that he was just putting on his “active-listening face”—his colleague gently explained that his active-listening face looked a lot like his angry face.
A magnitude 7.8 earthquake struck Nepal early on Saturday, centered 10 miles below the surface, less than 50 miles from the capital of Kathmandu. At least 2,200 are already reported to have been killed by the quake and subsequent avalanches triggered in the Himalayas. Historic buildings and temples were destroyed, leaving massive piles of debris in streets as rescue workers and neighbors work to find and help those still trapped beneath rubble. Below are images from the region of the immediate aftermath of one of the most powerful earthquakes to strike Nepal in decades. (Editor's note, some of the images are graphic in nature.)
In the fall of 2011, the U.S. Secret Service orchestrated a sting operation. The target was a Vietnamese man named Hieu Minh Ngo. Investigators believed he was a big-time identity thief who sold packages of data known as “fullz,” each of which typically included a person’s name, date of birth, mother’s maiden name, Social Security number, and e-mail address and password. Criminals could buy fullz from Ngo for as little as eight cents and then use them to open credit cards, take out loans, or file for bogus tax refunds. They could also pay Ngo for access to a vast database of people’s personal records.
As part of the operation, an agent attempted to buy the identities of hundreds of U.S. citizens. In such illegal transactions—be they for drugs, guns, or stolen identities—finding a payment system that both sides trust can be tricky. Cash is safest because it leaves no record. But handing over a briefcase stuffed with bills isn’t an option when the parties are on opposite sides of the planet. Ngo suggested an alternative. In an e-mail to the agent, he offered simple instructions: “Please pay to our LR: U8109093.”
Soon, thousand of police officers across the country will don body-worn cameras when they go out among the public. Those cameras will generate millions of hours of footage—intimate views of commuters receiving speeding tickets, teens getting arrested for marijuana possession, and assault victims at some of the worst moments of their lives.
As the Washington Post and the Associated Press have reported, lawmakers in at least 15 states have proposed exempting body-cam footage from local open records laws. But the flurry of lawmaking speaks to a larger crisis: Once those millions of hours of footage have been captured, no one is sure what to do with them.
I talked to several representatives from privacy, civil rights, and progressive advocacy groups working on body cameras. Even among these often allied groups, there’s little consensus about the kind of policies that should exist around releasing footage.
In Baltimore, where 25-year-old Freddie Gray died shortly after being taken into police custody, an investigation may uncover homicidal misconduct by law enforcement, as happened in the North Charleston, South Carolina, killing of Walter Scott. Or the facts may confound the darkest suspicions of protestors, as when the Department of Justice released its report on the killing of Michael Brown.
What's crucial to understand, as Baltimore residents take to the streets in long-simmering frustration, is that their general grievances are valid regardless of how this case plays out. For as in Ferguson, where residents suffered through years of misconduct so egregious that most Americans could scarcely conceive of what was going on, the people of Baltimore are policed by an entity that perpetrates stunning abuses. The difference is that this time we needn't wait for a DOJ report to tell us so. Harrowing evidence has been presented. Yet America hasn't looked.