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.
Heather Armstrong’s Dooce once drew millions of readers. Her blog’s semi-retirement speaks to the challenges of earning money as an individual blogger today.
The success story of Dooce.com was once blogger lore, told and re-told in playgroups and Meetups—anywhere hyper-verbal people with Wordpress accounts gathered. “It happened for that Dooce lady,” they would say. “It could happen for your blog, too.”
Dooce has its origin in the late 1990s, when a young lapsed Mormon named Heather Armstrong taught herself HTML code and moved to Los Angeles. She got a job in web design and began blogging about her life on her personal site, Dooce.com.
The site’s name evolved out of her friends’ AOL Instant-Messenger slang for dude, or its more incredulous cousin, "doooood!” About a year later, Armstrong was fired for writing about her co-workers on the site—an experience that, for a good portion of the ‘aughts, came known as “getting dooced.” She eloped with her now ex-husband, Jon, moved to Salt Lake City, and eventually started blogging full time again.
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.
In continuing to tinker with the universe she built eight years after it ended, J.K. Rowling might be falling into the same trap as Star Wars’s George Lucas.
September 1st, 2015 marked a curious footnote in Harry Potter marginalia: According to the series’s elaborate timeline, rarely referenced in the books themselves, it was the day James S. Potter, Harry’s eldest son, started school at Hogwarts. It’s not an event directly written about in the books, nor one of particular importance, but their creator, J.K. Rowling, dutifully took to Twitter to announce what amounts to footnote details: that James was sorted into House Gryffindor, just like his father, to the disappointment of Teddy Lupin, Harry’s godson, apparently a Hufflepuff.
It’s not earth-shattering information that Harry’s kid would end up in the same house his father was in, and the Harry Potter series’s insistence on sorting all of its characters into four broad personality quadrants largely based on their family names has always struggled to stand up to scrutiny. Still, Rowling’s tweet prompted much garment-rending among the books’ devoted fans. Can a tweet really amount to a piece of canonical information for a book? There isn’t much harm in Rowling providing these little embellishments years after her books were published, but even idle tinkering can be a dangerous path to take, with the obvious example being the insistent tweaks wrought by George Lucas on his Star Wars series.
Encouraging a focus on white identity is a dangerous approach for a country in which white supremacy has been a toxic force.
Donald Trump and the disaffected white people who make up his base of support have got me thinking about race in America. “Trump presents a choice for the Republican Party about which path to follow––” Ben Domenech writes in an insightful piece at The Federalist, “a path toward a coalition that is broad, classically liberal, and consistent with the party’s history, or a path toward a coalition that is reduced to the narrow interests of identity politics for white people.”
When I was growing up in Republican Orange County during the Reagan and Bush Administrations, lots of white parents sat their kids in front of The Cosby Show, explained that black people are just like white people, and inveighed against judging anyone by the color of their skin rather than the content of their character. The approach didn’t convey the full reality of race as minorities experience it. But it represented a significant generational improvement in race relations.
After a lackluster summer, the famous neurosurgeon is finally surging—but his reliance on the conservative grassroots might be a burden as much as a boon.
The Ben Carson surge that everyone was waiting for is finally here.
The conservative neurosurgeon has been a source of fascination for both the Republican grassroots and the media ever since he critiqued President Obama, who was seated only a few feet away, at the National Prayer Breakfast in 2013. He’s been a steady, if middling, presence in GOP primary polls for most of the year—always earning at least 5 percent, but rarely more than 10. Yet over the last two weeks, Carson has secured a second-place spot after Donald Trump, both nationally and in the crucial opening battleground of Iowa, where he is a favorite of the state’s sizable evangelical community. A Monmouth University poll released this week even showed him tied with Trump for the lead in Iowa, at 23 percent.
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 man who made computers personal was a genius and a jerk. A new documentary wonders whether his legacy can accommodate both realities.
An iPhone is a machine much like any other: motherboard, modem, microphone, microchip, battery, wires of gold and silver and copper twisting and snaking, the whole assembly arranged under a piece of glass whose surface—coated with an oxide of indium and tin to make it electrically conductive—sparks to life at the touch of a warm-blooded finger. But an iPhone, too, is much more than a machine. The neat ecosystem that hums under its heat-activated glass holds grocery lists and photos and games and jokes and news and books and music and secrets and the voices of loved ones and, quite possibly, every text you’ve ever exchanged with your best friend. Thought, memory, empathy, the stuff we sometimes shorthand as “the soul”: There it all is, zapping through metal whose curves and coils were designed to be held in a human hand.
An image of a small child evokes an unfathomably huge tragedy.
I had just dropped my son off at daycare when I opened Twitter and came across a photo that over the next 24 hours would become a totem of the refugee crisis in Europe and the Middle East, and the blight that is the Syrian civil war. The picture would quickly reappear, this time as an earnest social-media meme, at a meeting of dithering UN officials and a gathering of unfeeling Arab leaders: a small Syrian boy in a red shirt, blue shorts, and worn shoes, lying face down in wet sand, his head cocked to one side along a gray, glistening shoreline, his lifeless hands cupped upwards, his knees slightly bent.
My first reaction was despair. My second was: My son sleeps just like that.
The attention this photo has received has generated discomfort as well as indignation—for understandable reasons. There are important ethical questions surrounding the taking or sharing of photos of children, dead or alive, in the media, including questions about the intent of the sharers and the consent of the subject. The scale of the Syrian tragedy is orders of magnitude greater, and infinitely more variegated, than this one picture, or this one victim’s story, can possibly convey. Over the last four and a half years, an estimated 240,000 people have died in the grinding violence, including nearly 12,000 children. More than half of Syria’s pre-war population—half, the proportional equivalent of nearly 170 million Americans—have been forced to flee their homes, spawning the largest exodus of refugees in a generation. Seven hundred and fifty thousand Syrian children won’t be going back to school this fall.
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.
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.”