Improving global health isn't just about increasing access to tools or technology -- it's cultivating the right kind of people that matters most
Villagers undergo eye examinations at a camp organised by Aravind Eye Care System in a village outside Madurai, India. (Reinhard Krause/Reuters)
One of the stars in the global health community, especially when the topic turns to affordability of care, is the Aravind Eye Hospital in South India. Founded by Dr. Govindappa Venkataswamy ("Dr. V") in 1976, the Aravind group of hospitals and clinics is renowned for performing hundreds of thousands of sight-restoring eye surgeries each year. The organization has effectively turned certain ophthalmological procedures into assembly line operations, thus delivering fast, high-quality surgeries at a low cost. Surgery to treat cataracts, for example, costs less than US$20 for patients who can afford it; patients who can't afford the fee are fully subsidized by those who pay. In the United States, the same procedure can cost several thousand dollars.
As a result, Aravind is frequently praised not only in discussions of global health, but also when the topic turns to for-profit social enterprise -- businesses that have a social cause. As economies slow worldwide, the international development community has turned to social enterprises as an alternative to donor-funded programs. The reasoning goes that if philanthropic largesse can't be counted on during times of economic austerity, public services must be run on a for-profit model. Fans often suggest that Aravind's methodology could be applied to primary care, or that the model should be exported to the developed world, which is itself struggling with the costs of healthcare.
The "model," however, is not so easy to duplicate in part because it depends on hard-to-measure qualities that stump technocrats. At the Pacific Health Summit in London two weeks ago, where the theme was technology and affordability, I spoke with Aravind's chief medical officer, Dr. Rengaraj Venkatesh.