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.
Five days after Hurricane Maria made landfall in Puerto Rico, its devastating impact is becoming clearer.
Five days after Hurricane Maria made landfall in Puerto Rico, its devastating impact is becoming clearer. Most of the U.S. territory currently has no electricity or running water, fewer than 250 of the island’s 1,600 cellphone towers are operational, and damaged ports, roads, and airports are slowing the arrival and transport of aid. Communication has been severely limited and some remote towns are only now being contacted. Jenniffer Gonzalez, the Resident Commissioner of Puerto Rico, told the Associated Press that Hurricane Maria has set the island back decades.
How could six senior presidential aides mimic the strategy for which Trump lacerated Hillary Clinton? Only if they believe they are as immune to the usual rules as he is.
Updated on September 25 at 8:20 p.m.
Late Sunday night, Josh Dawsey of Politico dropped a story that, in any other administration, would have been cause for concern but hardly surprise.
“Presidential son-in-law and senior adviser Jared Kushner has corresponded with other administration officials about White House matters through a private email account set up during the transition last December,” Dawsey wrote. “Kushner and his wife, Ivanka Trump, set up their private family domain late last year before moving to Washington from New York, according to people with knowledge of events as well as publicly available internet registration records.”
One hundred years ago, a retail giant that shipped millions of products by mail moved swiftly into the brick-and-mortar business, changing it forever. Is that happening again?
Amazon comes to conquer brick-and-mortar retail, not to bury it. In the last two years, the company has opened 11 physical bookstores. This summer, it bought Whole Foods and its 400 grocery locations. And last week, the company announced a partnership with Kohl’s to allow returns at the physical retailer’s stores.
Why is Amazon looking more and more like an old-fashioned retailer? The company’s do-it-all corporate strategy adheres to a familiar playbook—that of Sears, Roebuck & Company. Sears might seem like a zombie today, but it’s easy to forget how transformative the company was exactly 100 years ago, when it, too, was capitalizing on a mail-to-consumer business to establish a physical retail presence.
E!’s 10-year-anniversary special celebrating its flagship family was surprisingly honest and strangely tragic.
On Friday, as Puerto Rico contended with the aftermath of a hurricane that had left much of the island without power, and North Korea threatened to detonate a hydrogen bomb in the Pacific Ocean, the internet-gossip complex grappled instead with the momentous news that an unmarried 20-year-old reality star was pregnant. Kylie Jenner, TMZ reported, the youngest scion of the Kardashian family, had been telling friends that she and her boyfriend, the rapper Travis Scott, were going to have a baby. Unidentified family friends promptly confirmed the news to People. And some fans began to wonder—had Kylie’s mother, Kris Jenner, leaked the news herself to boost the ratings for E!’s Sunday night 10-year-anniversary special of Keeping Up With the Kardashians?
The foundation of Donald Trump’s presidency is the negation of Barack Obama’s legacy.
It is insufficient to statethe obvious of Donald Trump: that he is a white man who would not be president were it not for this fact. With one immediate exception, Trump’s predecessors made their way to high office through the passive power of whiteness—that bloody heirloom which cannot ensure mastery of all events but can conjure a tailwind for most of them. Land theft and human plunder cleared the grounds for Trump’s forefathers and barred others from it. Once upon the field, these men became soldiers, statesmen, and scholars; held court in Paris; presided at Princeton; advanced into the Wilderness and then into the White House. Their individual triumphs made this exclusive party seem above America’s founding sins, and it was forgotten that the former was in fact bound to the latter, that all their victories had transpired on cleared grounds. No such elegant detachment can be attributed to Donald Trump—a president who, more than any other, has made the awful inheritance explicit.
More comfortable online than out partying, post-Millennials are safer, physically, than adolescents have ever been. But they’re on the brink of a mental-health crisis.
One day last summer, around noon, I called Athena, a 13-year-old who lives in Houston, Texas. She answered her phone—she’s had an iPhone since she was 11—sounding as if she’d just woken up. We chatted about her favorite songs and TV shows, and I asked her what she likes to do with her friends. “We go to the mall,” she said. “Do your parents drop you off?,” I asked, recalling my own middle-school days, in the 1980s, when I’d enjoy a few parent-free hours shopping with my friends. “No—I go with my family,” she replied. “We’ll go with my mom and brothers and walk a little behind them. I just have to tell my mom where we’re going. I have to check in every hour or every 30 minutes.”
Those mall trips are infrequent—about once a month. More often, Athena and her friends spend time together on their phones, unchaperoned. Unlike the teens of my generation, who might have spent an evening tying up the family landline with gossip, they talk on Snapchat, the smartphone app that allows users to send pictures and videos that quickly disappear. They make sure to keep up their Snapstreaks, which show how many days in a row they have Snapchatted with each other. Sometimes they save screenshots of particularly ridiculous pictures of friends. “It’s good blackmail,” Athena said. (Because she’s a minor, I’m not using her real name.) She told me she’d spent most of the summer hanging out alone in her room with her phone. That’s just the way her generation is, she said. “We didn’t have a choice to know any life without iPads or iPhones. I think we like our phones more than we like actual people.”
What J.R.R. Tolkien’s classic The Hobbit still has to offer, 80 years after its publication
“In a hole in the ground there lived a hobbit.” So began the legendarium that dominated a genre, changed Western literature and the field of linguistics, created a tapestry of characters and mythology that endured four generations, built an anti-war ethos that endured a World War and a Cold War, and spawned a multibillion-dollar media franchise. J.R.R. Tolkien’s work is probably best remembered today by the sword-and-sandal epic scale of The Lord of The Rings films, but it started in the quiet, fictionalized English countryside of the Shire. It started, 80 years ago in a hobbit-hole, with Bilbo Baggins.
Although Tolkien created the complicated cosmological sprawl of The Silmarillion and stories like the incestuous saga of Túrin Turambar told in The Children of Húrin, Middle-earth itself is mostly remembered today as something akin to little Bilbo in his Hobbit-hole: quaint, virtuous, and tidy. Nowadays, George R.R. Martin’s got the market cornered on heavily initialed fantasy writers, and his hand guides the field. High and epic fantasy are often expected to dip heavily into the medieval muck of realism, to contain heavy doses of sex and curses, gore and grime, sickness and believable motives and set pieces. Characters like Martin’s mercenary Bronn of the Blackwater are expected to say “fuck.” Modern stories, even when set in lands like A Song of Ice and Fire’s Essos that are filled with competing faiths, tend toward the nihilist, and mostly atheist. Heavenly beings are denuded of potency and purity; while the gods may not be dead, divinity certainly is.
“This fear is very deeply felt and not understood in the West—and it comes from a real place rooted in history.”
Over the past month, a crackdown by Burma’s military has forced more than 400,000 Rohingya Muslims from Rakhine state to flee to neighboring Bangladesh in what the UN human-rights chief has called a “textbook example of ethnic cleansing.” The military crackdown was prompted by an attack August 25th by the Arakan Rohingya Salvation Army (ARSA), a Muslim militant group with reported links to Pakistan and Saudi Arabia, on security outposts.
The international community has condemned the violence unleashed by the Burmese military on Rohingya civilians. It has also voiced sharp criticism of Aung San Suu Kyi, the Nobel laureate and de-facto Burmese leader, for, in the view of her critics, not doing enough to protect the Rohingya, who have been stateless for more than three decades. But where humanitarian groups and Western nations see the world’s most persecuted minority, the government of Burma (also known as Myanmar) and an overwhelming majority of its people see a foreign group with a separatist agenda, fueled by Islam, and funded from overseas. It’s this difference in perception that will make any resolution of the Rohingya issue extremely difficult.
Guillaume Dumas attended classes, made friends, and networked on some of America's most prestigious campuses—for free. What does this say about the value of a diploma?
If you want to start taking classes at an Ivy League university unenrolled and undetected, says Guillaume Dumas, a 28-year-old Canadian, start with big lecture courses. If you must sit in on a smaller seminar class, it’s important to show up consistently starting with the first session, instead of halfway through the semester. Also, one of the best alibis is that you’re enrolled as a liberal-arts student. “That's the kind of program that's filled with everything and that you expect people to be a bit weird, a bit confused about what they do,” he says.
From 2008 to 2012, Dumas claims he did stints on a number of elite North American universities—Yale, Brown, UC Berkeley, Stanford, and McGill, to name a few—sitting in on classes, attending parties, and living near campus as if he were an enrolled student. This deception may sound like a lead-up to a true-crime story, but Dumas’s exploits appear to be harmless, done in a spirit of curiosity. "A lot of students are bored in class," he observes, "so if you participate, if you ask questions, if you are genuinely interested in the class, I think the teacher will like you."
When he began taking a knee during the National Anthem, earning the attention of the president and the entire press was the best outcome he could possibly have desired.
Friday morning, things didn’t look great for Colin Kaepernick.
The former San Francisco 49er had made headlines around the world last season for kneeling during the National Anthem. The offseason had seen a raging debate about the fact that he hadn’t been signed from free agency, which boiled down to whether teams were justified in deciding that his controversial protest outweighed his talent. Despite some comically atrocious performances by quarterbacks on NFL rosters in the first two weeks of the season, Kaepernick remained unsigned. A few fellow players said publicly that he deserved a roster spot somewhere, and some had taken up his protest, but it remained a niche question, and the cause to which Kaepernick wished to draw attention—police brutality against people of color—had faded a bit from the headlines, overwhelmed by the onslaught of Trump-related news.