Global Health Ideas

Finding global health solutions through innovation and technology

Archive for April 2008

Mobile Phones for Global Health: Vodafone-UN Partnership

The UN Foundation and the Vodafone Foundation released a new report this week – Mobile Technology for Social Change: Trends in NGO Mobile Use. Thanks to Mark over at the UN Dispatch blog for telling me about this in the first place. Credit for the below description goes to an email I recieved (thanks very much Adele!) from folks at the UN Foundation, which is reproduced below:

Case studies exploring use of ‘mobile activism’ for public health projects include:

Mobile health data collection systems ( Kenya and Zambia ): Collecting and tracking essential health data on handheld devices, in countries where statistical information was previously gathered via paper and pencil, if recorded at all.

Monitoring HIV/AIDS care ( South Africa ): Using mobile devices to collect health data and support HIV/AIDS patient monitoring in a country with the world’s highest HIV/AIDS infection rates, and where rural populations often otherwise go unassisted.

Sexual health information for teenagers (US and UK ): Connecting youth to important information on sexual and reproductive health via anonymous text messaging, to empower young people to make informed sexual health decisions.

Continuing medical education for remote health workers ( Uganda ): Providing medical updates and access to vital information via mobile phones for doctors and nurses working in some of the most destitute regions, where continuing medical education services are lacking.

A total of 11 case studies identify emerging trends in ‘mobile activism,’ and investigate both the promise and challenges of innovative use of mobile technology to meet international development goals.

Written by Aman

April 30, 2008 at 9:48 pm

Public-private investment partnerships in health systems

Richard Smith at the BMJ Blog wrote about last week’s Private Sector Health Systems conference [program PDF] in Wilton Park. The full text is at the BMJ, but here’s my summary. In many developing countries, the poor are much more likely to use private providers than public sector, if they use healthcare at all.

People in Bangladesh get 80% of their healthcare from the private sector. Across Sub-Saharan Africa it’s 60%, and the proportion is increasing. The poorer people are the more likely they are to receive private care, and the middle classes consume more publicly funded care than the poor…Much of the private care that the poor receive in developing countries is, of course, of low quality. It is often provided by unqualified practitioners and is undermined by corruption, but there are – a McKinsey study in Africa showed – “islands of excellence.”

As Smith indicates, private healthcare in many low-income countries isn’t the only sector suffering from highly inconsistent quality.

government provided health care is also commonly poor, throughout Africa public health systems are derelict, and governments cannot fund, provide, and regulate care.

Smith’s intended audience of high-income country donors and policymakers may be reluctant to engage with private sector actors. Some caution is understandable but the need for practical solutions to dramatically improve healthcare provision leads to private sector mechanisms (for a good review of competitive contracting, performance-based finance and similar tools check out “Getting Health Reform Right” by Roberts, Hsiao, Berman, and Reich). The interesting thread I don’t hear as often, but have run across in my own work, is the challenge that low-income governments will have regulating the purchase private sector healthcare. Smith didn’t address it at length but the comments that followed focused on government’s regulatory role. The first response from Nigeria Health Watch blogger Chikwe Ihekweazu got to the point.

The major problem in many African countries in addition to the resistance of the concept is ‘management’ and ‘strategic thinking’ in the health sector. In Nigeria, where I am from, there is a proliferation of private health care facilities at all levels with no regulation, no accountability and no governance. …the private sector has a huge role to play…but only if there is the strategic leadership by governments to drive and regulate this.

As has pointed out more and more in the literature, private healthcare deals in volume in many low-income countries, but for these schemes to succeed governments need to lead and donors ought to be willing to invest in building effective public management of broad (diagonally funded?) health systems.

Written by Ben

April 23, 2008 at 10:49 pm

Redesigning Technology for Global Health

This is an interesting story — GE redesigning an EKG machine (the last one of which they made in 1999) for a place like India. The have also been advertising a lot on TV – I was able to find the ad on YouTube which is pretty cool. Four things immediately struck me:

1) The accomplishment – Cost reduction from $10,000 to $1500 in under 2 years and weight from 15lbs to 3lbs!

2) The original machine took 3.5 years and $5.4 million to develop. Compared to drug development this is minuscule. Making devices is generally orders of magnitude cheaper, far quicker to develop and face far fewer regulatory hurdles (FDA). So why didn’t this happen sooner?

3) This is great for India, but what about for use in the US (especially for community clinics and in rural areas)?

4) Let’s not forget that the introduction of any “new” technology will have unintended social consequences which are sometimes horrendous, here is another example from GE and their ultrasound machine.

EKG Story:
“GE Healthcare engineer Davy Hwang’s marching orders were straightforward. Take a 15-lb. electrocardiograph machine that cost $5.4 million and took three and a half years to develop. Squeeze the same technology into a portable device that weighs less than three pounds and can be held with one hand. Oh, and develop it in 18 months for just 60% of its wholesale cost. ‘He thought I was crazy’…” Crazy or not, Hwang pulled it off…The result: The new MAC 400, GE’s first portable ECG designed in India for the fast-growing local market.”

Full story at Business Week.

Related Links:
NIH and India partner to develop low cost medical technologies, Link
Medical basics still needed in developing countries, Link

Written by Aman

April 20, 2008 at 8:10 pm

Friday Fun

It’s worth taking a departure from the usual business on Friday’s for the fun geekiness below. These videos shed light on how some Berkeley students are easily distracted from their dissertations (I won’t mention any names, Ben, Jaspal and Mahad 😉 ). This is for all you grad and former grad students out there. Thanks to Ben for sending this along from Chris Blattman’s blog. Check out the very funny remake of the Rolling Stones hit, I can’t write no dissertation and an even better second video. The production quality is excellent, enjoy:

Written by Aman

April 11, 2008 at 11:55 am

Posted in Global Health

One Net One Pill One Life

These were the words of Forest Whitaker (academy award winner for his leading role in The Last King of Scotland) on tonight’s inspired 2nd annual two and half hour Idol Gives Back show which raised funds for six causes. Forest was the ambassador for Malaria No More, and definitely gave an emotional appeal for people to call in and donate money.

Earlier today I was lucky enough to be on a conference call with the medical director (Steven Phillips) for ExxonMobil’s foundation which is a major supporter and funder of the malaria component of tonight’s American Idol show. Phillips traveled to Angola twice this year, once with American Idol contestants and winners and the second time with Forest Whitaker to get them involved in combating malaria. I was joined on the call by Bill Brieger, professor at Hopkins and an expert in malaria, definitely check out his blog – Malaria Matters. Rob Katz of NextBillion and the Acumen Fund fame was the other “blogger” on the call.

According to Phillips, ExxonMobil teamed up with American Idol because they are the most watched TV show with over 30 million viewers and because their first experimental show last year was a huge hit. Exxon is reaching out to of course let their work be known and also because he feels that “one of major issues with malaria is that it (malaria) had historically been among one of most neglected diseases.” Their funding breakdown is: 25% for advocacy, 10% for R&D (e.g partnerships with MVI, MMV, others), and 65% for disease control (goes to African NGOs or iNGOs).

The Idol show had a blockbuster lineup, some of the celebs included: Bono, Alicia Keys, Heart, Brad Pitt, Robin Williams (who was beyond awful), Gloria Estefan, Mariah Carey, Celine Dion and many others. One of the highlights was Gordon Brown, prime minister of the UK, making an appearance to announce the equivalent of $200 million in funding for bednets. The three presidential candidates were also supposed to make an appearance, but perhaps this got cut. For a great recap of the show check out Kristin’s post.

Last year the show raised $76 million, it will be interesting to see what happens after tonight. Despite various criticisms and those much more cynical than I, credit has to be given to all the corporate sponsors for reaching out… I’ll post more on this if I get a chance this weekend.

Written by Aman

April 9, 2008 at 8:31 pm