Global Health Ideas

Finding global health solutions through innovation and technology

Archive for July 2008

Mobile Phones and Global Health Link Drop

Over the last year there I have noticed a tremendous up-tick in mobile phones for health/global health stories. The innovation in this area has been worldwide and the sense I get is that use outside the US and in developing countries is far more creative and wide ranging (I haven’t done the research, but this is probably a case where a country like the US will be taking lessons from less developed regions or the “South” as people love to say). We did a previous link drop on SMS/Text Messaging for Global Health that you should check out. Below I begin with two links about the power of mobile phones in general followed by recent links in a plethora of areas from countries around the world. Enjoy:

“Within the next three years, another billion people will begin to make regular use of cell phones, continuing the fastest adoption of a new technology in history” Taken from a very good post on “Mobile Phones for Development” over at CrissCrossed.

New NextBillion MIT Network: “Eventually there will be more cell phone users than people who read and write.” —Eric Schmidt, CEO, Google. The goal of the Next Billion Network is to deploy innovative mobile technologies that help people reduce friction in their local markets from the bottom up. (Link)

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  • Telemedicine and Monitoring AIDS Treatment in Africa (Link)
    “With software developed by Ericsson and phones donated… health workers can call up the medical records of pregnant women from an online database and then, by cell phone, tell care-givers what to do during an emergency…”

    • Another story on the above: A toll-free mobile service being launched in selected remote areas in Africa promises to save lives by connecting people with emergency medical cases to health personnel. (Link)
  • STOMP (STop smoking Over Mobile Phone): “Clinical trials have shown that using STOMP doubled reported quit rates from 13% to 28% after six weeks“. This would be of tremendous use in LDC’s as smoking is a serious global health issue. (Link)
  • Glucose (Diabetes) and exercise monitoring (Link)
    • Tracking chronic conditions remotely and sending info to clinicians (Link)
    • Managing symptoms for cancer care (Link)
    • Cardiomobile exercise and monitoring system: “The Cardiomobile system works by the patient attaching to their chests a mini ECG (electrocardiogram or heart signal) monitor and wearing a cap with a lightweight GPS receiver, both connected to a mobile phone via Bluetooth.” (Link) ; mini ecg picture (Link)
    • Mental Health Monitoring: Mobile phones and the internet will soon be used to help up to two million Australians manage their mental health problems. (Link)
    • India to develop their unique mobile phone health monitoring system (Link)
    • Erricson to offer mobile health services across India (Link) via Sneha
    • Review Article: Innovation in practice: mobile phone technology in patient care. (Link)

    OTHER

    • Solar Charger For Mobile Phones (Link)
      • Nokia Phones go Green: “Today Nokia chargers save 90% more energy, 65-80% of the phone components are recyclable and have reduced packaging by more than 50%…” (Link)
      • Kenya’s mobile revolution (Link)
      • iPhone health and fitness applications (Link)

      Written by Aman

      July 28, 2008 at 8:30 pm

      Stat of the Day: Dabbawala 99% Error Free Rate

      As many of you may know, the tiffin delivery/dabbawala system in India has achieved remarkable rates of success in setting up a complex delivery system. Their ability to deliver millions of meals a year without making mistakes makes me think about how this system can be transferred to healthcare and for what purpose… something to think about. As Dr. V took inspiration (WSJ, PDF) from a highly standardized and high volume system, I am wondering the same thing for a system already in place in a low resource setting. Food for thought, well worth checking out:

      From The Economist (link):
      “Using an elaborate system of colour-coded boxes to convey over 170,000 meals to their destinations each day, the 5,000-strong dabbawala collective has built up an extraordinary reputation for the speed and accuracy of its deliveries. Word of their legendary efficiency and almost flawless logistics is now spreading through the rarefied world of management consulting. Impressed by the dabbawalas’ “six-sigma” certified error rate—reportedly on the order of one mistake per 6m deliveries—management gurus and bosses are queuing up to find out how they do it.” Full story link here.

      Hat tip Intangible Economy.

      Written by Aman

      July 21, 2008 at 10:35 pm

      Free Journal Access: Enterpreneurial Solutions to Global Challenges

      The MIT sponsored journal (Innovations in Technology, Governance and Globalization) is free until August 30th. They have some fantastic articles in there (disclosure we have a publication on Aurolab in there), it is worth checking out. The earlier volumes have several global health articles (I have listed some examples below) and one of their most recent issues is devoted entirely to global health (click here). Click on the graphic and it will take you to the journal’s homepage.

      Ending an Epidemic: The International AIDS Vaccine Initiative Pioneers a Public-Private Partnership
      Seth Berkley.
      Innovations: Technology, Governance, Globalization Winter 2006, Vol. 1, No. 1: 52–66.

      Creating Markets for Vaccines
      Rachel Glennerster, Michael Kremer, Heidi Williams
      Innovations: Technology, Governance, Globalization Winter 2006, Vol. 1, No. 1: 67–79.

      Toward an Entrepreneurial Society: Why Measurement Matters
      Carl J. Schramm
      Innovations: Technology, Governance, Globalization Winter 2008, Vol. 3, No. 1: 3–10.

      Geographical Information Systems (GIS) Innovations For Primary Health Care in Developing Countries
      Frank Tanser
      Innovations: Technology, Governance, Globalization Spring 2006, Vol. 1, No. 2: 106–122.

      A Patent Policy Proposal for Global Diseases
      Jean Lanjouw
      Innovations: Technology, Governance, Globalization Winter 2006, Vol. 1, No. 1: 108–114.

      Harnessing the Power of Autism Spectrum Disorder (Innovations Case Narrative: Specialisterne)
      Jonathan Wareham, Thorkil Sonne
      Innovations: Technology, Governance, Globalization Winter 2008, Vol. 3, No. 1: 11–27.

      Written by Aman

      July 20, 2008 at 7:41 am

      New Global Health Center@MIT: Medical Innovation for the Next Four Billion

      There has been a major boom (dare I say, even a bubble?) in global health degree programs and organizations at universities in the US. To a much lesser degree there also has been an associated growth in university based centers that are action oriented. There is one in particular (MIT center for Innovation in International Health) that I would like to highlight because they have tremendous potential and a great set of leaders. The other program I just heard about, Global Resolve, is at Arizona State University (more info at the bottom).

      Jose over at Little Devices that Could is playing a major role in the new MIT international health outfit which already has several products in the pipeline. From his blog:

      “IIH is a collaborative research program that spans across MIT Departments and brings in partners from around the country and around the world to create a rich multidisciplinary environment to launch medical technology for the next four billion.” (For more discussion in this area see nextbillion.net)

      One of the founders is Macarthur Genius award winner Amy Smith. You can view her TED video here. A quick digression on Prof Smith, her bio from TED: Amy Smith designs cheap, practical fixes for tough problems in developing countries. Among her many accomplishments, the MIT engineer received a MacArthur “genius” grant in 2004 and was the first woman to win the Lemelson-MIT Prize for turning her ideas into inventions.

      If you know of new innovations in global health, Jose would love to hear about it, you can email us or him. Unlike the vast majority of other actors in the global health sector, I get the impression that IIH is all for “high-risk” and truly innovative projects that can break the mold and solve problems today. This reminds me of the DARPA model. I’ll let you read about the fascinating history and structure of DARPA at wikipedia – but just note that DARPA played a role in bringing us the internet, GPS, and speech translation because of this philosophical approach of investing in high risk ideas. Wouldn’t it be great if we had a $3 billion slush fund to produce innovative global health breakthroughs? Yes, we still need coordinated public health programs and health system infrastructure development, but the stuff that could come out of the MIT center is also a major part of the picture. Besides DARPA the other entity that came to mind is the Pioneers division at the Robert Wood Johnson Foundation (RWJF). The other thing I like about this effort is that they seem to be truly open to collaborating and connecting with other groups – so please email with any ideas you have.

      ——
      Neat new other organization I just heard about, definitely check out what they are doing:

      “GlobalResolve, is a social entrepreneurship program at ASU connecting students with projects designed to improve the lives of the rural poor in developing countries.” They are focused on sustainability and have 3 main projects:

      • Producing a smokeless stove system (clean burning stove)
      • Creating a water purification system in Ghana
      • A neurosurgery device to treat head injuries in South Africa’s rural hospitals

      Several student alums from Global Resolve “launched a startup called Energy Derived, a company developing technologies to support the alternative energies market. Their first project is an algae de-watering system designed for the commercial production of algae bio-fuels”.

      More information here: Social Entrepreneurs Develop Cleaner Alternative to African Wood-Burning Stoves

      Written by Aman

      July 17, 2008 at 8:55 pm

      Mosquirix – Promising New Vaccine for Global Health?

      More than 12 years (let that time horizon sink in) after the first indications of success,  there will be a large scale trial for a new malaria vaccine. The potential global health implications of this are obvious, read the full news article, it has some good tidbits in it:

      “With the exception of Mosquirix, there’s no possibility of one coming on the market within five or six years…It took eight more years of development and testing before scientists were ready to conduct a large-scale trial of the vaccine. London-based Glaxo and its partners will begin a $100 million study of Mosquirix later this year, vaccinating 16,000 children in seven African countries. If the results are positive, the drug could be on the market as soon as 2011, making it the first vaccine against the deadly disease. “

      Full article at Bloomberg (here).  Hat tip to  Families USA.

      Written by Aman

      July 16, 2008 at 9:20 pm

      India’s Supply Chain: Impact on Global Health?

      ‘The Biggest Challenge Is There Is No Organized Supply Chain’

       

      This headline in Wharton’s newsletter intrigued me, only time for a quick posting, but this is certainly food for thought. Wal Mart is expanding operations in India and there are two quotes of note that we should think about in the context of culture; delivery and distribution of medical/health goods to those in need; and in the context of refrigeration of medication and/or vaccinations:

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      “The biggest challenge is that there is no organized supply chain in India. We’ve even been surprised by some of the leading manufacturers in India like Unilever, Procter & Gamble, and some other big names, who are actually welcoming the arrival of organized supply chains in India and Wal-Mart pioneering that effort. Because of the lack of that supply chain today, there is no forecasting, there is no understanding of how demand is. It’s largely a push based system. So, I think, getting that transparency across the supply chain will be very unique.”

       

      “The other thing is, there is no refrigerated cold chain for fresh produce in India, so therefore a lot gets wasted. By McKinsey’s own work, which the consulting firm has done, almost 40% of fresh produce in India gets wasted from farmland to the time it reaches the consumer.”

       

      “India is very unique. In fact, I have lived in China, so maybe I can say it with a little bit more liberty that the only thing common between India and China is the one billion people. If you really operate in the two countries, I think, there are very different consumers, very different kinds of legislation, very different levels of economic development, social infrastructure, and governmental management of the economy.”

       
      Read the full interview here.

      A Massive Wave of Chronic Disease in China and India

      When most people think of global health they think of infectious diseases and all of the associated images this conjures up (and it is harder to capture provocative images of chronic diseases). However, as we have empahsized before, developing countries are facing a dual burden of both chronic and infectious diseases.

       

      This past Tuesday I was privileged enough to attend the launch of the new Health Affairs issue on global health in China and India. I was joined by an esteemed panel of guests who gave great presentations about various issues facing these two nations. Unfortunately I don’t have time to summarize all of their talks but encourage you to read them in the latest issue. I want to focus on Dr. Somnath Chatterji’s paper because the projections of the aging of China and India are quite stunning and the associated social and economic implications will be profound.

       

      Somnath Chatterji runs the WHO’s Study on Global Ageing and Adult Health (SAGE). Here are some highlights from his paper and quotes I picked up (these are based on my hand written notes, so please forgive any factual mistakes):

       

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      The pace of change is stunning – what took 100 years in France (the graying of the population) is going to take place in 30 years in China/India (I can’t remember which one he specified). “Aging has been on the backburner…but China and India are facing dramatic demographic shifts in very short periods of time”.

       

      By 2030, 65.6 percent of the Chinese and 45.4 percent of the Indian health burden are projected to be borne by older adults.

       

      By 2019 in China and 2042 in India, the proportion of people age sixty and older will exceed that of people ages 0–14.

       

      Within the next 20 years there will be 42 million diabetics in China and 80 Million in India.

       

      “In four decades 40% of the worlds elderly population will be in China and India…these countries are getting older before they get richer”.

       

      “Traditionally, people think of chronic diseases as diseases of the of the rich, this is probably not going to be true for China and India…we really need longitudinal data to track this”.

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      There are dozens of issues that come to mind when hearing these projections, some of which include – access, who will get access to care? how will the delivery system be set up for this? where will the focus be (primary care?)? how will this be financed at both health system level and a household level – how much payment will be borne by the patient? can we use capacity developed for tackling infectious diseases for chronic diseases (a very different ballgame in some ways)? what will be the role of the private sector? if the private sector gets involved heavily to sell their drugs and devices in this  new “market” – will that lead to better infrastructure for delivery and distribution of medical supplies? how will this impact the economic growth of these countries? There are many more pressing questions, but I will stop here.

       

      Another one of the articles in this global health issue is on obesity in China. This paper is authored by one of world’s leading experts in nutrition (Barry Popkin). We covered some of this before in a recent issue of Scientific American and here is the link for the new paper. Kudos to Health Affairs for the issue and to Burness Communications for a well run launch.