Archive for July 2008
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)
- 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)
- Review Article: Innovation in practice: mobile phone technology in patient care. (Link)
- 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)
- Solar-powered GSM towers (Ethan Zuckerman)
- Kenya’s mobile revolution (Link)
- iPhone health and fitness applications (Link)
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.
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
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
Innovations: Technology, Governance, Globalization Spring 2006, Vol. 1, No. 2: 106–122.
A Patent Policy Proposal for Global Diseases
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.
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. “
‘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:
“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.”
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):
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”.
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.