Milwaukee: hub of water technology in global health?

It’s been more than two years since we reported on Seattle as the new Geneva, that is, as the new epicenter of global health activity. An article in this morning Journal-Sentinel (Water-engineering firms see potential, challenge in developing countries) – which includes an exclusive interview with the Acumen Fund’s chief executive Jacqueline Novogratz – suggests that Milwaukee is angling to do the same for water technology:

It’s an issue that almost certainly will preoccupy business leaders in metro Milwaukee in their strategy to brand the region as an international hub of water technology. The metro area is home to scores of water-engineering companies. Gov. Jim Doyle and the University of Wisconsin-Milwaukee this month announced plans to invest millions of dollars for UWM to become a center of freshwater research.

An 2008 article from the same newspaper (Area’s tide could turn on water technology) provides more evidence:

[F]our of the world’s 11 largest water-technology companies have a significant presence in southeastern Wisconsin, according to an analysis of data from a new Goldman Sachs report.

…

Wall Street has tracked automakers, railroads and retailers almost since there were stocks and bonds. But water remains a novelty. Goldman Sachs Group Inc. didn’t begin to research water treatment as a stand-alone industrial sector until late 2005.

While several large MNCs have shown an active interest in clean water in developing countries (e.g., Procter and Gamble, Vestergaard Frandsen, Dow) open questions remain as to what role large MNCs will play in providing access to safe water for the one billion people who don’t have it.

(Thanks to Dr. Jessica Granderson for sending the link)

Innovation as a Learning Process

Cross-posted from Design Research for Global Health.

The California Management Review recently announced the winners of the 2009 Accenture Award: Sara Beckman of Berkeley’s Haas School of Business and Michael Barry, founder of design consultancy Point Forward and Adjunct Professor at Stanford, for their article, Innovation as a Learning Process: Embedding Design Thinking (Fall 2007, Vol. 50, No. 1).

From the award website (which is still on the 2008 winner as I write this): “The Accenture Award is given each year to the author (or authors) of the article published in the preceding volume of the California Management Review that has made the most important contribution to improving the practice of management.”

The paper makes a compelling argument that innovation can be achieved by management and provides a model for cross-functional, cross-disciplinary teams to engage in this process. The relevance to global health as I’ve discussed before (really what this entire blog is about) is that the process can help us improve health systems through innovation.

The challenge in coming years will be how to get organizations and institutions working in global health – foundations, Ministries of Health, NGOs, development programs, health research centers, etc. – treating innovation as a way of working, not simply an input or an output.

The abstract/lead-in isn’t openly available online so I’m copying it here:

Companies throughout the world are seeking competitive advantage by leading through innovation, some — such as Apple, Toyota, Google, and Starbucks — with great success. Many countries – such as Singapore, China, Korea, and India — are investing in education systems that emphasize leading through innovation, some by investing specifically in design schools or programs, and others by embedding innovative thinking throughout the curriculum. Business, engineering, and design schools around the U.S. are expanding their efforts to teach students how to innovate, often through multi-disciplinary classes that give students a full experience of the innovation process. However, what does leading through innovation really mean? What does it mean to be a leader, and what does it mean to engage in innovation?

There is a vast literature on leadership covering a wide range of topics: the characteristics of a good leader, how leadership is best displayed in an organization, leadership and vision, authority, leadership styles, and so on. There is also a growing body of literature on innovation and its various facets, much of it focused by application of the innovation process. Hundreds of publications describe the process of innovation for products — both hardware and software — and a growing number of publications focus on innovation in services. Further, there are dozens of books on innovation in building and workplace design.

Here we examine a generic innovation process, grounded in models of how people learn, that can be applied across these sectors. It can be applied to the design and development of both hardware and software products, to the design of business models and services, to the design of organizations and how they work, and to the design of the buildings and spaces in which work takes place, or within which companies interact with their customers. The model has evolved through two streams of thought: design and learning.

This video, which seems to be unaffiliated to the authors, summarizes the article [correction – I just found out that Shealy did work with the authors on this video – Tues-24-Mar-2009 12:18PM PDT]:

 
[Innovation as a Learning Process from Roger H. Shealy on Vimeo]

Here are slides from Beckman and Barry’s presentation at the Inside Innovation 2007 Conference and the Google scholar view of who is citing this work.

[(Dis)claimer: Sara Beckman served on my dissertation committee and Michael Barry provided guidance on my applied research in Mongolia]

Why bad presentations happen to good causes

Cross-posted from Design Research for Global Health.

Giving talks is not one of my strong suits, but it seems to be a part of the job requirement.  Earlier this month, I had the opportunity (even though I’m no good, I do consider it an opportunity), to give a couple talks, one to the Interdisciplinary MPH Program at Berkeley and one to a group of undergraduate design students, also at Berkeley.  Despite the difference in focus, age, and experience of the two groups, the topic was roughly the same: How do we effectively use design thinking as an approach in public health?

The first session was so-so, and I suspect that the few people who were excited about it were probably excited in spite of the talk.  It started well, but about halfway through, something began to feel very wrong and that feeling didn’t go away until some time later that evening.  Afterwards, I received direct feedback from the instructor and from the students in the form of an evaluation.  I recommend this if it is ever presented as an option.  Like any “accident”, this one was a “confluence of factors”: lack of clarity and specificity, allowing the discussion to get sidetracked, poor posture, and a tone that conveyed a lack of excitement for the topic.

It’s one thing to get feedback like this, another to act on it.

The second session went much better, gauging by the student feedback, the comments from the instructor, and my own observations.  This in spite of a larger group (60 vs. 20) that would be harder to motivate (undergraduates with midterms vs. professionals working on applied problems in public health).  I chalk it all up to preparation and planning.  Certainly there are people that are capable of doing a great job without preparation – I just don’t think I’m one of those people.

Most of that preparation by the way was not on slides.  I did use slides, but only had five for an hour session and that still proved to be too many.  Most of the time that I spent on slides, I spent developing a single custom visual to convey precisely the information that was relevant to the students during this session (see image).  The rest of the preparation was spent understanding the audience needs by speaking to those running the class; developing a detailed plan for the hour, focusing on how to make the session a highly interactive learning experience; designing quality handouts to support the interactive exercise; and doing my necessary homework.  For this last one, I spent 20 minutes on the phone with a surgeon friend, since the session was built around a case study discussing surgical complications and design.

Three resources I found really useful:

1. Why Bad Presentations Happen to Good Causes, Andy Goodman, 2006. This commissioned report was developed to help NGOs with their presentations, but I think there is value here for anyone whose work involves presentations. It is evidence-based and provides practical guidance on session design, delivery, slides (PowerPoint), and logistics.  Most importantly, it is available as a free download. I was fortunate enough to pick up a used copy of the print edition for US$9 at my local bookstore, which was worth the investment for me because of the design of the physical book.  It’s out-of-print now and it looks like the online used copies are quite expensive – at least 3x what I paid – so I recommend the PDF.
2. Envisioning Information, Edward Tufte, 1990. I read this when I was writing my dissertation. Folks in design all know about Tufte, but I still recommend a periodic refresher.  This is the sort of book that will stay on my shelf.  Also potentially useful is The Visual Display of Quantitative Information. For those working in global health, don’t forget how important the display of information can be: (a) Bill Gates and the NYTimes, (b) Hans Rosling at TED.
3. Software for creating quality graphics.  The drawing tools built into typical office applications, though they have improved in recent years, are still limited in their capability and flexibility, especially if you’re looking at #2 above.  In the past 10 days, three people in my socio-professional network have solicited advice on such standalone tools, OmniGraffle (for Mac) and Visio (Windows): a graphic designer in New York, an energy research scientist in California, and a healthcare researcher in DC.  Both are great options.  I use OmniGraffle these days, though I used to use Visio a few years back.  If cost is an issue, there are open-source alternatives available, though I’m not at all familiar with them (e.g., the Pencil plug-in for Firefox).

One Rural Town’s Battle with Obesity

I heard this fascinating case study on indigenously driven innovation and how this rural community has come together to tackle obesity. Don’t read the story, listen to it. We need more stories like this from the local community level (see our previous post on the global obesity index).

Global Hunger Hearing and Rwanda’s MCH Week

I got a couple of requests to post two informative efforts. Note the Senate hearing tomorrow and the tie made to global food security. Second various agencies are linking up to administer 4 million anti-worm medication, that’s an impressive amount:

GLOBAL HUNGER HEARING
As a reminder, tomorrow, Tuesday, March 24th, the Senate Foreign Relations Committee will hold a hearing entitled “Alleviating Global Hunger: Challenges and Opportunities for U.S. Leadership” at 9:30 a.m. in room 419 of the Dirksen Senate Building (AGENDA). The committee has invited Dan Glickman, former secretary of agriculture, and Catherine Bertini, former executive director of the World Food Program to testify at the hearing, offering their insight as co-chairs of a recent Chicago Council on Global Affairs’ report entitled “Renewing American Leadership in the Fight Against Global Hunger and Poverty:  The Chicago Initiative on Global Agricultural Development.”

Congress has recently recognized the importance of this global food security (2009 Foreign Operations Appropriations bill). This legislation mandated that $75 million in Development Assistance funding be spent “to enhance global food security, including for local or regional purchase and distribution of food, in addition to other funds otherwise made available for such purposes and notwithstanding any other provision of law.”

RWANDA’S MOTHER AND CHILD HEALTH WEEK KICKS OFF MARCH 24

The Global Network for Neglected Tropical Diseases’ Control Program Teams with Rwandan Government and International Organizations to Deworm More Than 4 Million Children Nationwide, Covering Nearly Half of the Country’s Population

NTD Prevalence Rates Up to 95% Among Rwandan School-Children

Over the course of the week-long initiative, representatives will administer albendazole to a targeted population of 4 million children under five, school-aged children, and post-partum women, to treat for soil-transmitted helminthes (STHs). Additionally, in the high prevalence areas, praziquantel will be administered to an estimated 100,000 people for schistosomiasis infection. The goal of the campaign is to treat all pre and school-aged children nationwide – covering approximately one-half of Rwanda ’s population.  Vitamin A, immunizations, family planning services and health education messages will also be delivered throughout the country during the course of the campaign.

Why: Research has shown that eliminating the burden of NTDs could lift millions out of poverty worldwide by ensuring children stay in school to learn and prosper and improving maternal and child health. NTDs infect over 400 million school-aged children throughout the developing world. Treating their infections is the single most cost-effective way to boost school attendance. Controlling intestinal worms alone will help to avoid 16 million cases of mental retardation and 200 million years of lost primary schooling

When: Tuesday, March 24th – Friday March 27th

The Girl Who Silenced the UN

This video has been floating around recently, I thought it was worth sharing. This took place 16 years ago, I wonder where this girl is now? Hat tip Humanity in Focus.

CATER NYU Workshop on Technologies for Humanity (April 10)

I’ll be in New York attending the health portion of the following workshop. Please pass the word and if you are around and want to meet up send us an email (thdblog AT gmail).

“The CATER research group cordially invites you to attend the 2009 workshop on “Technologies for Development” which showcases our ongoing research efforts in the space of appropriate technologies that aid development in under-developed areas around the world.

Cost-Effective Appropriate Technologies for Emerging Regions (CATER) is a new multidisciplinary research initiative at NYU that focuses on developing appropriate, low-cost Information and Communication Technologies (ICT) for addressing pressing problems in developing regions. CATER is a joint initiative comprising faculty from Computer Science, the School of Medicine, the Wagner Graduate School of Public Service, NYU’s Economics Department, and NYU-Polytechnic.

This workshop will feature a combination of invited talks from accomplished researchers and short talks by student researchers within
CATER on their ongoing research efforts. The talks will cover four important areas:”

·         Technologies for improving access to communications in rural areas
·         Technologies for enhancing rural healthcare
·         Technologies for enhancing financial and commerce services
·         Technologies for enhancing rural education

FULL SCHEDULE

The End of the Era of Generosity? Global Health Amid Economic Crisis

If you only read one thing this week, the below article deserves your attention. I have excerpted only bits and pieces, the full piece is worth reading. Co-authored by Laurie Garrett, this is a much better, more cohesive and articulate encapsulation of the current economic crisis than what I wrote last week (if I only had 1/4 of the writing ability of Garrett!).

The End of the Era of Generosity? Global Health Amid Economic Crisis
Kammerle Schneider email and Laurie Garrett
Philosophy, Ethics, and Humanities in Medicine, Jan 2009
Global Health Program, Council on Foreign Relations

For too long, the international community has responded to global health and development challenges with emergency solutions that often reflect the donor’s priorities, rather than funding durable health systems that can withstand crises…The global health community must now objectively evaluate how we can most effectively respond to the crises of 2008 and take advantage of this moment of extraordinary attention for global health and translate it into long term, sustainable health improvements for all. Over the past eight years global health has taken center stage in an era of historic generosity as the wealthy world has committed substantial resources to tackle poverty and disease in developing countries…there has been a massive swell in the number of nonprofit organizations (NGOs), faith based groups, and private actors contributing to this boon.

Past is prelude
The emergence of HIV/AIDS fundamentally transformed the way in which the world engaged global health. It shook world leaders…It awoke the average citizen to gross disparities… The fight against HIV/AIDS rallied tremendous financial support for global health, while at the same time, moving investments in health from infrastructure: clinics, roads, sanitation, and personnel, to funding disease specific initiatives with emergency, short term targets, and often unsustainable results.

International institutions and governments heavily reliant on steady inflow of foreign donor funding are now frantically trying to resolve how to continue the operations of their health programs… Undoubtedly, the economic crisis will crimp humanitarian aid, and international efforts to fight disease and alleviate poverty.

The special challenge of HIV
Increased focus on the urgent management of specific diseases has weakened the ability of health systems to respond to crises. To respond to the AIDS epidemic, the share of global health aid devoted to HIV/AIDS more than doubled between 2000 and 2004 – reflecting the global response to an important need, yet, the share devoted to primary care dropped by almost half during the same time period...In many of the countries hardest hit by the pandemic, a large portion of their funding for AIDS medications come from outside donors. For example, in Mozambique, 98 percent of all funding for the country’s HIV/AIDS programs comes from outside donors…the nation’s extraordinary dependence on external support begs questions about the efforts’ sustainability, and country ownership and control… As we enter an economic downturn, the sustainability of emergency initiatives, such as PEPFAR, that are 100 percent dependent on a never ending supply of donor dollars, are called into question.

Moral hazard amid complexity
Instead of making things simpler and more efficient on the ground, in many cases, the rapid increase in funding and number of global health players has made the mechanisms for delivering aid even more complex. At the developing country level, hundreds of foreign entities are competing for the attention of local governments, civil society interest, and the desperately short supply of trained healthcare workers…

A moral path forward
Given the scale of the world’s healthcare workers deficit, no progress can be made in the creation of universal primary care systems if models continue to be doctor-based. Even if the world committed today to the most massive medical training exercise in history, the deficit would not be overcome for more than two generations. Only a substantial commitment to building genuinely viable health infrastructures centered on community based workforces, coupled with local profit incentive systems, and global scale supply and inventory management…The crises of 2008 have brought together committed government officials, UN agency leaders, NGOs, faith-based groups, and corporate actors to collectively think about new ways to break out of patterns of charitable giving and move towards real sustainable investments in health…A number of promising initiatives are beginning to emerge. In this time of financial catastrophe, the onus sits squarely on the shoulders of global health advocates living in the wealthy nations: push your governments and philanthropic institutions to not only maintain their technical and financial commitments to the poor nations of the world, but actually increase the scale of investment to reflect the rising costs of doing good in a troubled world. It is conceivable that 2008 will mark the beginning of the end of the Era of Generosity. But it is equally probable that the economic crisis will usher in a bold new era of investment in the public goods of poor and emerging market nations worldwide. Successful navigation of these turbulent waters will require a shift from the morality of “charity,” to that of “change”…

Join Us! Online Chat: OBA and Vouchers in Kenya and Uganda

On March 19th I will be participating in an online conversation about output-based aid hosted by PSP-One. Output-based aid (OBA) financially empowers patients to make choices about where they receive their healthcare and incentivizes providers to deliver high quality services. The management of OBA systems builds institutional capacity to provide cost-effective care to targeted populations. However, OBA is by no means a panacea to what ails health systems in low-income countries. Join in on the discussion to find out more! Once again it is March 19th:

9:30 am Eastern (United States)
1:30 pm (13:30) Greenwich Mean Time
2:30 pm West Africa Time Zone
3:30 pm Central Africa Time Zone
4:30 pm East Africa Time Zone

If you would like to receive details about the chat or would like to suggest questions for discussion, please email the organizers at: n4a@abtassoc.com. You will need to register beforehand on the Network for Africa. Registration takes 30 seconds at the following link: http://www.conferences.icohere.com/vouchers

Video Games for Health: Tetris Therapy for Trauma?

Very early fascinating research, which will hopefully be developed further. This is not a top 10 list you want to be on, but considering the global burden of disease projections for 2020 include depression (#3) and war (#8) in the top 10 contributors to disability, greater understanding of the mind and brain function is desperately needed. Additionally, considering mental health is such a complex and difficult issue, it’s great to see potential innovation in this area. Source: BBC News

(sorry I cannot find the blog I read this on, send me a note and I’ll add your link in):

Previous related posts:
Where are the games (to educate on HIV/AIDS risks)? Link
Donate computation time …on your PS3? Link
Free Rice Word Game. Link

Mobile Phone & Development Link Drop

Mobile Phone & Global Development Link Drop

• New Mobile Health Newsletter launches, full story, newsletter
• MIT Course: mobile technologies for social change, link
• Mobile Phones fighting Cholera, link
• So You Want to Quit Smoking: Have You Tried a Mobile Phone? link
• The Cellphone That Could Change the World, SE Change blog
  
• Phones for Health: Great Idea But Where’s the Evidence? Center for Global Development
• UC Berkeley Human Rights Center Mobile Challenge, [deadline March 20] link
• Foundations announce Mobile Health, Banking Initiatives, we have blogged about the UN-Vodafone-Rockefeller alliance before, link
  • For a full list of all projects in the mHealth for Development alliance see 3G Doctor, link
    
• New article on the bandwidth threshold needed to diagnose stroke remotely (telemedicine), link
• Mobile Phone Quick Hits Around Africa, link
• Remittance estimate via mobile phones cut by 50%, link
• International Women’s Day: Women in Mobile and Mobile for Women, MobileActive
• iPhone Apps for Nonprofits, HaveFunDoGood (hat tip ckreutz)
• Bullet Point on the Challenges with Mobiles Phones for Human Development, link
• Are Hospital Mobile Phones Dialing Up Superbugs?, link (hat tip ckreutz)
  

Previous link drops:
Mobile Phones and Global Health Link Drop
Mobile Phones and International Health Links Part II
Mobile Phones & Global Health III: Ultrasound, Imaging & ECG to Go! Link

How will the Economic Crisis Change Global Health?

I feel compelled to throw out some slightly disjointed thoughts about the global economic meltdown, especially since the discussion with respect to global health is just beginning. One of the other voices discussing this is Lucy Bernholz, she has a series of fantastic posts on the impact of this downturn on philanthropy and I link to some of her posts below which is must reading.

Backdrop
Global wealth has been destroyed to the tune of 50%; Microsoft and NPR are laying off people for the first time in a long time; Google, Disney, WSJ and the NY Times are laying off and NYC Mayor Bloomberg is suggesting he might have to cut 20,000 city workers; the nation of Iceland has declared bankruptcy and tens of millions have been laid off in China where they are facing a gargantuan commercial real estate bust in Beijing coupled with dwindling job prospects. And if you think the US is in bad shape, Europe is facing a whole lot more pain. The point is that the economic meltdown is having an impact far beyond the usual suspects; this economic crisis is wide and deep and no one knows how long it will last. There is no question that we are entering a fundamentally different world on many levels – dialogue is needed now on what can be done and how this will reshape giving, accountability, fiscal responsibility, priority setting, and of course what counts at the end of the day – health and poverty. The global health community should have discussions on how we can all be more accountable and how we are using funding. We need to be aware of the coming impact on global health funding and beyond.

Pillars of the Global Health Complex
Capital flows and financial support for global health comes from a spectrum of actors (governments, foundations, NGOs, private donations, and many others – see our previous post here on R&D funding flows). These agents are the threads that provide patchwork netting for funding and capital injections through a range of channels, whether that is via medical donations, immunization campaigns, pilot projects, research, education, training programs or remittances. Make no mistake, all of these channels have been or will be impacted. “CGD fellow David Roodman has shown that after each previous financial crisis in a donor country since 1970, the country’s aid declined…“Aid for health is no exception.” But don’t expect governments to announce cuts in foreign assistance; the contraction will be invisible, with disbursements quietly dragged out and a contracting seeing a slowdown…” (Source: Global Health Magazine). With regards to US based foundations, a March 2009 research report found that “of the largest 100 foundations ranked by total giving, only two with announced intentions to grow their funding in 2009–the Gates Foundation and the MacArthur Foundation…six of the largest 100 foundations have so far announced plans to reduce their giving in 2009.” (Source Foundation Center).

I have blogged previously on the University based global health bubble (?) and I would like to see some hard numbers on global health jobs placement, impact on these new programs, whether the programs are halting building construction and staff hiring (as many universities are). Endowments at top universities in the US have taken a beating, so much so that some are considering selling prized art collections. Even one of the world’s richest business schools, with a $1 billion endowment, is cutting back. What will be the impact on schools of public health or all the newly opened schools of global health? Will all this promised global health funding actually materialize? Will students rethink spending tens of thousands on graduate programs in global and public health? Will there be scholarship funding for international fellowships and the development of new ideas and products for global health populations? The university system is of course just one corner of the global health complex but an important one – one that is a foundation for research into neglected diseases or developing human resource capacity in developing countries through education and exchange programs. Steven Davidoff, a professor at the Univ. of Connecticut, has a must read breakdown of why schools like Harvard are cutting back and are facing a worsening economic picture in 2010 and beyond (NY Times, 3/3/09, Harvard, Private Equity and the Education Bubble). In short, below are five obvious trends to watch, by no means is this a comprehensive list.

Impact on pillars of the global health/development sector:
1. Foundations/Philanthropy – many will suffer due to unprecedented (poor) investment returns and reduced donations.
2. Corporate Sector – reduced giving and less leverage to engage in partnerships or development of new products (drugs, etc).
3. Government Aid – some countries rely on massive amounts of aid for even basic things like immunization programs.
4. Remittances – with global job losses this will continue to erode.
5. Universities – endowments have been drastically reduced, classes cut and hiring freezes implemented.

Reorientation to Infrastructure Spending
This crisis is an opportunity to recognize bigger picture global health issues and perhaps with the relatively recent shift in thinking and the push to reshape the global health agenda to emphasize health system infrastructure and workforce development, there may be more interest in funding long range macro level projects (as with some of items included in the US stimulus package for infrastructure). Even small amounts of money for infrastructure can have large impacts, like building bridges to reduce malaria, for example.

And let’s not forget, that one of the best things Cuba did for population health after its economy collapsed was to invest in its health system. Obama has called for massive infrastructure spending and I am wondering if poor economies will be able to do the same. There is some hope for this because low income nations know they must continue to build roads, bridges, and highways in order to continue “development”. Hopefully this will largely be positive for global health efforts (especially if some of that includes public health and medical infrastructure). Perhaps this economic meltdown will be an opportunity to take stock and shift some funding towards long term capacity building.

Reason for Hope
On the positive side, the Gates Foundation is actually increasing their payout, not decreasing it by $300 million as we first discussed a few months ago. Additionally the new center of gravity for global health (Seattle) is going to be adding 2400 global health jobs over the next few years. The World Bank is going to double their health loans and as of now very few ministries of health are reporting they will cut back on health spending (although I am not sure I believe this entirely). There is also some evidence that giving actually rose through the depression, perhaps because people still give to causes that are part of their core belief sets (as opposed to nixing discretionary spending like holidays or eating out).

Conclusion
I believe the pain is going to be severe (with 2010 being worse) and we are already seeing major cracks in the social fabric in various locations. The velocity and violence of this global economic downturn will have serious widespread impacts. Over the past decade the Gates Foundation along with others have brought unprecedented financial resources that helped fuel a boom in certain sectors and innovation in the development of appropriate technology, social ventures and the growth of areas like microfinance, all of which generated tremendous energy and buzz. We have now entered a new era with a drastically different macroeconomic backdrop, yet we are equipped with these new tools (think Kiva) developed during what might be have been a golden age of global health funding/philanthropy in comparison to what might happen over the next decade. A discussion is needed on how to prepare for the worst, how to fund and spend more wisely, how to allocate resources, and how to spot vulnerabilities (e.g. what areas or diseases are especially sensitive to funding flows). I welcome your thoughts and discussion on this.

Additional Reading
1.  Some nonprofits can’t touch their money, link
2.  Global Financial Crisis, Global Issues
3.  How to Get Funding for Your Global Health Activity, Change.GlobalHealth.Org (my new favorite blog)
4.  Economic crisis fueling social unrest, link
5.  Aid Agency Budgets Go Bye-Bye, Change.org
6.  Global Health tv: Global Economic Downturn, video
7.  Philanthropy in a Global Economic Crisis, link
8.  The Economic Crisis: A Generation of Reproductive Health “Horror Stories”, RH Reality Check
9.  Migration in light of the economic crisis, NextBillion
10. Hard Times for Health Charities, link
11. WHO on the crisis, WHO
12. The global financial crisis: an acute threat to health, Lancet
13. No relief: Red Cross hit with tough times, ChemistsWithoutBorders
14. World Bank offers dire forecast for world economy, link

Global Obesity Diagram

BMI is far from a perfect measure of obesity and can be misleading – but you get the picture below (via Miscellanea). Also check out our previous obesity related posts:

A Massive Wave of Chronic Disease in China and India, link

The 88 Worst Fast Food Items, link

Scientific American on Food, Fat and Famine, link

“Innovating for the Health of All” open for registration (Havana, November 2009)

Forum 2009
Innovating for the health of all
Innovando para la salud de todos
Havana, Cuba, 16-20 November 2009

Registration here

The letter:

Dear colleague,

Forum 2009: Innovating for the Health of All is this year’s milestone event in research and innovation for health. Organized by the Global Forum for Health Research, it will take place from 16-20 November in Havana, Cuba, at the invitation of the Ministry of Public Health.

What exactly is “innovation”?* How can decision-makers and practitioners work together to foster innovation for health and health equity? What can we learn from innovation policies and initiatives around the world? These questions will be answered in Forum 2009‘s interwoven discussions of social innovation and technological innovation.

This event will bring together some 800 leaders and experts from around the world to share ideas and forge new partnerships. It will include a unique mix of stakeholders from health and science ministries, research agencies and institutions, development agencies, foundations, nongovernmental organizations, civil society, the private sector and media.

As you expand your networks, you will also be able to learn from discussions on social entrepreneurship for health, public-private product development for neglected diseases, eHealth, knowledge-translation platforms, national health innovation systems, donor-country harmonization and coherence, and innovative financing strategies.

With the theme “innovation,” we are challenged to be innovative in the programme itself including new session formats that are more interactive, new ways to network and share information, and new opportunities for inclusion.

So please join us. Registration is now open on http://www.globalforumhealth.org. We very much look forward to seeing you in Cuba.

Yours sincerely,
Professor Stephen Matlin
Executive Director
Global Forum for Health Research

International Health Diplomacy Link Drop

Global Health Diplomacy Digest:

Strategic Implications of Global Health (Dec. 2008 Report on ID threats), link

Global Health as American Foreign Policy, link

Using the diplomacy angle to build support for Global Health, link

Send a Navy Hospital Ship to Gaza? link

Medical Relief: An Effective Diplomacy Tool, link

PhotoVoice(+cultural probes) for clean water and sanitation in Mumbai

Last Thursday, I had the opportunity to view a PhotoVoice exhibition at the University of California, Berkeley organized by Haath Mein Sehat (HMS), a group working to improve access to clean water and sanitation in six slums of Hubballi and Mumbai, including Dharavi.

It was exciting to see a group effectively blend the advocacy elements of PhotoVoice with the design elements of cultural probes. The difference between the two approaches is less in the methods and more in the use of the outputs. In this case, they organized the exhibition to raise awareness and break down stereotypes of slum life, and they are using the photographic corpus to guide the design of both programs and technologies related to their core mission.

What I was most interested in from a design perspective were the instructions given to community photographers and how this tied back to the mission of HMS. The results below followed from the simple prompt: “Represent your daily experience with water”.

Microbicides – Where are they Now? How much have we spent?

I was just sent this information (thanks to Becky!) about a new round of funding for microbicides, which comes on the heels of promising results from a trial of the PRO2000 microbicide candidate. We covered this a couple of years ago and at the time I said – the potential of this drug is revolutionary. With microbicides there was great excitement and hope, then there was failure and now there is some maturity. Okay, maybe I am overstating the case, the take home point is that we still don’t have a product and this is not cheap, easy, or quick. Developing a drug is complicated, involves huge risk, can take decades and is highly uncertain. Let’s review the drug development time line again for those of you not familiar – the graph below gives the most simplistic picture:

The early microbicide discussions took place almost 15 years ago (International Working Group on Vaginal Microbicides, source). Over half that amount of time, from 2000-2007, $1.1 Billion has already been invested in microbicide R&D! It takes anywhere from $200M to $1 Billion to bring a single novel drug to market. Let’s hope one of these compounds works and makes it through phase III. But how much will we have spent? $2 Billion, $3 billion? If it works, it will have been worth the money, however, we must ask if we took the most efficient financial route to get to the end point and if there were better financial models – that is a valid question.