Global Health Ideas

Finding global health solutions through innovation and technology

Archive for the ‘Private Sector’ Category

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]

“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 We very much look forward to seeing you in Cuba.

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

Donation Mapping Tool

The Partnership for Quality Medical Donations (PQMD) Mapping Tool, provides unprecedented access to information about the medical product donations being made…to the world’s most vulnerable populations. [Anyone] can easily determine where PQMD member donations are sent, find information on how the donations are being used by the communities who receive them and access a library of medical donation resources…” Source: Google Map Technology Enhances First Global Medical Donations Map


I was alerted to the newly launched donation mapping tool by Jessica over at GHP (Global Health Progress). Thanks to her I got to sit in on a presentation of the tool which I found fascinating (but not sure anyone else did based on the lack of questions in the audience). The tool is a mashup of Google maps and donation metrics globally (location, type of donation, organizations involved, what type of supplies, volume, staffing on the ground to name some). The goal is to help collaboration, answer questions and facilitate the process of identifying who is working where and what are they doing? Second they wanted to bring to life the impact of donations (places, faces and outcomes). Other things I took away from the presentation:

  • Massive unmet need for medical supplies. Poor infrastructure & distribution are key challenges
  • Donations are meeting up to 40% of health needs in some areas
  • PQMD has 27 members total (non cash EX US dollar volume was $4 Billion dollars, including non PQMD members)
  • Private sector + NGO + Academia combo mix: The tool was incubated at Loma Linda School of Public health and is a joint effort with PQMD and industry.

They have put a lot of work into this and I think they have lots of neat information. The data comes from primary and secondary data sources. For example they use actual donor member shipping records and augment that with onsite data collection, interviews and site visits on ground with facility staff (location, staffing, needs). The public view is different from the private view so as not to compromise security of the facilities. There is a lot more I could write about this, but I’ll stop here and let you play around with the tool yourself:

A few other things to note – the PQMD site has various interesting resources. Here are some more notes, and things to check out:

Have comments about the tool, leave them here:

Google Flu Trends for developing countries?

A few days back Aman wrote a post about Google Flu Trends.  Thought I’d add a few thoughts here after reading the draft manuscript that the Google-CDC team posted in advance of its publication in Nature.

By the way, here’s what Nature says:  Because of the immediate public-health implications of this paper, Nature supports the Google and the CDC decision to release this information to the public in advance of a formal publication date for the research. The paper has been subjected to the usual rigor of peer review and is accepted in principle. Nature feels the public-health consideration here makes it appropriate to relax our embargo rule

Ginsberg J, Mohebbi MH, Patel RS, Brammer L, Smolinski MS, Brilliant L. Detecting influenza epidemics using search engine query data. Draft manuscript for Nature. Retrieved 14 Nov 2008.

Assuming that few folks will read the manuscript or the article, here’s some highlights.  I should say I appreciated that the article was clearly written.  If you need more context, check out Google Flu Trends How does this work?

  • Targets health-seeking behavior of Internet users, particularly Google users [not sure those are different anymore], in the United States for ILI (influenza-like illness)
  • Compared to previous work attempting to link online activity to disease prevalence, benefits from volume: hundreds of billions of searches over 5 years
  • Key result – reduced reporting lag to one day compared to CDC’s surveillance system of 1-2 weeks
  • Spatial resolution based on IP address goes to nearest big city [for example my current IP maps to Oakland, California right now], but the system is right now only looking to the level of states – this is more detailed CDC’s reporting, which is based on 9 U.S. regions
  • CDC data was used for model-building (linear logistic regression) as well as comparison [for stats nerds – the comparison was made with held-out data]
  • Not all states publish ILI data, but they were still able to achieve a correlation of 0.85 in Utah without training the model on that state’s data
  • There have attempted to look at disease outbreaks of enterics and arboviruses, but without success.
  • For those familiar with GPHIN and Healthmap, two other online , the major difference is in the data being examined – Flu Trends looks at search terms while the other systems rely on news sources, website, official alerts, and the such
  • There is a possibility that this will not model a flu pandemic well since the search behavior used for modeling is based on non-pandemic variety of flu 
  • The modeling effort was immense – “450 million different models to test each of the candidate queries”

So what does this mean for developing world applications?

Here’s what the authors say: “Though it may be possible for this approach to be applied to any country with a large population of web search users, we cannot currently provide accurate estimates for large parts of the developing world. Even within the developed world, small countries and less common languages may be challenging to accurately survey.”

The key is whether there are detectable changes in search in response to disease outbreaks.  This is dependent on Internet volume, health-seeking search behavior, and language.  And if there is no baseline data, like with CDC surveillance data, then what is the best strategy for model-building?  How valid will models be from one country to another?  That probably depends on the countries.  Is it perhaps possible to have a less refined output, something like a multi-level warning system for decision makers to followup with on-the-ground resources?  Or should we be focusing on news+ like GPHIN and Healthmap?

Another thought is that we could mine SMS traffic for detecting disease outbreaks.  The problem becomes more complicated, since we’re now looking at data that is much more complex than search queries.  And there is often segmentation due to the presence of multiple phone providers in one area.  Even if the data were anonymized, this raises huge privacy concerns.   Still it could be a way to tap in to areas with low Internet penetration and to provide detection based on very real-time data.

Google Flu Trends: Predicting the Future

In case you missed this in the NY Times today – fascinating experiment with a new Google tool on the frontiers of diseases surveillance and global health trends. Remains to be seen how useful this will be and lots of validation needs to be done, but this is yet another example of people outside of traditional health/public health communities who are on the leading edge of public health innovation:

“What if Google knew before anyone else that a fast-spreading flu outbreak was putting you at heightened risk of getting sick? And what if it could alert you, your doctor and your local public health officials before the muscle aches and chills kicked in? That, in essence, is the promise of Google Flu Trends.

“Google Flu Trends ( is the latest indication that the words typed into search engines like Google can be used to track the collective interests and concerns of millions of people, and even to forecast the future.”


We have discussed before how data indexed on the web can used for all sorts of fascinating things. We had a previous posts on global health job trends and also on publications that use the terms global health and private sector. The graphs below show a large increase in both areas, however there are dozens of caveats with this kind of trend analysis and the below graphs have to be taken with a grain of salt:

1. Global Health Job Trends (see for full post)

2. Trends: Development/Global Health in the Business Press (see for full post)



Written by Aman

November 11, 2008 at 4:31 pm

M-Money Maturing

Russell Southwood had a short story (full report at on Kenyan banks crying foul with the rapid expansion of mobile money credits acting profitably as current account institutions without the same regulatory oversight.  From Southwood’s emailed summary:

“Currently, the two leading mobile phone service providers – Zain and Safaricom – are offering money-transfer services in the country under Sokotele and M-Pesa brands respectively… To avert undue competition with the banking fraternity … M-Pesa and Sokotele services have to meet the capitalisation requirement as stipulated in the Banking Act. According to the Act, a deposit taking institution should maintain a minimum capitalisation of Ksh250 million ($3.5 million). This is however expected to double come December next year before hitting Ksh1 billion ($14.2 million) by 2010 after capitalisation requirements were amended in this financial year’s budget.”

How small is too small for regulation?  As clear from Kenya, small transactions at scale can leverage significant economic activity and worry the big bank competition.

The question was raised elsewhere this week.  The World Affairs Council of Northern California and UC Berkeley are holding a roundtable dinner next Wednesday with space reserved for UCB students if they address, in 150 words, some of the industry challenges as microfinance and m-money mature.  So any UCB students reading this post, check out BalancingAct for a few ideas.  A few choice subjects:

– When is a bank account a bank account?
– Does the market want mobile phone enabled financial services?
– What’s makes a successful customer business model interface?

The growth of the mobile services in microfinance has been breathtaking and defining the space where traditional banking, microfinance and mobile services intersect will continue to be a challenge as the technology matures and demand continues to grow.

Written by Ben

October 17, 2008 at 1:06 pm

Global Health Council 2009: New Technologies + Proven Strategies = Healthy Communities

The Global Health Council has released the theme for their 2009 conference to be held in Washington, DC: “New Technologies + Proven Strategies = Healthy Communities”.  I’ve been helping them with development of their CFP over the summer months – the focus is largely on ICT, but there is consideration given to other technologies also.  This is an applied conference with significant international representation.  In terms of a broad global health meeting, this is the best I’ve attended.

Written by Jaspal

September 2, 2008 at 2:30 pm

BusinessWeek on Social Enterpreneurship

We have covered this before and it is worth mentioning again, there has been a definite movement among the mainstream media to cover social issues including those specific to global health. See our previous post on “Trends: Development/Global Health in the Business Press” and another one here. And don’t forget what might have been a groundbreaking commercial by ExxonMobil on malaria during the Olympic Opening Ceremonies. The more the better so that we can hopefully get these messages embedded into the larger social consciousness (especially those who work in the private sector, don’t forget the original social contract between the first corporate organization and the community has been broken, maybe with increased coverage corporations will find their way again). Excerpt below:

Making Social Entrepreneurship Matter, BusinessWeek August 6, 2008
“Social entrepreneurship (BusinessWeek, 12/14/07) has become a hot topic in recent years, attracting people filled with the loftiest of intentions who want to do good by doing good. But it’s the tricky feat of running a sustainable operation that is the more elusive goal. So when I learned that Lubetzky had created a viable business model (in operation since 1994) that brings Arabs and Israelis together while plowing profits into peacemaking efforts, I rang up PeaceWorks’ New York office and was invited down for a visit.”

There are also some good posts on a what seems to be a relatively new GlobeSpotting blog at BusinessWeek, with dispatches from current travel in Africa: Globespotting and Social Entrepreneurship.

Also see these other blogs for good content:
1. Social ROI and specifically this Corporations Exploiting The Concept Of Socially Responsible Business?

2. Jim Fruchterman debates social entrepreneurship

3. Feministing on changing the world and SE

4. Riches for Good

4. So What Can I Do hosts the Carnival of Change

5. Renjie on measuring social impact

6. Finally, Alberto from the Hub in London finds inspiration in this closing video

Written by Aman

August 11, 2008 at 7:19 am

Mobile Phones and International Health Links Part II

I missed a few links from our previous post on global health and mobile phones, so this is part deux, which will be followed by Part III later this week. As you can see from the frenzy of recent activity – the mobile phone for health revolution is moving ahead rapidly, where it will take us and how useful it will ultimately be will be known in due time. And as mentioned, this is a case where the “Third World is First”, innovation is happening far ahead of what we are seeing in the US. There are a several good links below. For those seeking more documentation beyond news items, see the report from the Bellagio e-health conference which I believe is being organized by the UN Foundation, Vodafone Group Foundation and the Telemedicine society of India.

CellScope: Mobile-phone microscopes, Link
Dan Fletcher, a professor of bioengineering at the University of California, Berkeley (Go Bears!!), has developed a cheap attachment to turn the digital camera on many of today’s mobile phones into a microscope. Called a CellScope, it can show individual white and red blood cells, which means that with the correct stain it can be used to identify the parasite that causes malaria.

Cellphones for HIV, Link

Mobile Phone Telemedicine Interview: Full Interview at
(title and link via Drew – thanks!)

mHealth and Mobile Telemedicine – an Overview
Great links below and full news link here

  • Sizing the Business Potential (Link)
  • Relationship among Economic Development (Link)
  • mHealth: A Developing Country Perspective (Link)

Wireless Technology for Social Change: Trends in NGO Mobile Use, Link

Related to above: “Technology plays crucial role in vaccination distribution”, Link

The Pill Phone for US Markets. This kind of application was used long before in developing countries – now it is slowly entering the US market: “In a first-of-its-kind application, Verizon customers in the US can get information and set reminders regarding medication and dosage with “the Pill Phone”. Link

Managing Symptoms By Mobile Phone May Revolutionize Cancer Care For Young People, Link

New wi-fi devices warn doctors of heart attacks, Link
“The Bluetooth wireless technology that allows people to use a hands-free earpiece could soon alert the emergency services when someone has a heart attack…” How they will manage the data flow and response is a big question in my opinion.

Other Links:

  • Microtelecom for the Next Billion Mobile Users, Link
  • MobileActive08 is the only global gathering that is connecting leaders who are working at the convergence of civil society, mobile technology and social change. Link

Written by Aman

August 3, 2008 at 7:45 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

Global Health Council 5: We ♥ Margaret Chan

Friday ended with an impressive lineup of global health leaders discussing the disconnect between horizontal and vertical funding in the plenary session titled Meeting Along the Diagonal: Where the First and Last Mile Connect.  A webcast of this session, and 2-3 others from the Global Health Council Conference, will be available on starting Tues-3-Jun-2008.  It’s nearly 2 hours long, but brings together ideas from the Gates Foundation, WHO, the Global Health Council, and USAID.  As much as it was about these organizations and the types of organizations (foundation, multilateral, advocacy, bilateral), it was about the individuals who spoke their minds:

  • Jaime Sepulveda, Director, Integrated Health Solutions Development, Bill & Melinda Gates Foundation
  • Margaret Chan, Director-General, World Health Organization
  • Nils Daulaire, President and CEO, Global Health Council
  • Henrietta H. Fore, Administrator, U.S. Agency for International Development, Director, U.S. United States Foreign Assistance
Victor Kamanga of the Malawi Network of People Living With HIV/AIDS was supposed to speak at this panel representing the community perspective, but was denied a visa by the United States.  Nils was brave enough to say that it may have been due to Kamanga being HIV-positive.
The session was moderated by Susan Dentzer, Editor-in-Chief of Health Affairs, and her performance – one that was witty, but neither overbearing or spectatorish – made more sense after I learned about her NewsHour and NPR roots.
Administrator Fore spoke of USAID’s accomplishments and left immediately for the White House.  The session was awash in metaphors related to the theme: diagonal (Sepulveda), fractal (Daulaire), circular (Gordon Perkin, in the audience).  Dentzer synthesized the overall position of each of the speakers in a few words (in order that they spoke):
  • Fore: “horizontal aspects to vertical programs”
  • Sepulveda: “integration”
  • Chan: “connect”
  • Nils: “fractal”
The collective message for me from the session was this: health systems are complex, we need to look at integrated solutions, and it will take time.
Sepulveda’s framework for looking at health systems requirements was his effort to “make that black box {of health systems] transparent”.  His four requirements of health systems are:
  1. Stewardship
  2. Financing
  3. Delivery (personal and non-personal services)
  4. Resource Generation (people, information, vaccines, technology)
He referred in his comments to 2 articles:
  1. Walsh J A & Warren K S. Selective primary health care: an interim strategy for disease control in developing countries. N. Engl. J. Med. 301.967-74, 1979.
  2. An “forgotten” article that Sepulveda wrote in the 1980s in the Bulletin of the WHO on the topic of “diagonalism”, but perhaps not in those words.  (I wasn’t able to find it, but if you know of the article, please post a link as a comment.)
Both Sepulveda and Daulaire had some interesting things to say, but I want to focus on Margaret Chan.  About 2/3 of the way through the sesssion, I was so taken by Margaret Chan’s honesty and perspective that I wrote “I ♥ Margaret Chan” in my notebook.  I passed my notebook to an NIGH colleague sitting next to me, who then showed me his notebook which had “I [heart] Margaret Chan” written atop his penultimate page of notes.  He didn’t want to draw a heart, he later told me, because he was afraid somebody might see it.  If that wasn’t weird enough, I told the story to another NIGH colleague, who responded that she too had written “I ♥ Margaret Chan” in her notebook.
Some Margaret Chan highlights (keep in mind her emphases in her tenure at the WHO have been Africa, primary healthcare, and women)
  • Dentzer told her she was “the James Brown of global health”, a reference to her work ethic
  • “What works for Hong Kong doesn’t work for Zambia.”  This sounds obvious, but there was quite a lot of talk at this conference about exporting successful models from one country to another.  I’m not saying you can’t learn from successes, but there is at least some better work we need to do in adapting those models to different situations.
  • “Primary healthcare faded from the vocabulary of global health.”  She cited Periago’s “crushed” comment from earlier in the day.  In fact, she brought in a lot of examples of what other people were saying throughout the day, so it’s clear that she was listening.
  • One of the other examples she brought up was a Johns Hopkins professor who in a morning comment advocated for “health impact assessments” like “environmental impact assessments” prior to doing something new.  (Sorry, don’t know the name of the JHU professor.)
  • “Famous soft drink”.  She didn’t name it because she didn’t want to advertise for it, but asked “why can’t we get to the same areas of the world?” (a reference to technologies like vaccines and medicines).  If we can’t do that, “we fail our people”.
  • “It’s easy to blame people when you fail.”
  • In referring to her 30+ years of experience: “I look young, but I’m not”.
  • “Primary healthcare was alive” in places like Brazil, India, and Argentina, even though it wasn’t in the “official vocabulary”.
  • “I’m not going to repeat the WHO definition of health.  To me health is a social objective.”
  • In indicating that we need to train more mid-level professionals: “For the clinicians in the audience, don’t worry, there’s plenty of work.”
  • “We have not listened enough.”  “We underestimate the ingenuity of the community.” “If you say ‘talk is one thing, walk is another’, I rest my case.”
  • “We are insular. We only look at the health sector.”  We need to look at safe water and sanitation, education, etc.
  • “Ministry of Health [alone] cannot handle the complexity of the situation.”
  • “Let’s be realistic. Even NGOs are making profits.”
  • “Why is it that working with industry is seen as dirty?” “Industry is part of the solution.”  We need to work with food and pharmaceutical industries.
  • Peer review is “another elephant in the room”- Chan identified most of the elephants.  It is a process by which “your friends condone your work”.

And my favorite, because it directly addresses the work I do and that we need to advocate for in the development of new technologies and services:

  • “I didn’t realize that the color of bednets makes a difference.”
  • “It wasn’t until we brought in the anthropologists that we found out that the color red represented death.”
  • They changed the color to yellow and people started to use them.
I encourage you to watch the session if you can spare the time.  Posted from the Wi-Fi bus between DC and New York.

Global Health Council 1: Social Marketing

On Tuesday of the conference, I attended the Social Marketing to Facilitate Behavior Change and Action workshop.  I personally found it to be very educational, although I did have one gripe (see #3 below).  A few thoughts I had during the workshop:

(1) Creating new products and the lead user. In describing the role of social marketing, the facilitators considered the question “how do we make the choice easier [for adopting healthier behaviors]?”.  Their answer was “creating new products” and the example they gave was the LifeStraw.  A woman from Vestergaard-Frandsen, the company that makes LifeStraw, was in the audience and shared the story of the conceptual development of the product – it seems this was a case of a lead user.  One of the fieldworkers who worked on a national Guinea worm eradication campaign created her/his own life straw with reed and some mesh for local use.

(2) Social marketing and social design ethnography. The reason I went to this workshop was to establish a better understanding of how my work relates to social marketing.  My work uses applied ethnography for the purposes of design in global health, not just products, but also services and systems.  While there is considerable overlap, the idea of creating new products felt like an awkward fit within the framework of social marketing.  I expect it was there because it has no other home (e.g. social product design).  The danger in placing it in the context of social marketing is that it may ignore the considerable knowledge we have developed and are developing in the field of human-centered design.  There is also a difference in the methods.  Ethnographic research seems play a minor role in social marketing, and as in many fields, the label ethnographic seems to be used fairly loosely.

(3) Know your audience.  The majority of examples (not all) in the workshop were drawn from the US context (e.g. commercial advertisements, surveys, anecdotes), and further weren’t well-contextualized.  Not what I expected at a global health conference, with a very international group, where the focus of the workshop was “know your audience”.

(4) Adapt, don’t adopt. One of global health’s strengths is that it borrows from so many diverse fields.  The dangers with this are in simply adopting the idea rather than adapting it to the contexts of global health. In the case of social marketing the ideas that have been borrowed are framework (effect behavior change), process (how to understand your consumer), and theory (behavior change models).  The typical dangers of doing this are: (a) what is borrowed can be viewed as gospel (e.g. if Madison Ave. does it this way, it must be right) or (b) the ideas don’t progress as they do in the original field (e.g. is social marketing making use of advances in commercial marketing?  is it evolving on its own?).  I still don’t know enough about social marketing to argue this, but I’ve seen this pattern with other ideas that have been borrowed across fields.

(5) “We’ve already been doing this”. One of the audience members brought up the fact that people have been doing this for a long time in many places and that it simply hasn’t had the “social marketing” label.  Agreed, but in my opinion – and that of the facilitators – the value is in the framework.  By creating a formal way of thinking, we can improve the social marketing work that people have been doing by other names, and bring it to people who haven’t been thinking in these terms.

Ben was there for part of the workshop and may have more thoughts.

Update from Aman – here are some other great resources in the area of social marketing:

Written by Jaspal

May 28, 2008 at 8:35 am

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

First year improvements in Uganda OBA clinic utilization and claims quality

This piece is cross-posted from the Uganda output-based aid (OBA) site which just got a major under-the-hood overhaul in its move to a blog format. The Uganda OBA project contracts private clinics to see qualified patients for complaints of suspected sexually transmitted infections (STIs). Patients who buy a subsidized voucher from local drug shops and pharmacies are entitled to seek care for themselves and their partner at any of the contracted clinics. Clinics are reimbursed on a negotiated fee-for-service schedule.

The following report (“VSHD, 2007, Assessment of OBA Clinic Utilization”) is an evaluation of the OBA program’s first year impact on utilization at participating clinics (July 2006 to June 2007).  The study, led by Berkeley graduate students Richard Lowe and Ben Bellows, was undertaken June to August 2007 and required an extensive review of thousands of handwritten lab and outpatient entries at OBA facilities. Records were kept differently at many of the clinics and,at several clinics, data were simply not available. However, we have information from 7 of the 16 clinics and they indicate a strong patient uptake and program improvement in the first year of OBA. One of the more dramatic findings is that the total number of patient visits at contracted clinics increased 226% in the first year of OBA compared to the year before OBA.

It does not appear that patients who have attended OBA clinics simply substituted the OBA voucher for their own out-of-pocket spending. Taking all seven clinics together, the number of non-OBA patients seeking STI treatment actually increased in the first year of OBA. One likely reason is that social marketing stimulated greater demand for STI treatment beyond the voucher-using population.

Program adherence also appears to be improving over the first year of OBA as the number of fully paid claims increased from 30% of all submitted claims in July/August 2006 to 70% of all claims in June 2007. Although it should be stressed that claims quality varied significantly between providers.

There is some concern about the quality of lab testing at participating clinics. Lab technicians could benefit from better on-site follow-up and incentives for high quality diagnoses. However, the percent of positive gonorrhea tests more than doubled, indicating increased awareness of this infection in the community and at provider clinics.

The report paints a detailed picture of the participating clinics in their first year of OBA and it is hoped that findings can be used for program improvement as the expansion is planned.

Our many thanks go to both Microcare and MSI who graciously assisted with our many requests for supplemental data and assistance reaching clinic providers. Many thanks as well to the KfW Development Bank and the Bixby Program at UC Berkeley for funding the research.

Written by Ben

January 16, 2008 at 3:09 am

Back in the Saddle – Happy New Year Link Drop

After a holiday hiatus I should be back to blogging much more frequently. I did some desk clearing from emails that had gathered over the past month and naturally many of them were year end Top 10 lists. I thought it would be appropriate to capture some of these below. In addition to starting off with a couple of miscellaneous links, I included a section on business and global health. Once again I do this because I strongly believe it is important to understand the impact the business community/private sector is having on the issues we care about. In my opinion folks in the public health world are almost completely incognizant of what is happening with respect to this (and to be fair the opposite is also true). Enjoy the links below, I probably will have some more desk clearing to do as the week goes on. In particular the first link under the business and global health section below on Melinda Gates is quite interesting if you care to know more about her.

Global Health Photo Contest, link
The Global Health Council’s Photography Contest is dedicated to drawing attention to health issues that have a global impact. Deadline is Feb 15, 2008.

What can $611 Billion buy? Try this – feeding the world’s poor for 7 years. Link
via Good Magazine.

Top 10 Lists
*Top 20 Global Health Priorities, link
In one of the world’s largest public-health collaborations, 155 experts from 50 countries have a plan to tackle the world’s deadliest diseases. The result is a list, published in the journal Nature, of the top 20 research and policy priorities in chronic non-communicable diseases – which account for 60% of all deaths worldwide. It’s “a road-map” for action, says lead researcher Abdallah Daar at the McLaughlin-Rotman Centre for Global Health in Toronto.

*A Year of Worldchanging Ideas, link
Exec editor Alex Steffen of Worldchanging has compiled their best of list in several categories. The full list is below, I have selected a few that I liked: “Over the last year we ran more than 2,000 stories, including a number of pieces that I think are pretty much the best stuff we’ve ever done… here is my list of the top Worldchanging posts of 2007. It’s very subjective, though many of these stories have also been among our most popular (judged by visits) and provocative (judged by media coverage and blog links) posts.

  • Tools for Understanding Poverty, link
  • The Open Architecture Network and the Future of Design, link
  • Transforming Philanthropy, link

*10 Highly Consequential Implications of Climate Change, link
A new report called The Age of Consequences, forecasts climate change in the coming century. It makes for fascinating if frightening reading. See table for impact on global health. via.

*Top 7 Social Entrepreneurship Blogs via Riches for Good
Finding and funding sustainable, scalable solutions to end global poverty

*Top 10 Wins For Women’s Health in 2007, link
Women’s health was a priority concern in 2007, as global donors, international agencies, and influential private foundations realized that investing in women’s health is investing in the world (hat tip – Pump Handle).

*The Independent announces its top 6 social entrepreneurs, link
Last year, The Independent – in collaboration with The Schwab Foundation for Social Entrepreneurship and the Boston Consulting Group – began a quest to find the UK’s most successful social entrepreneurs. (hat tip)

*10 Videos to change how you view the world (all TED videos), link

*10 top global health issues according to WHO, link (via)

*10 Universities With the Best Free Online Courses, link (via)

Business and Development/Global Health

*Who is Melinda Gates?, link
Interesting read: “Years before Melinda French met and married Bill Gates, she had a love affair – with an Apple computer…Of all the tricks that life can play, it’s hard to imagine any stranger than what befell Melinda French. Today she is married to the richest man in America – and giving billions of dollars away…”

*Global pharma firms take a tropical dose, link
Multinationals focus on diseases in developing countries as they lose protection by patents at home. The big multinational drug makers are increasingly focusing their research on diseases that no longer afflict their home countries. As many as nine companies are developing medicine for tuberculosis, which claims two million lives every year. At least seven are focusing on malaria, another killer.

*IFC betting 1 Billion on Africa’s private sector to improve health, link
The IFC plans to set up an equity investment fund, ultimately worth up to $500m, including money from other donors, to invest in small and medium-sized enterprises in the health-care industry. It also wants to create a $400m-500m debt vehicle that will fund local banks that lend to such entrepreneurs. See also –

*On Malaria: Charity vs. Capitalism in Africa, link
Africa’s best hope to fight malaria is the wide distribution of mosquito-repelling bed nets. But who best serves that need: the public sector or private interests?

*2 Young Hedge-Fund Veterans Stir Up the World of Philanthropy, link
As hedge-fund analysts, Holden Karnofsky and Elie Hassenfeld made six-figure incomes deciding which companies to invest in. Now they are doing the same thing with charities…Their efforts are shaking up the field of philanthropy.

*Oprah effect brings microlending to Main Street, link
Kiva hit the publicity jackpot in September when Oprah Winfrey featured the organization on her daytime television program, attracting a tidal wave of interest from Middle America. Demand was so high the day the episode aired, every loan on the site was fulfilled.

*Heinz Pledges to Provide Free Micronutrient Assistance to 10 Million Children by 2010, link
The H. J. Heinz Company is working to develop solutions to reduce global malnutrition, a commitment underscored in the Company’s 2007 CSR report. The report lays out the Company’s plans to provide free micronutrient assistance to 10 million children at risk of iron-deficiency anemia by 2010.

Harvard Study in PLOS Medicine: Brazil’s ARV Policy Saved US$1 Billion

BBC reports that “a study published in the Public Library of Science journal by researchers from the Harvard School of Public Health suggests the policy has saved Brazil around $1bn between 2001 and 2005.”  The article itself is available freely online as a part of  the open access policy of PLoS.

From the Harvard School of Public Health press release:

The results showed that, although costs for Brazil’s locally produced generic antiretroviral drugs (ARVs) increased from 2001 to 2005, the country still saved approximately $1 billion in that time period through controversial price negotiations with multinational pharmaceutical companies for patented ARVs. Since 2001, Brazil has been able to obtain lower prices for patented ARVs by threatening to produce AIDS drugs locally. Though these negotiations initially prompted major declines in AIDS drug spending, HAART costs in Brazil more than doubled from 2004 to 2005. The steep increase reflects the fact that more people living with HIV/AIDS began treatment and are living longer. The increase also reflects the challenges associated with providing complex, costly second- and third-line treatments as people develop resistance to first-line drugs, live longer and require more complex treatment regimens.

Figure 6 from the articleImpact of Alternative Price and Quantity Scenarios on Total ARV Costs, 2001–2005 – shows how the increase in spending is primarily related to increases in quantities rather than costs (Figure 6.A).  This figure also shows how much would have been spent if there were no price changes (6.B) and the theoretical minimum that could have been spent by buying the lowest-priced generics on the market (6.C).

Poor air quality after California fires safer than indoor air from biomass-burning in low-income countries

A Berkeley school of public health prof recently posted to the SPH listserv a great NASA link to high altitude photos of the southern California fires. You can click through several days worth of pics and see what conditions were like prior to the fires as well as tell when the winds kicked up as they carried dust plumes in areas unaffected by fire (for instance Oct 22nd).

The point the prof made was that as bad as the air is there, the particulate matter density of 200-300 micrograms per cubic meter (10x greater than average figures for US cities) is still less than the levels typically seen in biomass-burning homes in the developing world.

More efficient, hotter burning charcoal stoves are one immediate solution to indoor particulate matter (i.e. soot) in low-income homes. In Uganda for instance, Kampala residents use a huge amount of charcoal (my own estimate…) every day. The city’s air, not to mention the air in individual homes, has a great deal of suspended soot – you can easily smell it across the city during the peak cooking hours. Venture Strategies for Health and Development in Berkeley, together with an innovative Kampala for-profit stove manufacturer, are marketing the hotter burning stoves through targeted subsidies financed in part with carbon credits.

Perhaps one silver lining to the devastation in southern California will be greater awareness of the importance of high air quality.

Written by Ben

October 25, 2007 at 8:14 am

Forbes on Fixing Healthcare in Africa

Its great to see a generally conservative business magazine discussing positive, successful global health efforts in Africa. Forbes has 3 very recent pieces that are worth skimming. Again, this is yet another indication of increasing convergence of the social and business sectors that we had previously profiled (trends in global health coverage by the business press).

The Rwanda Cure: Success Stories
Forbes Oct 29.2007, link

Western do-gooders are pouring billions of dollars into ontrolling malaria, AIDS and other killers ravaging the world’s poorest continent. Now comes the hard part…Some of what sub-Saharan Africa needs is new technology, like a malaria vaccine. But what’s needed most, particularly in Africa, is better logistics.

“The hardest truth for people to come to terms with is that the practical solutions are already out there, but they are not being applied…Donors always want to do something new. The simple things aren’t so glamorous.” Full story 

In Pictures: Seven Ways To Fix Health Care In Africa
Follow this link 

HealthStore to expand to Rwanda, link
How do you get basic care to the remotest villages in Africa? One clever idea is to borrow tactics from retail chains like McDonald’s and Subway–operate an easy-to-replicate, owner-operated franchise system focusing on health care.With a budget of under $1 million a year, HealthStore Foundation subsidizes nurses in rural areas to run 65 for-profit retail clinics in Kenya that provide basic treatments for malaria, respiratory infections and worms.

Nurses pay about $300 to buy a clinic, and sell medicines for a modest profit at a retail price of $1. The 65 clinics run under the name CFW Shops and treated 400,000 patients last year. Many are run by retired nurses lured back to work by the prospect of owning their own business.
Full story here.

Written by Aman

October 16, 2007 at 8:49 am

MTV Launches Activist Network

Here is a new site by MTV – They have various videos and links that of course feature artists and also non-artist involvement. MTV can clearly be a powerful motivator, their engagement is interesting and a testament to the hipness of being involved in social causes or at least giving that perception. Let’s hope this does well and gets a younger generation mobilized, screen shots and description below (along with a Jay Z video of him at the UN, click on the picture):

“NEW YORK (Reuters) – Viacom Inc’s MTV will launch a new Internet social network sponsored by foundations operated by the founders of Microsoft and AOL to encourage youth activism….It will let users create pages, as on other online social networks Facebook and MySpace, and upload photos and videos, some of which may be aired on MTV’s online or cable network.” Full story here: MTV to launch activism social network

Jay Z on his issue – Water:

The web site:

Written by Aman

September 30, 2007 at 7:43 pm

TruDiagnosis: The Ultimate Diagnostic Device

Wired magazine has a fascinating piece from last month on the “ultimate medical diagnostic device” which is being developed in collaboration with the private sector. It is by Thomas Goetz who runs his own blog: Epidemix. Excerpts below:

Our inability to diagnose and track infectious disease quickly and accurately remains a serious problem…The problem with cultures is that they take a long time — three weeks or more — to produce a definitive result. In those three weeks, antibiotics may be fortifying the bacteria’s resistance rather than curing the patient. In those three weeks, a TB patient goes back into the population and spreads disease. In those three weeks, the bacteria have enough time to escape our grasp. What’s needed, then, is a new way to diagnose the disease: one at least as fast as the sputum microscopy test, as accurate as the culture, and refined enough to differentiate between garden-variety bacteria and drug-resistant strains. What’s needed is nothing less than a new gold standard…Those tests might finally be at hand. There is a crop of diagnostic tools on the horizon… Dozens of companies are investing hundreds of millions of dollars to develop these new tools.”

“TruDiagnosis: It combines advances in microfluidics (miniaturized pumps and channels), microarrays (micron-sized sensors affixed to a chip), and engineering into what could be the ultimate medical gadget: a handheld device that, using a small sample of blood or spit, reveals in mere minutes every pathogen inside the body.”

Written by Aman

September 18, 2007 at 9:20 pm

McKinsey Report: Indian drug market to reach $20B

Here is another story on the growth of medical technology consumption and production in emerging regions. A few days ago we had a related post (Trends in Global Pharmaceutical Manufacturing). According to the McKinsey report, the rural health services sector will provide significant growth in the demand for pharmaceuticals.

India’s fast-growing economy, expansion in health care insurance and infrastructure, to grow national drug sales to triple by 2015. The report said India will undergo a “significant transformation” to become one of the top 10 pharmaceutical markets in the next decade.

In addition, improvements in medical infrastructure – like rural hospitals and clinics – would contribute to 20 percent of the projected growth, while the strengthening of health insurance within the country would contribute to 15 percent of the growth, the report said. Full news release at CNN Money.


Other Sources:
Pharma boom: Drug market to hit $20 bn by 2015, The Economic Times

Table: Global Insight, Link

KPMG Pharmaceutical Practice Report: The Indian Pharmaceutical Industry, (PDF)

India: The Next Pharma Superpower?, IPA Convention 2007, Trade Group

Pharma & Biotech in India Presentation, (PDF)

Written by Aman

August 24, 2007 at 4:48 pm

Trends: Development/Global Health in the Business Press

Over the past several months I have noticed what seems to be consistent coverage of development and/or global health issues by the business press. Almost every time I open up Fortune Magazine, Business Week, Forbes, or some other mainstream business publication there seems to be some coverage of the issues we care about (water, clean tech, etc.). You might ask – so what? For those in the public health world, yes “business” is a four letter word, but this is an important development (good and bad) because the private sector unlike never before is having an increasing impact on development and global health issues. Even the financial news channel, CNBC TV, has had consistent coverage of issues such as the global water crisis (probably largely due to one main proponent). To give you an idea of frequency and content covered, below the graph is a sample of articles I have seen in the major business news publications in just the past couple of months.

In addition I decided to do a very quick and dirty check of the number of publications listed on Google Scholar over the past decade to see if there has also been an increase in attention in the academic press. I searched using the following two terms:

“Global Health” and “Private Sector”
“Global Health” and “Business”

You can see the results in the below graph which again is a back of the envelope analysis that has flaws, but gives us a rough idea of changing content being published. In 1996, the use of those words “Global Health or Private Sector” and “Business” was almost non-existent and a decade later we see a tremendous increase that is 12-23 times greater (some of which can be attributed to SARS).


Back to changes by the business press, there seems to be no question that there is much greater interest in development and social issues compared to a decade ago. However, the majority of these articles seem to be clear that their interest is largely driven by profit, as the Smart Money July 2007 issue states: “It’s not a social or moral debate, it’s all economic…”

Business & Development Examples
1. Jeffery Sachs: “How I’d fix the World Bank”, link
Fortune Magazine 6.9.2007

2. Vitamin fortified super rice: “Eat Some Ultra Rice”, (PATH is featured in the article), link
Forbes Magazine 8.13.2007

3. Richard Branson’s Latest Venture, link, via
Business Week, 7.25.2007

4. BusinessWeek on BOP – A False Dichotomy? via NextBillion
Business Week 8.1.2007

5. SRI: Invest With Your Heart and Soul, link, via Philanthrophy 2173
Business Week, 7.31.2007

6. MTV Searches for Hope & Profit in Africa, link
Forbes, 6.18.2007

7. 5 Great Green Stocks, review here,
Barrons, 7.16.2007

8. Money Magazine August 2007 page 61: Full page color ad for (sorry no link to the ad)

9. “Reap profits & save the planet…Corporate America is responding to climate change considerably faster than the US.” Smart Money, June 2007 (sorry no link to article available, see print edition)

On a related note, definitely read this-
Environmentalism for Billionaires: “How businesses are looking to cash in on global warming with green-washed plans that aren’t as eco-friendly as they seem.”

Clean tech becomes big business (8/2/2007), link

While I am not aware of blogs that are mostly devoted to covering development or global health issues from a business perspective here are some blogs that have related content. If you know of any others please let me know:
The Heart of Business
Lunch over IP
Silicon Valley Microfinance Network
The Discomfort Zone

Written by Aman

August 9, 2007 at 7:12 pm