In December, PATH hosted a Transformative Innovations event in Palo Alto, with a panel discussion on ways that public and private sectors can work together to save lives. In three installments, we bring you excerpts of the discussion from our panelists Ponni Subbiah and Anurag Mairal, program leaders of PATH’s Drug Development and Technology Solutions programs, respectively, and Joel Segrè, an independent strategy consultant focused on product development and distribution challenges in global health. In our third post, Anurag addresses the difficulty of multi-directional innovation, the arc of developing a new solution, and the potential for global innovation hubs.
Q: One of the shifting paradigms of the future is that innovation will be multi-directional and come from anywhere in the world. What impacts do you see this having on the global health challenge?
AM: The biggest challenge with all of these great innovations is that they’re sometimes disconnected from the realities of what is needed on the ground in low-resource settings. The hurdles that innovative ideas face before they can become a sustainable global health solution are many. What is needed is a structured approach to sourcing and nurturing these innovations. Without a defined process, strong partnership amongst key stakeholders, and a well-designed framework, this bank of potential solutions (both conceptual and in early design phases) will be lost. Impact-driven health solutions would suffer if stakeholders were to see no evidence-based outcomes.
In the best interest of the world, we should foster these innovations and make sure the optimal ones make it through, that the still-promising ones get time and investment to make improvements, and that the ideas with the least potential are eliminated. We don’t want to divert time of talented innovators and limited resources on ideas that have a low likelihood of becoming viable solutions.
Q: As we are now living in a more globalized world, new technologies have a role to play. What is the full picture of what is needed to achieve impact? Is it technology development? Or is it needs assessment? Tell me the full arc of the story from opportunity to impact.
AM: This is a really interesting time for global health, and things are changing dramatically. The funding environment that existed until roughly five years back, into the late 2000s, is changing. It’s become more constrained, and there’s a bigger push for engaging a broader set of stakeholders and donors.
Many donors are investing directly in countries with the most pressing needs and in the work being done in those countries. Countries themselves, both middle- and low-income, are starting to take on a leadership role, deciding which problems they want to solve and how to solve them. I’m in strong agreement with Bill Gates’ statement in the 2014 Gates Annual Letter. He said, “By 2035, there will be almost no poor countries left in the world.” Countries with growing economies, such as Ethiopia, have the desire to take ownership and leadership over addressing their own challenges. These countries have reached a point where they understand the framework and importance of innovations, the role of innovations, cost advantages, and better outcomes for citizens.
Middle-income countries like India, China, and South Africa are beginning to take on the leadership and investment role that the United States fulfilled for a long time. They’re empowered not just by financial capacity, but by infrastructure improvements, increased clinical and operational capacity, donor funds, better-resourced ministries of health, advances in technology, and new global partners. Perhaps most importantly, investment in education has meant that there is now a formidable intellectual capital that is ready to contribute to global health solutions.
The work going on today with middle-income countries is especially important for completing solutions and making them available across the world, not just in those countries. It makes sense to go to the next level and create global innovation hubs that identify and prioritize – in a very structured manner – needs where they exist and then work with local communities and ecosystems to address those problems. That is the best way to tap into resources, industrial capacities, ideas, and overall, perceptions and needs. It’s the way of the future. All sustainable, effective, and accessible solutions come from that type of close collaboration.
Unfortunately, it’s not easy to do. Even though we have talent and some understanding of needs, in addition to national investment from emerging economies, the capacity of these countries to translate brilliant ideas into viable products that solve global health problems is limited. What is needed is to convene deep experience and technical expertise of global NGOs, innovators, and stakeholders locally to develop that capacity.
Q: How do you envision a global innovation hub working in practice?
AM: A global innovation hub would bring together local organizations working on urgent health problems and provide clinical know-how and technical expertise to foster the success of their programs and coordinate initiatives for maximum impact. We should identify local innovators, industries, incubators, and investors to share our approaches and strategies, so that we may take promising ideas into the product development process and scale them up.
Q: Who should be our first target users for global health innovations? Is it correct for some critics to say that new technologies will mostly benefit wealthy people?
AM: From concept to impact, evidence-based interventions, combined with rigorous technical and scientific training, can and should be practiced by regional hubs. The advantage with creating best practices in China, India, South Africa, and other middle-income countries is that in addition to having rural areas of significant health need, they also have city centers with funds, academic institutions, and industrial capacities. We’ll be able to take those practices and implement them beyond the borders of the country, in rural, low-income countries that are the most in need of those interventions.