DAY 2 – Tuesday 3 May – 11:15-12:45
Swiss Tech | Room 2C | Level Garden
Ecole Polytechnique Fédérale de Lausanne, Switzerland
Klaus Schönenberger obtained a PhD (1996) from EPFL on medical technology. After a post-doc at Lawrence Livermore National Laboratory, he spent 10 years working in the medical devices industry in leading positions such as Global Vice-President of Research and Technology in a company with a turnover of US$ 1 billion. In 2010 he started-up EssentialMed, an innovative non-profit venture, which he is now leading as CEO. In 2011 he joined EPFL to launch EssentialTech, a program directed at developing technologies and business models to fight poverty.
Many important medical devices, such as X-ray diagnostic imaging systems and neonatal incubators, which are essential to primary healthcare, are still not available in much of the developing world. Moreover, even when such medical devices might be available, they are often dysfunctional and not correctly utilized, thereby diminishing and/or eliminating their intended benefit and impact.
The context of healthcare delivery in developing countries is characterized by scarcity in three main areas: in financial resources, in quality infrastructure and in trained personnel. These unique features warrant a complete or significant rethink/redesign of technology solutions and business models, so as to better fit the needs, and is a necessary condition for successful large scale and sustainable deployment. However, a complete redesign/rethinking of technology and business models typically requires high financial investments, a factor that discourages companies and investors as they still perceive these “markets” as financially unattractive and too risky. Risk is inherent to entrepreneurship, but this risk is perceived as even higher in developing markets because there are few prior established benchmarks.
This session will hear from players operating in these markets how the different risks were/are mitigated, using examples of innovations that are in the process of development, deployment and/or in the scale-up phase. Participants in the session will help extract lessons about good strategies and best practice for maximizing the chances of successfully transforming a new technology to the private sector and sustainably scaling it up, thereby maximizing positive impact on global health.
Adriana Velazquez Berumen, Senior Advisor and Focal Point Medical Devices, World Health Organization, Switzerland [invited speaker]
Kelley Maynard, Rice University, United States, Development and Scale-Up of Essential Newborn Technologies
Three million neonatal deaths occur each year, 99% of which take place in low- and middle-income countries. One factor contributing to this inequality is a lack of basic neonatal technologies in low-resource settings. Here, we advocate for the comprehensive development and implementation of a package of affordable, appropriate neonatal care technologies to address the primary causes of newborn death. We present a case study of one such package of newborn technologies: the Nursery of the Future project by Rice 360°: Institute for Global Health at Rice University and Queen Elizabeth Central Hospital in Malawi. Finally, we recommend key focus areas regarding implementation of technologies in low-resource settings, including early business planning, affordability, translation to scale, interdisciplinary collaboration, in-country innovation and capacity-building, and implementation research and optimization.
Debbie Lin Teodorescu, MIT D-Lab & Harvard Medical School, United States, Developing a Low-Cost, Ultraportable, Modular Device Platform to Improve Access to Safe Surgery [PDF Full Paper]
Surgery saves lives in traumas, obstetric emergencies, infections, oncology, and more. Indeed, 30% of the global disease burden requires surgical therapy, yet in lower-middle income countries, 5 billion people have little or no access to safe surgical care. Costly infections from unsterile surgeries threaten developing infrastructures. Safe surgery is thus a global health priority. SurgiBox, a joint project of MIT D-Lab and Massachusetts General Hospital, aims to develop, evaluate, and ultimately deploy a new technology to help increase access to safe surgery. SurgiBox shrinks the scope of the sterility challenge from the room to the critical space immediately over the incision. Users seal the modular system of sterile clear containers over the patient and operate via ports. An integrated airflow system controls enclosure conditions. Everything folds for rapid deployment. This project requires close dialogue among stakeholders with iterative, rapid prototyping changes. Benchtop and simulation testing to date demonstrate superior environmental control compared to standard operating rooms, notably including setup time, time to surgical site sterility, resistance to active contamination, and air changes per hour. Ongoing efforts include testing in stress use scenarios to replicate field conditions, field testing, in vivo testing, minimizing device cost, and mapping out a sustainable deployment and scale-up strategy.
Lina Sayed, Gradian Health Systems, United States, Innovating Beyond Technology: Building a Business Model to Distribute and Sustain the Universal Anaesthesia Machine
An estimated 5 billion people around the world lack access to appropriate surgical and anaesthesia care – the vast majority of whom live in low- and middle-income countries (LMICs). Because of this, a third of the global disease burden is attributable to surgically treatable conditions – more than HIV/AIDS, malaria and tuberculosis combined (16.9 million deaths per year) – and the world is on pace to lose more than $12.3 trillion in economic productivity by 2030. Part of the global surgery challenge lies in the infrastructural constraints facing hospitals in LMICs. On one hand, with most medical equipment in LMICs being donated or refurbished, there is often no clinical training provided, no spare parts available and few local technicians to conduct repairs, leaving up to three-quarters of all medical equipment inoperable. On the other hand, even when machines are donated, they’re rarely designed for low-resource environments. This disconnect is problematic for hospitals in regions like sub-Saharan Africa, which rarely have reliable access to electricity or medical oxygen. Gradian Health Systems is presenting our approach to combat this challenge: a business model to develop, distribute and sustain medical equipment for LMICs. The company’s primary product is the Universal Anaesthesia Machine (UAM) – a CE-certified device designed to deliver anaesthesia reliably and safely with or without electricity and oxygen. The UAM functions by using its built-in oxygen concentrator or by drawing oxygen from the room air when the power goes out, making it ideal for operating rooms all over the world. While the UAM itself is a critical innovation for low-resource hospitals, we believe the distribution, service, training and ongoing support we provide is just as critical. By building a global network of in-country biomedical technicians, anesthetists, spare parts depots and training hubs, we’ve helped enable more than 100,000 surgeries in 23 countries, and hope to expand our model to many more hospitals throughout the world.