GSK “Open Innovation” Strategy for Global Health

Posted by | Posted in Access to Health, Data, Global Health, Infectious Diseases, Malaria, Pharmaceuticals, Private Sector | Posted on 21-01-2010

Yesterday we were invited to sit in and meet the CEO of GSK, Andrew Witty, as he announced the new GlaxoSmithKline Open Innovation Strategy To Aid Poor Countries. The following entry is by one of our new bloggers, Sarah Searle (@sarahsearle on twitter) from the Johns Hopkins International Health program:

“Big Pharma as a Catalyst for Change”: GSK “Open Innovation” strategy

It’s estimated that one-third of the world’s population go without essential drugs–often drugs for treating diseases that disproportionately affect the world’s poorest. The pharmaceutical world proves to be especially difficult to navigate for those seeking to provide such medicines to underserved populations, however. Pharmaceutical science is a field with billions of dollars in R&D, ironclad patents and intellectual property rights that are prohibitive to making drugs available to the poor. Andrew Witty, CEO of GlaxoSmithKline, claims that he’s looking to change this nature of big pharma, in the same way that the open source movement has revolutionized the tech world.

I love the word “innovation” combined with anything related to global health, so the prospect of sitting in on a blogger’s roundtable with GlaxoSmithKline CEO Andrew Witty was exciting enough just from the topic at hand: “Breaking Down Barriers to Innovation and Access to Medicines in the Developing World.”

The ante was upped in a press conference this morning, when Andrew Witty announced GSK’s “Open Innovation” strategy to make drugs more available and break down barriers to access. This strategy includes several components.

“Open Lab” initiative
$8 million in seed funding has been provided establish an “Open Lab” at GlaxoSmithKline’s research facility in Spain. As many as 60 scientists from around the world will be able to work at this lab, which will be devoted to research for drugs that target diseases of the developing world.

13,500 malaria-combating compounds in the public domain
This is perhaps the most exciting announcement. GlaxoSmithKline has been collaborating for years with PATH and other organizations in the development of a malaria vaccine. Scientists at GSK have screened all compounds that have ever been created in their labs, and identified 13,500 compounds that successfully combat P. faciparum, the deadliest form of malaria. The big news? The chemical structures and other recorded data regarding these compounds will be open sourced, in hopes that malaria vaccine research will be accelerated.

New pricing model for GSK’s malaria vaccine candidate
GlaxoSmithKline is in the process of developing the world’s most advanced candidate for a malaria vaccine—it’s the only vaccine in Phase III clinical trials, and could be available to the public as early as 2012. Maintaining that a tiered pricing model simply isn’t feasible for a drug which is needed almost exclusively by the world’s poor, Witty announced a pricing model for the vaccine which covers the cost of the vaccine with a marginal return for GSK, all of which will supposedly be channeled back into R&D for “next-generation” malaria vaccines.

It goes without saying that some present at the roundtable were wary of the corporate world’s ability to selflessly decide change the mechanics of drug information and pricing in order to benefit the world’s poor. Witty has struck a nice balance between acknowledging that GSK is a profit-driven company but maintaining that he strives to keep a “restless” socially-conscious agenda.

And let’s be honest—GSK won’t be suffering much financially with this move. First of all, the malaria drug market isn’t very competitive to begin with, because of the very fact that it is a poor person’s disease. Secondly, GSK is already the developer of the leading candidate for a malaria vaccine. It’s unlikely that, even with the compound information made publicly available, anyone can come up with a vaccine to rival GSK’s in any short amount of time.

Indeed, as Witty acknowledged, making drugs and drug knowledge more universally available is an investment in the future. Drugs will not be provided for free, he stressed, but rather provided at a marginal price that won’t completely alienate other pharmaceutical companies from healthy competition for lifesaving drugs.

Regardless of motivation, it’s refreshing to see big pharma recognizing the issues of access to medicines for the world’s poor. Moreover, Witty’s emphasis on being in step with progressive intellectual property movements is laudable. Whether or not GSK’s initiatives will stimulate other pharmaceutical companies to follow suit remains to be seen.

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Forum 2009, No. 5: Innovation for Remote Populations/mHealth (#GFHR09)

Posted by | Posted in Access to Health, Conferences, Data, Design, Education, Entrepreneurship & Microfinance Blogs, Franchise, Global Health, Government, HIV/AIDS, Health Systems, Human Resources, ICT, Infectious Diseases, Infrastructure, Innovation, Leadership & Management, Malaria, Mapping, Maternal and Child Health, Mobile Phones, Non Profit, Private Sector, Public Private Partnerships, Research, Social Entrepreneurship, Stats, Supply Chain, Surveillance | Posted on 08-12-2009

The Global Forum for Health Research Forum 2009: Innovating for the Health of All took place in Havana, Cuba from 16-20 November. This is the fifth in a series of posts from the conference. Only one or two more after this one.

My reason for attending Forum 2009 was to participate in a session title “Innovation for Remote Populations”. This post is a about that session. What follows is taken from my recent report to the Global Forum for Health Research – edited only slightly.

Innovation for Remote Populations

Thurs-19-Nov-2009, 14:00-15:45, Global Café, Palacio de Convenciones, La Habana, Cuba

Coordinators/Facilitators:
Patricia Mechael, mHealth and Telemedicine Advisor, Millennium Villages Project, Earth Institute, Columbia University, USA & Egypt (organizer & facilitator)
Tim Hurson, Facilitators Without Borders (facilitator)
Charles Gardner, Global Forum for Health Research (focal point)
Speakers (alphabetical order):
Simon Adebola, NEPAD Council Global Health Commission, Geneva
Najeeb al-Shorbaji, Director, Knowledge Management and Sharing, WHO
Caren Serra Bavaresco, Student, Epidemiology, Universidade Federal do Rio Grande do Sul, Brazil
Karl Brown, Associate Director, Rockefeller Foundation
Arul Chib, Assistant Professor, Wee Kim Wee School of Communication, and Assistant Director, Singapore Internet Research Center, Nanyang Technological University
Dziedzom Komi de Souza, Ph.D. Student and Research Assistant, Parasitology, Noguchi Memorial Institute for Medical Research, Ghana
Bastiaan Hoefman, co-Founder, Text2Change
Bernardita Labarca, Project Coordinator, Zoltner Consulting Group, Chile
Claire O’Neill, Chairperson, Cell-Life-South Africa
Ravi Ram, Head, Monitoring & Evaluation, African Medical Research and Research Foundation (AMREF), Nairobi Kenya
Marco Salmen, OHR-GMCP Initiative for HIV/AIDS, Global Micro-Clinic Project, United States
Jaspal S. Sandhu, Design Researcher, College of Engineering, University of California, Berkeley, USA
Joel Selanikio, co-Founder and Director, Datadyne.org, USA
Garance Upham, General Secretary, Direction, Safe Observer International, France

Coordinators/Facilitators:

  • Patricia Mechael, mHealth and Telemedicine Advisor, Millennium Villages Project, Earth Institute, Columbia University, USA & Egypt (organizer & facilitator)
  • Tim Hurson, Facilitators Without Borders (facilitator)
  • Charles Gardner, Global Forum for Health Research (focal point)

Speakers (alphabetical order):

  • Simon Adebola, NEPAD Council Global Health Commission, Geneva
  • Najeeb al-Shorbaji, Director, Knowledge Management and Sharing, WHO
  • Caren Serra Bavaresco, Student, Epidemiology, Universidade Federal do Rio Grande do Sul, Brazil
  • Karl Brown, Associate Director, Rockefeller Foundation
  • Arul Chib, Assistant Professor, Wee Kim Wee School of Communication, and Assistant Director, Singapore Internet Research Center, Nanyang Technological University
  • Dziedzom Komi de Souza, Ph.D. Student and Research Assistant, Parasitology, Noguchi Memorial Institute for Medical Research, Ghana
  • Bastiaan Hoefman, co-Founder, Text2Change
  • Bernardita Labarca, Project Coordinator, Zoltner Consulting Group, Chile
  • Claire O’Neill, Chairperson, Cell-Life-South Africa
  • Ravi Ram, Head, Monitoring & Evaluation, African Medical Research and Research Foundation (AMREF), Nairobi Kenya
  • Marco Salmen, OHR-GMCP Initiative for HIV/AIDS, Global Micro-Clinic Project, United States
  • Jaspal S. Sandhu, Design Researcher, College of Engineering, University of California, Berkeley, USA
  • Joel Selanikio, co-Founder and Director, Datadyne.org, USA
  • Garance Upham, General Secretary, Direction, Safe Observer International, France

Additional participants – from the audience:

  • Elmer Zelaya – Fundación Chica/Nicaragua
  • Timothy Dye – SUNY Upstate Medical School/USA
  • Jane Kengeya – WHO
  • Oyewale Tomori – Redeemer’s University/Nigeria
  • Lishandu/Zambia (full name/affiliation not available)
  • Vargas/USA (full name/affiliation not available)

Summary:

  1. Diverse users and uses: The speakers presented a variety of mHealth/eHealth applications involving a wide variety of users, including both the health workforce and community members, e.g. educating teenagers about HIV/AIDS in South Africa (O’Neill), Internet access in western Kenya to improve uptake of HIV VCT (Salmen), mobile emergency response systems in Aceh (Chib), electronic IMCI in Tanzania (Brown), text-based health education and health service promotion in Uganda (Hoefman), training for health workers as a downloadable game package for phones in Kenya (Ram), telemedicine to improve the skills of health workers at primary levels in Brazil (Bavaresco), delivery of health information to communities in Chile (Labarca), a general set of tools for mobile data collection being used worldwide (Selanikio), and handheld computers to support rural healthcare delivery in Mongolia (Sandhu).
  2. mHealth/eHealth is about enabling access: A common theme across diverse applications was that information and communication technologies are being used to enable access to health information and services in places where access is difficult because of remoteness and/or cost.
  3. Coordination among the various players: Coordination among donors and projects is necessary to avoid unnecessary duplication of effort and to share what works. This is the role of the mHealth Alliance, supported by Rockefeller Foundation among others (Brown). While there were questions from the program side as to what data donors want (Chib), there was a simultaneous sentiment that donors need “stepwise” guidance (al-Shorbaji).
  4. De-emphasizing technology: The mHealth Alliance has recently been discussing development of an “mHealth Toolkit”, to provide a common technical architecture and platform for those planning to implement mHealth programs (Brown). The existence of free technology platforms – in this case DataDyne’s tool – enables programs to focus on developing health content (Labarca). It is important to have a generalizable tool, as DataDyne has done, that can be used by anyone; if individual governments must approve technology “you’ve lost the battle” (Selanikio). Programs must focus on understanding people and applications more than technology; in response to a question from Dye about the use of ethnography in this field, three examples were given: ethnography of teen chat rooms in South Africa (O’Neill), multi-year ethnographic fieldwork as the basis for the program in western Kenya (Salmen), and design ethnography of the information management practices of rural health workers in Mongolia (Sandhu).
  5. Defining good evaluation: There are challenges to seeing change in population health outcomes (Chib). It is difficult to measure behavior change (Hoefman) and to evaluate systems that provide health content to people (Labarca). Ethnography should be considered more seriously as a complementary evaluation strategy in mHealth (Sandhu). In evaluation, the metrics should match the intervention – mHealth is another intervention; in addition, we want to see the unintended effects of technology (Ram).
  6. New modalities of engaging people: Mobile phones enable fundamentally new ways of engaging with people. As opposed to mass communication that is often used in social marketing, phones allow for interpersonal communication that can be tailored and cost-effective (O’Neill). There are two modalities, moving messages out to people and demand-driven services, where people demand the information that they need (Ram). Salmen lent his support to the importance of demand-driven services and argued that phones will bring more equity. This is all supporting the shift to citizen-centered healthcare (Mechael).
  7. Cautions moving forward: In natural disasters, the cellular network is the first to go (Zelaya). An open question: Who owns the data? (al-Shorbaji). Nobody is thinking about “real sustainability” (Adebola). Reliable phone networks are a challenge (Lishandu). We should be careful that we don’t become too dependent on one tool (al-Shorbaji).
  8. Need to think more creatively: We should be bolder with approaches; if we are, poor countries “could leapfrog” in health and development terms (Upham). Many of the applications discussed focused on SMS and telephony capabilities; we should think about leveraging more advanced capabilities of mobile phones (Kengeya).
  9. Who should design technology? There is an assumption that Africans cannot develop software, but that is not true (Adebola). DataDyne software was already developed by Africans (Selanikio). Africans should develop software, but they shouldn’t redesign what has already been built (Brown).

Conclusions/Recommendations:

  1. There is a need for increased knowledge-sharing about mHealth/eHealth within the global health community. This should definitely include policymakers. As Prof. Tomori elegantly stated, while we are thinking about how to reach remote populations, we should think about “hard-to-reach” African leaders.
  2. While there was discussion of both eHealth and mHealth, the discussion focused primarily on the latter.
  3. There is a need for a continuing dialogue about mHealth. It is unrealistic to expect policy recommendations to come out of this meeting given the state of the field (many open issues) and the limited engagement at the meeting.
  4. Major mHealth topics to be discussed at future meetings: definitions; standards, including how to conduct evaluation; and successes and failures from the field.
  5. The value of the meeting was threefold: (1) it helped extend the network of those working in mHealth; (2) it provided those outside the field with an understanding of the opportunities and challenges of using mobile phones to improve population health; and (3) it placed a much-needed emphasis on prioritizing people and applications over technology.
  6. Mechael suggested reviving the Mobile Metrics and Evaluation Group as a means of maintaining an active mHealth community discussion outside of official meetings.

Other observations:

  1. The fishbowl format was successful in eliciting relevant commentary from a large group of speakers as well as from the audience. Time was an issue, though, as several invited speakers only spoke once and several audience members had comments or questions that they were unable to share.
  2. One key issue that was not explored – as I stated at the end of the session – was the link between social entrepreneurship and mHealth. This is especially relevant to issues of demand, incentivization, and sustainability.
  3. There is a need for an ongoing discussion of these issues at Forum 2010 and beyond – while the conversation will continue in other settings, the Global Forum for Health Research should continue to be involved because of its systems focus, its emphasis on actionable research, and the unique mix of parties (policymakers, donors, implementers) it brings together.
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Accountability, AIDS and Africa – Stop the Stockouts, Financial Oversight (BEMF)

Posted by | Posted in Access to Health, Finance, Food for thought, Global Health, Government, HIV/AIDS, Health Systems, ICT, Infectious Diseases, Innovation, Malaria, Mapping, Mobile Phones, Pharmaceuticals, Research, Supply Chain, TB | Posted on 24-09-2009

In my work in the field, I am no longer surprised to see test stockouts, essential medicines stockouts, supply stockouts, broken or missing diagnostic machines, or patients who are afraid of healthcare workers. It is a complete tragedy, and as I work to help, I think of all the people who are sick or die because of failures of the healthcare system, who cannot tell anyone their stories. For those who do not work in the health system, or haven’t had an experience of health system failure, transparency and data on implementation is practically invisible – so there’s no public awareness of the issues.

So I was thrilled to see recent developments in accountability – the Stop the Stockouts campaign, and the creation of the Budget and Expenditure Monitoring Forum in South Africa.

Power to the People: Stop the Stockouts

Stop the Stock-outs , a multi-country Africa campaign, is using text messages sent by activists and members of the public to expose stock-outs of essential medicines at public health facilities and put pressure on governments to address the issue. It was launched in Kenya, Uganda, Malawi and Zambia by Health Action International (HAI) Africa. During Pill Check week in June, facilities were surveyed, and a map of stockouts was created. The image below incorporates July 2009 data. It was found that many government health facilities were routinely running out of, or just not stocking essential medicines to treat common diseases such as malaria, pneumonia, diarrhoea, HIV and tuberculosis (TB).

“We were finding availability levels in rural, lower-level health facilities of 40 or 50 percent for essential medicines,” said Christa Cepuch, a pharmacist at HAI Africa. Read more from IRIN here

intromap

Show me the Money: HIV Policy AND the Budget and Expenditure Monitoring Forum in South Africa

With a new government in South Africa as of May, there have been some very positive signs. Read the rest of this entry »

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Global Health Council (GHC36): Vouchers work, but there will be challenges

Posted by | Posted in Access to Health, Conferences, Design, Finance, Franchise, Global Health, Government, Health Systems, ICT, Infrastructure, Innovation, Leadership & Management, Malaria, Maternal and Child Health, Population & Reproductive Health, Private Sector, Public Private Partnerships, Research, Social Entrepreneurship, Transportation, Trends | Posted on 27-05-2009

As with the last post, I’m copying the description of the session I just attended – Vouchers for Health (Session C3) - from the conference website:

Presenters Discuss: the potential of competitive vouchers in increasing access to priority services for currently underserved populations (Nicaragua); how subsidized, targeted vouchers can achieve the goal of improving health of poor women and children, elements that improve access to high quality health care services, how targeted voucher subsidies help meet the goal of contributing to development of a national social health insurance system that is accessible, affordable and acceptable (Kenya); a nationwide, high transaction distribution project for insecticide treated nets (ITNs) that has given rise to the application of technologies in the use of a relational database as a means to track each voucher transaction, ensuring security and traceability, providing spatial analysis using GPS coordinates, leveraging data from this project to others by providing a central data repository to government, and exploring SMS and mobile phones for automating voucher transactions and gathering patient information (Tanzania); and how poor pregnant women were selected for vouchers jointly by field workers and community support group members, how the institutionalization process for the voucher scheme was implemented, and how the health facilities were strengthened to provide quality maternal health care (Bangladesh).

Why should we care about voucher schemes? Three reasons from where I sit. These schemes provide:

  1. An attractive model for extending the reach of services without significant infrastructural investment
  2. Incentives for competition to improve the quality of service delivery
  3. A mechanism for reducing financial barriers for the poor

Despite this promise, my experience over the last few years – including stumbling through a poster presentation about vouchers in Uganda for Ben at APHA in Boston a couple years back – has taught me that the concept tends to be elusive to “outsiders”. The World Bank’s Private Sector Development Blog has a concise overview of output-based aid for those that aren’t familiar. I won’t try to explain myself, since I’ll probably make some errors.

This session brought together diversity in geography – the talks covered Latin America, Africa, and Asia - and in services – anti-malarial bednets, safe motherhood, family planning, STI prevention and treatment. What was most interesting to me then was not the details of any specific program, but what we might be able to learn from having these different experts in the same room.

So what were the common themes?

  1. Vouchers work. Nicaragua saw increases in service utilization, condom utilization, family planning uptake, and KAP. Much of this across different subgroup analyses – age, level of sexual activity, type of residence. The others similarly all saw positive gains in what they were trying to achieve.
  2. Institutions matter. In Tanzania, the market is being flooded with free ITNs (possibly LLINs) under a new policy to achieve universal coverage – the fate of the 7000 bednet retailers under the Tanzania National Voucher Scheme (TNVS) is unknown. In Kenya, Nairobi and Kiambu saw better results for the voucher scheme because of existing infrastructure. Nairobi actually had provided more voucher-based services than vouchers sold in Nairobi because of women coming in from outlying areas. Tanzania benefits from a manufacturing base that can produce ITNs and a system that encourages people to pay for a portion of their health care.
  3. The system will be gamed. The much higher reimbursement for providers of C-sections than vaginal deliveries has led in some cases to higher rates of C-sections than is necessary. April Harding who was moderating said that multiple schemes have been used/proposed for dealing with this, including capitation (e.g. for 100 women, X% will be reimbursed for C-sections). Fraud is also a problem. While nobody discussed incidences of counterfeiting, the Tanzania program has taken big steps to prevent counterfeiting, including watermarks, microprinting, and a bar code. The bigger issue with fraud is related to ineligible participants obtaining and using vouchers intended for other populations, whether by income or geography. Which leads us to the next point…
  4. Equitable distribution is hard. Ineligible participants seem to be a problem with all these programs. In Bangladesh they responded by bypassing governmental decisions about who would get vouchers and relied on CSGs (community support groups) to make the decisions. Another trend is that those who are more poor tend to utilize vouchers less – it is unclear if this due to cost, education, and interaction among the two, or something we’re not thinking about.
  5. Understanding redemption is complicated. This was my one question. In both Tanzania and Kenya – the others didn’t present these numbers or I didn’t catch them - the rate of redemption (number of people receiving services under the voucher scheme divided by the total number of vouchers distributed) – was around 80%. After I asked the question and before the panelists responded, my neighbors said that: (1) 80% is pretty good, and (2) the Tanzanians unlike the Kenyans don’t pay for their vouchers until they use them. In Tanzania then, the reasons are grounded speculations: perceived value of the ITNs, access, cost. In Kenya, the majority of the outstanding 20% is due to accounting. The real utilization is expected to be much higher since the cutoff for the evaluation excluded women who had received vouchers, but had not yet delivered (safe motherhood program). Still a minor portion of this is due to women who are unable to deliver at contracted facilities due to a lack of transportation or the timing of the pregnancy.
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R&D Funding for Global Health Diseases

Posted by | Posted in Access to Health, Chronic Disease, Finance, Food for thought, Global Health, HIV/AIDS, Infectious Diseases, Malaria, Philanthropy | Posted on 18-02-2009

1. HIV/AIDS, TB, Malaria Account for 80% of Disease Funding in Developing Countries, Report Says
2. More funds needed for lesser known tropical diseases, Link

The above two headlines on global health funding flows and allocation caught my attention. The original study was published in PLoS Medicine. The article has some great figures (some of which I have reproduced below). A few things immediately stick out – the amount concentrated on HIV/AIDS, TB and malaria is astounding. Second the US is providing 70% of the funding and on the surface one could argue that other countries really could be pitching in more. On that note, the Gates Foundation by itself is out funding the European Commission almost 4 to 1 – if that isn’t embarrassing I don’t know what is. Finally, the US Department of Defense is high on the list (surpassing USAID). Interesting stuff:

“HIV/AIDS, tuberculosis and malaria initiatives accounted for about 80% of the $2.5 billion that was spent on research and drug development for developing countries in 2007… However, pneumonia and diarrheal illness, which are two major causes of mortality in developing countries, received less than 6% of funding.”
gh_fundingflows

gh_fund2

Original Sources:

  • PLoS Medicine – Neglected Disease Research and Development: How Much Are We Really Spending? Link
  • WHO Top 10 Causes of Death, Link
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Google Flu Trends for developing countries?

Posted by | Posted in Global Health, ICT, Infectious Diseases, Innovation, Malaria, Mobile Phones, Non Profit, Private Sector, Public Private Partnerships, Research, Stats, Trends | Posted on 14-11-2008

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.

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Beijing Olympic Cause Marketing & Global Health Ads

Posted by | Posted in Access to Health, Cause marketing, China, Chronic Disease, Global Health, Innovation, Malaria, Media, Medical Devices | Posted on 23-08-2008

We previously mentioned the malaria ad sponsored by ExxonMobil during the Olympics. I have seen this several times now during coverage and said in the original post:

“with regard to ExxonMobil’s commercial on Malaria during prime time, when over 1 Billion people were watching, this might have been the largest audience ever for a global health ad.”

I realized after I said this that I probably made a major miscalculation. The NBC channel broadcast I have been watching is only produced for an American audience. The top estimates I have seen for viewership at a given time hit 66 million people. So while Exxon may have had their ad broadcast across countries and major national networks, it is likely that somewhere between tens and hundreds of millions of people saw their commercial – which is still an impressive number. Thanks to Responsible China I found the youtube version of this ad, which is below. In addition I have also seen GE’s portable re-designed low cost EKG machine advertised several times as well. Despite what you may think about these companies it is better than nothing to see MNC’s promoting social causes. We blogged about the EKG machine previously and the commercial is the first one below, followed by the malaria ad. For another check, definitely check out ResponsibleChina.

[youtube=http://www.youtube.com/watch?v=yB47wx-b6sY]

[youtube=http://www.youtube.com/watch?v=s7qVlbG1i7A]

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Mosquirix – Promising New Vaccine for Global Health?

Posted by | Posted in Global Health, Infectious Diseases, Innovation, Malaria, Research, Vaccine | Posted on 16-07-2008

More than 12 years (let that time horizon sink in) after the first indications of success,  there will be a large scale trial for a new malaria vaccine. The potential global health implications of this are obvious, read the full news article, it has some good tidbits in it:

“With the exception of Mosquirix, there’s no possibility of one coming on the market within five or six years…It took eight more years of development and testing before scientists were ready to conduct a large-scale trial of the vaccine. London-based Glaxo and its partners will begin a $100 million study of Mosquirix later this year, vaccinating 16,000 children in seven African countries. If the results are positive, the drug could be on the market as soon as 2011, making it the first vaccine against the deadly disease. “

Full article at Bloomberg (here).  Hat tip to  Families USA.

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One Net One Pill One Life

Posted by | Posted in Access to Health, Cause marketing, Global Health, Malaria, Media, Public Private Partnerships | Posted on 09-04-2008

These were the words of Forest Whitaker (academy award winner for his leading role in The Last King of Scotland) on tonight’s inspired 2nd annual two and half hour Idol Gives Back show which raised funds for six causes. Forest was the ambassador for Malaria No More, and definitely gave an emotional appeal for people to call in and donate money.

Earlier today I was lucky enough to be on a conference call with the medical director (Steven Phillips) for ExxonMobil’s foundation which is a major supporter and funder of the malaria component of tonight’s American Idol show. Phillips traveled to Angola twice this year, once with American Idol contestants and winners and the second time with Forest Whitaker to get them involved in combating malaria. I was joined on the call by Bill Brieger, professor at Hopkins and an expert in malaria, definitely check out his blog – Malaria Matters. Rob Katz of NextBillion and the Acumen Fund fame was the other “blogger” on the call.

According to Phillips, ExxonMobil teamed up with American Idol because they are the most watched TV show with over 30 million viewers and because their first experimental show last year was a huge hit. Exxon is reaching out to of course let their work be known and also because he feels that “one of major issues with malaria is that it (malaria) had historically been among one of most neglected diseases.” Their funding breakdown is: 25% for advocacy, 10% for R&D (e.g partnerships with MVI, MMV, others), and 65% for disease control (goes to African NGOs or iNGOs).

The Idol show had a blockbuster lineup, some of the celebs included: Bono, Alicia Keys, Heart, Brad Pitt, Robin Williams (who was beyond awful), Gloria Estefan, Mariah Carey, Celine Dion and many others. One of the highlights was Gordon Brown, prime minister of the UK, making an appearance to announce the equivalent of $200 million in funding for bednets. The three presidential candidates were also supposed to make an appearance, but perhaps this got cut. For a great recap of the show check out Kristin’s post.

Last year the show raised $76 million, it will be interesting to see what happens after tonight. Despite various criticisms and those much more cynical than I, credit has to be given to all the corporate sponsors for reaching out… I’ll post more on this if I get a chance this weekend.

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Back in the Saddle – Happy New Year Link Drop

Posted by | Posted in Access to Health, Finance, Food for thought, Global Health, Malaria, Microfinance, Pharmaceuticals, Private Sector, Social Entrepreneurship | Posted on 13-01-2008

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.

Miscellaneous
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 – http://www.ifc.org/HealthinAfrica

*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.

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