This post is courtesy of the Time Global Health Blog where they point out that it is about time we have some focus on solutions. Of course we whole heartedly agree that we need to start documenting these projects and sharing ideas:

From VOA: “A new report finds the health of people in Africa is worse than in any other part of the world. But, the report by the World Health Organization also presents a number of success stories that show Africa can tackle its own health problems. This report, for the first time, focuses on the health of the 738 million people living in 46 countries in the African region.” Read the rest of the story at VOA and you can view the full WHO report on their website.

Today Business Week profiled the Acumen Fund and their focus on developing country solutions. The Acumen Fund (based in New York City) is an interesting organization, they are “a non-profit global venture fund that uses entrepreneurial approaches to solve the problems of global poverty”.

Below an advisor to the Acumen Fund says that the charitable money is there, but the solutions are not. I would have to disagree with such a stark statement. The money making solutions may not be there, but the solutions to some major global health problems are certainly there. Not every solution will be sustainable on its own, there are some problems that will need to be funded outright until a particular problem is eradicated or alleviated. I definitely applaud Acumen’s overall approach and their ability to raise capital make a robust attempt to find innovative projects, but let’s be clear about what type of solutions they are pursing – those with a financial return on investment. This is a great thing, but it is a mistake to send the message that solutions are not there. I highly recommend you read this article.

From Business Week, November 10, 2006:
By Jessi Hempel: “Acumen is a leader in the fast-emerging hybrid sector that straddles private industry and nonprofits. Technically a nonprofit, it invests in enterprises in developing countries with the strategy and discipline of a Silicon Valley venture-capital firm. Acumen’s founder is Jacqueline Novogratz, a former banker with an infectious magnetism…Under her leadership, the fund manages $20 million in investments that fall within three portfolios: health, water, and housing. But Acumen’s goal is far larger than successful companies. Says Novogratz: “We’re creating an overall design for how you provide goods and services to poor people.”

“There’s growing interest among investors eager to fund for-profit businesses that have both social and economic impact. Rather, there’s a paucity of creative ideas. “It’s all about innovation,” says CEO Tim Brown of Ideo, who advises Acumen. “The money is there, but the solutions aren’t.”

“Acumen uses classic consumer-focused design methods to solve the problems of poverty…Acumen’s portfolio companies create from the bottom up…”Start with the individual,” says Novogratz. “Build systems from their perspective. Really pay attention, and then see if they can scale.” Plenty of nonprofits have embraced the term “venture philanthropy” in recent years. But while most aspire to new forms of grantmaking, Acumen eschews giving money away. Instead, it buys equity in companies and offers them loans. It made a $600,000 investment in WaterHealth International, which will help the startup expand its franchise model for delivering safe, affordable water to Indian customers.” FULL STORY.

From the Business Week article here are couple of more excerpts from their photo essay on the A to Z anti-malarial bed net solution, the full slide show is availabe at the beginning of the article:

Acumen’s most successful company to date is A to Z bednet factory in Tanzania, which makes inexpensive mosquito nets that protect people from malaria. This fall, A to Z will make its final payment on a $325 million loan. Acumen’s investment allowed A to Z to introduce a new kind of anti-malarial bed net that originated from Japanese company Sumitomo Chemical. This net is impregnated with a long-lasting insecticide that lasts for up to five years. A to Z also has found a cheaper way to weave the bed net. This will bring down the cost of production to $5 from $7.

Increasing Production, Creating Jobs: By the end of 2006, A to Z’s bed net production will ramp up to 7 million per year. The nets are currently protecting more than 5 million people in Tanzania. And 2,000 jobs have been created, primarily for women. Right now, most of the nets are purchased by UNICEF and distributed as a part of their aid efforts. Acumen is working with A to Z to distribute the nets through women sales agents, who buy them from A to Z and make a commission by selling the nets in their villages.

Thanks to Farzaneh for sending this, it looks like a fantastic film. Another testament to the use of video to spread messages about global development, RSVP IS TODAY – mandy@radioaktivefilm.com:

Dear friends and colleagues,

For those of you who know me personally and/or through my work, you know that I have spent several years working tirelessly on a few documentary film projects about Africa while also committing my NYC time to an innovative youth organization called Urban Word NYC which provides after-school programming for inner city youth writers and poets throughout the five boroughs.

I’m happy and excited to announce that I’m finally blending these two passions with a new film project called MYTH OF THE MOTHERLAND that I have wanted to do for at least four years now. The film will follow ten Urban Word youth on a creative writing journey throughout Africa . For five weeks this summer, we will travel to five different countries as the youth meet with African scholars, writers, musicians and activists, creating poetry and art that will help break stereotypes about Africa and Africans for their American youth peers.

Perhaps an experience I had earlier this week will give you a sense of the impact I believe this project may have. On Monday, I screened Kebba Jobarteh and Nduka Amankulor’s film I directed called “We Will Not Die Like Dogs” profiling four African AIDS activists at a big American public health conference in Boston . The response I received from the Africans in the packed 250-person room solidified my belief that the next generation will have a better understanding of global health, development and the responsibility of the U.S. in world affairs if they are part of the dialogue about it, which is basically the premise of the film. Going to Africa has changed my ideas about the world immensely. Now I want to share it with the incredible and talented young people I have grown to love and respect.

I am attaching an invitation for a special cocktail reception that is occurring next Thursday, November 16th in anticipation of our fundraiser on December 12th in NYC. Hosted by Amanda Ward of Radioaktive Films, this reception is basically a call out to people who have great ideas, great contacts and/or great pocketbooks. I have included you on my personal invite list bc I believe you are at least one of them and understand or “get” what it is I am trying to do using the medium of film as my tool.

So, please come out and support this project. If you do not live in NYC, feel free to forward it to your contacts who may have an interest as well…it will be a very good night for networking and inspiration.

Thank you so much. Hope to see you next week!

Best,
Lisa

Global health tasks can be conceptually divided into research, disease surveillance, health education, and health programs. In much of the developing world populations are quickly connecting to telecommunication networks via mobile phone systems. As new wireless systems come online, there is great potential to expand current global health activities. There are difficulties, however, in building the “last mile” of communications systems. To help bridge that information and communication technology (ICT) divide, USAID has funded engineering research through the Last Mile Initiative. The effort was recently profiled on the Development Gateway.

In the fall of 2005, under the supervision of Principal Investigator, Dr. Michael Best, thirteen students from the Georgia Institute of Technology came together as USAID Last Mile ICT Initiative (LMI) Innovation Fellows. This activity took place within the framework of USAID’s Last Mile Innovation Committee managed by dot-ORG. The students’ job was to provide fresh and dynamic new perspectives into LMI programs in Africa, S.E. Europe, and Latin America. These student research fellows came from every major discipline represented at Georgia Tech, including International Affairs, Computer Science, Industrial Engineering, Engineering Psychology, Mechanical Engineering, and Industrial Design. The results of these activities are contained in a volume titled “Last Mile Initiative Innovations: Research Findings from the Georgia Institute of Technology”

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“A declaration of a war on SARS using a 1960s image”

In the realm of ICT (information and communciation technology) we have a current tendency to focus on the internet and mobile phone technology. Yesterday, while I was at the NIH campus, I was reminded of the powerful use of another form of ICTs – posters and poster advertisements. The NIH has a collection of over 7000 posters documenting public health and Chinese society from 1930s to SARS.

A visiting scholar (Dr. Liping Bu) in charge of this project discusses the importance of tactics for reaching people on a mass scale: “Say you have a public health problem whose scale is vast: a population of 500 million, with 90% living in the countryside, where the literacy rate is 5% and life expectancy is 35 years. Malnutrition is stark. Disease and mortality rates are atrocious – millions of cases of cholera, smallpox, typhoid, malaria, TB and schistosomiasis. Meanwhile, the country is emerging from decades of conflict, foreign invasion and civil war. This was China, 1949…Later in 1965 85-90% of the population lived in rural areas and 80% of health care workers lived in cities. A massive public health campaign was born that included ‘barefoot doctors’…While only 40% of barefoot doctors were women, a female was used as the public image which helped advance the idea of women as workers of equal status with men…the posters have played a key role in educating the public” The NIH poster collection can be found here.

“In 1965, a massive public health campaign used posters touting barefoot doctors”

“Posters have been a powerful force in shaping public opinion because propagandists have long known that visual impressions are extremely strong. People may forget a newspaper article but most remember a picture… The main objective of posters…is to influence attitudes…to alter the consciousness of the public to bring about an improvement in health practices.”- William H. Helfand, National Library of Medicine.

A Berkeley-based NGO, Venture Strategies for Health and Development, is working to win developing countries’ regulatory approval for use of misoprostol in treatment of postpartum hemorrhage. Nigeria and Ethiopia are two early adopters of the technology. The report below underscores the drug’s efficacy in settings where other drugs simply cannot reach. Misoprostol is heat stable, easy to administer, and safe at a wide range of doses.

Ben

Cheap drug to make childbirth safer in poor countries

October 2006, ScidevNet
The abortion drug misoprostol can be used to help save the lives of women who bleed heavily after giving birth, say researchers. The condition is a major killer of women in developing countries.

The results of a clinical trial in rural India published today (6 October) in The Lancet indicate that misoprostol reduced the incidence of postpartum haemorrhage by almost half. Death due to postpartum haemorrhage accounts for almost 30 per cent of maternal deaths in India, where nearly half of all births take place in the home or in facilities without a trained gynaecologist or obstetrician in attendance.

“The researchers showed that giving women misoprostol after birth is a safe, inexpensive means of preventing postpartum haemorrhage from occurring”. “This advance has the potential to save thousands of lives each year.” The researchers say it is “currently the only available pharmacological option for preventing postpartum haemorrhage and reducing postpartum blood loss in these communities”.

A major concern is the potential for the misuse of misoprostol. The drug is available, although illegally, as an over-the-counter pill. Approved for use in India in 2002, it is only supposed to be
taken under medical supervision, yet it is sold in several pharmacies.

Link to full paper in The Lancet
Reference: The Lancet 368, 9543 (2006)

The scope of people engaing today in the global health battle is unprecedented. In this case, pop figures have the potential to have a huge impact on awareness and involvment in global health. Again while this is not a direct innovation or technology I felt it noteworthy enough to include here because Jay Z is focused on solutions to the water crisis. Some of you might not agree with Shawn Carter’s (Jay Z) politics or lyrics, but this will be interesting. Something like this provides free education, free marketing and hopefully increases action. I read about this a couple of months ago, but the MTV piece – The Diary of Jay-Z: Water for Life – will air next month – SPREAD THE WORD!!

“Jay Z will be appearing in a new documentary where the multi-platinum rapper witnesses first hand the impact of the global water crisis.”

A great website by MTV on the water crisis.

“More than one billion people lack access to safe drinking water, according to statistics, and water related diseases are the leading cause of death – constituting 80% of the world’s sicknesses. “

“In the beginning when I was going out on a world tour I was going out to play music in places that I haven’t played. I said to myself ‘I can’t go to these places that I haven’t been and not go out and see the people.’ The people that have been touched by my music for over ten years and the culture, what’s going on in these areas,” Jay told the press. “From that morphed, ‘well I’m not just gon’ go and do rap songs. I wanna touch, and maybe help, and see what I can do in these areas.’ As I start looking around me, looking at things in ways that I can become helpful, starting at the first thing, water. Something as simple as water.”

“I’m very pleased to announce today, a groundbreaking collaboration between the United Nations, MTV, [and] Jay-Z to raise awareness about the world’s water crisis,” Annan offered. “Jay-Z with his enormous influence will inspire young people everywhere to care and join in the search for solutions for our water crisis.” From SOHH…

I did not read the full report and based on the press release I am not sure how “groundbreaking” this study really is. I guess for the time being we will have to take their word for it. Either way its great they have (hopefully) demonstrated an investment case for vaccines and global health:

“WASHINGTON, October 20, 2006 — According to a groundbreaking study released today by BIO Ventures for Global Health (BVGH), a vaccine to prevent tuberculosis presents a significant opportunity for industry investment with a potential global market of US $450 million to nearly $1 billion.

The first study of its kind, Tuberculosis Vaccines: The Case for Investment analyzes the demand for a tuberculosis vaccine and the potential return on industry investment, while demonstrating that a new TB vaccine would have tremendous public health impact.

“Every year, tuberculosis kills more than 2 million people and approximately 8 million new cases develop…TB vaccines could reduce deaths by as much as 62 percent…’This study is a key achievement in the field. BVGH confirms that pursuing solutions to global health challenges is not only good business but a compelling opportunity to save millions of lives…Industry’s expertise is invaluable in our work to make an effective and affordable vaccine for TB a reality. We hope that this study encourages more companies to get involved in the fight against tuberculosis.”

Full story here.

This is a good example of the public banking sector using financial capital schemes to aid global health. Its great to see others invovled because the traditional public health community would not think of this or have access to capital in such a way:

“Six European countries plan to raise up to $1 billion in the international bond markets next week to buy life-saving vaccines for millions of children in the world’s poorest countries…”

Credit for this information goes to the fellow at Pienso, where you can read more.

This recent Wharton newsletter reinforces the power of mobile phones. We can see why mobile phones have had such a large impact on developing countries. Also the application to healthcare/global health has potential:

A good interview with NetCore CEO Rajesh Jain in the “Knowledge @ Wharton” e-newsletter reinforces the relative size of the mobile internet market relative to the PC users.

In India some 10 million people have access to a PC either at home, or at work, or both…That’s only for 10 million people at the top of the digital pyramid. This is the “PC first” segment.

In the middle of the pyramid are 30 million people who access the Internet through cybercafés. The price point today hovers around 15-20 rupees [35-45 U.S. cents] an hour. But you cannot build your digital life around cybercafés… That is where the mobile phone comes in. It is a device that these people have with them all the time — This is the “mobiles first” segment.

At the bottom of the pyramid are about 70 million people who have mobile phones but who have no access to computers, mostly for economic reasons. For them, the mobile phone is their primary device to connect to the world. This segment uses pre-paid mobile services; this is the “mobiles only” segment, and it is growing rapidly.