NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

I had the good fortune to attend the conference “Mobilizing the Private Sector for Global Health Development,” organized by the McLaughlin-Rotman Centre, Program on Life Sciences and Global Health at the University of Toronto, from May 2-4.

The food was really good. The conference was a seamless execution of mass organization. And, even though the majority of attendees were from biotech and pharma R&D companies, many speakers addressed questions that are central to health discussions on NextBillion.

Multiple components of healthy living; Return on Effort (ROE)

Professor CK Prahalad opened the event as keynote speaker and presented a schema of the several resources that must be available for people to enjoy good health:

1. Clean water
2. Hygiene products (soap, bednets, etc.)
3. Fortified foods
4. Vaccines, other preventatives
5. Medications and treatment
6. Long-term care (AIDS, diabetes, etc.)

The availability of each resource depends on the existence of certain services and infrastructure, though some infrastructure could clearly serve multiple purposes.

#1-3 (clean water, hygiene products, and fortified foods) require that there are adequate product and health education delivery channels.

#4 (vaccines, preventatives) requires physical infrastructure and a skilled workforce.

#5-6 (medications; long-term care) may require insurance.

Prahalad asked the audience which of these resources would yield greatest “return on effort” and investment. He left the question open, but I assume #1-4 are the answer. It’s much less expensive to prevent than treat illness.

On the last day of the conference, Dr. Keith Martin, a Member of the Canadian Parliament, again raised the importance of looking at the many necessary components that go into good health. He wondered what good it would be to get medication to the poor if they did not have clean water with which to drink it.

A more holistic approach to good health underlies a project that I and others in my team are assisting–Living Goods. This project could potentially deliver or at least facilitate the delivery of all 6 resources discussed by Prahalad. Living Goods will undoubtedly get its own blog posts as the project advances. For a preview of things to come, its website is definitely worth a visit. (By the bye, if you have suggestions on market-ready products that Living Goods could carry–water filters, solar/hand-crank lanterns, etc.–please do contact me or leave a comment on this blog.)

Market opportunities and business models

Carol Dahl, Director of Global Health Program at the Gates Foundation, ended her presentation by asking, “Are there new business models [which could deliver healthcare to the poor]? Are there markets we’re not tapping simply because we’re not working hard enough?” I, of course, felt compelled to follow up with Carol and give her a copy of The Next 4 Billion. That addresses the second question and the first to some extent.

Speaking of new business models, I learned of Abhay Clinics in India through a presentation and interview given by Mr. Balasubramaniam, Director of Indian Immunologicals, based in Hyderabad. Abhay Clinics really deserves its own blog post. It’s a franchise chain of about 2,000 doctor-owned rural clinics and delivers rabies and other vaccines to tens of thousands every month. Wow–there’s some scale for ya! AND, the franchise operation is for-profit and fully profitable. More on Abhay later.

Subsidies/health financing

In my conversations with Dr. Eddie Addai, a Director of the Ghana Ministry of Health, and William Warshauer, VP at Population Services International, the subsidy question came up. Dr. Addai believes the $158 billion figure cited in The Next 4 Billion as the size of BOP health spending could be supplemented by government and donor spending on healthcare for the BOP. That is, private sector delivery models could potentially tap into a market much larger than $158 billion given proper subsidization mechanisms. Microinsurance and output-based aid voucher systems seem ripe with potential.

Telemedicine

Remote diagnostics, the use of mobile technology, medical imagery, etc. were mentioned in passing by a few speakers. Dr. Prahalad believes telemedicine will perhaps be the only way to deliver world-class healthcare to rural communities.

The conference portended of exciting biotechnology innovations to come in the global health space. I saw presentations on respirable powder vaccines, cheap lab card diagnostics, malaria vaccines, nasally administered antiretroviral drugs, and other projects under development with the potential to improve millions of lives.? Hopefully we’ll soon see these products being distributed through the business models we profile and analyze on NextBillion.