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

Three of the eight Millennium Development Goals focus specifically on improving the health of the world’s poor, but improving healthcare is critical if any of the goals are to be achieved. Much of the medical equipment produced for rich countries is too expensive for use in rural developing areas, despite the need for improved care. Tackling this contradiction are several initiatives that are reinventing medical devices and procedures with the needs and resources of poor countries in mind.

Disease Detection

Recognizing that conventional laboratory diagnosis of diseases can be prohibitively expensive in developing countries, San Francisco-based Sustainable Sciences Institute (SSI) is helping public health workers in poor areas take advantage of the latest advances in molecular and biological technology. The group has demonstrated how – with a basic knowledge of the processes – DNA, blood and urine analysis can be done without expensive equipment for one-hundredth the cost of traditional methods.

With support from the Acumen Fund, SSI is also testing a portable disease detection device capable of diagnosing major illnesses such as dengue fever, HIV, malaria, and measles in the field, for one-third the cost of existing technologies. Other companies are also producing equipment designed to rapidly and accurately make diagnosis in the field. In India, for example, the TeNeT Group at the IIT Madras and Neurosynaptic have developed an affordable telemedicine solution which includes a Remote Diagnostic Kit. The device incorporates an electronic stethoscope, and can conduct physiology tests including temperature and blood pressure measurements, and ECG. Designed to be installed in remote locations which have Internet connectivity, the benefits are further enhanced by connecting the doctor and patient to one another via a low-bandwidth video conferencing link. The use of such devices also allows for the early detection and prevention of potential disease epidemics that originate in rural areas.

Neonatal Care

Freeplay is expanding beyond just wind-up radios and torches. The company has teamed up with a group of doctors at University College London to redesign four pieces of standard neonatal-care medical equipment to better suit developing country environments. The portable hand-powered devices include: a pulse oximeter to measure levels of oxygen in the blood, a syringe driver for delivering small amounts of fluid and drugs in tightly timed doses, a micro-centrifuge, and a hand-held fetal heart monitor. Several prototypes of each apparatus are now being tested in hospitals in South Africa.

Water

According to the UN, 1.3 billion people already lack access to “safe” drinking water, and with global consumption of water currently doubling every 20 years, 48 countries are expected to face chronic water shortages by 2025. In developing countries, this means higher prices for clean water, and as a result, higher rates of diarrhea and other illnesses; at any one time, it is estimated that half of the world’s hospital beds are occupied by patients suffering from water-borne diseases.

One company, KX industries, has recognized the growing need, and seized upon the market opportunity by developing a nanotech microbiological water filter specifically for emerging market economies. The gravity-flow device known as the “World Filter” is expected to cost as little as $6, and removes chemicals, bacteria, and viruses to provide clean and safe water for an entire family for only $ .02 / day. To keep costs low and quickly scale their operations, the US-based company is establishing local partnerships for both manufacturing and distribution, using a model similar to the beverage bottling industry. While other competing technologies do exist – such as ceramic or reverse osmosis filtration – the KX filter is the least expensive, due partially to the fact that it was developed explicitly for BOP markets.

Disabilities

In developing countries, where social safety nets are limited or non-existent, being born with or acquiring a disability often relegates a person to a life as a beggar, and prevents them from living up to their full potential. Several initiatives are combating this inevitability by developing low-cost technologies aimed at helping the even the poorest overcome their disabilities and live a productive life.

The Affordable Hearing Aid Project (AHAP) in India is alleviating the burden of hearing impairment for the poor through its innovative digitally programmable analog hearing aid named Impact 1. Designed to minimize component cost, the device wholesales for as little as 1/12th the price of comparable models in the US. Through a multi-tiered pricing model, the device retails according to the patient’s ability to pay, where profits from wealthier customers are used to offset losses from poorer ones. The project has further reduced costs and maximized benefits by distributing the Impact 1 through socially franchised partnerships with other non-profit organizations already working in the fields of health care, disability, and hearing impairment.

Comcare International is also producing a hearing aid aimed at the BOP. The solar-powered device has an extremely strong case that seals the internal parts from dirt and moisture, an easy to use rotary volume switch, and larger, more reliable and less expensive components. Distribution is accomplished through onsite clinics.

Also developed in India, the Jaipur Foot is a cheap, durable prosthetic foot for amputees, whose lightness and mobility allows the user to run, climb trees and pedal bicycles. The device costs only $30, compared with several thousand dollars for a similar device in the US. The prosthetics are primarily fabricated and fitted by the NGO BMVSS, which annually provides fittings to 16,000 people and services another 44,000 through seven centers within the country. BMVSS is expanding the reach of Jaipur Foot by organizing mobile camps throughout India and in 19 other countries abroad, where a temporary facility is set up to fit and manufacture the prosthetics on site.