NB Health Care

Saturday
August 8
2015

NextBillion Editor

Weekly Roundup – 8/8/15: A solution to a perennial global health problem – and all the world’s other ills! – highlight this week in development

It was a particularly intriguing week in global development – and maybe even a historic one. In this roundup, we run down the breakthroughs, battles and thought-provoking viewpoints that have crossed our computer screens in recent days. (And we think we’ve settled on a workable format for these posts – we hope you agree.)

An actual game-changer in global health

The news: In a stunning development this week, the world’s first malaria vaccine has been approved for use in sub-Saharan Africa.

The backstory was almost as extraordinary: The pharmaceutical firm GlaxoSmithKline (GSK) that made the vaccine has been working on it for 30 years. The discovery resulted from a collaboration with the PATH Malaria Vaccine Initiative, with funding from the Bill & Melinda Gates Foundation and a “booster” made by U.S. biotech company Agenus. And – get this – Mosquirix (the vaccine’s cool name) will be made available on a nonprofit basis.

It has been argued that malaria has killed more than half the people who ever lived. While that’s debatable, this is not: Malaria claimed 584,000 lives in 2013, most of them children in sub-Saharan Africa. It’s an overused term in global development, but the vaccine, which was approved by the European Medicines Agency and will now be considered by the World Health Organization, could be a legitimate game-changer.

Our take: You’ve probably heard the canard that for-profit drug companies won’t invest R&D money in diseases that affect the world’s poorest people, because there’s little financial upside. Well, this vaccine makes that concept seem even more outdated. Our market dynamics initiative here at NextBillion is all about finding health care solutions and getting them in the hands of those who need them. There’s a lot of innovation going on worldwide on that front and Mosquirix proves it.

Kyle Poplin

Over-promise, under-deliver?

The news: This week, after over two years of negotiations, the U.N. announced that its 193 member states have unanimously agreed on new Sustainable Development Goals (SDGs). The agenda includes 17 goals that member nations aspire to reach by 2030, and picks up where the reasonably successful – and soon to expire – Millennium Development Goals (MDGs) have left off. “This is the people’s agenda, a plan of action for ending poverty in all its dimensions, irreversibly, everywhere, and leaving no one behind,” said U.N. Secretary General Ban Ki-moon after the agenda was finalized on Sunday.

If you think that sounds ambitious, you’re right. Rather than focusing mainly on improving a few specific issues among the poorest and most disadvantaged populations like the MDGs, the SDGs have drawn some criticism for taking a universal, maximalist approach. For instance, among other things, they propose to “end poverty in all its forms everywhere” and “end all forms of discrimination against all women and girls everywhere.” The price tag is equally immodest. Though some U.N. officials were reluctant to go into specifics, one of the co-facilitators of the intergovernmental consultative process told reporters on Monday that the agenda could cost from $3.5 trillion to $5 trillion per year. Officials emphasized that this money would come mainly from public and private domestic resources mobilized by each separate country – not from the U.N. itself – and that the business sector would need to get on board.

Our take: Look, nobody really thinks all (or perhaps any) of these goals will be fully achieved in 15 years. And with runaway climate change, a projected 1 billion-plus population increase and politicians in some key member countries opposed to the very concept of international action, we may be lucky if the world’s not a Mad Max-style hellscape by 2030. But I still find something admirable – and stubbornly hopeful – about attempts to shoot for the moon. Is the new set of goals utopian? Sure. But people said the same thing about the MDGs, and some of them were achieved. The same thing is likely to happen with the SDGs: modest success in some areas, frustrating failure in others – and maybe a few surprise breakthroughs along the way. In any case, more subdued phrasing at the U.N. isn’t likely to make a difference one way or the other – though more involvement from the business community clearly would.

James Militzer

M-PESA dodges a bullet – for now

The news: The sighs of relief from Safaricom’s boardroom must have been audible for miles, as this week saw Kenya’s attorney general delay proposed regulations in Parliament that could have declared the mobile network operator (MNO) an anti-competitive monopoly. The regulations would apply to MNOs with more than a 50 percent market share – which Safaricom has – and could potentially force the company to spin off M-PESA, its market-leading mobile money product (and cash cow), as an independent entity.

Unsurprisingly, the regulations were enthusiastically backed by Airtel, Kenya’s second largest MNO, which has long complained about Safaricom’s anti-competitive practices – and which recently launched (in collaboration with Equity Bank) a mobile money product of its own. As the long-delayed Airtel/Equity vs. Safaricom showdown begins in earnest, an assist from the regulator could be decisive. And it may still happen: The attorney general instructed Parliament to withdraw the proposed regulations and subject them to more discussion, so there’s still a possibility that they may be reintroduced later. In the meantime, both sides continue to plead their cases, with Safaricom CEO (and newly minted Acumen board member) Bob Collymore maintaining that his company earned its dominant position – and needs to keep it to fend off competition from outside Kenya. “It’s the foreign firms that want to break a national company,” he argued. “We are actually fighting bigger multinationals such as Microsoft and Google that are making entry into the market.”

Our take: In light of its long (and ultimately unsuccessful) legal and political battle to keep Airtel and Equity’s mobile money product off the market, Safaricom can hardly complain about other mobile money players using government regulators to gain a competitive edge. But with Airtel and Equity’s strong challenge to M-PESA finally a reality – and apparently gaining traction – I’m hoping regulators hold their fire long enough to see how things play out on the battlefield.

James Militzer

There’s not an app for that …

The news: It wasn’t news, as such, but it was certainly worth a bit of thought when Melinda Gates wrote a piece for The Economist entitled, “If Every Woman Has a Smartphone: Imagine All the Empowered People.”

Her point was that if all women everywhere had a smartphone, it would “help shatter their isolation and unleash their powers like never before.” She cited the implications it could have for health care, farming and banking in the developing world.

Last year, she said, more than 1 billion smartphones were sold worldwide, but they’re still not everywhere. Plus, men are more likely to own them than women, and there are limitations related to illiteracy, connectivity and data costs. But she certainly got us thinking …

Our take: The world’s entrepreneurs should pause their thinking about what’s available to people via smartphones and start thinking more about making smartphones available to people. There’s not an app gap, there’s a phone gap. (Consider Uganda, which was inundated with so many mHealth initiatives that it famously placed a moratorium on them, despite having only one doctor for every 25,000 people.) On a related note, we’re aware that Google and Facebook are already on the connectivity case, but wouldn’t it be more productive – and competitive – if the Internet providers serving the developing world were actually based in the countries they were serving?

Kyle Poplin

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