Friday Think: why syringes should self-destruct

SoloShot syringe is inserted into a vial.

A PATH designed SoloShot™ syringe can only be used once, reducing reuse and possible disease transmission. Photo: PATH/Will Boase.

A brief history of vaccines takes us back over a thousand years ago—when it’s said the Chinese learned to remove matter from smallpox scabs to build immunities of the disease in healthy people via a scratch in their arm.

We live in better days since those rudimentary inoculations. Fast forward to the advent of syringes, and the process for delivering vaccines was made even safer with more predictable results.

So why did the World Health Organization (WHO) put out a call for the world to adopt self-destructing syringes?

A 2014 WHO-sponsored study (using data as recent as 2010) found that the improper use of injections caused an estimated 1.7 million people to be infected with the hepatitis B virus, 315 000 with the hepatitis C virus, and potentially 33 800 with HIV.

Reporter Todd Frankel goes into more detail in a recent Washington Post Wonkblog post about why syringes should self-destruct:

The WHO’s quest began in 1987–just as the spread of a disease called HIV was beginning to cause alarm. At the same time, the widespread switch from glass syringe tubes to plastic ones made reuse even more risky, since glass containers could be disinfected with heat, while plastic melted and warped.

Close up of syringe and cap

The SoloShot™ syringe. Photo: PATH/Glenn Austin.

One place that took up the challenge was Path, [at the time] a small international health technology nonprofit in Seattle. Staff already had begun playing around with different designs two years earlier. They knew they had to make their invention work with existing plastic syringes to keep costs down, said Steve Brooke, the company’s commercialization adviser. …

Path came up with a plastic syringe with a metal clip inside it that locked into place after the plunger was depressed. A syringe manufacturer licensed the product. In 1990, the Soloshot hit the market. Since then, it has been used to deliver more than 6 billion vaccine shots.Friday Think logo

Some of the new “smart” syringes cost nearly twice as much as standard syringes. However, by calling on donors to support the adoption of these devices, it’s anticipated prices will decline as demand eventually increases.

Read this piece in its entirety on the Washington Post Wonkblog.

Each week, we scour the news for the hottest stories on innovation. Our weekly feature, The Friday Think,highlights one we’ve found particularly fascinating.

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My kind of hero: a global health profile

Today’s donor profile of Bob Dickerson was written by Lesley Reed, a PATH staff writer and personal friend of Bob’s.

Bob Dickerson

“I have had a wonderful life, beyond what I ever could have imagined,” says Bob Dickerson, who has survived 15 years of cancer. Photo: Rebecca Sullivan

Bob Dickerson was practicing law in Seattle when he was diagnosed with a slow growing and incurable form of cancer in 1999. His doctors gave him anywhere from 1 to 20 years to live.

So, with his characteristic combination of pragmatism and enthusiasm, Bob launched a new career.

“I chose to assume what they said was true. I quit my job. I wanted to have death without regrets.”

Fifteen years later, it’s clear the man with the big heart, boisterous laugh, and tenacious commitment to children has achieved his goal.

Hero on the House floor

I met Bob three years after his diagnosis. By then, he’d become one of Washington State’s most committed advocates for ending global poverty. He volunteered full-time as the leader of the Seattle chapter of RESULTS, an advocacy organization that helps raise political will and funding for anti-poverty programs, including those that tackle global health.

Ever aware of death nipping at his heels, Bob met with members of Congress and global leaders hundreds of times, pressing them to increase funding to prevent the deaths of children; address HIV, tuberculosis, and malaria; and ensure that everyone has access to education and opportunity. And he inspired people like me, who felt hopeless about influencing our government.

Bob is a man who feels deeply and is just as deeply determined to make change happen. He can be moved to tears one minute and exhorting those around him to do more the next. He mentored RESULTS volunteer activists like me in how to speak to elected representatives with head and heart, and pushed us to make the world a better place—always with love and appreciation for our efforts.

Bob Dickerson (second from left) laughs with Washington Senator Patty Murray .

Bob Dickerson (second from left) laughs with Washington Senator Patty Murray during a meeting to solicit her support for global health programs. Photo: Lesley Reed.

And what success! This past December, Senator Patty Murray told more than 200 hundred people who had gathered to honor the man: “Bob never let me or my staff forget the plight of the poor at home and abroad.”

In October, Congressman Adam Smith recognized Bob on the House floor, saying, “His passionate and ever present voice for the powerless—especially children—is truly remarkable.”

Devoted to making a difference

Not surprisingly, Bob learned about PATH during a meeting with a congressional office. One of PATH’s disease experts was there, and Bob was impressed by his knowledge. “After that, PATH was always on my radar.”

He became a regular at PATH events and a donor. He recognizes that we can’t do this work alone. Ending poverty, he says, calls for the triad of government with its resources and influence, advocacy groups like RESULTS who raise awareness and apply pressure, and “successful organizations like PATH who can get smart interventions and best practices to the people who need them.”

In a class that never gives up

Closeup of Bob Dickerson.

PATH donor Bob Dickerson. Photo: RESULTS/Lesley Reed.

One Saturday after we heard that Bob had entered hospice, dozens of his fans gathered in his living room to sing. Before we left, he asked me to share a story I’d once told him, of a baby I held in Niger during one of the country’s famines—a baby who did not survive. Unbeknownst to me, that little boy was one of Bob’s inspirations to protect all children everywhere.

Turning to the youngest person in the room, a young woman he’d watch grow up, Bob said, “I can’t imagine not having you in this world.” Just as we were all beginning to cry, he reminded us to write letters to the editor, calling on the US to commit $1 billion at the upcoming pledging conference for Gavi, the Vaccine Alliance. Being tired is no excuse, he said.

He should know. Bob now sleeps more than 16 hours a day, but he still communicates with members of Congress and even tabled at a local community college last week.

“I am in a class that never wants to give up,” he says. “Because life for me is easy. I don’t have the right to give up when there are children and poor people dying and suffering needlessly.”

An opportunity to have no regrets

So this is what death without regrets can look like: In the time that Bob has dedicated his life to this work, child deaths have dropped by more than half, and the end of preventable child deaths is now a realistic goal.

“We look back at Mahatma Gandhi, Martin Luther King, Jr., Jonas Salk, or the other people we read about in history books who made such a difference for people who were suffering. We have a chance to be there with them,” says Bob. “If a group of us makes a difference—that’s history-making. To me, it’s one of those opportunities you just can’t pass up.”

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Friday Think: airbags in cars, sure. But for skiers?

Airbag deployed in car with dummy.

An automotive airbag deploys in a car with a dummy. Photo: DaimlerChrysler AG/Wikimedia Commons.

After the first airbags were introduced to the automotive world in the 1970s, it took two decades of lobbying and legislative wrangling for the technology to become a standard manufacturing feature. And now these lifesaving devices are required in every car that’s sold in the US.

Today, automotive airbags are a no-brainer. And consumers are the first to say that they clearly benefit from the added safety.

A skier wearing a Dainese airbag.

The alpine airbag design makes sense, but will competitive skiers use them? Photo: Dainese.

But try introducing that same technology to athletes who throw themselves down steep mountain slopes at breakneck speeds with little more than Lycra and a helmet to protect them.

You’ll find most of them want nothing to do with it.

Airbags look funny, they’re constricting, and they might impact speed

Sam Borden (with contributor Kelley McMillan) writes about a proposal to use this established technology on the hills in the New York Times article, “Airbag Is Approved, but Ski Racers Are Largely Shunning It for Now”:

Broken collarbones. Shattered shoulders. Internal bleeding. Punctured lungs. Those injuries, and worse, are possible every time a world-class skier plunges out of a starting gate and slides down a snowy racecourse.

Given that, it is not surprising that skiing’s international governing body recently approved for use an airbag safety device that has been in development for nearly four years. But many racers have expressed reluctance toward the new technology. . . .

In the article, United States Olympian skier Marco Sullivan sums it up best,

“No one is going to wear it until everyone is wearing it.”

But here’s where the old technology meets the new user-focused design, and things get interesting:

In 2011, Dainese, working with F.I.S. (a skiing federation, known by its French acronym), began developing an airbag that could be used in skiing. The challenges were considerable. First, there was the matter of creating a system that could consistently determine when it was needed, effectively distinguishing the difference between skiers who lost their balance but were able to recover and skiers who lost their balance and went into a dangerous tumble.

…Vittorio Cafaggi, a manager for strategic development at Dainese, said in an interview at the company’s research and development lab in Molvena. “It isn’t enough for it to just protect you; it has to know when you need protection, too.”

To make that possible, Dainese’s technicians use gyroscopes, accelerometers and a GPS tracking device to monitor an athlete’s position, angle to the ground and speed. If a skier’s angle and speed suddenly change drastically, sending the values outside the algorithm’s normal range, the airbag inflates.

The airbags have been approved for use since December 2014, but the only skier who’s worn the device during competition so far is Mirena Küng, a Swiss skier, during a women’s event in St. Moritz, Switzerland. And although the airbag scored a neutral rating during aerodynamic tests, Mirena did not come in first.Friday Think logo

You can read this article in its entirety at the New York Times.

Each week, we scour the news for the hottest stories on innovation. Our weekly feature, The Friday Think,highlights one we’ve found particularly fascinating.

PATH’s vaccine imperative: protecting children at home and abroad

In an op-ed that appears in The Hill, CEO and president of PATH, Steve Davis, shares his views on why we need to make a global commitment for the safe, continued, and expanded use of vaccines to protect children here and overseas. Following is an excerpt:

Seated nurse pinches a young girl's cheeks and ues a dropper to place vaccine in the girl's mouth.

A nurse gives a polio vaccine to a young girl. Photo: PATH/Richard Franco.

Portrait of Steve Davis.

Steve Davis is president and CEO of PATH. Photo: Auston James.

Every parent wants the best for their child

A trip to Disneyland is supposed to be a dream come true for a child. But in December, “The Happiest Place on Earth” became the epicenter of a measles outbreak that has infected 67 people to date, including young children. This latest outbreak has drawn attention to the fact that the anti-vaccination movement in the United States is putting people of all ages at risk of highly contagious diseases like measles, which had previously been eliminated here.

We know that vaccines are one of the most cost-effective ways to save lives and support development. We also know—and saw with searing clarity this fall with Ebola—that disease knows no borders. For these reasons, the US has a dual obligation. We must focus not only on urging the vaccinations necessary to protect our own children from infectious disease, but continue to do our part to ensure preventable diseases like measles are controlled or stomped out everywhere.

A woman holds an infant in her lap as an oral vaccine is dispensed into the infant's mouth.

An infant receives a vaccine against polio. Photo: PATH/Gabe Bienczycki.

But the current measles outbreak proves once again that the successes we have achieved in the US and abroad will take ongoing effort and commitment to sustain. The world we live in is increasingly complex and interdependent. To protect our gains, we must make a global commitment to the safe, continued, and expanded use of vaccines.

You can read Steve Davis’s full op-ed in The Hill.

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Meet the “Valentine Pill” and three other innovations

A father and mother with their children in front of their home in Uganda.

Scovia Namuyiga with her husband Vincent Mawano and their children, in front of their home in Uganda. They use family planning to space their children so they can choose the size of their family. Photo: PATH/Will Boase.

PATH’s reproductive health teams are hard at work spreading the love in an effort to make sure that women and couples can access and use their preferred contraceptive method.

And to illustrate, we’re highlighting a few of the family planning innovations PATH has had a hand in designing, developing, testing, or delivering to women and their partners around the world—as well as sharing responses from some of the people these innovations are designed to reach.

The Woman’s Condom

Developed by PATH and research partners with input from women and their partners, this innovative method was designed to protect from unintended pregnancy and sexually transmitted infections (STIs), including HIV.

Two women examine a Woman's Condom.

“My message to the ladies is: don’t give away your power, but make a choice to live a happy and fulfilled life free of unplanned pregnancies, STIs, and HIV. Try female condoms, it’s the best thing you can do for yourself and your loved one.” —Married woman, South Africa. Photo: PATH.

The Sayana® Press

Sayana Press is a lower-dose formulation of the three-month contraceptive Depo-Provera® in the Uniject™ injection system. PATH has played a role in the Sayana Press journey, from developing its Uniject delivery mechanism to conducting upcoming research on self-injection.

Hand holding Sayana Press, a tiny needle attached to a small bubble of plastic filled with contraceptive.

“Self-injection of Sayana Press might have a catalyzing effect, involving the husbands. Because the husband can call it in for his wife and go get it. So it can really be catalyzing for the husbands and their involvement in family planning.” —Family planning NGO representative, Senegal. Photo: PATH/Will Boase.

The SILCS Diaphragm

The SILCS diaphragm, marketed as CayaTM is a reusable, nonhormonal, one-size fits-most contraceptive device that women helped to design.

A woman holding a SILCS diaphragm in her hands.

“I purchased a Caya diaphragm and absolutely love it! I’ve been using diaphragms for 28 years but this design is far superior as it is easier insertion, easier removal, and, of course, one-size fits-most. Women really need to know how easy, practical, and with no side effects a diaphragm is.” —A Caya diaphragm user, North America. Photo: PATH/PatrickMcKern.

Pericoital or on-demand oral contraceptive

This is a new type of contraceptive pill, in early stages of development, that a woman could take before or after sex to prevent pregnancy—on demand, rather than daily.

A woman stands outside with an infant strapped to her back.

“It should have a beautiful name…the love pill, friendly pill, Valentine pill. It should be packaged in love colours.” —Health provider, Uganda. Photo: PATH/Will Boase.

A brighter future for everyone

When women can plan their families, independently or with their partners, they live healthier lives. And healthier mothers mean healthier children and improved child survival. Families may also have more resources to better care for and educate those children, and communities benefit when women can participate in broader economic and community activities.

We strive to make the world a better place for women, and their families, every day of the year. To learn more about the impact our innovations have had around the global, visit our reproductive health and family planning programs.

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Friday Think: HIV test results in 15 minutes via smartphone

HIV and syphilis diagnostic test: plastic components attached to a smartphone.

An accurate new HIV and syphilis diagnostic test utilizes a smartphone and accessories. Photo: Tassaneewan Laksanasopin.

As technology becomes increasingly embedded in our everyday lives, our phones—and the accessories that we sync to them—do more than make calls, send texts, and click pics. They’ve really become portable data-gathering and synthesizing devices.

Demand is high for personal electronic devices that make health care cheaper and more accessible. And no wonder. Their cost, interface, and size make them ideal tools for point-of-care diagnostics. (Want to take your pulse? See how your blood glucose levels are doing after lunch? Check your smartphone.)

A dongle, a drop of blood, and a phone = a dual test for HIV and syphilis

Researchers at Columbia University have figured out a way to find out, in 15 minutes, if an individual has HIV or syphilis. The original intent behind the design of this test was to help reduce the infection rate of HIV and syphilis from mothers to their children as these two diseases have a high potential for transmission.

Here’s an excerpt from an article written by Abby Phillip of the Washington Post:

Researchers at Columbia University have taken the mechanics of a laboratory test for HIV and syphilis and crammed them into a device the size of a wallet.

It attaches to a smartphone and can provide accurate results in 15 minutes. . . .the device could help make in-field tests for sexually transmitted diseases faster and more accurate in places where a second visit to a doctor for treatment isn’t feasible.

“If you can start to bring core health services to the smartphone beyond just measuring the heart rate—like blood tests—then you’re going to start seeing a pretty fundamental shift in the health-care system,” said Samuel Sia, an associate professor of biomedical engineering at Columbia, and an author of the paper on the device published in the journal Science Translational Medicine.

The new device essentially replicates the HIV test considered a gold standard for laboratory testing, as well as the same kind of syphilis tests you might get in a standard laboratory. But it produces results 10 times more quickly and, in a small study, Sia’s team found it to be very accurate.

“The cost, size and power. . .those three things, we just reduced it by orders of magnitude from what we did before,” Sia said, noting that his team first began working on the technology about 10 years ago, before the first iPhone even existed. “It replicates all the things that a lab-based robot would do.”

“We’re actually not really developing a totally new way of doing things, but insFriday Think logotead we’re just replicating what lab-based instruments do, step by step.”

To learn more about the impact of this new test, read Abby Phillip’s full article in the Washington Post.

Each week, we scour the news for the hottest stories on innovation. Our weekly feature, The Friday Think, highlights one we’ve found particularly fascinating.

PATH recognizes the contributions of Dr. Gaetano Borriello

Gaetano Borriello.

One of Gaetano Borriello’s remarkable abilities was to anticipate trends so he could be an early developer of technologies that would later be deployed in low-resource settings. Photo: UW.

Dr. Gaetano Borriello, University of Washington professor of Computer Science & Engineering, passed away at his home following a long fight with cancer. This remembrance was written by PATH’s Richard Anderson, a colleague of Dr. Borriello’s at the University of Washington.

On February 1, PATH and the entire global health community lost a great friend and innovator.

Dr. Borriello’s work often focused on applying mobile technologies to public health problems in the developing world.

He led the Open Data Kit (ODK) project, developing a suite of open source tools to support mobile data collection solutions. The tools were designed to be “easy to try, easy to use, easy to modify, and easy to scale.”

Health worker tapping the screen of a smartphone.

Teams working with PATH’s MACEPA program in Zambia use Android smartphones equipped with Open Data Kit software to collect demographic information as they go house-to-house testing and treating for malaria. Photo: PATH/Gabe Bienczycki.

Dr. Borriello’s projects and students played an important role in a range of PATH projects including:

  • Human Milk Banking, where the FoneAstra Temperature Monitor is a crucial component of a low-cost milk pasteurization system.
  • Mobile Midwife project, where mobile devices were used by nurses to support household visits with decision support, data collection, and a video education application.
  • mPneumonia, a mobile application that uses a pulse oximeter to help with the diagnosis and management of childhood pneumonia.
  • Data collection for Malaria Control and Elimination Partnership in Africa (MACEPA), where community health workers used ODK to record malaria cases.

One of Dr. Borriello’s remarkable abilities was to anticipate trends so that he could be an early developer of technologies that would later be appropriate to deploy in low-resource settings. He began his work on ODK when smartphones were exclusively a product for the affluent, arguing that they would soon be ubiquitous, creating opportunities to provide services to a vast number of people in developing countries.

In his honor, the Computer Science & Engineering Department at the University of Washington has established the Gaetano Borriello Fellowship for Change, which will support students whose work focuses on exploring how technology can improve underserved populations.

Dr. Borriello’s work has positively impacted the lives of many thousands of children and mothers in developing countries. Our thoughts are with his family and friends.

Our guest contributor today is Richard Anderson, Digital Health Solutions Group technology advisor in PATH’s Digital Health Solutions program, and a professor in the Department of Computer Science and Engineering at the University of Washington.

Friday Think: robots, rolling in a hospital near you

 The UCSF Medical Center employs a fleet of 25 robots. Video: CNET.

A new hospital just opened in the same region that gave birth to computing. Which is to say, the fanciest technological bells and whistles are well represented in San Francisco’s new $1.5 billion UCSF Medical Center at Mission Bay.

For instance, patients communicate with their doctors via tablets and get their medications delivered by robots called “Tugs.”

This may sound cold and impersonal in a futuristic way, but the hope is that this marriage of technology to care will result in more one-on-one time between providers and patients.

“We want to use technology in a way that frees up our human providers to do what they’re good at, which is to focus on our patients,” said Dr. Seth Bokser, the center’s associate chief medical officer. “Patient-centered care is not just about putting technology into a hospital.”

But what about those robots?

A waist-high, box-shaped robot rolls past staff in a hospital hallway.

An Aethon robot shares a hospital hallway with staff. Photo: Aethon.

The fleet of more than two dozen self-directed robots is the largest number at any hospital.

Journalist Stephanie M. Lee writes more about the hospital’s rolling ‘bots and what they do in this article from the San Francisco Chronicle:

The tall, boxy computers on wheels can navigate the hospital on their own because they receive signals through Wi-Fi, and elevators and doors are designed to open for them.

In the course of a day, they carry meals, linens, medical instruments, medications and lab samples more than a dozen miles.

Programmed to know exactly who their targets are, the robots can be opened only by PIN codes and biometrics, such as fingerprints. If they get blocked en route, an engineer can redirect them.

The robots aren’t intended to replace doctors, Bokser said, but instead handle mundane, tiring tasks.

“This, for example, will free up our nursing staff from having to bring things back and forth from the lab,” he said, “from taking sample cups from the lab up to the floor and sending samples back to the lab.”Friday Think logo

It’s futuristic, but not completely so. Aethon’s robots are already used in more than 110 hospitals worldwide.

You may read the article in its entirety at the San Francisco Chronicle.

Each week, we scour the news for the hottest stories on innovation. Our weekly feature, The Friday Think, highlights one we’ve found particularly fascinating.

A fresh perspective at PATH: introducing David Shoultz

David Shoultz with a child in a Garifuna community on a small island near Roatan, Honduras.

“As we pursue drug development, we may be focused on one particular disease, but it is critical that we understand and think about people holistically.” David Shoultz. Photo: PATH/David Shoultz.

Today we profile David Shoultz, our new Drug Development program leader. We spoke to him recently to find out what first drew him to global health, what inspires and motivates him, and what he envisions for PATH’s Drug Development program.

Q. What first drew you to global health?

A. My mother was an early influence. She recently retired, but for many years, she was a professor of community health nursing at the University of Hawaii. She focused on issues affecting rural communities, including domestic violence and nutrition. Watching her career develop, I saw the passion and the reward, and I got to know more about the critical work she did. Her stories helped to fuel my early interest in global health.

David Shoultz on a remote section of the Great Wall of China in the Beijing Region of China.

On a remote section of the Great Wall of China in the Beijing Region of China, 2009. Photo: David Shoultz.

Later, in the 1990s, Dr. King Holmes at the University of Washington drew me to global health as we know it today, teaching me the critical value of understanding the knowledge, attitudes, beliefs, and practices of the people that we intend for our global health interventions to benefit. I was—and am to this day—inspired by his ingenuity, generosity, and work ethic.

Q. What motivates you?

A. The idea that we don’t live in a zero-sum world. Over the past 100 years, the health and well-being of people around the world has improved dramatically. I’m confident that we’re going to make even greater strides over the century to come. I’m motivated by the knowledge that our work today is going to be a part of that progress.

Q. Tell us about a time when you witnessed the need to shift how we think of drug development.

When I was at the Gates Foundation, I traveled as part of a team to Bihar, India, to visit programs working on multi-drug resistant tuberculosis (TB). While visiting one family’s home, I met a 16 year old girl with TB.

3 Outside of Dar es Salaam, Tanzania with a household health survey program funded by the Bill & Melinda Gates Foundation, 2011. Photo: David Shoultz.

Outside of Dar es Salaam, Tanzania with a household health survey program funded by the Bill & Melinda Gates Foundation, 2011. Photo: David Shoultz.

As it turned out, TB, which is common among people in this area, was not her primary concern. She had type 1 diabetes, and was more worried about this “strange” disease that would require her to inject herself daily with insulin. It raised concerns that she would never marry, have children, or be able to be independent. For her and her parents, it was like a life sentence.

It is critical that we understand and think about people holistically. As I may have a number of health needs that require treatment, so do people in low-resource settings. I think about how our programs can keep that in mind and develop products that make a difference.

Q. What do you see as the biggest opportunities and challenges in global health right now?

David Shoultz, Drug Devlopment program leader at PATH.

David Shoultz, PATH program leader, Drug Development. Photo: PATH/Patrick McKern.

A. The biggest opportunity is the historic number of credible global health product candidates in the pipeline right now—drugs, vaccines, diagnostics, and other health technologies. Never before have we had this pipeline of promising candidates.

The biggest challenge is long-term funding for product development. It’s an area of high risk, and it takes a long time—five, eight, ten years, or more. We need to ensure that the funding continues to be there as these products advance.

Q. What global health “wins” have you been most excited by recently?

Two health workers in white uniforms, one man and one woman, stand behind a table holding a vaccine carrier and boxes of syringes.

Health workers, like these preparing for a meningitis A vaccination campaign, spend vast amounts of time keeping vaccines constantly cold. Photo: PATH/Gabe Bienczycki.

A. One big win is the announcement last year that MenAfriVac® can be used outside the cold chain. This approach could reduce the workload of health workers and extend vaccines to areas the cold chain could never before reach.

I also think it’s a big win to see so many high school and college students interested in global health and asking what they can do to make a contribution and a career in the field.

Q. Looking ahead, what do you envision for the Drug Development program?

A. We’re all about building right now in the Drug Development program—building on our past successes, building momentum and support, and building the future of drugs at PATH.

This year, we’re focusing on continuing to execute on our funded projects in HIV pre-exposure prophylaxis, enteric diseases like diarrhea in children, and malaria. We’re also refreshing our organizational strategy; I want to make sure that we’re working on the right diseases and conditions and also contributing at the points in the value chain that make the most sense.

David Shoultz is PATH’s new program leader for Drug Development. Before PATH, he served as the Director of Grantee and Partner Engagement at the Bill & Melinda Gates Foundation, where his work centered around building liaisons with partner organizations. To keep up with David, follow him and the Drug Development program on Twitter @shoultztweets and @PATHDrugDevelopment.

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Global health and development take center stage at World Economic Forum

Two moms and babies

In Davos there was an increased focus on accelerating progress towards development goals. Photo: PATH/Gabe Bienczycki.

A few reflections on the World Economic Forum (WEF) meeting in Davos, Switzerland, and the Gavi, The Vaccine Alliance’s pledging conference in Berlin from PATH’s president and CEO Steve Davis.

Portrait of Steve Davis.

Steve Davis is president and CEO of PATH. Photo: Auston James.

Through my roles at PATH and previous organizations, I have been fortunate to be invited to attend the annual WEF gathering in Davos over several years. In that time I have seen nonprofits and civil society organizations take increasingly important roles at these agenda-setting gatherings. While it is difficult to get a handle on the key trends in this multi-layered, complex environment, this year, the importance of inclusive growth and global development, and the role of nonprofits and civil society in that work, seemed to take center stage.

Yes, Davos has the jet-setting, celebrity, power-brokering aspect that gets played up in the media. But both there and at the Gavi pledging conference I attended in Berlin (where the global community pledged over US$7.5 billion for vaccine and immunization programs), there was an increased focus on the important leadership and partnership roles that nonprofit and civil society organizations like PATH are playing as we confront global challenges and work to solidify and accelerate progress towards development goals.


A WEF participant considers the notes from a discussion called The Globalization of Chronic Disease. Photo: WEF.

Resilience was a recurring theme

Many of the challenges discussed at Davos were not even on the agenda one year ago: new conflicts, new epidemics, new fiscal uncertainties, new evidence of accelerating environmental change. So this year the focus on growth was tempered by conversations about resilience.

Graphic table

We have made remarkable progress. How can we accelerate it? Click to see full-sized chart.

In some conversations, I got the sense that people and institutions are feeling overwhelmed by the sheer magnitude of global challenges. At a lunch panel with technology leaders like Marc Benioff (Salesforce), Marissa Meyer (Yahoo), and Satya Nadella (Microsoft), upbeat assessments of the transformative power of the Internet were tempered by concerns about the magnitude of global security challenges and the continued and growing public distrust of business and government worldwide.

But wise voices of optimism also spoke powerfully about the dramatic improvements in health we’ve achieved in poor countries, and the clear markers of progress over the past few decades. Today, we have unprecedented tools and collaborations that we can harness to accelerate impact.

One moment that drove this home was a breakfast on our renewed commitment to nutrition and food security, in which many senior business, government, and nonprofit leaders pledged to a more ambitious agenda. At several meetings on health there was very little skepticism about our ability to continue to dramatically reduce child and women’s mortality in the coming decade.

Global health and development takes a leadership role

It seems global health and development has moved to center stage in international discussions about security, development, and governance. Health has always been part of the WEF agenda, but this year in particular there were an exceptional number of discussions about health-related topics: nutrition, food security, Ebola, noncommunicable diseases like cancer and diabetes, digital health initiatives, mental health, reform of global health institutions like the World Health Organization, and more.

While this focus stems in large part from the Ebola crisis, it is also occurring because the sector can point to remarkable, measurable, rapid successes. It is very compelling to be able to describe tangible achievements at scale, like having reduced under-five child mortality by 50% since 1990, or vaccinating more than 200 million Africans against Meningitis A in five years.

2015 will be a huge year for the global development agenda, with a key meeting on new development financing models this July in Ethiopia, the finalization and announcement of the new sustainable development goals in September at the UN General Assembly, and perhaps the conclusion of a climate treaty at the end of the year in Paris.

In a remarkable plenary video message from Stephen Hawking, he described the resilience of the planet and species, acknowledging the specific challenges ahead in the global development agenda but expressing his profound optimism about the human ability to love, persevere, and thrive. It was a powerful moment.

Health systems in emerging economies can leapfrog to a new paradigm

WEF has released a new report and video on the idea of "leapfrogging." Illustration: WEF.

WEF has released a new report and video on the idea of “leapfrogging.” Illustration: WEF.

“Leapfrogging” was a word on many health sector leaders’ lips at Davos. Emerging economies have an opportunity to build accessible, high-quality, and cost-effective health systems while potentially leaping over problems embedded in the models and systems prevalent in developed economies.  The WEF has actively led this conversation, releasing a recent report and video. Having served as an advisor to these efforts, it was exciting to see them bear fruit, and be an active topic of conversation at the highest levels.

Headshot of a man speaking.

South Africa’s Health Minister Aaron Motsoaledi. Photo: MOH.

South Africa’s Minister of Health Aaron Motsoaledi and I led a Davos session on creating “ideal clinics” for primary care in his country. Can an emerging health system leapfrog some of the issues that challenge primary care in more developed nations, leverage digital technologies, and be intentional about a user-centered approach to systems design?

I travel to South Africa in a few days, and I want to pursue this idea and see what we can do to bring more of our partnerships, tools, and ideas to the Minister’s exciting commitment.

Innovation was central to almost every conversation I had all week. As we move towards the UN’s new sustainable development goals, we must learn from the last decade, and work to identify, fund, and support promising innovations as early as possible. This is a focus of many efforts, including the PATH-Norway-Gates Foundation partnership called Innovation Countdown 2030, which will release a major global health innovation report this summer.

Gavi’s remarkable funding conference

Of course, one of the most powerful public health interventions is vaccination. PATH’s growing and well-regarded vaccine platform was part of many conversations, especially at the Gavi replenishment meeting that took place in Berlin after Davos.

There, we heard stories from communities and countries where the impact of vaccines is being deeply felt. The MenAfriVac project’s groundbreaking work was highlighted: since vaccination began in 2010, the annual cycle of deadly meningitis epidemics has been completely stopped across much of what was formerly described as Africa’s “meningitis belt.”

Bill Gates on a large stage at a podium.

Bill Gates spoke passionately at Gavi about reducing child deaths. Photo: Gavi.

PATH is a founding Gavi partner, and we have partnered closely since the beginning. We have actively advocated for Gavi funding, and I was privileged to see this important organization receive the global support and pledges it needs to continue its transformative and lifesaving work.

Bill Gates, from the Gavi stage, described unequal access to vaccines as a global injustice that we have the power to correct, and led by example with a remarkably large pledge from the foundation. There is much work ahead before this injustice is rectified, but for one day in Berlin, as countries committed more than US$7.5 billion, there was palpable optimism and excitement.

A whirlwind trip

Overall, it’s been an exciting and exhausting trip: snowy shuttle rides, engaging conversations, the occasional celebrity sighting.

We have much work ahead of us, but after these meetings I am starting 2015 with renewed confidence that we can find new and innovative ways to partner across geographies, industries, sectors, and political philosophies in service to the larger goals we all share: equity, opportunity, and health for all.