Friday Think: a game night at the museum

Friday Think logoBig news for all the adolescents out there who, for years, have insisted it’s good for them to camp out in front of a screen playing video games. Apparently the art of video games is a hot medium among nouveau art aficionados.

At least for those who live in Toledo, Ohio.

More than 52,800 people, many of whom were under 30 and male, attended The Art of Video Games at Toledo Museum of Art (TMA), an exhibit curated by the Smithsonian American Art Museum.

To say video games are a salve for the soul may be a stretch, but here’s the case for reaching out to a new audience through an accessible exhibit: only 1 in 10 attendees ended up being museum members. And it was one of the largest exhibits at TMA this year, drawing a distinctly different crowd.

But the innovation at the museum doesn’t stop at games exhibits. Read an excerpt from The Blade:

In January, the museum (2014-15 budget is $14.3 million) put its visual literacy philosophy, including teaching plans, online at VisLit.org.

A passion of museum director Brian Kennedy, visual literacy promotes careful and slower scrutiny of images in order to glean more information and think more critically. The entire staff and volunteers have received 12 hours of training on the topic. Moreover, the museum offers tours for the ultimate visual learners—babies—and is studying whether gazing at images improves vocabulary for toddlers and preschoolers.

And then there are the purchases, which don’t always follow the standard art acquisition fare:

Luca Giordano (Italian, 1634–1705), The Liberation of St. Peter. Toledo Museum of Art. Museum purchase.

Luca Giordano (Italian, 1634–1705), The Liberation of St. Peter. Oil on canvas, shortly after 1660. 79 by 121 inches. Toledo Museum of Art. Museum purchase.

It’s always fun to see what the museum buys and in 2014 the biggest, both physically and in terms of price, is a 350-year-old painting that’s nearly 6-by-10 feet and hangs in the Great Gallery. It’s ‘The Liberation of St. Peter,’ a dramatic depiction of an angel knocking the stuffing out of beefy soldiers, thereby liberating Peter from prison, by Luca Giordano.

If you want to read more about angels “knocking the stuffing out of beefy soldiers,” read the full article at the toledoblade.com.

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.

 

Bold innovations: 7 global health picks of 2014

Powerful innovations emerged in 2014 offering bold new ways to save lives and improve health. To help us narrow the list, we stopped our PATH colleagues in the hallways, on the elevators, and after meetings to ask them what life-changing innovations caught their attention, both within and beyond our PATH footprint.

Here, in no particular order, are seven bright global health ideas that our colleagues felt made the world a better place to live in this year.

Young woman smiles as a health work administers a shot to her upper arm.

Vaccines are among the safest products in medicine—another reason we like them. Photo: PATH/Gabe Bienczycki.

The first vaccine allowed outside the cold chain

The MenAfriVac® vaccine campaign was the first mass vaccination campaign conducted in Africa with a vaccine that doesn’t require constant refrigeration. Currently, more than 200 million people have been protected with MenAfriVac, and not a single case of meningitis A has occurred among the vaccinated individuals. The vaccine remains viable even when kept outside the cold chain for up to four days, saving money on the costly vaccine “cold chain” and allowing the vaccine to reach more people in remote locations. (Learn more.)

Person behind the filigree window of a TB Hospital and HIV/TB Center.

PaMZ can cure some forms of drug-resistant tuberculosis in as little as four months. Photo: PATH/Nguyen Ba Quang.

New drug therapy offers tuberculosis treatment for HIV patients

A novel drug combination was unveiled at the AIDS 2014 symposium that allows HIV-positive patients to be treated for tuberculosis (TB) while they’re taking HIV drugs. Researchers from the Global Alliance for TB Drug Development say the new drug combination, known as PaMZ, can also cure some forms of drug-resistant TB in as little as four months. Current TB treatments take up to two years, increasing the chance of drug resistance among patients. (Learn more.)

A simple, low-cost injectable contraceptive launches in four African countries

“Women, no matter where they live, should have access to contraceptives that meet their needs,” says Sara Tifft, director of PATH’s Sayana® Press pilot introduction and evaluation project. Sayana Press, which PATH helped to develop, has the potential to reach tens of thousands of women who want the choice of an injectable contraceptive but who lack easy access to clinics where the injections are given. (Learn more.)

A woman looks into a microscope in a lab.

A global partnership has mobilized $4 billion to help finance and strengthen health systems in developing countries. Photo: PATH/Mike Wang.

A global partnership has mobilized $4 billion to help finance and strengthen health systems in developing countries. Photo: PATH/Mike Wang.

Innovative new financing facility boosts budgets for global health

This past year, the World Bank Group and Governments of Canada, Norway, and the United States came together to create a Global Financing Facility to help developing countries finance and strengthen their health programs, and build the necessary systems to end extreme poverty. So far, the partnership has mobilized $4 billion to fund a facility that’s expected to be fully operational in 2015. (Learn more.)

Latin American woman looks at the camera and smiles.

Eighty-five percent of cervical cancer cases occur in the developing world. Increasing prevention, screening, and care is essential in countries like Nicaragua. Photo: PATH/Mike Wang.

Cervical cancer self-sampling shown to be as effective as clinic-based exams

In a recent blog post, Dr. José Jerónimo, senior advisor for women’s cancers at PATH, says that when women are taught to self-test for human papillomavirus, it frees up the time of busy health workers. This dramatically increases the ability of clinics and hospitals to treat more women who test positive for precancer, thereby preventing cases of cervical cancer.

The self-sampling test works nearly as well as when doctors or nurses gather cervical mucus samples during a pelvic examination. Pelvic exams are a rate limiter—the exam takes time, limiting the number of women who can be seen by each trained provider.

Baby being admired as mother rests in background.

More than 190 countries signed on to support the Every Newborn action plan. Photo: PATH/Evelyn Hockstein.

First-ever Every Newborn action plan

Over the past two decades, improvements in newborn death rates have failed to keep pace with improvements for older children. The landmark Every Newborn: An Action Plan to End Preventable Deaths addresses this by focusing attention on existing low-cost, high-impact interventions that will prevent millions of newborn deaths and stillbirths across the globe each year. (Learn more.)

Technician in protective gear holding an antimalarial tablet.

Sanofi’s gold-standard artemisinin-based combination therapy, pictured here in the manufacturing plant, is now available to patients and health care facilities for the first time. Photo: Sanofi.

Malaria drugs made with semisynthetic artemisinin make their way to patients

The first shipment of semisynthetic artemisinin (ssART)-based malaria drugs—1.7 million treatments of Sanofi’s gold-standard artemisinin-based combination therapy, Artesunate Amodiaquine Winthrop®—made their way to customers for the first time. This opens a new future for the global artemisinin market. By providing a year-round source of this key ingredient in malaria medicine, ssART helps to manage imbalances in supply and demand, and maintain stable and affordable pricing—ultimately expanding access to treatment. (Learn more.)

Powerful stories: our 2014 global health reporting picks

Video capture of Liberian man in the street with subtitle about Ebola.Every year powerful reporting is published and broadcast globally on a wide variety of global health topics, and 2014 was no different. PATH’s media relations team reads, watches, and listens attentively, summarizing the best for our staff each week. So we asked the team to think about which stories had made the biggest impression on them this year, for the quality of the reporting and the power of the narrative.

While Ebola was a focus of much of this year’s coverage, they also cited excellent pieces about reproductive health, noncommunicable diseases, and deadly mosquitos. Here, listed in no particular order, are a few of PATH’s picks for best 2014 global health reporting.

Fighting Ebola Outbreak Street by Street
Ben Solomon, New York Times, October 16, 2014

“We were all moved by the powerful on-the-ground video reporting from the New York Times’ Ben Solomon and his crew,” says PATH’s senior media strategist Kate Davidson. “This video, in particular, conveys the chaos and fear in the streets of Monrovia, in an up-close, visceral, and indelible way.”

The Future of Sex?
Emily Anthes, Mosaic, March 2014

Once derided as being like a plastic bag with the erotic appeal of a jellyfish, the female condom is being reinvented as the next big thing in safe sex. 

“Working at PATH, where we developed the Women’s Condom, you would think I would know all about it,” says communications associate Molly Haas. “But this in-depth article provided great new perspective on the challenges of developing, introducing, and especially popularizing the female condom.”

Mothers in Egypt feeding their babies with the rehydration solution.

A mother feeds her baby with the rehydration solution. Photo: BBC.

The Man Who Helped Save 50 Million Lives
Lin Lin Ginzberg, BBC Health Check, August 2, 2014

A solution of sugar, salts and water, many of which can be found in a kitchen cupboard, can be all it takes to save a child’s life—and it has saved an estimated 50 million people. But finding the right balance was crucial—and Dr Norbert Hirschhorn played a key part.

“I am always intrigued by the story of simple innovations with lifesaving reach,” says Claire Hudson, media relations associate. “And it would be hard to find a simpler, or more powerful and impactful innovation than oral rehydration salts.”

Microscope image of mosquito close-up.

Microscope image of mosquito close-up. Photo: Gates Notes.

The Deadliest Animal in the World
Bill Gates, Gates Notes, April 25, 2014

“This creative, week-long multimedia feature got our attention with its playful spin on ‘Shark Week’ and impressed us with its hard-hitting reporting on the deadly impact of mosquito-borne diseases,” says Amy MacIver, PATH’s director of communications. “I am a huge fan of finding innovative ways to convey the challenges we face in fighting these complex diseases.”

Neglected tropical diseases: Trachoma, schistosomiasis and river blindness documentaries
Al Jazeera Lifelines

Lifelines is a TV documentary series on global health topics funded by the Bill & Melinda Gates Foundation. “All of their coverage is generally very strong,” says Lippi Doshi, a senior communications associate. “But this multi-part series on neglected tropical diseases, in particular, brought great long-form documentary coverage to this very important topic.”

African DJ in a radio booth.

Elliott Adekoya, 31, aka The Milkman, is a DJ at Monrovia’s Sky FM radio. Photo: NPR.

Liberian Singers Use the Power of Music to Raise Ebola Awareness
Jason Beaubien, NPR News, October 12, 2014

The Ebola scenario is something that people don’t want to listen to anymore, because they’re so fed up, so sick of it,” (Liberian DJ Adekoya) says. “If you’re making a song—an Ebola song that people gonna listen to now—it has to be danceable.

“This is a story made for radio,” says senior media strategist Kate Davidson, “and exemplifies Jason Beaubien’s talent for finding characters and perspectives other outlets miss. These songs are a beacon of hope during a very dark time.”

Friday Think: a wastebasket full of possibilities

Friday Think logoThe world’s thinnest and possibly strongest material was found in a lab’s wastebasket.

Trash cans aren’t the usual places where you’ll find the next big thing. But Andre Geim, a physics professor at the University of Manchester, has always believed important discoveries are the result of “curiosity-driven research. Something random, simple, maybe a bit weird—even ridiculous.” Par for the course from a previous Ig Nobel Award winner who used electromagnets to levitate a frog (learn more about his experiment “Of Flying Frogs and Levitrons”).

Magnetically levitating a live frog.

Magnetically levitating a live frog, an experiment that earned Geim and Michael Berry the 2000 Ig Nobel Prize. Photo: Wikipedia.

What Geim and his assistants found in the wastebasket that day was a wad of Scotch tape covered with a film of graphite residue.

Here’s an excerpt from an article written by John Colapinto in The New Yorker:

In the fall of 2002, Geim was thinking about carbon. He specializes in microscopically thin materials, and he wondered how very thin layers of carbon might behave under certain experimental conditions. Graphite, which consists of stacks of atom-thick carbon layers, was an obvious material to work with, but the standard methods for isolating super thin samples would overheat the material, destroying it. . . .

Graphene is made of carbon atoms.

Graphene, an atomic-scale honeycomb lattice made of carbon atoms, was once considered impossible to isolate. Photo: Wikipedia.

One of his senior fellows glanced at a ball of used Scotch tape in the wastebasket, its sticky side covered with a gray, slightly shiny film of graphite residue.

It would have been a familiar sight in labs around the world, where researchers routinely use tape to test the adhesive properties of experimental samples. The layers of carbon that make up graphite are weakly bonded (hence its adoption, in 1564, for pencils, which shed a visible trace when dragged across paper), so tape removes flakes of it readily. Geim placed a piece of the tape under the microscope and discovered that the graphite layers were thinner than any others he’d seen. By folding the tape, pressing the residue together and pulling it apart, he was able to peel the flakes down to still thinner layers.

Geim had isolated the first two-dimensional material ever discovered: an atom-thick layer of carbon, which appeared, under an atomic microscope, as a flat lattice of hexagons linked in a honeycomb pattern. Theoretical physicists had speculated about such a substance, calling it “graphene,” but had assumed that a single atomic layer could not be obtained at room temperature—that it would pull apart into microscopic balls. Instead, Geim saw, graphene remained in a single plane, developing ripples as the material stabilized.

To find out more about graphene and its possible uses, read the full article at The New Yorker.

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.

Condom dancers, vaccine smilers, and toilet sweepers: our favorite 2014 photos

Sometimes a single photo conveys more about our work than a thousand words ever could. Here’s a look back at some of our favorite 2014 PATH images.

Girl looks back at camera among a large group of girls facing the other way in a classroom.

This classroom full of girls at Nakasangola Primary School in Uganda is brimming with pre-teen energy. Several years ago, these girls were among the first in Africa to receive the HPV vaccine. During this 2014 follow-up visit, the girls and their teachers were still able to offer detailed explanations of how the vaccine protects them from cervical cancer. (Learn more.) Photo: PATH/Will Boase.

Laotian boy sweeps out a brightly tiled bathroom.

This photo from Laos stood out among the submissions for the 2015 Places We Go calendar. We love the beautiful tile pattern, unusual angle, and the piercing gaze of the student (not to mention the sparkling cleanliness of the toilet!). We also loved the story communicated in the image: through the GIZ Regional Fit for School Programme, students learn healthy hygiene habits and help maintain the school’s toilets, creating a ripple effect in families and communities. (Learn more.) Photo: GIZ/Ivan Sarenas.

Two dancers in motion with a Dance 4 Demand banner behind them.

On Global Female Condom Day 2014, dancers all over the world joined the “Dance4Demand” advocacy effort to highlight the need for increased access to female condoms. We love the energy of these dancers photographed while performing at a popular mall in Johannesburg, South Africa. (Learn more.) Photo: PATH.

A girl smiles while receiving a shot.

That smile! In all our decades of vaccination campaign work, this might be the biggest smile-while-getting-a-shot we have ever encountered. The Japanese Encephalitis vaccine, which PATH worked to accelerate and get approved by the World Health Organization, was distributed in April by the Laotian government in a campaign partly supported by Microsoft employee donations. (Learn more.) Photo: PATH/Aaron Joel Santos.

Fisherman sitting on boat at sunset.

In communities across southern Zambia, the comprehensive malaria elimination efforts led by the government, PATH, and our partners are starting to bear fruit. Today the disease is still affecting the fishing villages along Lake Kariba, but we are optimistic that this fisherman’s children may grow up into adulthood in a malaria-free Zambia. (Learn more.) Photo: PATH/Gabe Bienczycki.

Photographer Gabe Bienczycki takes a photo as kids gather around him.

Bonus behind-the-scenes photo: The fisherman portrait shown above conveys an almost classical serenity, but in fact the mid-December photo shoot on the shore of Lake Kariba occurred at the epicenter of a joyful (and muddy!) mayhem of children, onlookers, stray dogs, and grazing cows. This was photographer Gabe Bienczycki’s fourth trip for PATH, and we look forward to sharing more of his remarkable Zambia portraits, and a short video about his process, in 2015. Photo: PATH/Tom Furtwangler.

Friday Think: every tool tells a story about human ingenuity

Friday Think logoMost stories are told through some combination of words and imagery. They’re natural partners in the way we relate information in a memorable way. So when we saw an article claiming tools could also tell a story, one that spans from the Paleolithic to the space age, it caught our attention.

“Nearly Two Million Years of Innovation, As Told Through Tools” illustrates the development and design of 175 tools crafted by humans over eons of time. The tools are on display in a new exhibit marking the reopening of the Smithsonian Design Museum.

Here’s an excerpt from Natasha Geiling’s article at Smithsonian.com:

Sextant and case, 1865.

Sextant and case, 1865. Photo: Smithsonian Institution, National Museum of American History.

The tools celebrate the ingenuity of the human spirit across time and culture,” says Matilda McQuaid, the museum’s deputy curatorial director. “Materials may vary, but they’re using the skills and materials of their time, whether it’s using the gut skin from beluga whales to create an absolutely windproof and waterproof parka, or technology of our contemporary time to look at the Sun, millions of miles away, to understand how what happens on the surface of the Sun reflects what is happening to us here on Earth. It’s about how we push ourselves, as humans, regardless of where we are and what period we’re from.”

As you can imagine, there are unique challenges inherent in selecting 175 tools for an exhibit that represents the evolution of human design. For instance, how to show if tools are related in some way across time and cultures.

A hand holding a replica of a stone hand ax.

A replica of a hand ax and blade. Photo: Studio AmiDov.

Though the items in the exhibit might seem like unique entities, McQuaid and McCarty were most interested in showing connections between one tool and the next. The iPhone and Paleolithic hand ax might seem completely different and used by different cultures and separated by thousands of years, yet both are designed to be multipurpose, small, portable tools. “We sometimes think that someone has a brand new idea that no one has ever had before, but so much of what we do is about connections, about our experiences and about references to other cultures and time periods,” McCarty says.

Read the full story at Smithsonian.com.

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.

Looking ahead to a new day

The Bill & Melinda Gates Foundation is matching all donations to PATH through December 31st. Watch this 1-minute video to learn more. Video: PATH.

Picture this: We can radically improve the course of human development and balance the scales of health equity. We can work to make it unheard of for a child to die of malaria. We can help ensure that no child dies of preventable diarrhea. Imagine that day.

At PATH, we not only imagine that day, but see it getting closer all the time. A day when all people have the tools they need to thrive no matter where they live.

By coming together, we can impact global outcomes

Portrait of Steve Davis.

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

I believe that many of the problems we still face in the 21st century—eliminating polio, mitigating climate change, or making sure both girls and boys get a quality education—will be solved by multisector partnerships and innovation. If you believe that too, I invite you to partner with us and be part of the solution.

At PATH, we target the leading health problems in low- and middle-income countries by tackling them from every angle—prevention, detection, and treatment—using a “toolkit of innovation.” To make that happen, our work almost always involves teams from across PATH and partners from governments, industry, and local community organizations.

On a personal level, I’ve always been interested in bringing people and ideas together to solve challenges. And that’s what PATH does: we use the power of innovation to improve the trajectory of communities and individuals, so everyone has the opportunity to thrive.

We have a great opportunity to enact change, now

With staff and partners on the ground around the world, especially across Africa and Asia, and an emphasis on finding innovative solutions, we often need to move quickly, to take experimental approaches, to support proof-of-concept work, to pilot transformative strategies.

Woman holds a young girl in a fancy white dress.

Donations helped make it possible for thousands of children in Southeast Asia to avoid permanent neurological damage each year from Japanese encephalitis. Photo: PATH/Aaron Joel Santos.

For instance, PATH developed a partnership to advance an affordable vaccine with the potential to safeguard millions of people against a fast-moving brain infection called Japanese encephalitis. Donations from our supporters helped make it possible for thousands of children in Southeast Asia to avoid permanent neurological damage each year from the disease.

We invite you to be our collaborator

We know that by coming together, we can have the greatest impact.

This is why we need your support, to continue making a difference as we find lifesaving solutions, to bring the most promising of these to scale.

Help us realize a new day, together.

Through December 31, the Bill & Melinda Gates Foundation will match your gift to PATH up to $375,000

The Bill & Melinda Gates Foundation—our longtime partner and supporter—has generously offered to match every dollar of every donation toward our $375,000 goal, but only until December 31. Send your gift today or donate online. Your gift will be doubled, helping PATH work to develop breakthrough health solutions that reach millions of people in more than 70 countries worldwide.

Bringing health care to everyone

A nurse holding a diagram of the female reproductive system speaks to a group.

Although Universal Health Coverage (UHC) may be particularly challenging to implement in low- and middle-income countries, that’s where the potential benefits are greatest. Photo: PATH/Will Boase.

Today is the first-ever Universal Health Coverage Day

Here at PATH, we’re not strangers to health-focused observation days. In fact, we often commemorate these days by recommending ways in which high-quality health care and its delivery systems can be integrated and strengthened. I’m thrilled that for the first time in history, the world is calling attention to that solution in an official way.

About 1 billion people around the world lack access to basic health care. An estimated 2 billion people lack regular access to essential medicines.

More equitable health coverage would go a long way in preventing the deaths of children and women. Expanding coverage has been shown to prolong life, especially among underserved populations. But we must also ensure that all people obtain the high-quality health services they need without suffering undue financial hardship.

The cost of inaction is high

Although Universal Health Coverage (UHC) may be particularly challenging to implement in low- and middle-income countries, that’s where the potential benefits are greatest, specifically among the poorest and most rural communities.

Support among global development thought leaders is widespread. World Bank Group President Dr. Jim Yong Kim declared UHC to be central to reaching their global goal to end extreme poverty by 2030. And World Health Organization Director-General Dr. Margaret Chan has declared that “universal health coverage is the single most powerful concept that public health has to offer.”

Group of children smiling and laughing.

More equitable health coverage would go a long way in preventing the deaths of children and women. Photo: PATH/Siri Wood.

Global knowledge can help solve local problems

Where do we start? Although UHC solutions must be locally tailored for each country, there are recommendations all countries can take to ensure progress is made. Here are a few:

  • Committed: A primary health care system must receive a long-term commitment from national and local leadership, as well as support from donors and investors.
  • Accessible: Not only must health care be accessible to those seeking it, but the shared knowledge and resources needed by those providing care must also be available.
  • Measurable: Measurement and monitoring of health data must be strengthened to better understand health gaps and enact policies to ensure equitable health coverage.
  • Accountable: Mechanisms at local, national, regional, and global levels must be in place to ensure that policymakers deliver on promises and resources are used efficiently.

At PATH, we’re constantly looking for new and innovative ways to provide health equity, channeling the tremendous potential of inventive ideas, scientific discovery, and collaborations into better health and opportunity for all.

I encourage the global health community to talk about UHC as a realistic solution to ending preventable illnesses and deaths around the world.

Our guest contributor, Heather Ignatius, is a senior policy and advocacy officer in PATH’s Advocacy and Public Policy department.

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Friday Think: two field lessons on huddles

Friday Think logoThis week’s innovation story is actually a twofer with origins harkening back to a huddle on a football field in the 1890s.

That’s when Paul Hubbard, the quarterback for Gallaudet—at the time a college for deaf students in Washington, DC, and now a university—had his offense form a tight circle around him so they could discuss plays in sign language without the other team catching on to their strategy. Innovation born out of necessity which, coincidentally, led to a successful season.

Football players gather in a huddle.

Teams that innovate well, focus on the end game. Photo: Sean Murphy/Getty Images.

Fast forward to 1921 when University of Illinois started their own mini-strategy sessions on the field. It must have worked because the Fighting Illini went on to win the national championship two years later by changing the way the game was played.

What happened after these two teams innovated on the field? Everyone followed.

Here’s an excerpt from Harrold Sirkin’s article on innovation in Bloomberg Businessweek:

Today it would be unimaginable to play a football game without huddles–except, of course, when teams use a “no-huddle” offense, a back-to-the-future innovation the Cincinnati Bengals introduced in 1988. The Bengals won the AFC Championship that year, and quarterback Boomer Esiason was named the NFL’s Most Valuable Player.

The simple lesson here is that innovation can give you a competitive advantage, even put you on top—but only until others copy what you’ve done or the Next Big Thing replaces it. Innovation must be an ongoing process.

Sirkin then takes on how innovation in the corporate world aligns with innovation on the field and the value of strong support systems to continued success.

But sustaining innovation can be a challenge. Some companies do it well; others struggle. This is especially true among newer companies without strong support systems to keep the momentum going. As a result, companies that show great promise sometimes end up like “one-hit wonders” in music: They achieve a lot of success early on, then lose their mojo. . . .

There’s an important distinction between strong innovators and breakthrough innovators. The latter put a higher priority on innovation than other companies, cast “a wider net for ideas,” emphasize business model innovation as well as product innovation, and develop company cultures “geared toward breakthrough success.”

Read the full story on the Bloomberg Businessweek website.

Digital health at scale: getting beyond pilot projects

Nurse uses a laptop in a clinic in the Democratic Republic of Congo.

A nurse manages patient data in a clinic in the Democratic Republic of Congo. Photo: PATH/Yori Matumona.

It took almost 20 years for barcodes to be fully adopted across the grocery industry. Today they’re in use worldwide, delivering efficiency and automation on a massive scale.

It took the efforts of a dedicated visionary to show the impact that a single, universal-sized shipping container would bring to the trucking and freight industry. Today, shippers around the globe can be sure that a standard-sized container will fit on the truck that delivers it to the port in Mombasa and on the truck that unloads it in Seattle.

In a paper being released this week by PATH, commissioned by the Bill & Melinda Gates Foundation, we describe the journey our global community needs to take to shift the use of digital tools for health from a series of one-off projects to an institutionalized common practice—much like grocery barcodes and shipping containers impacted their industries’ common practices.

Cargo ship with containers.

An ocean freighter transports standard-sized containers. Photo: Flickr/GP1974.

Using these examples as case studies, we discuss how we can move past an era of small-scale pilots, towards more comprehensive efforts that align systems and allow for much larger-scale impact.

Changing how we think about scale

We often use “going to scale” in development efforts as a goal for moving projects beyond the pilot phase. Yet despite a decade of investment, there are only a handful of “scaled” digital health interventions to count, and no single shared definition of scale.Marcel Proust quote: We must never be afraid to go too far, for success lies just beyond.

We believe a digital product or service can only be considered successful after it’s become embedded into a health system workflow or an individual’s daily habits.

This embedding or “institutionalization” of digital health solutions is the end goal we focus on in our report, one we hope becomes more broadly shared. When a digital innovation becomes institutionalized, discussions of mHealth and eHealth will cease and our focus will simply be on health impact.

Can you imagine an entrepreneur anywhere in the world considering opening a grocery store without bar code equipment? That level of institutionalization is also possible with digital health solutions, but our stakes are much higher than groceries: we have the potential to save lives, while bringing efficiencies to health systems that could most benefit from savings.

What if automatic reminders could be sent to caregivers or community health workers notifying them when a child is due for vaccines? And what if that system integrated the local availability of vaccines and immunizations? Furthermore, what if suppliers used barcodes so health officials could track and efficiently distribute stock?

PATH’s Better Immunization Data (BID) Initiative is one example of bringing efficiencies to country-wide health systems. Supported by a grant from the Bill & Melinda Gates Foundation, the BID Initiative will help countries strengthen their immunization programs through improved data quality, collection, and use by identifying practical, country-owned, country-led digital health solutions.

Moving towards consensus in 2015

We are emerging from a period marked by great enthusiasm and innovation in digital health, but one with a very fragmented landscape of hundreds of small digital health pilot projects.

Of those, a very small proportion, fewer than 1 percent, have gone to scale or achieved institutionalization.

However, our digital health community is rich with creative, persistent, and passionate innovators who recognize that “it is not about us, it is not about technology, it is not about money, it’s about impact.”

Consensus is emerging among donors and governments that digital health institutionalization is the outcome we collectively seek, as well as a willingness to share the journey together. Now is the time for us to pause in our individual journeys, assess the current landscape, and align on a common path forward.

Editor’s note: guest contributor Kate Wilson, director of Digital Health Solutions at PATH, announces the release of a new paper at this week’s Global mHealth Forum.

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