Designing a device to save newborn lives: thinking big while thinking small

Group holds a tubing device and discusses it in the PATH shop.

Clinicians confer with PATH product development engineer Gene Saxon on the 3D-printed prototype of a low-cost oxygen blender. Left to right: Drs. Anna Hedstrom and Ryan McAdams of University of Washington/Seattle Children’s Hospital, Dr. James Nyonyintono of Kiwoko Hospital/Adara Development in Uganda, and PATH’s Gene Saxon. Photo: PATH/Tom Furtwangler.

When experts gather around the prototypes of lifesaving devices in the PATH shop, it never takes long for questions, opinions, and stories to start flowing.

This week, the devices in question were a low-cost bubble continuous positive airway pressure (CPAP) kit and an oxygen blender. We have been collaboratively developing these technologies with partners from University of Washington Department of Pediatrics, Seattle Children’s HospitalAdara Group, and Kiwoko Hospital for use in health facilities with limited resources. And the experts who gathered from PATH and those partners represented diverse fields: neonatal medicine, medical product engineering, commercialization, and public health.

There is a clear need for these devices: respiratory infections are a leading cause of infant mortality in many of the world’s poorest places and claim millions of newborn lives each year. A bubble CPAP device can provide an infant with the air pressure needed to support their breathing, and when combined with an oxygen blender, it can deliver critically needed oxygen at appropriate concentrations. These interventions can mean the difference between life and death, and between healthy infant development and lifelong neurological damage or blindness.

Newborn baby in blankets

How can we ensure that every baby, no matter where he or she is born, has an equal shot at a healthy, productive life? Photo: PATH/Gabe Bienczynski.

While bubble CPAP devices and oxygen blenders are standard in American neonatal wards, their high cost puts them beyond the reach of many hospitals, as does their requirement for pressurized oxygen and air, steady power, and access to trained technicians and replacement parts.

PATH and our partners have been working to refine the design for an oxygen blender and an ingenious, low-cost bubble CPAP that is made primarily from common medical supplies kept in stock by most medical equipment vendors in the developing world.

Tubing and 3D-printed device held in hands.

PATH is developing an inexpensive oxygen blender that mixes air and oxygen in specific concentrations, and can be used when administration of 100% oxygen is not appropriate. Photo: PATH/Tom Furtwangler.

The inspiration for these devices came, as it often does, from stories of newborn lives that had been saved with improvised, cobbled-together bubble CPAP solutions built by clinicians who were short on resources and long on ingenuity. Those handmade devices worked in some settings and situations, but they had not been rigorously tested, were difficult to scale up, and sometimes relied on the presence of their designer for effective use.

Group in PATH shop engaged in discussion.

In the PATH shop, experts from a variety of disciplines contributed to a wide-ranging discussion about how to develop a device that is inexpensive, easily maintained, and meets the needs of clinicians caring for newborns in respiratory distress. Photo: PATH/Tom Furtwangler.

Funding from the Saving Lives At Birth Grand Challenge and other supporters is allowing refinement of these concepts into manufacturer-ready designs suitable for widespread distribution.

But there are many hurdles to getting inexpensive, high-quality devices designed, manufactured, and commercially available in the settings that need them. So in the shop, as experts from each discipline contributed to the conversation, the design decisions and trade-offs became sharper, while the list of issues and considerations grew longer.

Can hospital staff be trained to disinfect and reassemble, or should some parts be single-use and disposable? Is there a manufacturer in Africa who can make precision parts at low cost, or will they need to be imported? Is it more important to make a simple device that is effective in the most critical situations, or a more complex, adjustable device that is effective in a wider range of situations and environments?

Shop staff member demonstrates equipment for a group.

Part of the product design process includes running low-cost parts through highly sensitive tests designed to mimic real world conditions. PATH shop technician Alec Wollen shows how it’s done. Photo: PATH/Tom Furtwangler.

Passing around a variety of tube-and-bottle bubbler combinations as they worked through the lunch hour, the group nailed down dates for an upcoming round of user input at a Ugandan hospital and planned site visits to African device manufacturers. And then after breaking for just a few minutes, the group began considering the next design perspective, as a commercialization expert presented a comprehensive overview of the market for bubble CPAP devices in India.

Designing for very small infants and for the very big picture

This cross-disciplinary process embodies many of PATH’s unique and distinctive competencies. Focusing a broad group of experts on the challenge of saving the largest number of newborn lives possible, the project asks them to consider the design of neonatal respiratory devices from every angle, to learn from each other, to try hands-on experimentation, and to think holistically. Having advanced hundreds of projects over four decades, PATH brings our own experience to the table as a convening partner.

Hands hold tubing designed to be inserted into infant nostrils.

In order to design an effective and sustainable solution, a wide range of factors are considered: from the width of premature newborns’ nostrils to the World Health Organization’s policies. Photo: PATH/Tom Furtwangler.

The design thinking encompasses the whole system in which the device will be manufactured, approved, marketed, used, and maintained. The conversation ranges with equal emphasis from the shape of tubes that will fit comfortably into a premature baby’s nose, to the complexities of manufacturing, assembly, and supply chains, to the relevant World Health Organization policies.

Detailed charts and graphs are presented. Stories are told. The group names other experts they should consult, lists manufacturing partners to consider, and brainstorms questions to ask in Africa when gathering additional stakeholder feedback on the prototypes.

But no matter how technical the discussion gets, nobody forgets why they are here. “When you follow up, and a baby has passed away,” says Ugandan colleague Dr. James Nyonyintono, who traveled to Seattle for this work, “you ask yourself: what could I have done differently?”joi-bug_blog-link

This post is part of a multi-part series, Mapping the Journey, which explores how PATH turns ideas into solutions that bring equity, dignity, and health to women, children, and families worldwide.

Other posts in this series

PATH’s partners on this project include Adara Group, Kiwoko Hospital Uganda, the University of Washington Department of Pediatrics, and Seattle Children’s Hospital. This project is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of PATH and do not necessarily reflect the views of USAID or the United States Government.

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True story: how truckers introduced Tarun Vij to global health

Meet Tarun Vij, our India country program leader at PATH. Tarun joined our organization in 2011 after 18 years in the private sector and leadership roles in several Indian development projects.

Tarun Vij at the Taj Mahal.

Tarun Vij at the Taj Mahal in November 2014. Photo: Adarsh Minocha.

Q: Your work in health came after 18 years as an automotive entrepreneur. How did that change come about—and how has your background informed your current role?

A: I transitioned from being an entrepreneur who built and ran an automotive company with a national footprint to leading a national HIV prevention project for India’s truckers, whom my past experience in the automotive sector positioned me to understand well.

I was able to apply an understanding of the “buying” behavior of the community in a commercial setting to preventive practices and health-seeking behavior in their personal lives. It was immensely satisfying to be able to apply business metrics to scaling up a national HIV prevention program among a high-risk group.

I moved from business without a clear idea of transitioning to heath—the truckers became the connection! As a trained engineer and businessman, I could relate to the need for structure, scale, analytics, and accountability to deliver impact.

Q: What brought you to this work—and keeps you motivated?

A: Initially it was the thrill of applying business skills and experience to a new setting and scaling services using the same variables—cost, quality, and reach—to sustain service uptake and generate measurable impact. Apart from being deeply satisfying at a personal level, I engaged with India in many ways that I would not have as an urban businessman. So there is deep personal enrichment and transformation in the work.

Through our work, I have learned that no matter how underserved or economically deprived communities may be, people will come forward and take charge to improve their lives and the lives of those around them, once they become aware and come together as community groups. There is great satisfaction in catalyzing that latent self-esteem in every individual and helping to translate it into personal and community wellness.

Q: Can you tell us about the history of PATH’s work in India and some of the program’s unique strengths and challenges?

A: PATH has been in India for over three decades, with a country office since 2001. Our India portfolio is diverse, representing most of PATH’s global focus areas and collaborations with national and state governments, research and academic institutions, and the private sector. I’d say diversity across the value chain is a key strength. India presents a unique opportunity to connect our products and technologies with the health delivery system and communities to deploy innovations at scale.

Tarun Vij, PATH's India country leader.

Tarun Vij, PATH’s country leader in India. Photo: PATH.

A changing donor landscape consequent to India’s recent economic growth will challenge international development organizations such as PATH to rethink their evolving role in India. PATH is well-poised to accelerate our product development work and support Indian efforts to grapple with emerging health challenges in a rapidly urbanizing population.

Update: Tarun Vij left his role as PATH’s India Country Leader on April 30, 2015.

Tarun Vij, country program leader for India at PATH, holds a degree in electrical engineering from Panjab University, India, and a master’s of business administration from the University of Michigan. This profile originally ran in Spotlight, PATH’s internal newsletter.

Friday Think: could a $2 billion contest accelerate new antibiotics?

Lab worker Patrick Kakembo looks into a microscope in the lab.

We need to encourage the development of new antibiotics that will fight the growing number of drug-resistant strains of bacteria. Photo: PATH/Will Boase.

The battle against super bugs—that growing class of virulent bacteria resistant to antibiotics that the US Centers for Disease Control and Prevention estimates sickens 2 million people annually—results in tens of thousands of deaths each year. It also delivers a $20 billion toll in associated health care costs.

There aren’t many antibiotics in development to battle these super bugs right now. It takes money—lots of money—and often decades to shepherd a promising new drug through R&D to scale. Some pharmaceutical companies are no longer developing new antibiotics because the return on investment is greater in other areas of product development.

Maybe what we need is a new system, and some prize money

In a New York Times op-ed, Ezekiel J. Emanuel, an oncologist and vice provost at the University of Pennsylvania, says the development of antibiotics has “been glacial,” and that we need a new approach.

Here’s an excerpt from Emanuel’s op-ed suggesting governments come together to pool the money needed to develop more antibiotics, and then award the kitty to worthy contenders:

Let’s use prize money. What if the United States government — maybe in cooperation with the European Union and Japan — offered a $2 billion prize to the first five companies or academic centers that develop and get regulatory approval for a new class of antibiotics?

Awarding prize monies for innovation isn’t a novel idea; it’s already successfully spurring advances in everything from space travel to ocean health.

As the XPrize — a foundation that runs competitions to spur innovations for difficult problems that often aren’t being addressed — and others have demonstrated, prizes for lofty goals can catalyze the creation of hundreds of unexpected research teams with novel approaches to old challenges. The prestige, bragging rights and renewed sense of mission created by such a prize would alone make an investment in research worthwhile.

Because it costs at least $1 billion to develop a new drug, the prize money could provide a 100 percent return — even before sales. From the government perspective, such a prize would be highly efficient: no payment for research that fizzles. Researchers win only with an approved product. Even if they generated just one new antibiotic class per year, the $2-billion-per-year payment would be a reasonable investment for a problem that costs the health care system $20 billion per year. Friday Think logo

Read this op-ed in its entirety in 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.

Mapping the Journey: how we turn good ideas into large-scale solutions

Today we’re launching a multi-part series, Mapping the Journey, that explores how PATH turns ideas into solutions that bring equity, dignity, and health to women, children, and families worldwide. This is the first installment of the series.

Child receives oral vaccine while others look on.

In 2014, children in Laos were vaccinated against Japanese encephalitis for the first time. The vaccine’s journey took more than a decade of effort from PATH and our partners, finally receiving World Health Organization approval earlier that year. Photo: PATH/Aaron Joel Santos.

In a world that’s always innovating, there’s no shortage of great ideas that can help people live healthier lives. New technologies. Strategies that accelerate the slow development of drugs and vaccines. Novel partnerships that cross continents and sectors. Yet many ideas never get the chance to make an impact—at great human cost.

The journey from idea to real, large-scale solution is complex

Barriers and pitfalls, from regulatory hurdles to deep-seated cultural beliefs, can prevent even the most promising ideas from succeeding. But the odds of success can be greatly increased when those ideas have a creative guide who knows how to navigate the journey—a guide like PATH.

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Ideas move through a long and complicated journey before they can have widespread impact.

We call the process of moving from idea to impact the “journey of innovation.” And at every stage, there’s work to be done:

  • Adapting a design for low-resource settings.
  • Shepherding a new medication through approval.
  • Working alongside communities with the will, but not the tools, to protect their children.
  • Expanding access to vital care where it’s needed around the world.

It takes tenacity, know-how, and commitment to see the journey through. And that’s where PATH comes in.

A closeup of Sayana Press being injected into an arm.

In 2012, multiple partners, including PATH, committed to delivering Sayana® Press, a long-acting injectable contraceptive to four countries in Africa in order to increase contraceptive choice and access. Administered in the simple, single-use Uniject™ injection system that PATH developed, Sayana® Press has cleared multiple hurdles on its journey to scale. Photo: PATH/Will Boase.

Nothing should stand in the way of solutions reaching the people who need them most

We believe it’s unacceptable that people around the world continue to be devastated by preventable disease, when we know that innovation can change it. So we identify and cultivate promising ideas that can transform health—and make sure nothing stands in their way. We collaborate with a wide variety of partners, from researchers to manufacturers to local governments as we keep solutions moving toward impact. And we’ve earned a track record of constantly innovating to get those solutions to the people who need them most.

Graphic showing time to grow the plant versus the time to synthesize artemesinin.

Our partnership with researchers and industry led to a key malaria treatment innovation. Artemisinin, an essential plant-derived ingredient in key malaria medications (ACTs), can now be manufactured with a semisynthetic ingredient in three months, ensuring a more reliable supply. Infographic: PATH.

We transform the way health solutions are developed and delivered

We’re not afraid of complicated work. And we’re inspired by the partners who travel the journey with us—whether in the laboratory or the factory, in a government hall or the village square. joi-bug_blog-link

Behind every innovation, and at every stage in the journey, there are stories to share. Stories of ingenuity, commitment, and compassion. Stories of scientific discovery and of heroes who are changing their families and communities.

We look forward to sharing a few of these stories with you over the next eight weeks.

Other posts in this series

Sayana® Press is a registered trademark of Pfizer Inc. and/or its affiliates. Uniject™ is a trademark of BD.

5 lessons learned to achieve impact with global innovations

Young man receiving a vaccine at the MenAfriVac launch.

To be successful, we need to think about launch and scale-up at every stage of a project. Photo: PATH/Gabe Bienczycki.

By Steve Brooke, commercialization advisor at PATH, and David Milestone, senior market access advisor at USAID’s Center for Accelerating Innovation and Impact.

What separates impactful global health innovations from the rest? We have spent the better part of our careers thinking about questions just like that. And yet, we have not found a short or simple answer. But, we have uncovered many useful lessons.

IDEA to IMPACT: A Guide to Introduction and Scale of Global Health Innovations booklet cover.

Read “IDEA to IMPACT: A Guide to Introduction and Scale of Global Health Innovations.” Photo: PATH/Patrick McKern.

Some of these lessons are featured in a new resource we developed together. “IDEA to IMPACT: A Guide to Introduction and Scale of Global Health Innovations” by USAID’s Center for Accelerating Innovation and Impact (CII), highlights the challenges of achieving scale and impact, and uses case studies to draw out best practices and practical tips.

Drawing from our individual experiences, the guide, and reflections from panelists at a launch event that USAID and PATH co-hosted with The Aspen Institute, we sat down and challenged ourselves to summarize our five top takeaways on what it takes to achieve scale and impact with global health innovations.

Two women in colorful saris stand holding materials.

Health care workers are an integral part to the success of a mother’s group project in India. Photo: PATH/Gabe Bienczycki.

1. Start with the people

This maxim lies at the heart of good product development. It is important to listen to and observe users to better understand their needs. PATH learned this firsthand on our work on various water filtration systems. Everything from preferred color to size of a standard drinking cup needed to be considered for each different context.

woman drinking from a cup of water she poured from a water filter she owns as part of the Safe Water Project.

Observing how people use a product is just as important as surveys and focus groups. Photo: PATH/Gabe Bienczycki.

We’ve also found that while surveys and focus groups are incredibly useful, sometimes user observation is necessary. With our C1 water filter project we handed users a box of parts and didn’t call ourselves successful until they could assemble it without instructions.

A case study from Design that Matters (featured in the guide) also illustrates the importance of incorporating the needs of manufacturers and distributors into product design. It is important to consider all the users—not just end-users—in the ecosystem that will take a solution to impact.

Three vaccine coolers on tables covered with white cloths, white-clad health workers sit behind them.

Health workers in Burkina Faso wait to open their vaccine carriers at the launch of a meningitis A vaccination campaign. PATH/Gabe Bienczycki.

2. Plan for impact and scale at every step in the process

Core to IDEA to IMPACT is that launch and scale-up are not things you can start thinking about after you’ve developed a product and completed clinical trials—all aspects of delivery need to be incorporated throughout the project. But how can you keep your eye on this goal the entire time?

The Meningitis Vaccine Project faced this challenge when it embarked on an effort to create an affordable, effective vaccine to protect the more than 400 million people at risk in Africa’s Meningitis Belt. PATH and the World Health Organization (WHO) had to simultaneously focus on developing a scientifically sound vaccine and putting it through rigorous clinical trials and regulatory processes, while at the same time working to improve the ability of countries in the region to conduct studies and prepare to administer the vaccine.

The guide includes practical companion tools for outlining the steps required and how and when to plan for impact and scale. The tools provided can serve as examples and inspiration for global health practitioners to start thinking through delivery considerations early on in the design process.

3. Need is not enough

Just because a product fills a need, or has the potential to save many lives, does not mean people will line up out the door to buy it.

This lesson is highlighted in the guide through a case study of CycleBeads®, a family planning tool created by Georgetown University’s Institute for Reproductive Health and Cycle Technologies. Looking at a high unmet need for family planning in Mali and backed by the Ministry of Health, the partners overestimated demand and ended up scaling back. Pilot studies are often useful to test market acceptance and determine demand generation needs.

Godrej and Boyce’s low-cost chotuKool refrigerator. Photo: Godrej and Boyce.

Godrej and Boyce’s low-cost chotuKool refrigerator. Photo: chotuKool.

4. Don’t be afraid to fail (or pivot)

Taking a cue from Silicon Valley, the global health community should not be afraid to fail. The good news is that doesn’t always mean scrapping a project. Often it just takes a “pivot.” For example, Godrej and Boyce’s case study describes how they originally wanted to scale down an existing refrigerator model for lower-income users, but when research made it clear this plan would not work, they shifted their approach and designed a completely new product from the ground up.

5. Don’t forget the regulatory and policy environment

Another vital piece is the policy and regulatory environment in your target market. Of course there will be mandated processes, but don’t forget about other policies needed to support your product. An endorsement from WHO or inclusion in a national policy may be key to unlocking many opportunities for scaling up, as is highlighted in the case study about WHO’s guideline on community use of misoprostol to prevent postpartum hemorrhage.

We use these steps to test, introduce, and scale a product and measure impact, but the good news is they are concrete and achievable. And now you have another great tool to help: the full IDEA to IMPACT guide and companion materials also includes a toolkit.

More information

Steve Brooke is a commercialization advisor at PATH, where he plays a lead role in public-private product development collaborations, product commercialization strategies, and intellectual property management. David Milestone is a senior market access advisor at USAID, Center for Accelerating Innovation and Impact (CII), where he focuses on the development and implementation of market-based strategies to accelerate the adoption of priority health products.

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

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.

More information

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 walking through a government hallway.

“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: PATH/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.”

More information

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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