Part 2: Disrupting Trickle Down Innovation & Sharing the GWHT Network
Last month in Part 1 of our series about the meaning of “Educational Innovation,” Duke undergrad Neha Shaw shared from her experiences as part of the Duke and Durham community.
“This version of educational innovation consists of practices that focus on the experience rather than merely the methods of education.”
At The Center for Global Women’s Health Technologies (GWHT), we have several initiatives practicing educational innovation. We’re democratizing design thinking education to middle school and high school students both locally and internationally through the Ignite program, encouraging community engagement with sexual and reproductive health through storytelling with the (In)visible Organ, and empowering students through our cervical cancer and teaching project Bass courses, which place students on the pathway from technology to global impact through service learning activities that allow students to interact with the material beyond engineering classes.
To learn more about initiatives scroll down!
In the spirit of educational innovation, we are hosting a global leadership seminar series this year focused on creating the next generation of global health innovators through novel educational initiatives. These educational initiatives include Rice 360 founded by Prof. Rebecca Richards Kortum (September speaker) at Rice University and Q-Epic founded by Prof. Muhammad Zaman (October speaker) at Boston University, as well as many more to come throughout the year.
We will also be sharing monthly blogs that focus on health equity and innovation using the concept of “Trickle Down Innovation”:
The Global Health field has largely relied on the ‘trickle down’ model, where products and innovations are developed in the Global North, and after a decade or two (or maybe even longer), the products trickle down to the Global South. Research and development typically originate in high-income countries (HICs), and the products, which are designed for those high-income markets, are not affordable in low- and middle-income countries (LMICs). This is a big problem as these technologies (e.g. vaccines, drugs, diagnostics) are critical for addressing global health needs.
It takes significant efforts to make the new technologies accessible in LMICs. Efforts include extensive advocacy campaigns, product buy-downs, compulsory licensing, patent challenges, efforts to create competition, advanced market commitments, creation of alliances (e.g. Gavi, Global Drug Facility), and creation of non-profit R&D groups (e.g. DNDi) etc. Even after years of effort, many products are still not accessible to those who desperately need them (e.g. insulin, new TB drugs, hepatitis C treatment, and the list goes on). If the end goal is to save lives and do it quickly, then LMIC-designed innovations must be seriously considered. The alternative is to wait for two decades, while people die of preventable and treatable conditions.
Trickle down innovation is based on the premise that HICs are the sole driving force for innovation. Conversely, the idea of reverse innovation — or “trickle-up innovation” — is rapidly evolving. It encompasses a process by which a product or service takes root initially in low-income countries with the potential to move up, and eventually displaces established competitors. There are a number of reasons why innovations designed specifically to address resource-constrained health care environments are important. First, technologies developed for LMICs are usually designed with local conditions and end-users in mind. They tend to be robust and field-friendly (e.g. able to withstand frequent power failures or extreme heat). Second, service and maintenance is easier, as the devices are designed to not need regular consumables. Third, cost of goods is lower, as are labor and manufacturing costs. Taken together, all of these considerations make vital health care technologies more accessible.
An example of a trickle up innovation is the Portable ECG machine made for Rural India.
When U.S.-headquartered multinational company, GE, started to sell the same medical diagnostic devices in India, they quickly realized that adapting their devices to the local settings required an entirely new
approach. Soon after that, GE Healthcare debuted its ultra-portable, battery-operated electrocardiogram machine (ECG) specially designed for use in rural clinics in India — where electricity
is either intermittent or non-existent. They sold that for $500. Intended as a solution for rural Indian markets where bulky, $20,000 machines made little sense, the product is now making inroads in the U.S. as a solution for first responders.
The GWHT Network of Educational Programming
Bass Connections is a Duke program with the vision of “creating a distinctive new model for education, predicated on collaborative and interdisciplinary inquiry, that actively engages students in the exploration of big, unanswered questions about major societal challenges.” Each of these classes uses innovative programming to answer global health questions around technology design (Laparoscopy), scaling technologies (Pocket) and health equity through storytelling (WISH).
Laparoscopy: Sustainable Implementation of Laparoscopy in Low-income Countries
Pocket: Pocket Colposcope: Analysis of Bringing Elements of Referral Services to Primary/Community Care
WISH: Empowering Prevention of Cervical Cancer: Women-inspired Strategies for Health (WISH)
GWHT has several Initiatives that tackle different aspects of Educational Innovation in our local and global communities.
Our Ignite program empowers students to connect STEM concepts to social innovation and the WHO’s Sustainable Development Goals (SDGs) through the human-centered design process. Recently, Ignite partnered with the Durham Museum of Life and Science to host the “Summer Tinkering Experience,” where young learners had the opportunity to work through Ignite’s light curriculum, including building their own flashlight to fit the needs of their community.
Our WISH program is a partnership between GWHT and global collaborators to empower marginalized women with the knowledge, innovative clinical tools, and confidence to take control of their health and kickstart a worldwide movement against cervical cancer. By placing women, not hospitals, at the center of the solution, our model disrupts the status quo of reproductive health education.
The (In)visible Organ is GWHT’s storytelling initiative to destigmatize the cervix and the female reproductive anatomy in research, design, and medicine. Through initiatives such as the (In)visible Organ art exhibit and screenings of The (In)visible Organ, a feature-length documentary, this venture invites women to explore their own “invisible” organs and share stories about their health.
Global Health Leaders
This semester, GWHT is hosting a panel series featuring Global Health leaders practicing
Educational Innovation. We’re proud to welcome Dr. Muhammed Zaman this month, the Howard Hughes Medical Institute Professor of Biomedical Engineering at Boston University.
Dr. Zaman is the creator of the biomedical engineering educational program Q-EPIC that focuses on training engineers with a rigorous global focus and a deep understanding of challenges in emerging markets and resource limited settings. The program creates the opportunity for engineers to create solutions that are focused, targeted, and scalable, potentially having a transformative impact on healthcare in developed countries.
If you’re interested in learning more about his work, RSVP for our next Global Health Leaders panel on October 20th, 12–1pm ET, via Zoom.