Diabetes, chronic care and South-North technology transfer

4387185238_fb330c0bbf_oThe prestigious journal Science recently published a series of health articles examining the problem of African innovations that languish in obscurity for lack of resources and backing to commercialize and launch them into the global market, many aimed at conditions common throughout the world. Among them:

-A diabetes treatment called Madeglucyl developed from a traditional herbal treatment in Madagascar.

-A Nigerian effort discovered a low-toxicity, plant-based treatment for sickle-cell anemia, but hasn’t been able to get it into widespread use.

-An herb-based anti-malarial called Nibima being developed in Ghana.

The publication also characterizes some of the commercial successes, and provides a road map for some of the ways that innovations from the Global South could reach wider use, for the benefit of all.

But this is an issue that goes beyond fairness or the nicety of leveling the global innovation playing field. There are practical reasons, and potential solutions to some of the developed world's leading health care concerns that are currently underutilized because they are viewed as “developing world” solutions for “under-developed” problems. Not so.

It’s true that some health technologies or approaches have been developed in less-developed regions. This can be a huge plus. How?

Systems developed in and for the Global South tend to be robust, practical, optimized to run on low maintenance networks, and swiftly implementable. Those are all beneficial for potential deployment in more developed regions as well. For example, a recent discussion on Justmeans’ heath forum with a veteran CDC epidemiologist about using social media approaches to monitor diseases ranging from diabetes to seasonal flu, led us to InSTEDD’s Geochat as a potential solution. That system was designed with less developed settings in mind than the areas of the United States that we were pondering.

And Datadyne’s Episurveyor has unfortunately found itself pigeon-holed (by some writers and researchers, but certainly not by its users) as a “sub-Saharan Africa” application, despite being used in 150 countries around the world and across the development spectrum. It has huge potential to improve measurement and monitoring right here in the well-developed USA. And it’s a pre-made, off the shelf, free technology. What’s not to like?

Many mhealth solutions have been developed as a way of providing care to those in remote regions lacking access to health care facilities. But such tools are equally effective for providing care to diabetics and others with chronic conditions. Whether by providing health reminders, or more systematic approaches to care, mobile technologies have wide application as a way of streamlining health care delivery and enhancing treatment for chronic diseases. Here’s an example of some of the innovative ways that mobile technology is being used in the LSU health system to help manage diabetics. Unfortunately it’s the exception and not the rule:

The American Journal of Sociology, meanwhile, points out one of the possible reasons why many health solutions never make it beyond the preliminary, pilot-study stage.  In a paper about industry-academia collaborations, James Evans from the University of Chicago points out how academics is “incremental and theory driven,” while industry “rewards new (and potentially profitable) discoveries cares little for explaining those discoveries.” A generalization perhaps, but it’s a point well taken. Many Global South initiatives that are linked to Global North academic or governmental institutions may lack the practical, bring-it-to-market pragmatism of a business approach.  Academic researchers look towards, among other things, reproducibility, statistical validity, and publish-ability. Reproducibility, in the form of real world implementation, may be the most valuable, and lead to those other things.

So building local capacity to realize the full commercial potential of innovation is important. And perhaps more business, academic, community collaborations could help all of use? I’ve written about some interesting collaborations before for the CDC, you can read those tales here.

Photo credit: The author, via flickr