Engineering a Healthy Tomorrow for the Poorest Billion

It is not everyday that you hear the words big Pharma, billionaires, philanthropists and eradication of diseases in the same sentence. Well, Monday, January 30th was one such spectacular day.
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It is not everyday that you hear the words Big Pharma, billionaires, philanthropists and eradication of diseases in the same sentence. Well, Monday, January 30th was one such spectacular day. Bill Gates, WHO Director General, leaders of major pharmaceutical companies and senior government officials from around the globe unveiled in London, a joint declaration and a strategy to rid the world of ten neglected diseases that afflict the poorest of the poor in the world within a decade. The vision, goal and mission is bold, tremendously exciting, timely and hopefully a catalyst for a healthier world for all.

While there is little doubt that tremendous progress will be made by the London declaration to detect, diagnose, cure and manage the neglected tropical diseases better, the challenges for a healthy future for the world's poorest are far from over. Chief among the challenges facing the poorest regions of the globe is lack of capacity to innovate their way into a healthy future and sustain a healthy society. A quick survey of health professionals in any high disease prevalence regions of the world will indicate nearly identical obstacles to better management and cure of the disease.

The challenges in these regions are compounded by lack of staff that is adequately trained, or prepared, to handle medical devices. The workforce may have been trained decades ago on antiquated instruments and technologies, but there is also a continuous decline in the number of qualified and capable technicians. Retirement of existing staff and immigration of qualified young professionals continues to drain the system further. This unfriendly environment, therefore, offers little hope for innovation, local manufacturing and development of capacity to alter the status quo in any appreciable manner.

The problems associated with poorly functioning health services are not new. Yet, little has been done to comprehensively change the system. The London declaration is a breath of fresh air, yet the long-term impact can only be sustainable through local innovative capacity building. This is a large-scale and systems level grand challenge that requires multi-faceted actions to provide short and long-term solutions. While investment in higher education and innovative capacity building may not yield dividends instantaneously, the impact on the future will be transformative and felt by generations to come.

A multi-pronged strategy is therefore needed to address both the short-term and the long-term challenges in creating a healthy future through innovation. The strategy should consist of upgrading the skills of existing workforce, creating robust higher education in biomedical engineering, giving incentives for innovation and outside the box thinking and creating a culture of cross-country sharing of ideas and building the eco-system of collaboration.

First, hospitals in the poorest nations not only suffer from lack of equipment, but also lack of capacity to maintain the equipment. With thousands of pieces of equipment donated every year and limited capacity to understand its operation, the generous gifts quickly become thousand-pound paperweights and unceremoniously grace the junkyards of hospitals. Our first, and foremost responsibility, is to equip the workforce at the forefront of battle against disease with the knowledge ammunition. Strengthening the human capacity, through short-term and long-term training along with incentives for innovation are necessary to create medical facilities equipped to handle the burden of disease.

The second component of this proposed approach is to create context-aware biomedical engineers. Africa, Asia and Latin America have engineering institutions in nearly every country and most major cities. Yet, majority of these schools and colleges have not created the innovative workforce that can tackle and solve the problems in the domains of health and medicine. It is not unusual for anyone to find that the schools of medicine and the schools of engineering, even on the same campus, may never have offered a joint course or a joint seminar. These knowledge silos have to be broken immediately. Biomedical Engineering will create a bridge between health professionals and engineers to solve the challenges in diagnosis, detection, management and cure of the disease.

Third, neither the departments of biomedical engineering can be created overnight nor innovation can be limited to the domain of only biomedical engineers. We need to create incentives, either through competitions or national scholarships, to any and all who are able to identify local problems in healthcare, offer novel and innovative solutions and are passionate about saving lives. Innovation will benefit from structured education, but does not need to wait until the institutions are created. However, it needs the support, both of the local environment and of the government institutions, to take root and pollinate other would-be innovators.

As we march ahead, we need to invest in education and innovation, as a down payment for a better future for the poorest regions of the world. With increasing market sizes and opening up of the economies within Africa, Asia and Latin America, the demand for local technical capacity, better hospitals and disease free cities will only go up. It is this demand that we need to capitalize on.

Gone are the days when we accepted disease, suffering and poverty as the common lot of the poor. A healthier world for all needs a bold strategy that enables the men and women to bend the arc of time through knowledge, innovation and spirit to engineer a healthier tomorrow.

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