Co-authored with Michael Steele
It's easy to make an instant impression -- relate the importance of a cause, the revolutionary nature of an idea, the dire need met by a new innovation. We are often generous with enthusiastic praise and encouragement because it comes at no cost, figurative or literal, to ourselves. But let's look outside of ourselves for a moment. For every solution to a problem that goes unrealized, there may be billions of people around the world who suffer real consequences because for every "wow" there were not enough answers to the follow up question "now what" to make the vision a reality. As distasteful as it might be for some to acknowledge, getting from promising idea to improving lives doesn't just happen through good intentions, it takes follow up and an influx of capital. That is, the interest by people who are willing to take a leap to make an idea a reality and the money they are willing to give, whether as an investor or a philanthropist, to back it up. They are moved to no longer sit and wait for someone else to do it. In today's world those people (or organizations) are few and far between, and as a result the world's resources continue to be channeled towards the same established causes regardless of their continued relevance or success in improving lives.
Our experience has made it very clear that our current impact funding climate is not very conducive to the transfer of "wow" into substantial commitment. Over the last ten years a technology was developed that will solve a problem that impacts billions of people around the world, but that many in this country see as irrelevant to themselves. This innovation will make it possible for people who receive healthcare in settings without electricity to have surgical procedures performed with instruments that have been sterilized. The technology is developed and validated, but it is not yet being used where it's needed because the past two years have been spent raising the funds to be able to reach the target market. Anyone who has travelled significantly in the developing world knows that sterile medical care is a standard that has largely been considered to be unattainable in environments without electricity, and the consequence of high infection rates resulting from surgical care has been accepted as the norm. But we know that if most Americans (or people from any other country where sterile procedures are standard) took a moment to consider the meaning of surgery without sterility, they would immediately understand just how unacceptable these standards are.
Surgery without sterility means a woman who needs a C-section to save the life of her un-born child runs a high risk of dying from an infection contracted during the operation. It means that a simple cataract surgery that a man needs to be able to return to work could leave him permanently blind. This is the reality for the 1.2 billion people around the world who live in regions without access to electricity. Major donors and international aid have accomplished incredible progress in global health, but that progress can be undermined if essentials that may not have quite as high a profile are overlooked.
As far as global health causes go, sterilization is decidedly un-glamorous. It's not new -- the underlying concept has been understood for nearly two centuries; nor is it thought of as technologically cutting-edge -- the standard method of sterilization in most places is still the steam-based autoclave. But sterilization is a prerequisite for any invasive procedure to be performed without a high risk of infection. This means that it is relevant across virtually all health conditions. As innovators, we strive to make this critical component of modern healthcare possible in low-resource settings. As entrepreneurs, we hope to make this component relevant and important enough for people to invest in it. Despite the large number of compassionate people in this world who want to improve the lives of those in need, this effort is depressingly difficult to pull off.
We are obviously not the first to grapple with this issue. In a 2012 address to the Forbes 400 summit, Bill Gates described his own awakening that led to his commitment to "catalytic philanthropy." He saw that "when you come to the end of the innovations that business and government are willing to invest in, you still find a vast, unexplored space of innovation where the returns can be fantastic." Not to mention the lives that can be saved. So Gates took matters into his own hands and channeled his considerable resources towards problems that most people in the developed world were totally unaware of. He is the rare example of someone who had both the resources and the vision to make an impact in the spaces where no one else was willing to go.
More often however, understanding the need, the vision to address the need, and the resources required to accomplish it cannot all come from one source. It is in these scenarios that those who consider themselves impact investors have an important role to play. Yet projects that have the potential to truly change the lives of the world's poor in a measurable way are slipping through the cracks. They are passed over for apps or devices that pack more style than substance, and are generally useless in places that lack basic infrastructure. It's time for the impact investing world to see the sexy in something that might otherwise not be; or at least seem totally routine -- like the successful delivery of a healthy baby through a cesarean section. Although that might sound mundane, it is truly revolutionary in many parts of the world.