Pesticide Detecting Paper Strip

The Times Science section reports on a novel water testing strip developed by scientists at McMaster University in Canada. Instead of having to a fancy analytical assay to see if the water is good, you simply expose the lateral flow test which activates what is essentially a water diagnostic.

The New York Times:

...But scientists at McMaster University in Hamilton, Ontario, are reporting the development of a simple paper sensor — a “laboratory on a strip” — that can be dunked in a sample and give a reading a short time later, like a litmus test.

The sensor, developed by John D. Brennan and colleagues, makes use of the fact that organophosphate pesticides like diazinon inhibit the action of acetylcholinesterase, an enzyme involved in nervous system function.

More at the Journal of Analytical Chemistry

Photoessay: A Day in the Life of a Midwife

BBC has a fantastic short photoessay on midwives in Congo

Music video using cardiograph-like instruments

Sometimes people definitely come up with a better use for an old piece of equipment.

I'll be gone from KORB on Vimeo.

Got Clomiphene? Let's have a baby--in Africa!

Alright, don't get too excited. The October issue of the New Scientist write about a great new opportunity for infertile couples in the continent. We would normally think of Africa and fertility rates as a field that the focus of contraception endeavors given its high birth rate. 10 to 30 per cent of African couples are infertile however, which is higher than other parts of the world. That's twice the rate of Europe for instance. So a parallel group of scientists have developed schemes that bring affordable IVF to the continent---for about $350. Traditional IVF in the United States runs abour $12,000. How they are doing is the focus of an article in The New Scientist October issue.

By using generic drugs, modularizing the processes to essential steps, and using fewer eggs to start with they've produced an affordable approach to natural conception for couples.

The table below illustrates an example of how each approach saves money and achieves comparable results
New Scientist:

If successful, such efforts could lower the cost of IVF everywhere. In the US, the price of one round of treatment can be up to $12,000 and is rarely covered by health insurance. In the UK, it costs about £5000 ($8000), which the National Health Service may or may not pay for, depending on where a couple lives.

"Most of what we do in the western world is overkill," says Jonathan Van Blerkom of the University of Colorado at Boulder, a member of the ESHRE team. "If you get these procedures down to a low cost and they are successful, you cannot justify charging $12,000 for an IVF cycle."

The conclusion that is really interested here is the possibility of IVF latching on to a growing trend of South-North technology transfer: solutions aimed at the developing world that may very be useful for industrialized countries (e.g., OLPC--> Netbooks, Mobile phone 3G--> Pervasive Mobile Computing)

In contrast, the New York Times Science section recently ran a story on the rising costs of IVF back home.
A large portion of the expense comes from carrying multiple babies and the risks they carry as all too frequent premature births. It looks as if the CDC is talking to their African counterparts. The Times reports they hired an economist to look at the numbers.

In Atlanta, the Centers for Disease Control and Prevention hired an economist to predict what would happen if single embryo transfer were used in a large number of IVF cases.

Dr. Macaluso, the C.D.C. reproductive health official, estimates the patients, businesses and insurance providers would save more than $500 million annually, even taking into consideration the cost of extra in-vitro rounds, by lowering neonatal intensive care, special education and other costs of premature babies.

Expanded applications for Mobile phones in developing countries

The Economist has a special report on the transformative impact of cell phones in the developing world - a technology that we view as an enabler and multiplier of global health devices.

Tapping into a library of answers using cell-phones

I saw this article in today's New York Times about "Question Box" an answering service that people in the Uganda call into with their cell-phones and citizen-librarians scour the web for answers and call them right back. A simple solution that empowers and catalyzes development!
I was struck by the fact that these citizen-librarians are paid in cell-phone minutes ...similar to our approach to TB Therapeutic Compliance - XoutTB!

Microchipped BP Pills Remind Patients to Take Their Meds

Someone at a conference recently alerted me to this approach to compliance. Those are some tiny chips!

Microchipped BP Pills Remind Patients to Take Their Meds

Shared via AddThis

Simple Breath Counter to Combat Pneumonia

From our friends at Global Health Ideas, a new find for a live saving device---a breath counter.

healthcare + design award: fighting pneumonia in remote areas: "

I just discovered an interesting blog: healthcare + design and they had this post up on design excellence awards. Not sure how much this Breath Counter costs, but worth investigating further:

“Fighting Pneumonia: Breath Counter The Breath Counter is a simple, effective testing device to help detect pneumonia in children under five, living in remote areas in developing countries. Pneumonia is the number one cause of death in the under five worldwide, killing an average of two million each year. ”

Philanthropy by Design

“The Breath Counter was created within Philips Design’s Philanthropy by Design program, established in 2005 in which, together with partners such as Non-Governmental Organizations (NGOs), public bodies and social players with complementary expertise and values, Philips Design donates its creative expertise and socio-cultural knowledge to create solutions to improve the health and environment of the more fragile categories of the world’s developing societies.”

"

Medical Innovation in Nicaragua

The IADB is supporting our project in Nicaragua for an appropriate biomedical innovation cluster. We are deploying a number of learning kits so that local inventors, physicians, engineers, and public health personnel can develop their next little devices that could. I'll try to cross post as much as I can, but otherwise, please visit the team blog at http://iihnicaragua.wordpress.com

$10 Medical Simulation

No, it’s not OPERATION, but it take a few cues from it. We simple breadboard circuit to create a basic platform for a medical probe simulator. You can use any time of instrument but we started with a syringe (we’re trying to get a biopsy needle). Some tin for conductive leads placed in our tissue simulator and some emdedded anatomical structures provide signals to a circuit tied to a webcam that sounds an alarm if a wrong path in the “intervention” has taken place.

Our idea is to let the doctors and healthcare workers decide what type of instrument and procedure they want to simulate. We’re providing the electronic and mechanical tools for it.

Economist Magazine monitors XoutTB

The latest issue of the Economist magazine's Technology Monitor has a profile of our smart therapeutic compliance system - XoutTB.

THD Blog is now Global Health Ideas

Aman, Jaspal, Ben and company have outdone themselves. The venerable global health blog, THD (Technology, Heath, and Development) is now Global Health Ideas, featuring a fresh, clean look and feel with more of the same content that we have been used to seeing over the years. This has to be my favorite global health blog and I bet it will rank among your top 10, if it isn’t already. Take note of their new address http://globalhealthideas.org/ as well as their new RSS feed to keep your reader nourished.

http://globalhealthideas.org/feed/

Right now, they are live blogging the Global Health Council conference in Washington, D.C.

Check out some of the recent action

Global Health Council (GHC36): Trust & social desirability in m-health

Global Health Council (GHC36): No such thing as “HIV in Africa”

GHC36: Discovering New Strategies Using Proven [mHealth] Technologies

and a recent MIT spinoff!! Global Health Startup: SHE Innovates for Reproductive Health

Dr. Kris Olson featured in Scientific American

Dr. Kris Olson, who leads CIMIT's Global Health Initiative, just got featured in Scientific American 10: Guiding Science for Humanity. SciAm does a pleasant, if brief overview, of a physician who's at the forefront of changing the way we develop technologies for patients in developing countries.

From Scientific American:

One colleague told the Boston Globe that Olson is “The Man” when the topic turns to lifesaving technologies for the developing world. Last year Olson and the Center for Integration of Medicine and Innovative Technology (CIMIT)—a nonprofit consortium of Boston teaching hospitals and engineering schools—moved ahead with a program to demonstrate the effectiveness of $7 resuscitators, tubes through which a medical worker exhales into a newborn’s mouth. The program started after the 2004 South Asian tsunami. Since then, about 500 midwives in Aceh, Indonesia, have been trained to use the technology.

If want to learn more, go to CIMIT GHI. They even have a Facebook group.

D-Lab Health Update: May 9th at the MIT Museum

Where: MIT Museum
When: May 9, 2009
What: D-Lab Project Presentations including D-Lab Health

Our students have decided to address a group of multidisciplinary challenges they encountered in Nicaragua. Despite the awesome weather in Boston this weekend, they are furiously designing and prototyping in the lab to meet their deadlines.

What we expecting: We have devices that address issues in pulmonary drug delivery for the rural situations, post-operative infection control solutions, glucose monitoring, and novel centrifuge designs to enable accessible diagnostic procedures in developing world laboratories.

We'll keep you up to date!

Unite for Sight conference @ Yale

> I am at the Unite for Sight conference. A last minute registration +
> road trip with fellow D-Labbers led us to New Haven for the weekend.
>
> Some highlights
>
> - Appropriate surgical devices from BD (next post)
> - no wifi so it's difficult to blog
> - lots and lots of people!!!
> - Yale is prettier than MIT (but they don't let you bring drinks
> inside the buildings)
> - Blogging on the iPhone leaves much to be desired
>

Win $5,000: Designing for Better Health Competition

This is a fantastic opportunity for our readers.

The deadline for submission of entries is April 1, 2009. The three best entries win $5,000 each. For more details on the competition, please visit http://www.changemakers.com/en-us/designingforbetterhealth

Ashoka’s Changemakers and the Robert Wood Johnson Foundation have launched a global search for “nudges” – innovative little pushes that help people make better decisions for their own health and the health of others.

This year, the focus of this open forum competition is health---and there's only 4 Days left to Enter!

Full Disclosure: I am a judge in the competition. And naturally, I've love to see some really good entries.

D-Lab Health @ MIT

We have been incredibly busy this year. Starting today, I'm catching up to share what we've been up to. The blog has never really been about us and I kinda like that. Despite that, let me share...

Announcing D-Lab Health:

Medical Technology for the Developing World

I am teaching a new course we designed over the last few months called D-Lab Health. It's a new offering from the D-Lab family of classes. If you are not familiar with D-Lab then go to their website and catch up on some articles here and here. It's a cluster of MIT's academic offerings for the developing world under the leadership of Amy Smith, Senior Lecturer at the MIT Department of Mechanical Engineering.

The idea is create the next crop of little devices that could so I can blog about them. Maybe I can give the students credit for blogging about them (noted).

All kidding aside, what are aiming to train students to design the next set of medical devices for the developing world. This is what I do for a living at MIT and we thought it would be fantastic to show students who are already interested in appropriate technology how to go through the process as well.

Being a D-Lab class, our aim is to get them to do hands-on work as soon as possible. So we devised a series of training kits that could cycle the students through a series of medical technologies in at pretty good clip. Shown below for instance is the Drug Delivery Kit. Students were able to get acquainted with drug delivery technologies and make complete some initial design excercises.
The complete list of kits includes: Mobile telephony, Surgical instrumentation, diagnostics, microfluidics, imaging, and vital signs. The microfluidics has been incredibly popular for the students. They technology is certainly buzzing around scientific circles and it gives them access to very early stage hardware in which they can contribute their own designs and hacks.

Finally, after 8 weeks of cycling through technology and teaching them our approach to global health technology, we take them to Nicaragua for a week. In fact, they are down there right now and while we intended to have a live-blog going on at http://dlabhealth.blogspot.com/ , I think they have been too busy to be stuck in front of a computer (see Fig 1). The goal of the trip is to be able to spot local innovation, assess local challenge, and create a portfolio of problems by which they can design better device solutions.

More pictures to follow on the trip.

The D-Lab Health students travel back to MIT on Monday and we are very excited to begin Phase II of the class. This will involve applying the D-Lab design process to begin prototypes and understanding the nuances of medical device product development for these countries. We're excited!

For more information go to the D-Lab site.

You can also access to course pages and the entire set of materials in our Stellar page here. MIT is very open about and we are more than happy to contribute. If you have problems accessing anything, just leave a comment below.

XoutTB gets colors

XoutTB is a one of the projects underway at the Little Devices That Could Lab at MIT (ok, it's called something else). We have covered the technology in the past when reviewing therapy compliance for both infectious disease and chronic conditions. Technology Review was nice enough to cover the technology again. The story in the March issue also sports a new shot of the latest iteration of the actual diagnostic.

One of new things is a suggestion by Rachel Glennester: colors. Dr. Glennester is the Executive Director fo the Abdul Latif Jameel Poverty Action Lab at MIT. Since there is a specific sequence of diagnostics that the patient has to report, the addition of colors adds another way to randomize the sample and provides some variety to the user.

More at Technology Review

Spotlight on Brazil's Emerging Biotech Players

A report published last year in Nature Biotechnology points to the healthy growth of Brazilian biotechs against the backdrop of emerging players in India, China and South Africa. 

Of the main author's of the paper, Dr. Peter A. Singer,  states that "One thing is clear: when you think of biotechnology, its no longer just San Francisco, Boston, London and Tokyo. It's also Hyderabad, Shanghai, and Sao Paulo. While in the emerging economies it is still in it's adolescence, biotechnology is no longer the sole hegemony of the rich world. Biotechnology innovation is becoming globalized."

The paper covers 19 case studies of Brazilian-owned private health biotech companies and four public research groups. Unlike it's Indian and Chinese counterparts, the Brazilian case studies point to a focus to find affordable health technology for it's domestic population. While there is still no Pelé for biotech, there's several contenders.

"What you call a neglected disease, I call a business opportunity," said Fernando Kreutz, president of Porto Alegre based FK Biotecnologia. That type of optimism is what is needed to stay ahead of the investment opportunity curve. For Stateside investment firms not paying attention, firms like FK and diagnostics maker Katal Diagnostics, who makes a $25 TB test to replace the $150 version, represent real opportunities where development meets entrepreneurship and results in benefits for all both patients and investors. I don't want to play an armchair investment manager, but it's not hard to conclude that those who react to the current economic climate by circling the wagons and staying within our borders will miss out against those who choose to diversify abroad. 

The paper's press release notes some of the accomplishments of the Brazilian industry:

Notable products in the pipeline of various companies include:

• several monoclonal antibodies for cancer treatment (Recepta Biopharma, of São Paulo);
  
• a recombinant protein for treating melanoma as well as anti-hypertensive and an analgesic peptide – both isolated from snake venom (COINFAR, of São Paulo); and
  
• fetal, neonatal and adult stem cell therapies for cardiac disease, type I diabetes and neonatal hypoxia (Cryopraxis, Rio de Janeiro).

as well as some barriers to escalation:

A patent regime in desperate need of reform.

- Seven year wait period for patent processing

- Laws against IP protection of key biotech tools such as recombinant versions of proteins found in nature

- The national regulatory agency's final word on patented pharmaceutical products based on public access

Regulatory issues

- Lack of practical product development and manufacturing experience by regulators

- Long delayed in ethics approvals for clinical trials

- Complex navigation of biosafety and biodiversity rules

Human resources

- University centric academic models of research have yet to effectively transfer human resources specifically tailored to the health biotech sector

- Private enterprise are still working on ways to match career incentives systems currently found in academia and government sponsored research programs

We'll keep an eye of for the South African research paper and try to come up with a nice comparative review for our readers.