Before we move forward to Ebola, because Ebola was a unique model.
I'm excited about that.
I want to jump ahead to scale and as you're thinking about failure and
as you're thinking about success.
And I think the challenge is it does seem
like these innovations are context dependent.
So how do you actually find when things scale?
I mean this is one of the things that your center,
in particular, has been working on.
And some people argue you can't scale in development because things are so
dependent on local culture, local behaviors, the anthropology of the region.
>> Well, I mean, some of this may also get down to, what does scale look like.
And for us in global health a lot of what we are looking to scale are innovations.
And so you have these life-saving innovations where you do
want them to reach large parts of the population, and so you-
>> A vaccine, or a new hydration source.
>> Right, right.
So you can measure it in terms of coverage and often there are trade-offs,
because there's limited pots of money within governments.
And so they can't necessarily scale everything, but
you really do need targets and coverage and
you do want to be able to reach whatever your target mark is.
So the scaling piece is hard and
one of the things that we try to do when we work with our innovators is really
help them think it's not just about the idea that they are developing.
And this is very easy for the innovators to get focused on,
okay I got this great idea.
I want to be able to make it work, you focus on that technology.
Well they have to actually spend just as much time focusing on how do you
scale innovation.
And you have to do that from the very beginning.
So, how do you get innovators to think about designing with the end in mind?
And so the scaling piece is not something you worry about once you get your thing
to work.
The scaling piece has to be brought into the lab, essentially.
So we often say, one of the best places to fix problems with scale is actually in
the lab in the first place.
So, you- >> But
how do you foresee distribution problems, cultural problems?
How do you put that into design?
>> So much of that has to come with talking to the end user.
You've gotta build in that, you understand who is the end user for
that product, you go in.
>> Which is not someone on the hill.
>> Right, exactly, so you're going in and
figuring out who's going to use that product.
And it's not just the patient, it's the entire health.
In global health, you've got an entire healthcare system.
Yes, you have to think about the healthcare worker and
are they trained to be able to use it?
You have to think about how that product is going to get into that clinic.
And so you think about all the distribution channels.
So one of the things we make innovators do is map all of that out.
And so you spend time with your users, you get to understand your users and
what they need, what the conditions are that they're working in.
But then you map all of the stakeholders.
And when you do that, you can start thinking about distribution channels.
You start thinking about how the product's going to get from point A to B to C.
And then what happens when it breaks down and how do you fix it?
So all of those pieces.
I mean, industry does that all the time.
So industry brings in their marketing teams into their R&D process from
the very beginning.
So you're designing your target product profile with feedback from the marketing
teams who are thinking all the way down to the end of the chain, in terms of making
sure this product can actually scale to some level where it hits some target mark.
And so you have to work all of that backwards to the front end.
And then there's a process all the way along through development where
you're continuing to get that user feedback.
You're continuing to sort of reassess the market, think through distribution.
You gotta think through manufacturing really early on.
And some of the innovators get tripped up just because they design
a product pretty far along.
And then they bring in their manufacturing parter and they find out,
I didn't actually realize there are cheaper ways to do this.
Or if I design it this way it leads to these kinds of problems with supply chain.
And they they spent several more years redoing that process.
So you also have to design for manufacturing.
So all of these things are critical in terms of actually
developing scalable ideas.
>> This segment of my talk, I'm going to talk more about how we think
about scaling innovations and planning for scale.
And I'm going to share with you a new tool that we created and
some of the lessons and insights that we've learned and how you can do a better
job taking some of these tried and true practices from the private sector and
apply them in a global health setting and a development setting where
you're trying to work much more in a developing world context.
So just to provide a little bit more context in the beginning,
I had mentioned this earlier but in global health we have seen
many innovations that have been often created for a developed
world context first and they take a long time before they actually get introduced.
So they become available on the market and
then may take years before they're introduced in the developing world.
And then they face very slow uptake and low coverage.
And that's been the story of a lot of global health innovations.
And when we look at industry, look at big pharma,
we know they have well optimized processes.
So that day one when they have their FDA approval, they are out the door.
They have plans in place so that they can rapidly introduce and
scale their innovations, reach their peak market penetration in five to seven years,
get their return on investment, and they have accomplished their goals.
Now not all companies do that.
They don't always get it right, but
there's a lot that goes into achieving targets like that.
And so, we've thought a lot about how we can bring some of the practice and
thinking in how to achieve Much faster introduction,
faster uptake, for global health innovations.
And a lot of the solution lies in all of the things that happen
much earlier on before that product is ready to reach the market.