The purpose of this course is to introduce you to current global challenges in conservation and development, including changes in both sectors. This course will inspire you to rethink assumptions to address global challenges in conservation and development, and introduce you to new models and approaches that harness technological, behavioral, and financial innovation. This course will equip you with the insights, skills and approaches necessary to successfully overcome these obstacles. In addition, this course will provide participants with the tools, models, and approaches to address global grand challenges in conservation and development, to question fundamental assumptions, and to create and execute new solutions. Course participants will be trained in the processes around innovation and design to address global grand challenges. This includes content focused on constructing innovation pipelines, principals of design and engineering unique to the developing world and to conservation (Design for the Other 90%), on harnessing and developing disruptive technologies, principles of behavior and marketing, and on overcoming the challenges with setting up social ventures. The course format will facilitate the development of a global community of innovators who will help solve the current and future grand challenges our planet faces in conservation and development, and will encourage thinking about how to do so that rethinks traditional assumptions and approaches within both conservation and development. This course will leverage the incredible idealism and interest in social entrepreneurship, design, and innovation among the millennials, in the US and abroad, and is intended to appeal to those interested in the maker movement. It also seeks to engage individuals in the developing world who are closest to the problems of conservation and development, who would benefit from the approaches taught in the course, and who can leverage their own knowledge of local culture.
Getting to Scale
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來自 Duke University 的課程
Innovation and Design for Global Grand Challenges
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Entrepreneurship
Once you have your idea or innovation, how do you translate it into an enterprise (entrepreneurship) or a startup within a company or institution (intrapreneurship)? How do you influence other companies to adopt your novel approach (extrapreneurship)? How do you create a social enterprise, a value-driven organization that borrows heavily from tools of the private sector, or a new for-profit venture that has a double bottom line – the twin aims of both profit and impact? This module is an introduction to the art of the start – from understanding how to think about your business model, to putting together a team, to pitching for funding, and getting to scale. <p> To get started, view the video "Introduction to Social Entrepreneurship."</p>
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Alex Dehgan, J.D., M.S., Ph.DThe Chanler Innovator in Residence and the Inaugural David M. Rubenstein Fellow
Innovation & Entrepreneurship
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.
So, this just to kind of illustrate, if we typically have late
introduction flow uptake, and we want to actually shift the curve,
so we are further out here to some kind of optimal adaption rate.
There are a number of things that we think we can do, sort of better,
applying better practices, better planing for product introduction and scale up.
We should be able to start shifting those curves to the left and steepen them a bit.
But the other thing to recognize when we are working in the developing world
context is we're working in some markets that have a lot of inefficiencies and
some real, real challenges.
And sometimes we may actually have to think about ways that we can leverage
additional market tools and enhance the underlying market so that we're more
likely to be able to make it more optimal for introduction and for better scalar.
So we really think that the combination in many cases of both of these that's needed.
We've put out a market shaping primer and I'm not going to talk about that today but
it is available if you're interested in various text on market shaping.
Tools.
The other point to make is just to illustrate how important it is to get
your launch right.
And for those with,
in business school you may spend some time thinking about these things.
But there's some different groups, Kinsey, IMS and others have taken
a look at product launches, developed world product launches.
And seen that you have about a six-month window to get it right.
And if you end up on this lower level,
you had a little bit of time to course correct.
And if you don't get it right within that six-month window, very few innovators
will actually be able to recover and get back on the track where they want to be.
And so, it really illustrates how important it is
that you plan early and have a well orchestrated,
well planned launch out of the box right away.
And that's not a concept that in global health is sort of normal way of thinking.
A lot of what I've seen in global health is people don't even want to start
thinking about the launch, until you're pretty close to here,
because they say, but it might not work.
And so, if you have that mentality and start planning now,
you're already behind the curve.
So, one of the things we did is, as I mention as part of our business
model in our center is really bring in some of the best thinking and
practices from the private sector.
And see where it applies to global health.
So we brought together a lot of players from big pharma,
consulting firms, looked at successes in global health.
Looked at successes and failures outside of the sector, and really tried to compile
it into a framework that can guide a lot of our thinking.
And so we've got a nice guide that is available on our website.
You can download the whole thing.
But it lays out a framework which I'm going to walk through, and
also some case studies that helps sort of make it all real.
There's a workbook, and then a toolkit.
We pulled together labs, where we had all these folks from industry, sitting around
the table and saying, okay, well, it's clear they are all using different tools.
And their marketing teams have their own set of tools.
And when they start walking through each one of them,
you can kind of see the eyes light up around the table.
And then finally someone says, yeah,
I think we all hired the same consultants because they pretty much are all the same.
So, we started to realize there's a lot of similarity in terms of
how industry does this.
So the real question was thinking about how to apply it to global health.
So we broke it down into four different stages for simplicity.
But there's kind of that stage one, and we're also trying to think about something
that works for drugs, vaccines, diagnostics but also devices.
So it's very much of a product oriented view but it might apply elsewhere as well.
So stage one, identifying the needs in design,
then you start beginning your R&D, then you plan for introduction.
And this is that times zero right here,
where you launch your product that you've seen on the slide with the curves.
And so in each of these, what we've tried to do is bring the delivery lens to this.
So this is not the be-all and end-all of developing your product and getting sort
of the clinical approval, regulatory approval, or whatever you need to do.
This is really applying the delivery lens to it and
what you need to do to make sure you have a scalable idea.
And so I'm going to walk through these.
I want to point out that, like in any processes,
it is not an entirely linear process.
There's lots of feedback loops.
There's lots of going back to the drawing board.
Maybe it's the last step, maybe it's even further depending on how you do.
And so it's just important to keep that in mind.
So what we did in each of these areas, is we looked, well,
there's sort of common buckets.
Where you're thinking about some market and user understanding, manufacturing and
distribution.
Policy and advocacy, and clinical regulatory.
Where there are things you need to do in each of those categories
all along the way.
And so what we tried to do there is actually detail those out.
Now obviously, you can't read everything on here.
But in each, and we'll talk through some of this, I can't in 20 minutes,
walk through this.
This is days of training probably.
And for those in business school, it actually may sound awfully familiar.
But each one of these are steps that need to be taken, and
for each one of them, we actually have pulled together all of the tools.
And what's really interesting is when you start pulling together the tools,
you realize that a lot of these tools, you use them here,
when you actually still have little information.
And then you go back, and you check your assumptions.
And you re-update them based on more information.
And so you're kind of constantly revisiting a lot of these things.
And going back to, as your understanding deepens,
but you can use them throughout the process.
So and then, with just a caveat,
this is just actually launched this a couple of months ago.
And you are the first ones to actually get a more detailed walk through.
So you're a bit of my own user group, so
we'll actually welcome feedback in terms of whether or not any of these resonate.
It's going to be hard to sort of pack this into a short time frame.
So, the first thing to think about is that stage one.
So this is the stage, this is the formative stage of product design and
development where all of that starts.
And this is where your laying the foundation for
what becomes much more increasingly costly and complex later stages.
So this is where it is so critically important where you start to get that user
feedback from the very beginning.
And no matter what sector you're working in,
that user feedback is really the foundation where you've gotta start.
And you also need to consider the entire ecosystem of stakeholders.
We make a lot of our innovators actually do stakeholder mapping, and work through
who are all the various players along the way that they have to engage.
This where you also do you're early market segmentation,
start to figure out different user groups,
define your customer and kind of who you're trying to target.
And one of the things that's interesting when you think about developing world
context is customers.
You may have sort of tried and true practices, doing focus groups,
asking questions.
Customers in the developing world may not respond as well to the same kinds
of questions.
And so you have to think about sort of news ways of approaching them.
Also, if you're trying to get willingness to pay for your product.
One of the things we've seen consistently is a lot of the willingness to pay
analysis will often end up completely over inflated.
And you get a lot of people saying, yeah, I would definitely pay for that.
But really, taking out of context, in the end they might not, whether to minister
of health, whether it's actually, a patient to customer on the other end.
So, there's pieces, kind of important to think through.
And then also, this is where you really set your goals at the outset,
goals for impact.
What is your theory of change?
What is your desired impact?
And you stick to that, and you're constantly measuring.
So I'm going to walk through.
And then through the end, one of the things that you're going to get is you're
going to define your target product profile for your product.
So I'm going to walk through an example, this one is not in the health sector,
this is a company called Godrej & Boyce out of India.
They're a $4.1 billion Indian company.
And one of the things they sell is refrigerator and they figured out,
well, lets try and redesign our refrigerator and
sell to a lower income market that we are looking to reach into and
these were people that earned about 125 to $200 a month.
So definitely lower income market, lower ability to pay.
And so they figured, they could take their refrigerator.
Take out the fancy bells and whistles, kind of scale it down.
Sell it at a lower price and be able to break into this market, but
their market teams did some extensive market research.
And actually, through all of this research.
They found a number of issues.
So, they figured out this community doesn't use
refrigerators in the same way as their normal customers.
So, they have unreliable access to power.
They moved often.
They didn't actually think it's important to freeze ice or food, so
they didn't see any need for freezer.
They only kept items cool for about 24 hours at a time.
And so, it became clear to them after all this market research that they actually
needed to design a fundamentally different product.
And so, they had to kind of rethink that process.
And one of the things I found interesting is this,
the marketing guys had to convince the engineers.
But this was the case and they really resisted and
they had a hard time getting over the fact that who would not want a freezer, but
this market research was critical for them to really rethinking this.
So they developed this new refrigerator called the ChotuKool and
they even built in a fan that can be optimized during power outages and
it uses half the energy and it's about half the cost,
it's about a $69 refrigerator.
And then through this, they were able to actually discover other markets and
people using it for cooling beverages or using it in the office.
Maybe this could be a reverse innovation,
I think that would look kind of cool in a dorm room.
[LAUGH] But anyway, sort of this process was an important one.
And so, when we brought this in is just a way to think about it.
A lot of these lessons, you pull from other sectors that even apply
in the health context and it's really important to make sure you
challenge your own assumptions if you're the developer or
if you are the expert and your assumptions on what users want may be wrong.
And you have to really be able to listen and I even see that true in
the technical experts we work with who know they know what people need.
And so, getting them to actually step back from that and
kind of backing that up with data.
So really understanding your consumers, understanding the customers.
It can be a valuable participants in the design process.
So, I'm going to move onto this next stage.
And so now your potential solution, your target markets has been identified.
You're articulating that through your target product profile and this is where
you're really starting to work on your product development in earnest.
And you're starting to do your prototyping, you're thinking about how
you're going to demonstrate proof of concept that it works or
put your things in clinical trials and
this is where you start to really refine what are your pathways to scale.
Take some of those fuzzy concepts from that earlier stage and
they start to get a little more clear.
So you should be estimating your cost of goods sold,
really understanding manufacturing.
Thinking about that manufacturing process now, user segmentation.
And important to really think about what are the bottlenecks along that
entire value chain and analyze that now, so you can design for it and
plan for it in advance.
And start planning for manufacturing and distribution early, as well.
And we even hear from innovators who did not do that and brought their
manufacturing partners in later and then ended up spending several years
redesigning their product, because they really didn't design for manufacturing.
And they made wrong assumptions or
didn't really understand supply chain well enough.
And then another thing is that for those in business school,
this may seem like this is pretty straight forward, but
I have to tell you in global health, what we see over and
over again with a lot of the innovators we work with is they're consistently
focusing much more on the product and not on all of these pieces.
And they really view this as something that happens much later in the process,
but you bring these things in early it will.
It can have an impact on the design of your product and
help you really figure out whether or not you have the right product for
the right market, which is essential to actually being able to scale.
So, I'm going to give an example here and
you all heard already from Krista Donaldson from D-REV.
And this is an example of one of their products for a phototherapy device,
which we actually funded through Saving Lives at Birth.
And so Christa and team, they already had another product in phototherapy.
They already had another product.
They knew this market well and
they wanted to be able to take their phototherapy device for jaundice for
newborns and take it not just for the hospitals that they were serving, but
be able to take it down to a clinic level and be able to reach more patients and
reach rural communities that didn't have access to these things.
And then they ended up doing and I think I have this additional slide.
So they really spent the time understanding all of the different stake
holders and all the different purchasing, and user scenarios.
They did these user journeys.
They mapped out all the possible purchasers.
Looking at urban hospitals, rural hospitals, public,
private and end and each of those has different pathways.
And you can't generalize, you have to really understand each one and
then they mapped out all of the stakeholders along the supply chain and
understanding what all of their different needs are.
And in doing all of this, they actually developed some pretty important
insights and one of them, so kind of to just quickly summarize.
One is they found out that in these rural communities,
they're not even doing in patient care.
So one thing is critical for phototherapy device is you actually can leave
the newborn under the lights for extended period of time, you might need
that baby to stay in the clinic, but they were sending them home at night.
And then you've got unreliable power, which any engineer can solve for,
but the question is whether or not it makes sense.
You needed community outreach for
the home screening after you send that newborn home.
That didn't actually exist.
You need screening and diagnostics for any jaundice therapy to be effective.
That was nonexistent at the rural level.
Even when you're treating, they were discovering there is comorbidity.
So if you actually treat the newborn for jaundice and
they are not properly wrapped up, then they actually can get hypothermia,
which can be just as dangerous as jaundice.
So really kind of understanding all of these different dynamics.
And then even understanding the clinical training necessary.
And this is a great example,
just because in health, it's very often not just about the product.
But you have to understand the entire health ecosystem that you're trying to
put your product into.
And the setting, deficiencies in the setting,
the healthcare workers, their training, their skill level.
All of these things are essential.
So through all of this learning,
they actually decided that the product that we were funding them to develop was
not the right product at this time for this market, and they have pivoted away.
And to their credit, they've done a really nice job of outlining a lot of
why this actually didn't work.
And without having done that research,
they could have continued on and taken that product pretty far.
But they figured out these signals early and realized they could design
a product that works but it will never have the impact that they needed to have.
And so therefore they've moved on and focusing in other areas.
This third area, which is really where,
this is where you've got your product, your prototype and
you're really ready to get your development testing underway.
And your focus is starting to shift more toward planning for launch and
introduction.
And so you're going to start focusing on the necessary regulatory approvals,
if you're in the health side, developing your manufacturing capabilities,
establishing your distribution channels, organizing your demand generation
strategies, providing training, all of the things necessary to prepare for launch.
And at this time, you're still revisiting a lot of the work that you've done.
Understanding your users, understanding the market segments.
And so in some cases,
still may be several years out from when you're launching your product.
So it's not as if this is just a few months out,
this could be several years out.
It's hard because some things have shorter timeframes than others, so
it's hard to really fully dimension it.
But the point is that you want to have all these things buttoned up so
that the day you're ready to launch, everything's lined up and ready to go.
So I think we've got, I'm actually going to skip this one in
the interest of time, but can come back to it.
It's an example of microbicides where there've been some interesting insights.
And then move on to example, this is cycle beads, and
this is one of the case studies in our guide.
And this is probably the simplest form of
contraception out there using a standard days method where you're essentially
can figure out what parts of the month that you can abstain and
you can have significantly reduced your risk of pregnancy.
So and there's this group at Georgetown actually figured out how you can
use these beads, which has one bead for each day of the month.
And you can just move a little ring around and
figure out what day it is and which days you can actually abstain from intercourse.
And keep yourself from getting pregnant.
So very simple product, and they actually.
Mali got really interested in this.
And Mali has about 4% of their population has access to family planning at the time.
4%.
So they were really excited,
the government was really interesting in this product.
And so Georgetown got excited, they've got their manufacturer lined up.
The government had all these sort of big thoughts in mind in terms of just rolling
this out quickly which they all preceded to do.
They did some health care worker training.
They fullfilled a big manufacturing order but demand didn't materialize.
And health care workers were reluctant to promote it.
Women were not interested in using it and so they pretty quickly had to kind of stop
and completely regroup and figure out what they needed to do.
They clearly needed to, they had to double down on healthcare worker training, so
they actually went back and brought in an experienced NGO partner on how to do that.
They had to rethink logistics, and so they worked with the government and
their supply chain teams to get much better estimates of demand.
And then they had to really go back in and think about demand generation, and
brought in a social marketing group to be able to help think that through.
And that really helped them turn it around.
But it's just a way to illustrate how,
particularly on the demand generation side, how important that is.
Can we do questions now, or do you want to wait until?
>> We might want to wait a bit.
>> Okay, sorry about that.
And then I'm just going to quickly get through the last piece,
pivoting toward, and so key lessons is really,
one of the things that I think the assumption was you've got
the government on board, you've got that political will,
is that enough to help scale and clearly all that enthusiasm was not enough.
This last stage, this is where you've got your new product, your new service,
you've launched, you've scaled.
And you're now kind of out the door.
You're monitoring your progress.
You're expanding your product to other countries and regions.
This requires persistence.
It requires adaptability.
It requires that long term investment, which can be time and resource intensive.
But that's where you really are working on scaling.
And often you're picking where the first places to introduce initially.
You can't cover the developing world all at once.
No big pharma company will.
Often they pick one or two markets to introduce and
you have to really figure out where are the best places to introduce.
And have a whole strategy built into that and
really continue to understand where the supply and demand bottlenecks,
how can you evaluate your sort of demand generation strategy
when things perhaps are not going the way you need them to go and then refine.
So the last example I have is one that comes out of a West Kenyan NGO.
And they were involved in expanding a water treatment offerings.
And they decided to bring on as kind of an additional solution some
durable ceramic water filters, or these water pots.
And so, they contracted with a Kenyan manufacturer.
It had a certified ceramic water pot and
it had a good track record, had experience reaching more of the low income markets.
And so they started this process but
they found out that sales were low and they went back and
further evaluated to pinpoint a number of uptake challenges and they actually
figured out a lot of it went back to the manufacturing and distribution.
So the product was too expensive for the market, transportation costs for
this particular product were really high.
The product was hard for vendors to actually take out into the villagers.
The villagers actually wanted to see it, and feel it, and
try it before they agreed to purchase it.
So they ended up completely pivoting and bringing on board a completely different
manufacturer that helped him overcome a lot of these different challenges.
And And so it's one to just illustrate how important it is
to select the right manufacturing partner.
Sometimes that changing and pivoting may be harder.
And we've got one grantee right now where I can look at it and
I know for a fact that they've picked the wrong manufacturing partner.
And that manufacturing partner Is not equipped to be able to scale for
the kinds of markets we need.
And it's creating some real challenges for them.
They don't have the experience, they don't have the bandwidth,
they don't have the capacity.
And figuring out how to backtrack out of those once
you've got licensing deals gets a little bit harder.
So, I'm just going to recap a number of these lessons here, in summary.
One is begin with the end in mind, and we talked a lot about that.
But it is absolutely critical to having a scalable idea is you've
got to bring that scale concept to the beginning.
And we talk about it as the best way to fix problems at scale is in the lab
in the first place.
But also design for manufacturing, and
so don't assume that you bring your manufacturing partner on late,
or you may end up with some big delays in the process.
Fail fast.
Silicon Valley talks a lot about failing fast.
Pivoting is necessary, but
it's important if you're trying to move out there quickly.
Don't underestimate how hard it really is.
Understand your theory of change and
that estimated impact from your product inception.
And D-Rev did a really nice job of that.
They knew the kind of impact they were seeking, and they figured out that that
product that they had was not going to deliver that kind of impact.
So, because they've laid it out well, they were able to make decisions accordingly.
Test your scaling strategy, you get out into the field, you test it with users,
you try it out.
That is where you are going to start to see where you have distribution
challenges.
Where maybe some problems with supply chain you didn't anticipate, or realize
that the ecosystem has a number of other challenges you didn't anticipate.
And your product has many other things that revolve around it that you
need to also work through and understand that broader context.
Think about every stakeholder as your user, even your manufacturer,
if you have a happy manufacturer, you're more likely to scale your product.
So constantly bring that sort of user perspective in.
And then always just remember, the design process is never over and
you're continuing to sort of build and iterate and do better.
