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Saving lives with low-cost, global health solutions

In the United States, we almost take it for granted that we will have access to the latest, life-saving medical technologies. But shouldn't people in developing countries, though they may have fewer resources, have access to those technologies as well?

"For decades, devices and medical technologies have been overlooked as potential ways to reduce disease in low- and middle-income countries," Sidhartha Sinha, MD, a postdoctoral fellow in the Stanford Biodesign Program, told me. "While the progress the WHO has made in getting essential medicines to those in need is commendable, there has been a relative lag in doing the same for medical technologies."

In a perspective in this week's New England Journal of Medicine, Sinha and Michele Barry, MD, director of Stanford's Center for Innovation in Global Health present a framework for making vitally important, affordable medical devices and technologies more available to low- and middle-income populations. These devices don't need to be expensive to be useful, Barry notes. For instance, WHO recommends infant warmers, water purifiers, parasite detection systems and child safety seats as some of the potentially useful, low-cost tools that are worth investigating.

But it's important to make sure that the devices truly meet local needs, as well as being cost-effective, said Sinha, who has developed novel water sanitization systems for use in India. In the perspective, he and Barry note that about 70 percent of complex medical devices sit unused at their destinations because of lack of capacity, infrastructure, trained personnel or distribution channels.

"Understanding the needs are fundamental to developing a successful product," Sinha told me. He also told me:

Additionally, there is a misconception that medical technologies only increase the cost of healthcare. While it is true that there are many devices, particularly in developed countries, that are not cost-effective, this does not mean that medical technologies overall are not good investments to improve health. We must find the most important medical needs and work in multi-disciplinary teams to come up with cost-effective solutions.

That is precisely what he is doing now in Stanford's Biodesign Program, in which physicians and engineers work together to identify critical needs in medicine, both in the United States and abroad, and develop products to meet those needs. The Stanford Center for Innovation in Global Health also has developed a multidisciplinary program known as C-IDEA (Consortium for Innovation, Design, Evaluation and Action), in which teams design products and services to address global health needs. C-IDEA is powered by an $8 million grant from the National Institutes of Health.

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