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Building medical devices to address global health issues

Arundhati Parmar

Let the best not be the enemy of the good.

That notion is key to building devices to tackle global health challenges, according to Harshad Sanghvi, who has spent 30 years in developing innovative solutions for poorer nations, especially in emergency obstetric care.

Sanghvi, vice president of innovations and medical director of Jhpiego, a Johns Hopkins University affiliate dedicated to improving the health of women worldwide, was speaking recently at the University of Minnesota’s Design of Medical Devices Conference in Minneapolis.

He stressed that “frugal engineering” and “frugal design” are critical to serving the needs of people in nations like Nepal, Afghanistan, India, Bangladesh and Africa and other low-resource nations.

But simple by design and function doesn’t necessarily mean lower quality. As an example, he talked about a company that sells a $120 HPV test for cervical cancer detection in the first world, but a $5 one in poorer nations.

“The $5 test actually works better,” Sanghvi said.

He explained that in this case the company isn’t too worried that the $5 test will cannibalize the $120 test because the latter only accounts for 10 percent of the market.

Sanghvi also highlighted a simple preeclampsia test that his group helped to develop that women in rural areas could administer at home without any clinical expertise. Preeclampsia affects pregnant women and can be fatal for both mother and baby.

In designing products for global health, the challenge is to understand the local circumstances that may affect how many lives can be saved. For instance, how to design a life-saving product in a region that has power cuts regularly? Or a place where clean water is not available.

Understanding local needs is the biggest change compared to how devices were designed for the overseas market in the past, said Mike Hess, vice president of innovation at Medtronic.  Previously, companies simply sold older, and therefore cheaper, models of their current products overseas. But now a system-wide change is occurring with research and development centers popping up regionally.

“We have had a centralized model for the last 50 years where physicians came to us with a need and we made products and sold them globally,” Hess said. “But now we are seeing evolution from a centralized model to a local, regionalized approach. Ideas come to the regional (R&D centers),” and they will develop products that serve the local needs.

And serving those local needs in less prosperous parts of the world provides the opportunity to save millions of lives, Sanghvi said.

“Building simple, effective and low-cost products is much, much more challenging and more thrilling than designing more complex solutions,” for a smaller, domestic market, he noted.

Sanghvi shared an anecdote of a woman whose son had joined his efforts in helping improve female and newborn health. The mother told Sanghvi that her son was working for him for $30,000 by declining an opportunity to earn $120,000.

“But I am happy,” Sanghvi said the lady told him. “All his life he has talked about how his inventions would get him a million dollars and for the past one month he has been saying how they will save a million lives.”

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