Is Innovation the Answer?

| January 15, 2013 | 0 Comments
Image credit: Sarah Greenberg, September 2011.

Image credit: Sarah Greenberg, September 2011.

Innovation, derived from the Latin for new, is the current buzzword of global health.  It is difficult to peruse the labyrinth of global health dialogue without noticing “innovation” peppered about like a golden stamp of approval.  In order for a global health idea to garner merit in the present atmosphere, it must be christened as innovative, as something shiny, exciting and new.  However, innovation is not always the answer; instead, we need a return to the aged basics of the tried and true.

The fixation on innovation is pervasive.  A Google search for “innovation and global health” reveals nearly 150 million results.  Stanford has a Center for Innovation in Global Health.  Yale holds an annual Global Health & Innovation Conference.  The Gates Foundation’s Grand Challenges encourage “innovative, early-stage research” to promote global health improvement [1].  The list is voluminous and these entities all do amazing work.  However, we are still left with the haunting reality that hunger is the number one health risk in the world [2].

Take a minute to consider potential solutions to several major health problems.  Over 6.5 million children under the age of five die of starvation each year [2], while the wealthiest one percent of the population owns 40 percent of global assets [3].  Is the solution to childhood starvation innovation, or food availability and resource redistribution?  Cardiovascular disease is the leading cause of death in the world [4].  Is the solution more innovative techniques to re-vascularize the heart, or a focus on prevention, smoking cessation, diet revision and exercise augmentation?  Thirty percent of the world’s population cannot routinely access medications [5].  Would the greatest benefits to global health come from pharmacologic innovations to create novel therapies, or insuring universal access to core medications we already know work?

As I recently walked through the corridors of a hospital in rural Haiti, it was painfully apparent that the biggest problems were not lack of innovation, but rather scarcity of the basics.  The wide-eyed emaciated child would not be in the hospital had he enough to eat.  The young man who just shuddered his last breath would not be dead had there been a strong surgical infrastructure.  These patients are not victims of a paucity of innovation.  They are victims of a dearth of a robust health system, abject poverty and blatant inequality.  The current fascination with innovation displaces responsibility for global health on the few with ingenious capacity to be innovative, while ignoring the fact that a more generalized attempt to create equity, political reform and functional health systems may generate a far greater yield.

I am not arguing that innovation has no role to play in global health.  My contention is that there must be a stronger collective focus on reversing the core causes of poor health.  Where there is no doctor, the answer is not innovation, but rather provision of a human being trained in the ancient art of medicine.  Gandhi once said “I have nothing new to teach the world.  Truth and non-violence are as old as the hills.”  We already know so much.  Before chasing the latest innovation, it is time to face the uncomfortable truth:  we already know how to cure much of the global disease burden.  By instituting proven concepts, treatments, and programs, much of the world’s ill-health could be assuaged.


Sources:

  1. Grand Challenges in Global Health.  Bill and Melinda Gates Foundation.  (Accessed November 25, 2012, at http://www.gatesfoundation.org/global-health/Pages/grand-challenges-explorations.aspx).
  2. Hunger Stats.  World Food Program.  World Food Programme:  2012.  (Accessed November 25, 2012, at http://www.wfp.org/hunger/stats).
  3. Launch of the WIDER study on The World Distribution of Household Wealth.  United Nations University – World Institute for Development Economics Research.  UNU-WIDER:  2006.  (Accessed November 25, 2012, at http://www.wider.unu.edu/events/past-events/2006-events/en_GB/05-12-2006/).
  4. The top 10 causes of death.  The World Health Organization.  WHO:  2012.  (Accessed November 17, 2012, at http://www.who.int/mediacentre/factsheets/fs310/en/index.html).
  5. Stevens, Philip.  Diseases of poverty and the 10/90 Gap.  International Policy Network.  London:  2004.  (Accessed November 25, 2012, at http://www.who.int/intellectualproperty/submissions/InternationalPolicyNetwork.pdf).
  6. Table I:  Human Development Index and its components.  Human Development Reports.  The United Nations Development Programme.  2011.  (Accessed November 20, 2012, at http://hdr.undp.org/en/media/HDR_2011_EN_Table1.pdf).
  7. Bezruchka S.  The Hurrider I Go the Behinder I Get:  The Deteriorating International Ranking of U.S. Health Status.  Annual Review of Public Health.  April 2012.  Vol. 33:  157-173.
  8. The World Health Report – 2002.  The World Health Organization.  WHO:  2002.  (Accessed November 20, 2012, at http://www.who.int/whr/2002/en/whr02_en.pdf).
  9. Mathers, C. D., A. D. Lopez, and C. J. L.Murray. Forthcoming. “The Burden of Disease and Mortality by Condition: Data,Methods, and Results for the Year 2001.” In A.D. Lopez, C. D. Mathers, M. Ezzati, D. T. Jamison, and C. J. L. Murray, eds., Global Burden of Disease and Risk Factors.Washington, D.C.:World Bank; New York: Oxford University Press

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