Friday, August 3, 2012

[EQ] Technologies for global health

Technologies for Global Health - The Imperial College London/ Lancet Commission


August, 2012 – “………Collaboration between The Lancet and Imperial College London, UK, has resulted in a new Commission, which examines how medical technology should best be used to improve health in low- and middle-income countries. The report concludes that in many cases, medical technology—almost exclusively developed in rich countries—is simply inappropriate for use in poorer nations.

Executive summary

According to hospital inventories, an estimated 40% of healthcare equipment in developing countries is out of service, compared with less than 1% in high-income countries. The inappropriate deployment of medical technologies from wealthy countries plays a major part in this high failure rate.

Instead of relying on hand-me-down technologies from wealthier countries, which can be costly, inappropriate for local conditions, and even dangerous, the authors urge a renewed effort towards developing what they call "frugal technologies"—cost-effective technologies that are developed specifically to cope in local conditions.

Examples of frugal technologies which have been developed to meet local needs include: the Jaipur foot, a rubber prosthetic for people who have lost their leg and foot below the knee; PATH's Uniject injection system, which allows once-only use of needles for injectable contraceptives; and the eRanger, a durable rural ambulance, based around a motorbike and stretcher sidecar (which can be modified to carry one or two people).

The report also advocates a wider understanding of what we mean by medical technologies, pointing out that technological improvement to sanitation and road conditions could also have a far-reaching impact on public health in many low- and middle-income countries. Furthermore, the authors argue that advances in technology need to be accompanied by innovation to have a significant effect on health—this includes the development of effective delivery mechanisms and novel approaches to financing.


The Lancet, Volume 380, Issue 9840, 4 August 2012  

Technologies for global health


“……As well as making existing technologies accessible, new technologies specifically designed for the poorer settings—frugal technologies—are important. The Jaipur foot, a rubber prosthetic for people who have a below-knee amputation, is an example of a frugal technology that has been successfully rolled out in 22 countries. But still desperately needed are vaccines that are heat stable, a heat-stable form of oxytocin, and a test for sickle-cell disease that can be used in resource-poor settings. New frugal technologies do not have to be sophisticated gadgets, but can be as simple as a checklist. A 29-item Safe Childbirth Checklist has been developed and successfully piloted in India, with a draft version available by the end of 2012.

Technologies do not have to be specifically designed for health purposes to have an effect. Information technology has a part to play in ensuring that health advice, or behavioural interventions, reach the greatest number of people, for example via mobile phones. And the wider technologies associated with improving road safety, sanitation, and food supplies are crucial to improve health for all.

Innovations in distribution, including working with the commercial sector, are also important to ensure that technologies reach those who need them, even in remote areas…..”

Technologies for global health

The Lancet, Volume 380, Issue 9840, 4 August 2012  

Peter Howitt  a , Prof Ara Darzi  a, Prof Guang-Zhong Yang  a, Hutan Ashrafian  k, Prof Rifat Atun  l n, Prof James Barlow  n, Alex Blakemore  i, Prof Anthony MJ Bull  d, Josip Car  m, Lesong Conteh  a, Graham S Cooke  f, Nathan Ford  f, Simon AJ Gregson  g, Karen Kerr  a, Dominic King  c, Myutan Kulendran  c, Prof Robert A Malkin  d, Prof Azeem Majeed  j, Prof Stephen Matlin  a, Robert Merrifield  a, Hugh A Penfold  o, Steven D Reid f, Prof Peter C SmithA c, Prof Molly M Stevens d h, Michael R Templeton  e, Prof Charles Vincent k, Elizabeth Wilson  b

The Lancet

“….Availability of health technology is inversely related to health need. Although health-care systems in high-income countries make extensive use of technology, people in the world's poorest countries often lack the most fundamental drugs and devices. A concerted global effort to encourage the development and use of health technologies that can benefit the poorest people in the world is needed …..”




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