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Jeff Raikes on the 'Innovation Pile Up'

October 04, 2012

(Jeff Raikes is chief executive officer of the Bill & Melinda Gates Foundation. The following post originally appeared on the foundation's Impatient Optimists blog and is reposted here with the permission of the foundation.)

Jeff_raikes_headshotWelcome to my new blog series, where I'll be sharing my thoughts on the Gates Foundation and philanthropy. Every six weeks I'll be posting a new blog discussing a pressing issue at the foundation or addressing some of the challenges and opportunities facing the philanthropic community. More than anything else, this is a space for a conversation. So please submit your questions, share your feedback, and let me know if there are any topics you would like to hear about.

For my first post, I want to discuss a challenge at the foundation that's been on my mind lately. It's called the "innovation pile up." Let me explain.

At the Gates Foundation, we believe in the power of innovation to improve lives. That's why over the last decade we've invested in one of the fattest pipelines of lifesaving technologies the health and development world has ever seen. A new, rapid diagnostic test for tuberculosis that will help reduce transmission of the disease. Better tools to enable women to plan their families. Even improved toilets that provide clean sanitation for the world's poorest people. In all, the foundation and its partners have developed more than a hundred new innovations that are available today or scheduled to be introduced by the end of the decade.

That's the good news.

Here's the bad news: None of these innovations will make a difference if they can't reach the people we aim to serve.

Many obstacles stand in their way. Some public health systems in the developing world lack staff, training, or infrastructure to take advantage of these new tools and technologies. Regulatory agencies can be slow to approve new drugs and devices. Market forces may make it difficult to introduce these new products. Then there are actual roadblocks. Transportation systems and roadways may be so bad -- or nonexistent -- that just getting these new tools safely to the people who need them is a challenge. Finally, even if new drugs and tools arrive in remote villages, cultural practices may dissuade people from adopting them.

That's why we need to get smarter at delivering these innovations. If we don't, we risk not improving and saving as many lives as we could.

At the foundation, this challenge has been dubbed the "innovation pile-up," and solving it is one of my top priorities. As part of the re-organization of our global programs, which I outlined in my 2011 annual report letter, we are now balancing our research and development efforts with a greater focus on how these innovations will get delivered. Chris Elias, our new president of global development, brings decades of on-the-ground experience in heath and development. He is leading our work to better understand the obstacles to introducing and scaling access to new tools and technologies and how we can overcome them.

We've already learned a lot about effective delivery from our work on vaccines. We have a better understanding of the best funding mechanisms for new vaccines and the most reliable ways to deliver them safely to the remotest health clinics. Thanks to these efforts we are on track to significantly scale up the delivery of lifesaving vaccines in developing countries and prevent the deaths of millions of children under the age of five by the end of the decade.

Now we need to build on this success and ensure other promising technologies reach the people who need them the most. We are exploring ways to integrate some of these new innovations into existing delivery systems. For example, a new, easy-to-use injectable contraceptive that would provide women living in remote areas a simple, effective family planning tool will likely be introduced through family planning programs already operating in these countries.

Other existing innovations will require new delivery systems and business models to be successful. Consider the challenge of expanding access to a simple, lifesaving product like the mosquito coil. The spiral-shaped insect-repelling incense has the potential to protect families from malaria-carrying mosquitoes. But the cost -- even at pennies per day -- remains out of financial reach for many of the world's poorest families. Donors may be able to help drive down the costs for these families, but there hasn’t been much interest in this solution without more data on the impact of wide-scale coil use. That's why we’re working to fill this knowledge gap by funding new research studies. We're also exploring next-generation mosquito repellents that would last for months, cost less, and not require burning. All of these solutions will require the cooperation and partnership of governments, the private sector, and consumers to be successful.

These are tough challenges. But I'm confident we can overcome them. We now have a team dedicated to speeding up the delivery of existing innovations and finding new system delivery models for entirely new innovations. More importantly, we will be listening closely to the people who will benefit from these innovations. By understanding their needs, we can design the best solutions and most effective ways of delivering them. Working together, we will realize the full potential of these innovations, and, in doing so, help the people we serve realize the full potential of their own lives.

-- Jeff Raikes

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