Source: New England Journal of Medicine
In-depth understanding of countries' needs can help innovators develop tools for rapid diagnosis of diseases such as tuberculosis
Innovations in medical technology promise to improve healthcare in low-resource settings, but will fail to do so unless each developing country's needs and capacity limitations are assessed, argue Sidhartha R. Sinha and Michele Barry.
Roughly 70 per cent of complex medical devices are unusable in the low-income countries that receive them. And there is a shortage of basic devices, because of their cost as well as a lack of capacity — trained staff, for example, engineered systems, or spare parts such as adhesive patches for electrocardiogram leads.
The authors argue that creating medical products that suit developing countries will take in-depth understanding of their needs, capacity building, cost-effective innovation and "a rethinking of what is considered a health technology".
Medical devices are often perceived as expensive and nonessential, but the WHO has identified low-cost infant warmers, water purifiers, ventilators and parasite detection systems as necessary technologies that should be investigated.
Innovation in medical technology has the potential to overcome resource limitations just as cell phone technology by-passed copper-wire landlines in the developing world, say Sinha and Barry. For example, mobile phone-based devices for monitoring respiratory and heart rates being field-tested in Uganda can provide health workers with basic information for pneumonia monitoring.
Technologies that 'leapfrog' conventional methods may be ideal for some countries, whereas for others incremental innovations may be more appropriate. But innovations radically different from existing solutions would require extensive infrastructure, and will probably not work in countries other than China and India, write the authors.
Collaboration between engineers, health professionals, business and social scientists will be needed to develop cost-effective devices, but this collaboration should also extend to public-private partnerships to ensure that local people benefit from them. Financing and regulations will also be needed to ensure efficient use of resources, and that technologies are not pursued at the expense of traditional efforts or the safety of vulnerable populations.
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