Medical innovations will only benefit the people who need them if the global health community becomes sensitive to the limited resources available on the ground, argues Takunda Matose.
Public health researchers need to follow the lead of the development community, says Matose, and work with health workers and community leaders to learn how to overcome barriers to the effective use of new medical tools.
The Bill & Melinda Gates Foundation has spent billions of dollars on grants to foster global health innovation. But five years on, basic health challenges such as malaria, malnutrition and the spread of HIV are yet to be solved.
Matose says we can learn from failed projects and identify obstacles that go beyond obvious financial constraints. He highlights five key areas that must be tackled to conduct efficient and effective global health research: cost, power sources, portability, local needs, and obstacles to training and support.
Researchers working on innovative tools need to account for the cost of prototypes, for example. They must also consider how to use healthcare tools where power sources are unreliable and inaccessible, and develop portable devices that can be used in remote locations.
And barriers such as politics, infrastructure and social norms mean that researchers need to focus on developing technologies that do not require extensive structural or operational changes. Hand-held diagnostic tools, for example, have a high impact with minimal disruption. Finally, simple technologies that can be used without extensive training will help to tackle brain drain.
Matose says that 'técnicos' — non-physician clinicians that relieve the burden on qualified physicians in Mozambique — are a successful example of this approach. The Gates Foundation's new focus on smaller grants can encourage this kind of innovation, he argues. But more can be done, and requiring researchers to include local collaborators in projects could be one small step in the right direction.