Achieving the UN Millennium Development Goals

This blog's purpose is to connect in an every widening and deepening manner with others across the globe in support of the United Nation's Millennium Development Goals.

Let's be the first generation to end poverty by 2015 with the United Nations' Eight Goal Millennium Campaign.
1. End Hunger 2. Universal Education 3. Gender Equity 4. Child Health 5. Maternal Health 6. Combat HIV/AIDS and other diseases 7. Environmental Sustainability 8. Global Partnership.

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Speaking Out for the Millennium Development Goals

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What If - Millennium Development Goals Ending Poverty 2015

Wednesday, August 19, 2009

Galapogos Effect - Scaling in Health Care

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This post fits in with both the concept of Scaling versus Diffusion and with Global Health Care, two issues which have been dealt with in the recent past. From Hardware to Collaborative Philosophy "Whatever it takes" dealt with scaling. This article from FastCompany by Robert Fabricant appeared in July. I find scaling versus diffusion an interesting topic and Global Health Care a good medium for exploration. Robert Fabricant takes a biological approach to global health care delivery using the Galapagos Island Effect because, "It has evolved its own ecosystem and business practices that reflect this isolation" to understand the issues from a pragmatic perspective as to how best deliver services. As usual far more information is available at the orginal article.

TB: The Galapagos Effect in Health Care
And it was very apparent at the Pacific Health Summit despite the presence of some of the most brilliant minds in public health (like Tony Fauci, Paul Farmer, and Laurie Garrett). Despite their best efforts, industry leaders continue to betray an outdated, manufacturing mindset, referring to everything that has impact in the field--that touches communities and provides real human value--as "delivery." This one-way model of engagement is truly shocking in an age dominated by communications technologies and connectivity. Health is not 'delivered' to people. It relies on active engagement and participation. It is a dialogue.
He goes on to deal with some myths that to my mind can be applied beyond the health care field which a bulleted below.
  • #1: Innovation Happens in the Lab
  • MDR-TB vividly demonstrates that solutions that work in the lab are not necessarily well-suited to the behavior and cultural conditions in the field. So why not build those conditions into the model from the beginning? As designers, we find those conditions to be inspiring.
  • 2: Innovation Only Flows in One Direction
  • The prevailing direction of health-care innovation is not just from lab to field but also from first to third world. The "business" of delivering global health services was a post that featured both Dr. Ernest Madu: Creative ways to bring health care to the poorest and #Dr. Seyi Oyesola: Rich hospital, poor hospital
  • #3: The Field is Messy
  • The article points out that it is humans that are messy. This challenges us, "to think more broadly about human needs and behavior. To step outside the narrow lens of a particular condition."
  • #4 Innovation must be Market-Driven
  • The myth is that impact cannot be scaled and maintained without a market mechanism. This goes back to the idea of scalability as defined by market know-how. But as pointed out in the article, "does it hold equally true to scaling up access, outreach and support? How innovative are the large multi-nationals in this area particularly in relation to the routine and chronic diseases of the poor?"

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