Rice 360° Institute for Global Health | 100&Change: The Finalists Live Presentation
Continue. Your tweeting don't. Mean to interrupt. So. What comes to mind when you think of. Technological. Innovation, in healthcare if, you're. Here, and you're fortunate enough to live in the United States or develop plan you might think it's a piece of wearable technology one. That counts our steps and tracks our heart rate maybe it's a state-of-the-art, imaging, machine that can detect illness, earlier. But, what about those not quite, as fortunate. What. About those living in Africa a place where more than 1 million, newborns, die, each year from what are mostly preventable. Causes. Preventable. But only if, life-saving. Technologies, many of which we take for granted are available. Our. Next finalist team, has been working together to develop life-saving. Technologies, for 10 years, welcome. Rice 360. Institute, for Global Health, dr.. Queen Dube from the University, of Malawi, Rebecca. Richards quartum from Rice University, Robert, near Ross from third stone design and joy lawn from the London School of Hygiene and Tropical Medicine. Every. Year in Africa. 1.1. Million newborn, babies die. Most. Of these deaths, could. Be easily prevented, but. Existing life-saving. Tools are, too. Expensive or break, down in the harsh conditions of African, hospitals, that's. Why we created nest, a special, portfolio. Of newborn, essential, solutions, and technologies, designed. Specifically. To work in Africa to, be effective, affordable. And sustainable, with. 100, and change we will complete the innovations, to nest we will distribute nests to hospitals, across Africa. And we, will continually, measure its impact to, improve results. 1.1. Million, newborns died, in Africa this year that's, why your investment, is needed in nest now. My. Name is Quinn Dube, I'm. A pediatrician. Working. In Malawi, I look. After newborn. Babies. Every. Day I go to work I see. Babies die and. The. Most painful bid, for a doctor, is, actually, knowing. That you could have saved those, lives if. You had the, tools to enable. You to do, so. Sadly. What I see in my hospital, is happening. All across Africa.
So. Every, year in Africa we, lose 1.1. Million. Newborns. The. Heartbreak, is the ladies and gentlemen. 75. Percent, of those deaths are actually. Preventable. Preventable. With technologies. That, have been available in, the United States, for. Over 50, years, what. Actually, kills these newborns, hasn't. Changed over the past hundred years it's. Either they are born to Ellie they. Have an infection, onboard or they, suffer from some base related, trauma. My. Hospital back home every, year around about June July we. Receive container. Full of donated. Equipment it's, it's a joyful. Moment. But. The equipment fails. It. Doesn't, save the babies, because. Of devices. Are not tailor-made, to withstand the, hash African. Environments, the, heat the. Dust the. Frequent, power outages, and we. Don't have, the spare parts, to fix the technologies. So the equipment ends up in the equipment graveyard, this, is a picture of the equipment graveyard, in my hospital at the end of my long shift, I go, there and I pay my respects. These. Technologies. Donator technologies. They, don't save the babies are supposed to save. What. Africa, needs is a, solution. Africa. Needs, technologies. That, I effective. Technologies. That are affordable, technologies. That, are sustainable, equipment. That doesn't just break down and. That's. What we steam the, nest team is all, about nest. Standing, for newborn. Essential, solutions, and technologies. Alpha. Team we've, developed, a package of 17 technologies, a package. That addresses. All the three, major killers, of a, newborn, addresses. Nutrition, infection. Birthing later trauma. Jaundice. The, baby you see in the middle is. On breathing support, on top. Of us supporting, their breathing, they, need to be kept warm they. Need to feed if, they have an infection on board an African doctor should, be able to treat them and that's, what mist is all about. What. Really excites. Me as an African is. The cost of nest. Delivered. At scale, ladies. And gentlemen nest as a package, actually. Costs $1 for eight cents per. Bath delivered. At scale but. For us as a team to bring it to scale we, need a hundred million dollar investment. Nest. Is ready to scale through things that we're going to do as a team innovate, complete, the package who, distribute. The package first in my home country Malawi, home is best, Tanzania. Nigeria. The, rest of Africa, what about Asia, Brazil. Nepal, we. Won't miss to be there we. Want to measure the, impact of nest, how, many lives are we going to save as.
A Team, we, are more, than ready to, make. Sure that nest is available. Ensuring. That these, African newborns. Have a secure, environment, closing. The survival, guard for Africa, when. The SDG. Era sustainable. Development, goes well, everybody. Says. Leaving, no, one behind and, as, a team we, are ready not. To leave that African newborn behind. So, many African, newborns, 30, years from today they share this stage to. Tell you how we plan, to build, the nest is the. Mama of the team a great, engineer. Powerful. Innovator, who, take us through how we plan, to build, the nest Rebecca thank, you Queen. When. The 100 and change initiative. Came out we, knew, it was our chance, together, with Queen and her colleagues, to, make sure that clinicians. All across Africa have. The tools they need to help babies, survive. $100,000,000, means, the chance to solve this problem it is. Within our, grasp our. Solution. Has three parts, it, begins with innovation. We. Will, deliver the 17, life-saving. Innovations, of the nest package, we, will partner with nursing. Schools with, medical, schools and with engineering, schools to, train the clinicians, the, technicians. And the engineers, who are dedicated. To improving newborn. Survival. Hospitals. In Africa, they, need a simple. Way to order, nest we. Will solve this problem by establishing a non-profit. Distributor, by, the end of 100 and change this, distributor, will be financially. Sustainable. Creating. A permanent, solution. Now. We know, that we can't scale nest, without, broad. Demand, we need demand from governments, from w-h-o, from, UNICEF and also from the private sector. Generating. That demand, requires, rigorous. Evidence, and we will measure the, number of lives that are saved by, nest and the cost to save those lives and, we will use that data, to generate multi, country demand. How. Do we know that, we can do this, because. We have already done, it for the first nest.
Technology, I. Will. Never forget, my first visit, to Queen's Hospital in. 2005. I. Saw. Many, tiny. Babies, like chicken, jet so who you see here fighting. To breathe and queens, she, explained, to me that half, of babies who are born too soon they. Struggle, to breathe because their lungs are immature and, we, know that without treatment most of these babies will die. She. Also took me to the equipment graveyard, at her hospital, and she explained, why, the breathing, machines that are used in America, do. Not work in her Hospital. Now. I am an engineering, professor my. Job is to teach students. How, to build new innovations, to solve real problems so. We. Got to work we got to work with Queen and her, team and we designed a breathing, machine that, was effective, that, was affordable, and that was sustainable. We. Have our first prototype here, today and I gotta tell you when, we showed, that it delivered, the same therapeutic. Flow and pressure as breathing machines used in the United States we. Were so excited and, we, got on a plane and, we proudly, took, it to Queen and, we showed it to her and. She. Told us everything that was wrong with it, she. Said it's, in a shoebox it's, too flimsy it's gonna break you have tubes coming out the front and tubes coming out the back they, need to be polarized, the, buttons, need pictorial, icons, but. She said can. We keep it can. We use it to start treating, our babies, and, so. We worked and we made all of the improvements, that they requested, and we were so fortunate to, receive one of the very first saving, lives at Birth grants, from USAID, and. We worked with Queen to, measure the, impact, of this technology and we show. That for premature, babies treated, with this breathing device. Survival. Went up by 40%. And that mirrors, the improvement. That was seen when. This technology, was introduced, in the United States, in the late 1960s. Together. We, named the, device poom Ani, it's, a malawi n' word that. Means breathe, restfully. And. With. This data in hand we. Partnered. With Malawi's. Ministry of Health we got more support from USAID we. Got support from elma philanthropies. And we were able to roll pull money out to every, hospital in the country and, we trained, nurses. And doctors to use it today. Bomani, is saving lives in every, hospital in the country it. Cost. Less than 1/10, the price of, systems, used in the United States. Kimani. Worked, it, worked even, in district, hospitals, instead. Of ending up in the graveyard, it is, up in the newborn unit. We. Thought we were done but. Enrolling. Poo money out, we, saw babies, who were cold. We, saw babies who had jaundice and we, met many, clinicians, who were frustrated, they didn't have the tools they needed to, treat these conditions and, so. We, went back to work. Since. 2006. Our team, has worked with hundreds, of engineering. Students in the United States in Malawi, and in Nigeria and with, support from the Lemelson foundation, and from the Fogarty, Center together.
These, Students, have created many, other newborn, technologies. That. Became. The, nest, in. Assembling. The nest, we. Included, not just our own innovations. But, we looked at the medical marketplace. To, find the very best other innovations. And together. Put. Together a package that, allowed Queen to have what she needs to treat those babies. Now. This, afternoon you, will have a chance to come and see all 17. Of those technologies. In our breakout room I am so excited for you to see it, it's, awesome. Today. I only have a chance to tell you about three. Left. Untreated, newborn. Jaundice can, cause brain, damage and, death. District. Hospitals, often, don't have the tools they need to diagnose. Jaundice. This. 150. Dollar reader and diagnosed, jaundice, at the bedside in less, than two minutes with, the one drop of blood for, less than five cents per test. If. A, baby has jaundice, there's, another tool in the nest that, they can immediately use, to treat jaundice, these, photo therapy lights they. Are made by a nonprofit, called, D Rev they're. Commercially, available but, they're not distributed, in Africa, and so if Queen wants to order these lights it costs, more in shipping, to, get them to her hospital, than the lights actually cost, our nonprofit, distributor, it will solve this problem. Finally. Hypothermia. Is such a challenge, for newborn babies in, Africa, they're. Tiny they lose heat so quickly and we, know for every one degree, that, their temperature, drops the, chance they will die goes up by 28%. You. Can't tell by looking if. A baby is too cold this, $50, reusable, temperature, monitor Clips right on to the crib side and with, just a glance a nurse can know if a baby is too cold and immediately. Intervene to, warm them up. So. Are we ready to. Roll out these seventeen, technologies. The. Good news is that eight of them are already commercially. Available they, are just not yet distributed, in Africa, and our, non-profit distributor. Will, sell this challenge. We. Have four more that are in successful. Multicenter. Clinical trials. And with, investment, from one hundred and change we, will take them to products, in 24, to 27, months. We. Will take working, prototypes, of the last five two products, within 36, months the. Power of, value, engineering. Is, that these are simple technologies. And the development, timelines, are predict, people. Remember. Each. One of these technologies. It. Began, with, a team of students. Students. Who learned to, use the, process, of innovation to. Solve a real problem. Students. Who had a chance to see their, work have. An impact, on someone, else's, life and I. Think, I think. These students. They. Are our most, important, product, because. They, are what will keep the cycle of innovation going, after. A hundred and change ends. With. Just six, million, dollars, we took bomani from a shoe box prototype, to, a medical, product that, has not used just in 37, hospitals, in Malawi it is, saving newborn, lives in 30 countries. With. A hundred million dollars, we are ready, we. Are ready to, deliver the, 17. Life-saving. Innovations, of nest we. Are ready to, solve the challenge, of distributing, medical products, in Africa, and we. Are ready to measure the, impact of, this technology and, use. That data to drive uptake, across, Africa, we, are ready, to. Save hundreds, of thousands. Of newborn, lives every. Year. Now. To crack the distribution knot we know we need the right partner, and we, are so fortunate to be joined by Robert morose Robert. Shares our commitment, to distribution, at non profit, rates so, that these technologies. Are available to, the poorest families. When. I look back on the journey of puh money I know, we, could not have taken it from this, shoe box to, a medical, product without Roberts, partnership.
When. I joined the nest team in 2012. My company was already developing, medical devices for global health applications. We. Specialized in product, design and, have a unique focus on bringing global health products, to market. Our. Challenge, with bomani was to take that shoebox prototype. And transform. It into a real medical, product, as. You can see here we took the concept through several stages and development, and advanced. It to a final successful. Design, in. Two. Years we secured. The C II mark and found the right manufacturing. Partner to produce the devices, according to global quality standards. In. 2015. We began selling, the, lowest cost easiest. To use all-in-one, breathing machine on the, planet, today. There are 1000, Kimani machines in use and in production and boom. Ani is saving newborn lives in 30 countries across, the globe we. Prove that we can go from a prototype to, large-scale manufacturer. For a single medical device and offer, it at an affordable price so how. Do we replicate this, success for. The rest of the products in nest, the. Challenge, lies in the distribution system for. Purposes, of illustration let, me walk you through the costs, involved in making selling. And distributing one pomona unit. The. Unit costs us five hundred and fifty dollars to manufacture, we, sell it into the market for eight hundred dollars leaving, us two hundred and fifty dollars for sales, engineering. And regulatory. Costs. Then. Poo money leaves a warehouse and. Gets on an airplane, when. It lands in country it goes through customs, and regulatory clearances. Then. We deliver it to a hospital where we conduct training, for health care providers and to, assure long-term. Functionality. We provide service, and technical support and though. It varies somewhat from country to country these, costs add up to about seven hundred and fifty dollars so. What started out as an affordable product with a reasonable, margin in the beginning ends. Up with a $500, downstream, loss every. Time one leaves our warehouse. This. Is where Ness comes in though and why it's so exciting. Though. The costs of goods. For, the devices and the, sales price is necessarily, higher because we're at offering. An entire bundle of products, the. Relative, distribution costs. Are much less this. Is possible, because the distribution activities. Involved, for a breathing, machine or, a tool to diagnose jaundice, or a temperature monitor are all essentially, the same, so. When we deliver all the devices together and we conduct the training all together and we send one service, technician, to service, the whole suite, all, in one visit we. Effectively, spread the costs over the whole suite. Becoming. Sustainable in the process, so. How are we going to achieve this. We. Start by distributing nest in Malawi Tanzania, and, Nigeria, we.
Set Up distribution. Hubs in Tanzania. And Nigeria, and. From. Those places we, then reach the other four African, countries that have pledged with UNICEF, to, cut newborn, mortality in, half in the next five years. These. Seven, countries account, for 46%. Of the births in Africa, and we, believe will bring us to a tipping, point for the continent. This. Is the power of the 100 and change grant, it breaks, through the initial, barriers to effective distribution, and, allows, for economies, of scale, for nest. Which. Allow the overall. Enterprise, to, become self-sustaining. Indefinitely. And perhaps. Even more important, will, be establishing, a functional, market so, that those future medical innovators, that were educating, will have a place to take their products year, after year and, close. That health, equity gap in the, next decade. Without. 100 and change will be stuck in a business-as-usual situation. One, product at a time with. Incremental health benefits, and high, costs of distribution, with. 100, and change will. Build a sustainable, distribution. System, that. Will allow us to deliver world-class. Medical. Products and, after. 100 and change is spent we'll, have a financially, sustainable way. Nest to achieve its long-term goal of saving. 500,000, newborn lives per year. Now. As any of you in business know just, because you build it doesn't mean they will come, we. Will have to generate the demand and the global will to, recommend, and procure, this life-saving, technology. To. Drive this demand with, measured results, I can think of no one better than dr., joy lon. If. There's one leader that can be credited with shifting the international, policy landscape, for. The care of newborns, it, is joy. Thank. You Robert, but. What he didn't mention is, that, my true. Qualification. For standing here today is that I should have been a newborn death and I. Should have been a newborn death in the. Bush in northern Uganda, so. This is where, my family lived for. 20 years. My. Mother had. An obstructed, labor. She. Was taken. Into. This maternity, home. No. Running water no. Electricity. She. Was there overnight, and. In. The morning they. Were able to find somebody who, in fact had never done a cesarean, section, hadn't been properly trained, but he was able to do a cesarean section, and that. Saved my. Life and my mother's life. So. I'm standing, here, today. In front of you because. People stood up for me and stood, up for my mother because. People spoke up for us and. I've spent the last three, decades. Working. On newborn survival, and speaking. Up for mothers and their babies. Around. The world and particularly. In Africa, as a medical, doctor and as a professor, of Epidemiology, and I've personally seen. Hundreds. Of newborn, deaths that, should not have, happened, and. Today. I'm wearing, my Ghanaian, funeral, dress. And I'm wearing it because this year 2017. 1.1. Million, newborn, babies died in Africa. Most, of them, preventable. Invisible. And, yet. Something that we can and must change, and. My. Job and the, job of our nest team is to, stand up to. Speak up for newborns, and to see that that changes. Well. That sounds great but maybe we're just a bunch of dreamers is this. Actually, possible, or as we. Are just, hoping. And wishing and, it. Is possible, it's possible because, of three important. Shifts. That. Mean we, can do this now as never before and the, first is that we have powerful evidence, about, this, situation. 99. Percent of the world's newborn deaths actually happen, in low and middle-income countries but. It's only the last 15, years that. We've started to pay attention to those 99 percent. Of deaths we, now know where. And why those deaths happen, we, know that one-tenth of the whole global, burden of disease of all conditions all, over the planet is actually, related to newborn deaths.
We. Have trials, showing. What, we can do a community, level with community, health workers, or with traditional, birth attendants. And we. Know that, we can do something, but, without providing. High quality care. In hospitals, we can't truly. Reduce, death and also. Disability. Well. I used to think that. If we publish lots of papers, particularly, if we manage to publish them in Lancet, and then. We got w-h-o, you, know never, the fastest-moving organization. But we managed to get lots of global guidelines, that. The world would change, well. About 200. Papers and a whole heap of WTO, guidelines, later I can tell you necessary. But, not sufficient. Why because. Newborns, weren't, on people's political to-do, list we didn't have political will, so. What's the second, shift. Is that. We do now have political. Well, in. The, new sustainable development, goals just launched a couple of years ago for the first time, in history, we have a target, that specifies. Newborn. Survival. Every. Country, on this planet has, to meet that target by the year 2030. So. The. Newborn has finally, emerged on, the global agenda. But. It's really painful to, me as an African and, to, Queen my sister, African we swapped outfits, today. She's. Here in glamorous, Gucci. Maybe I. Hope. Not. It's. Painful. To me that. Africa, has, the highest risk, of newborn death and still, the slowest, progress. But. The good news here again, is that African, leaders. Recognize. This and they want to change that situation, 7. African, countries, have pledged to reduce Hospital, deaths by, 50 percent in five, years ambitious. Target, and here. Today we're honored to have the, Honorable Minister of Health from Nigeria, who's, carrying the greatest, weight of what needs to be done for, Africa, for Africans newborns. So. That's. All very well but what, happens if we can't reach, mothers, and their newborns, we could have the evidence we can have the political will but. We can't reach them so, the third shift, is that the place of birth has changed, now. 80%. Of the world's births happen, in hospitals. Big. Recent. Shift, into. Hospital, wards that in many cases look. Like this. Poor. Quality of care not, the right equipment things. In the hospital, graveyard, equipment, graveyard, has Queen talked about earlier, an. Opportunity. But. Also a. Place maybe where if we fail, women. And families. Will start, going. Back to home instead of coming into hospital, so. We need to, change this we have the opportunity but. Something, different needs to be done so. Never. Before. Have. We had this opportunity. We. Have powerful. Evidence. We. Have political. Will and. We. Now have a place where, we can reach women, and their, babies and this gives us the platform, where, nest. Now. Is able, to come in and have. Their impact. But. We can only drive, that change if we're able to measure the impact and, show cost-effectiveness. And. That's an important, component of, what the investment, of a hundred and change would, bring and with. A hundred and change we will be able to measure that, so, in Malawi. We will learn from.
What Has already worked or not worked, for. Scaling. Up the package. Of nest will. Move to Tanzania, where shockingly. The, neonatal mortality rate, is double, that within, Malawi, and we, will measure cost. And, impact. And then, we will work with the rest of these four countries in, the United Nations Network across. Africa, to, pull the lever of larger scale change. Our. Team has you've heard has, experts. In innovation. In distribution. And, in, measurement, our, team. Is composed of unlike, mines. Slightly. Online accents. As well. But. With a common passion, to. Change this, situation. We, are ready to do this and we, will do it together. Ladies. And gentlemen. This. Year. 1.1. Million newborns, died. In Africa, we. Could have prevented most of those deaths. Only. If. Effective. Affordable. And, sustainable. Technologies. We. Are available, in. My continent, Africa. We. Are ready to solve this problem, by, delivering, the 17, effective. Affordable. And sustainable, tools. Of nest, it gives, clinicians. The tools they need, to treat, and prevent the, three leading causes of newborn, deaths and it. Can be delivered at scale, for just one dollar and forty, eight cents per birth, with. 100, and change we, will innovate to complete the nest we, will solve the tough problem, of distributing, medical, devices in Africa, and we will measure the, number of newborn, lives saved. By the nest. Without. Nest. If, we continue, business as usual it's. Going to be a hundred, and ten, years before, a baby born in Africa, has. The same chance has, a baby born here, in Chicago. But. With nest. We. Have the opportunity, to close that survival, gap dramatically. Reducing, deaths for, newborns, in Africa. Here. Is chicken, jet so you. Met him earlier, when. He was one day old, struggling. To breathe, now. He's, to, thriving. Surviving. And kind. Of almost smiling. Chicken, jet so means, the. Conqueror. With. Nest. Hundreds. Of thousands, of newborns, would also have that opportunity to. Conquer. To. Survive and. Thrive. You. And I are, part of the first generation, that can make this change there. Are not many things left in global health which are a big problem. But. Also, with. Big impact. We've. Got the tools. Our. Team is ready. African. Leaders are saying the time is now. With. Your support. We. Will. Deliver. Thank. You. Thanks. To their presentation, and their commitment, to improving the survival, rate for newborns, in Africa, we're going to take our final brief break before hearing from our fourth finalist.