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How government investments catalyze innovation: A case study from maternal and child health

September 9, 2019 by PATH

Vaccine delivery technologies, including Soloshot syringes, vaccine vial monitors (VVMs), and a refrigerator monitoring device, among others. Photo: PATH/Patrick McKern

Vaccine delivery technologies, including Soloshot syringes and vaccine vial monitors (VVMs), were a few of the dozens of technologies made possible by PATH's HealthTech partnership with USAID. Photo: PATH/Patrick McKern

PATH’s HealthTech program, a 25-year partnership with USAID, exemplifies how government investment in research and development can accelerate innovation and produce scalable health solutions in low- and middle-income countries.

Innovation addresses health challenges with new vaccines, diagnostics, drugs, and medical devices. However, because these innovations are costly and time-intensive to develop, many of the health challenges faced by people in low- and middle-income countries (LMICs) remain unaddressed.

Donor governments can catalyze access to lifesaving technologies by providing private and social sector partners with the up-front investment needed to research and develop low-cost health innovations. With the resulting innovative products at their disposal, LMICs can solve their greatest health challenges and establish strong health systems.

For example, PATH partnered with the United States Agency for International Development (USAID) through the HealthTech program, which resulted in the launch of more than 20 new products uniquely designed for use in LMICs. Private sector partnerships were key for the development of these products, as every dollar from USAID was matched with two dollars of funding from other sources.

20 new products launched as a result of HealthTech
$2 of funding matched for every dollar from USAID

PATH received our first HealthTech award from USAID in 1987. The award aimed to support USAID’s goals of developing and introducing low-cost health products to improve maternal and child health. USAID’s decision to continue to engage with PATH for 25 years across a portfolio of products was a groundbreaking approach—and one that produced incredible results.

Funding an entire portfolio rather than a single product allowed PATH to shift funds between different technologies within the portfolio as they showed promise. It allowed technical experts to make decisions about which products showed the most promise and were worth continued investment, and it helped make the US government’s investment less risky by spreading financial risk across all the products. An auto-disable (AD) syringe that was licensed to a private sector partner in 1990 and a vaccine vial monitor that was introduced in 1996 are just two of the dozens of products launched through HealthTech. Both provide snapshots into the far-reaching health, policy, and economic impacts of the program.

Health worker holding an opened package containing a BD Soloshot Mini and a vial labeled "BCG vaccine.". Photo: PATH/Eric Becker

Health worker holding a BD Soloshot Mini and a vial of vaccine. Photo: PATH/Eric Becker

Auto-disable needles and syringes for safer injection and a policy shift in health care

Before the AD syringe, many low-income countries faced challenges ensuring the sterilization of injection equipment after every use. Recognizing the negative impact of unsafe injection practices, particularly reuse of needles and syringes, PATH, with funding from HealthTech, set out to develop and patent a design for an AD syringe that automatically locks after a single injection, making it impossible to reuse.

PATH combined our scientific and technical know-how with the large-scale production expertise of Becton Dickinson and Company, the world’s largest syringe manufacturer. The initial funding provided by HealthTech enabled PATH and Becton Dickinson to pursue an aggressive program that led to SoloShot™, the world’s first commercially available AD syringe.

SoloShot. Photo: PATH

SoloShot, the world’s first commercially available auto-disable syringe, was one of the technologies made possible through the HealthTech program. Photo: PATH

Since the launch of SoloShot ™, the use of AD syringes and other safe injection technologies have led to safe injections and improved health outcomes. Studies have shown that transmission of bloodborne diseases caused by dirty needles has been reduced by 90 percent in programs using some form of AD syringe.

HealthTech investment in AD syringes helped to pioneer the creation of safe injection as a new technology category. It also launched a global policy shift toward safe injection and improved healthcare delivery by enabling all healthcare workers, regardless of experience or training, to safely administer injections. More than 7 billion vaccinations have been delivered using SoloShot™ in more than 40 countries.

Lab workers in the Bandung BioFarma facility in Indonesia examine vials that have vaccine vial monitor technology incorporated into their labels. Photo: PATH/Umit Kartoglu

Lab workers in the Bandung BioFarma facility in Indonesia examine vials that have vaccine vial monitor technology incorporated into their labels. Photo: PATH/Umit Kartoglu

Safer transportation for safer vaccination

It can take weeks for a vaccine to journey from a manufacturer to a rural health center. Along the way, many vaccines must be kept cold to avoid spoilage. Too often in the past, damaged vaccines were used, or good ones tossed out because health workers had no way to tell the difference.

To address this challenge, PATH used funding from HealthTech and a partnership with start-up company Temptime, to develop a suitable technology that could monitor a vaccine's temperature and help health workers decide whether to use or discard them. Called the vaccine vial monitor (VVM), this world-changing innovation was introduced in 1996.

PATH worked with the World Health Organization (WHO) to field test the VVM and engage the United Nations Children’s Fund (UNICEF), the GAVI Alliance (Gavi), and vaccine manufactures to ensure vaccines destined for LMIC markets had VVMs on their vials. Buy in and demand from these partners kept Temptime engaged in the program.

Today, all vaccines procured by UNICEF and Gavi must include VVMs. More than 7 billion VVMs have been used to date, saving lives by ensuring vaccines are still potent when they are given. This tiny sticker has been estimated to save vaccine programs around the world a total of $14 million per year by preventing undamaged vaccines from being discarded. What’s more, Temptime went from a small start-up with 5 employees to over 60 employees and focused their business model on global health.

VVM. Photo: PATH

The vaccine vial monitor (VVM), a vial sticker that changes color to indicate that the vaccine should be discarded due to heat exposure, was one of the technologies made possible through the HealthTech program. Photo: PATH

Though research and development is inherently risky, innovative partnerships like the HealthTech program can minimize the risk of public sector investments. A variety of factors made HealthTech impactful, including its focus on supporting the whole product development pipeline (including clear plans for how products would be launched and used in-country), the flexibility to shift funds to promising products across the portfolio, and its focus on building multisector partnerships. As governments consider how best to invest to tackle health challenges, the HealthTech model is a promising one to explore.

This case study was originally published in the G20 Health and Development Partnership’s report Healthy Nations, Sustainable Economies: How Innovation Can Better Ensure Health For All, released in March 2019. Through the Partnership, PATH joins 15 collaborators to guide G20 countries toward a coordinated health innovation.