Build it, and they will come. Too often, that is how global health technologies are developed, says Anurag Mairal, leader of PATH’s Technology Solutions Program. Projects lurch forward—delayed and accelerated according to the tides of donor funding—based on an assumption that, in the end, markets and users will embrace the technology.
Now Anurag and his team are transforming this process and pushing the global health community to think outside the box. And he’s bringing his own outside-the-box background to the task.
Mind the medical gap
“I grew up in India, in a state called Chhattisgarh,” Anurag explains. “The southern part of the state is extremely isolated. The first time I went there, I was blown away by how pristine it was, but also by how modern medicine hadn’t quite reached it. It was a different world.”
It would take decades, however, before Anurag would find himself addressing that medical gap. First, he became a chemical engineer, moved to the United States to get his PhD, and developed a passion for integrating disciplines and sectors.
His PhD dissertation combined chemical engineering with physics and mechanical engineering to solve a costly problem in waste water treatment. His subsequent work in the biotech and then the medical device industries led to a flurry of patents in areas as diverse as water, energy, and medicine.
Teaching in order to learn
Throughout his career in the private sector, Anurag has focused primarily on developing technologies intended for markets in high-income countries. But in 2007, he was invited to help lead the Stanford-India Biodesign program, which mentors medical device innovators from India.
“Many of the fellows I mentored came up with solutions for people living at the base of the economic pyramid in India,” says Anurag. “I realized how difficult it was to scale innovations from prototypes in a workshop to products in the hands of patients and health providers in low-resource settings because there were no market mechanisms for those products.”
The son of teachers, Anurag believes that “teaching is the best way to learn.” Inspired by the efforts of the innovators he mentored, he helped start the Global Exchange Program at Stanford Biodesign, where he mentored researchers who were developing global health–focused medical technologies.
After three years of running the program, he says, “I knew that global health is a very different beast from the commercial sector work. You need to have a very different way of thinking about markets.”
Innovation that makes a difference
In 2012, Anurag was back in Chhattisgarh with a group of students when he received a call asking about his interest in leading PATH’s Technology Solutions Program, which advances affordable technologies that address developing-world health needs, from point-of-care diagnostics to devices that save the lives of women and newborns in childbirth.
“I visited PATH and just fell in love with the organization,” he remembers. “It offers such a great solution for all the challenges my students and I were working on, and then some.”
The position also met his other criteria: “Everything I pursue must be something I can see and feel, and it has to make a tangible difference to society,” he says. ”And it must be challenging. There has to be an element of innovation.”
Photo: PATH/Gabe Bienczycki.
An ambitious agenda
Now Anurag is using his broad expertise to address the problems with the “build it and they will come” approach. First off, he explains, “You don’t always know ahead of time which product you will be able to introduce and scale in the quickest manner or which will have the greatest impact.” What’s more, too much technology development happens in wealthy nations and not enough in places close to the problems the technologies are meant to solve.
So, as well as seeking flexible funding so that technologies receive timely support, he and other PATH staff are developing the Global Health Innovation Hub. This model relies on a portfolio management approach to identify technologies from around the world with the best chance of achieving impact. A key element of the disciplined approach is to drop those technologies that don’t meet a rigorous set of criteria.
PATH plans to launch innovation hubs in emerging economies to develop devices and diagnostics that meet both local and regional needs. “Places like India and South Africa are rife with innovation,” Anurag says. “There are really smart people there. They know what problems exist, and they have great ideas for potential solutions.”