Abstract
Fail early, fail often, and fail forward. Reduce complexity. Do more with less. Frugal innovation. Frugal engineering. These phrases, and the ideas they encapsulate, are hot topics that may have begun life as mantras in Silicon Valley but now span multiple arenas, including engineering, biomedicine, and global health and development. The term frugal innovation was coined by Carlos Ghosn, chairman and CEO of Renault and Nissan, in 2006, 10 years prior to the publication of this edited book. It seems he intended the term to mean how to do more with less: produce products that are good enough at a fraction of the cost, presumably through less expensive components and less costly research and development (R&D) infrastructure. The cost saving in R&D then allows for the products to sell to end consumers for less, expanding potential markets. This concept plays particularly well in the developing world. For example, in India, where the concept of frugal innovation is called jugaad, we have illustrations of the concept from Ghosn’s Renault-Nissan in the newly released Renault Kwid [1], a base-model sedan developed and made in India that sells for less than $5000, as well as General Electrics (GE) portable electrocardiogram (ECG) [2] and Manu Prakash’s origami microscope, the foldscope [3], all cheaper, more portable versions of the original products. These examples of doing more with less in the auto, medtech, and instrumentation industries are just a few; many companies have embraced the idea of frugal engineering to try to attract consumers and provide products and services in markets not previously considered profitable. But to save and improve lives in the Global South, doing more with less does not just mean making simpler, cheaper versions of existing solutions. It must mean doing what Renault-Nissan is attempting with the Kwid and Prakash with the foldscope: developing solutions with direct relevance to consumers in a particular country with mostly local materials as well as providing the ability to maintain and repair the technology with local expertise and parts. The jury is still out on how the Renault Kwid will do in India, but many of the right ingredients went into the design, development, and manufacture to give hope for success.
This is a preview of subscription content, log in via an institution.
Notes and References
For more information on the Renault Kwid, please review: Crabtree J, How Renault embraced Indian frugality with the $4,700 Kwid. Financial Times. 2015 Jun 1. Online. http://on.ft.com/1PZzinx and Radjou, N., Prabhu, J., Ahuja S.: Frugal innovation: lessons from Carlos Ghosn, CEO, Renault-Nissan. Harvard Business Review (2012). Online. https://hbr.org/2012/07/frugal-innovation-lessons-from
More information on the MAC line of ECGs developed and sold in India is available from GE’s newsroom: http://newsroom.gehealthcare.com/ecgs-india-reverse-innovation/
For a description of the foldscope, please see: Cybulski, J.S., Clements, J., Prakash, M.: Foldscope: origami-based paper microscope. PLoS One 9(6), e98781 (2014). doi: 10.1371/journal.pone.0098781. For additional information, visit the foldscope website at http://www.foldscope.com/ or join the foldscope community at https://microcosmos.foldscope.com/
For more information on the Nokia 1100 in India and Africa, please see: http://knowledge.wharton.upenn.edu/article/how-did-nokia-succeed-in-the-indian-mobile-market-while-its-rivals-got-hung-up/; http://mgafrica.com/article/2015-01-30-africa-to-the-rescue-why-the-world-needs-africa-to-keep-rising
WHO. Neglected tropical diseases. 2016. Available at http://www.who.int/neglected_diseases/diseases/en/
CDC Malaria Facts: https://www.cdc.gov/malaria/about/facts.html
Information on Merck KGaA’s praziquantel donations can be found on their website: http://www.emdgroup.com/emd/responsibility/living_our_commitment/schistosomiasis/schistosomiasis.html
Information on Bayer’s donations of nifurtimox for Chagas disease and suramin for human African trypanosomiasis can be found on their website: http://www.bayer.com/en/chagas-and-african-sleeping-sickness.aspx
An updated list of pharmaceutical donations for neglected tropical diseases can be found on the World Health Organization’s (WHO) website: http://www.who.int/neglected_diseases/pharma_contribution/en/ or http://www.who.int/neglected_diseases/Medicine_Donation_June_2016.pdf?ua=1
The WHO reports data based on the Global Burden of Disease. WHO’s most recent reports are available here: http://www.who.int/mediacentre/factsheets/fs310/en/, or see reports in the Lancet: http://www.thelancet.com/global-burden-of-disease or on the GBD website: http://www.healthdata.org/gbd
While certainly some, perhaps even a significant portion of the infectious disease burden in the developing world can be addressed by sanitation solutions (e.g. affordable, context-appropriate, sewer-less toilet options, clean water) – solutions which can and are being developed simply, with local resources, and scaled horizontally – to rid the world of the scourge of many of these infectious diseases such as malaria, HIV, dengue, and others, we will require the development of new therapeutics for treatment or prophylaxis, new vaccines (preventive or therapeutic), and even new diagnostics that will work in the developing world, and equally important, that can function sustainably among the worlds’ poor
Radjou, N., Prabhu, J.: Frugal Innovation: How to Do More with Less. The Economist in association with profile Books Ltd. and PublicAffairs, New York (2014)
Radjou, N.: Navi Radjou: Creative problem-solving in the face of extreme limits. [Video file] (2014). Retrieved from https://www.ted.com/talks/navi_radjou_creative_problem_solving_in_the_face_of_extreme_limits
PATH’s Work in Vaccine Development. Polio: Vaccines for Finishing the fight. http://sites.path.org/vaccinedevelopment/polio/
GeneXpert is a relatively new nucleic acid diagnostic test for pulmonary TB developed by the Foundation for Innovative New Diagnostics (FIND) in partnership with Cepheid and the University of Medicine and Dentistry of New Jersey. Initially, the cost was about $17 USD per cartridge, not including the cost of the GeneXpert platform. The Bill & Melinda Gates Foundation, UNITAID, and PEPFAR have committed funding to bring the cost down closer to $10 USD per cartridge. Read more about WHO’s recommendations for GeneXpert here: http://www.who.int/tb/laboratory/xpert_faqs.pdf, the public-private partnership to reduce cost here: http://www.gatesfoundation.org/Media-Center/Press-Releases/2012/08/PublicPrivate-Partnership-Announces-Immediate-40-Percent-Cost-Reduction-for-Rapid-TB-Test, and the CDC’s recommendations for GeneXpert here: http://www.cdc.gov/tb/publications/factsheets/testing/xpert_mtb-rif.htm and https://www.cdc.gov/tb/publications/factsheets/pdf/xpertmtb-rifassayfactsheet_final.pdf
African Programme for Onchocerciasis Control (APOC). World Health Organization. http://www.who.int/apoc/cdti/ivermectin/en/
Waye, A., Jacobs, P., Schryvers, A.B.: Vaccine development costs: a review. Expert Rev. Vaccines. 12(12), 1495–1501 (2013 Dec)
DiMasi, J.A., Grabowski, H.G., Hansen, R.A.: Innovation in the pharmaceutical industry: new estimates of R&D costs. J. Health Econ. 47, 20–33 (2016)
Singh, A., Mitra, M., Sampath, G., Venugopal, P., Rao, J.V., Krishnamurthy, B., Gupta, M.K., Sri Krishna, S., Sudhakar, B., Rao, N.B., Kaushik, Y., Gopinathan, K., Hegde, N.R., Gore, M.M., Krishna Mohan, V., Ella, K.M.: A Japanese Encephalitis Vaccine From India Induces Durable and Cross-protective Immunity Against Temporally and Spatially Wide-ranging Global Field Strains. J Infect Dis. 212(5), 715–725 (2015)
Dhar, A.: India launches vaccine to prevent Japanese encephalitis. The Hindu. Oct 4, 2013. Accessed at: http://www.thehindu.com/news/national/india-launches-vaccine-to-prevent-japanese-encephalitis/article5201813.ece
Bulletin of the World Health Organization. China enters the global vaccine market. 92(9), 621–696 (2014 Sep). Accessed at http://www.who.int/bulletin/volumes/92/9/14-020914/en/
Kaspar, G., Marcoux, J.: The re-emerging art of funding innovation. Stanford Social Innovation Review (2014). http://ssir.org/articles/entry/the_re_emerging_art_of_funding_innovation
Schuhmacher, A., Gassmann, O., Hinder, M.: Changing R&D models in research-based pharmaceutical companies. J. Transl. Med. 14, 105 (2016). doi:10.1186/s12967-016-0838-4
Douglas, F.L., Narayanan, V.K., Mitchell, L., Litan, R.E.: The case for entrepreneurship in R&D in the pharmaceutical industry. Nat. Rev. Drug Discov. 9(9), 683–689 (2010). doi:10.1038/nrd3230. Epub 2010 Aug 20
Another discussion, for which we have neither the time nor the space in this chapter, is how to best and consistently define impact. Organizations that measure impact use a variety of metrics, including DALYs, lives saved, dollars saved (or cost-effectiveness), deaths averted, lives touched, and so on. If even the development aid community as one small part could sign on to a specific impact metric, we would all start with the same basis for discussion
For more information on GAVI, please see their website: http://www.gavi.org/about/
Press release on the funding of the Child Health and Mortality Prevention Surveillance Network (CHAMPS): http://www.gatesfoundation.org/Media-Center/Press-Releases/2015/05/Child-Health-and-Mortality-Prevention-Surveillance-Network
For more information on Impact Investing, see the Case Foundation’s “A Short Guide to Impact Investing: A Primer on How Business Can Drive Social Change” http://casefoundation.org/resource/short-guide-impact-investing/
GAVI Alliance Annual Financial Report: 2015. Accessed at: http://www.gavi.org/library/gavi-documents/finance/financial-reports/2015/gavi-alliance-annual-financial-report--2015/
For more information on the Grand Challenges family of programs, please see: http://grandchallenges.org/
Center for Accelerating Innovation and Impact. United States Agency for International Development. Idea to Impact: A Guide to Introduction and Scale of Global Health Innovations. Updated version available on USAID website: www.usaid.gov/cii
Disclaimer
This book chapter was prepared by Rebekah A. Neal in her personal capacity. The opinions expressed in this article are the author's own and do not reflect the views of the Bill & Melinda Gates Foundation.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Neal, R. (2018). Funding Frugal Innovation in Global Health: Philanthropy, Aid, and Industry. In: Chavali, A., Ramji, R. (eds) Frugal Innovation in Bioengineering for the Detection of Infectious Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-66647-1_6
Download citation
DOI: https://doi.org/10.1007/978-3-319-66647-1_6
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-66645-7
Online ISBN: 978-3-319-66647-1
eBook Packages: MedicineMedicine (R0)