Monday, December 13, 2004

Making Medicine More Affordable in the Developing World

The Economist has a fascinating article on Freeplay Energy's work in developing applications for hand-cranked (or wind-up) energy: specifically, medical instrumentation for neonatal care. Besides the prohibitive cost of the kind of technology that has become vital to modern medicine, there is the prohibitive cost of running it--if you have problems getting enough electricity to keep the lights on, you may not have access to the amps necessary to run standard machines.

"Freeplay has now teamed up with a group of doctors at University College London to create medical equipment that works well in poor parts of the world. The project focuses on neonatal care, and with good reason. Infant death is still a fact of life in much of sub-Saharan Africa and South Asia; roughly 14% of babies born in Angola, for example, die before they reach their first birthday, more than 30 times the rate of infant mortality in Britain."

The article describes four instruments the collaboration has developed: a pulse oximeter to measure levels of oxygen in the blood, a syringe driver to deliver carefully timed miniature doses of medicine to small babies, a microcentrifuge for doing blood analysis, and a fetal heart monitor. They are currently being tested in the field.

Freeplay's roots are in creating radios and flashlights, powered by hand and aimed at the third world market. Nelson Mandela cut the ribbon of its 1998 factory expansion in South Africa, and the founders had hoped that their hand-powered radios would help spread knowledge about HIV & AIDS in sub-Saharan Africa. But the gadgets were more likely to sell at Sharper Image or REI, and in 2000 Andrew Maykuth of the Philadelphia Inquirer wrote this article detailing Freeplay's decision to move jobs away from the South Africa plant that employed the disabled, opting for a cheaper venue in Hong Kong and focusing on wealthier markets. Treehugger recently featured one of their newer handranked lights, saying, "Now this is the light that needs to mate with a bicycle!" Given the company's early setbacks, it's heartening to know that they didn't lose their idealistic notions and kept trying to find ways to help others.

The notion of making rural communities more medically self-sufficient reminds me of a Berkeley nonprofit I learned about a couple of years ago: the Hesperian Foundation, which creates "open copyright," royalty free health care manuals: "Hesperian publications are written simply and include many illustrations so people with little formal education can understand, apply and share medical information. " The book Where There is No Doctor, for example, recognizes the realities of many communities and deals with it, instead of being overwhelmed with the impossibility of the more ideal solution of having more doctors in poor places.

Not that ideal solutions shouldn't also be pursued. I am fascinated with recent reports (7online.com , The New York Post, & a much longer, more informative story at The Star Ledger by Kitta MacPherson) about an anti-HIV drug developed at Rutgers by a team led by chemist Eddy Arnold. This drug attacks the HIV virus's reverse-transcriptase enzyme, potentially knocking out it's ability to reproduce itself. As a single pill, instead of the current "cocktails" used in treating HIV-AIDS, it has great potential for helping out the epidemics in Africa and Asia. Let's hope that they are onto something, and that the companies holding the licenses do the right thing.