A year ago, the United Nations set two ambitious public health goals: to reduce the global maternity mortality rate to just 0.0007%, and to end all preventable deaths of newborns and children under 5 years old by 2030.
Those aspirations are now part of the UN’s Sustainable Development Goals, and experts believe they can be achieved — if the necessary devices, drugs and services can be developed and distributed.
“Innovation doesn’t always mean a new widget,” Amie Batson, chief strategy officer and vice president of strategy and learning at PATH, tells Business Insider. “Innovations are things that change the affordability, accessibility and/or effectiveness of practices or tools used for health treatment, prevention and care.”
The organisation mathematically modelled the impact of each of the chosen 11 innovations. If all of them are scaled and implemented according to PATH’s timeline, the nonprofit’s calculations suggest 6 million lives could be saved between now and 2030.
Here’s how we can get there.
'Hundreds of thousands of women die each year from complications that arise during pregnancy or childbirth, many from severe bleeding after delivery,' Batson says.
The medication oxytocin helps control hemorrhages, but it isn't available to many women in remote areas since it has to be injected by health professionals and comes as a liquid that must be kept cold.
'New forms of the drug oxytocin that are currently being developed and tested could increase coverage because they won't require skilled health workers to administer, or refrigeration for storage,' Batson says.
PATH expects heat-stable forms of the drug that don't require needles could launch by 2022.
When women have post-birth hemorrhages that are hard to control, nurses and doctors in wealthy countries use a device called a uterine balloon tamponade, which is essentially a small balloon that exerts pressure against the uterine wall, thereby reducing bleeding. A cheaper version can be made by tying a condom to a catheter and inflating it with clean water.
According to PATH, studies indicate that the device could be 85% effective for women who don't respond to medication. And its simplicity means this innovation can be launched immediately if the supplies are properly distributed.
Preeclampsia is a fairly common condition associated with dangerously high blood pressure -- it affects more than 5% of pregnant women. If it isn't detected or treated, it can lead to a related hypertensive disorder: eclampsia, the onset of seizures.
According to PATH's analysis, these two conditions are the leading cause of maternal death around the world. And they're especially problematic in areas that lack adequate prenatal care for expecting mothers.
Better methods for detecting preeclampsia, like low-cost handheld devices that measure blood pressure or tests for biomarkers that are early warnings of the condition, could eliminate these preventable deaths.
Though these innovations aren't available yet, PATH estimates such tools could be launched as early as next year.
Many newborn babies -- as many as one in ten, according to PATH experts -- need help breathing right after they're born. If resuscitation equipment isn't available, they could die.
New low-cost, reusable resuscitators are already being designed, according to PATH's report. The organisation's ideal product would make it easier to seal the mask to the baby's nose and mouth, be easy to clean, and be comprised of fewer parts. The organisation suggests these kinds of devices could start being developed this year.
'Another really exciting, frugal innovation is chlorhexidine, a low-cost antiseptic, which has been used for years but has only recently been applied to prevent umbilical cord infections,' Batson says.
PATH estimates that hundreds of thousands of babies born in low-resource settings die from infections every year, primarily because unsanitary conditions and a lack of antiseptics put them at risk of disease. By putting chlorhexidine (as a liquid or gel) on a baby's umbilical cord after it has been cut, the number of newborns who die from infections could drop dramatically.
'At a cost of less than 50 cents per dose, this innovation can save many newborns,' Batson says. The product is available now -- production and distribution just have to be scaled up.
The simplest innovation on the list, 'Kangaroo mother care' involves prolonged chest-to-chest contact between the mother and her newborn baby immediately after birth. That helps calm the baby's body down right away, initiates early bonding and attachment, and encourages breastfeeding.
'Innovation does not always mean the latest drug or device,' Batson says, adding that this low-tech, somewhat common-sense procedure can make a big difference if it's properly promoted. 'It has been shown to improve breastfeeding and thermal regulation of newborns, which is critical for survival in low-resource settings.'
Deficiencies in iron, vitamin A and zinc can reduce cognitive and immune function, leaving kids more vulnerable as they grow up.
Enriching a staple food like rice with vitamins and minerals can have long-term health benefits. PATH is already working to create a variety of fortified rice called Ultra Rice, which it claims tastes exactly like the regular grain. New methods of production can even tailor vitamins and nutrients to meet the needs of children in a specific area.
Access to clean water is a major issue in many developing countries. Contaminated water can lead to diarrhoeal diseases, which are a leading cause of death among young children.
PATH's analysis suggests that 65% of low- and middle- income populations get their water through a community source. But new technologies are making it easier to use chlorine to disinfect water.
PATH estimates that 23% of those who get water from small-scale community sources would use a chlorinator -- a device that attaches to a water pump and adds small amounts of chlorine to the supply -- if one were available. PATH believes that among the population that uses chlorinated water, the incidence of diarrhoea could decrease by roughly 84%.
The leading cause of death among children under 5 years old is pneumonia, but it can be difficult to diagnose and treat. Because detecting the disease is the first step to preventing those deaths, PATH recommends scaling up new ways of monitoring breathing rates.
Respiratory rate monitors already exist, but they aren't necessarily created with pneumonia diagnosis in mind, and aren't widely available in low-resource settings.
Work is currently underway to create low-cost, easy-to-use devices that can track respiratory rates or measure blood-oxygen levels, which would help health workers better diagnose children with the illness. UNICEF recently held a global design competition for respiratory rate monitors, and a company called Inspire Living has developed a product that can simultaneously measure breathing rate, temperature and heart rate. If production of such a device were scaled to meet global need -- a process that could start immediately with the proper funding -- it would go a long way.
Malaria rates have dropped 57% over the last 15 years -- a success Bill Gates has called 'a miracle.'
But in some regions, the P. falciparum parasite that causes malaria is developing a resistance to artemisinin, a key ingredient in traditional medications. PATH estimates that 40% of malaria cases will require a different kind of treatment by 2030.
Because of that, a new antimalarial drug that can attack the resistant malaria strains will need to be developed in the coming years. Ideally, it would only take one dose to completely cure the disease.
PATH believe this is possible, and estimates that such a drug could launch by 2022.
Most injectable contraceptives are currently only available in clinic settings. But a new product called Sayana Press packages a lower dose of the contraceptive in an easy one-time-use injection system.
'This tiny, simple device gives women a convenient and low-dose formulation of Depo-Provera in a package that is small, lightweight, and easy-to-use. That means trained community health workers can administer it, which increases access, and it even has the potential for women themselves to self-inject,' Batson says.
This is important, she says, because access to birth control is an important factor in preventing maternal and child deaths.
'Our modelling revealed that injectable contraceptives could save the most lives -- more than 3 million, including women, newborn, and children -- by putting power in women's hands to space their pregnancies in a healthy way,' Batson says.
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