A striking inequality
Almost a decade ago, Klaus Schönenberger was working in the medical devices industry when he came across an annual report of his company and was struck by the disparity in sales in rich countries versus the rest of the world. A quick desk research showed that 14% of the world population (USA, Japan and Europe) consume over 80% of the entire medical devices market. These figures were all the more shocking as the burden of disease is overwhelmingly tilted towards the rest of the world population living in developing countries.
A social business strategy
After some time spent digging into the causes of this global imbalance, Klaus started to think about a solution to address this problem. One of the leading causes why medical devices are failing in developing countries is the fact that technology -designed for rich countries- is simply neither adapted nor affordable in those regions. For medical devices to take hold, technology needs to be redeveloped based on knowledge of local conditions and resources. Klaus discussed the matter with Bertrand Klaiber who was active in marketing and business development in an electronics company. Together, they developed a strategy to address this challenge by harnessing the best of technology development and industrial competence. They also imagined the concept of an organization, run like a standard high-tech medical company, where the mission would be to provide access to appropriate medical devices in poor communities across the globe. All revenues from sales would be reinvested in the pursuit of the mission and, in order to maximize affordability, the organization would be strictly non-profit. The goal was to create a sustainable and long-lasting impact on global health.
Public Health and Tropical Medicine expertise chimes-in
In summer of 2009, Klaus decided to devote 100% of his time to this concept and has done so without any financial support since then. Bertrand kept-on exploring ideas on the way to build and manage the value chain, while Klaus set-out to meet with a wide spectrum of experts and leaders from the public and private sectors. That is when the team met Beat Stoll, a medical doctor teaching Public Health and Tropical Medicine at the University of Geneva. Beat was immediately enthused by the idea as he had had first-hand experience with the problem of lacking the appropriate technical equipment in developing countries. Indeed, Beat has lived and practiced medicine as a Joint Chief Medical Officer in Cameroon for 3 years. Beat asked Klaus if he wanted to join him on a trip to Cameroon to explore the situation on the ground. This trip took place in October 2009 and the team was able to consolidate all the main concepts and strategies through many discussions with leading health staff and representatives of the Ministry of Health. Right after that important trip, Beat decided to join the team and provided decisive input regarding the use and place of medical devices in developing countries’ health systems. Through his detailed knowledge of local health systems, he was able to help the team focus its efforts on the district hospitals (first level of referral), where the need for technology is the most blatant.
A first major challenge: Access to diagnostic Imaging
Based on a careful evaluation of medical devices in primary healthcare, the team was able to define a list of 10 medical devices which are essential in all district hospitals and which are either generally missing or failing to deliver the intended medical function. Diagnostic imaging was clearly sticking-out as the most urgent unmet need and this is why the team has decided to focus on this modality. The team spent the next 6 months analysing the technology, the business model and the healthcare environment until reaching a point where it was able to draft a detailed project proposal. This proposal was submitted to all key stakeholders from academia and industry and was met with unanimous interest.
Expansion of activities
EssentialMed’s first project, called GlobalDiagnostiX, was thus launched in 2009. Its objective was to make radiology more widely available to the 2/3 of humanity who do not have access to medical imaging. After several years of research and development, in collaboration with different labs at EPFL and at the HES-SO, a prototype combining the different technology innovations was presented, and used to create a start-up company, called Pristem SA with the mission to industrialize and deploy the device, especially in low- and middle-income countries. Today, this company has deployed the first X-Ray device in sub-Saharan Africa, as a fully certified medical device.
In parallel to this groundbreaking technology innovation, EssentialMed developed a “teach and train” program to improve the training of medical specialists in radiology, in order to tackle the lack of skilled staff in primary care facilities.
Finally, these efforts are also implemented via Pristem SA by means of an innovative business model that combines different aspects of the provision of medical technology (e.g. the medical device itself, its maintenance, staff training, long-term guarantee, etc…).
Following the same path as the GlobalDiagnostiX project, two projects in the field of child health are in progress: GlobalNeoNat and GlobalO2. The former aims to provide primary healthcare centers with the necessary skills and equipment to reduce long-term damage and preventable deaths caused by hypothermia. The latter targets another major cause of neonatal deaths, asphyxia, by improving access to oxygen.
GlobalNeoNat already produced several prototypes of infant incubators, and our partnerships allow us to prepare its deployment, including with possibilities of local assembling or manufacturing in Kenya.
GlobalO2 aims at improving the functioning of oxygen concentrators, but mostly at increasing the availability of oxygen for patients through a tilting of the oxygen provision business model, switching from a device-based payment to a fee-for-service model. Twenty hospitals have been equipped and trained in oxygen provision, in order to validate this new business model.
The Foundation has also launched the Tanzanian-Swiss Innovation and Entrepreneurship Initiative in order to reinforce the collaborations between Tanzanian and Swiss partners in the area of child and adolescent health, through the implementation of R&D and entrepreneurship projects. This project has been successfully taken over by the EPFL EssentialTech Centre and became an « Entrepreneurship-in-Residence » initiative.