Innovation occurs at the intersection of traditional disciplines. Novel approaches towards solutions require different perspectives. Nowhere is the urgency of cross-disciplinary dialogue more urgent than in addressing health crises in low-income countries. At this Forum, five distinguished speakers with a range of domain expertise in health delivery, design, diagnostics and engineering will focus on their approaches to addressing health problems where the burden of illness is the greatest:
Moderator: Kris Olson,
MD, MPH, DTM&H, Clinical Educator Svc, Dept of Medicine, Massachusetts
General Hospital; CIMIT Global Health Initiative Leader; MGH Center
for Global Health Senior Advisor; Instructor, Harvard Medical School,
krolson@partners.org
Enabling Data-Driven Rural
Healthcare Delivery
Manish Bhardwaj, Innvovators in Health, MIT,
manishb@mit.edu
Delivery of TB chemotherapy continues to be a challenge in rural communities in the developing world. Treatment only reaches half of the 8.8M new cases/yr, and outcomes need to be significantly improved: there are more than 500,000 new cases of MDR-TB annually. A central challenge faced by rural treatment programs is verifying that pills and health workers reach patients, that patients comply with regimen, and that treatment is effective. The mission of Innovators in Health is to gather and process real-time patient and operational data to improve delivery and judge its efficacy. The uBox is a low-cost, intelligent pill dispenser, which reminds patients to take their medication, records when they do so, and also tracks workers by recording when an electronic key is inserted into the box. The uPhone is a commodity cell phone with software that workers use to record patient symptoms. These are wirelessly relayed to a central location, allowing scarce and distributed physician resources to be intelligently allocated. By reliably and cheaply collecting data, the team's goal is to enable timely and targeted intervention in response to every failed transaction, supervision and reward systems for workers, and actionable means to improve programs. IIH is about to commence a 160-pt trial of its technologies in Bihar, India, this fall, in collaboration with the Prajnopaya Foundation, and the Bihar TB Association.
Diagnostics for Global
Health: Development of A Rapid Diagnostic for Tuberculosis
Jose Miguel Trevejo,
MD, PhD, Principal Investigator, Tuberculosis (TB) Breath Analysis
Project, Research Physician, Biomedical Engineering Group, Draper Laboratory,
jtrevejo@draper.com
Tuberculosis remains a major public
health problem worldwide with approximately 8 million new cases and
2 million deaths per year. A major obstacle to control TB is the lack
of a point-of-care diagnostic test that can detect Mycobacterium
tuberculosis (Mtb) promptly and with high sensitivity. Routine methods
for rapid Mtb detection are either insensitive (smear) or require extensive
infrastructure and time (culture). Jose Trevejo's research team has recently
used a differential mobility spectrometer (DMS), a highly sensitive
and portable mass sensor, and shown it can identify volatile organic
compounds (VOCs) or biomarkers specific for Mtb. In vitro studies indicate
a limit of detection of approaching 1000 bacilli/ml, which is an order
of magnitude better than current sputum microscopy. The goal of this
project is to extend in vitro findings to create a prototype point-of-care
device that provides rapid and sensitive diagnosis of pulmonary tuberculosis.
Because the DMS has already been incorporated into field-ready devices
that are robust and durable, the creation of a prototype for Mtb detection
would potentially enable a point-of-care device that could be implemented
in alternative settings where there is no access to a clinical laboratory.
Most areas of high tuberculosis burden lack the basic infrastructure
need to support a clinical laboratory. The value of this device is that
it could be a “black box” device in that little training of the
end user would be needed. This type of diagnostic could have a large
potential impact as Mtb could be identified earlier and treated accordingly.
Furthermore, once the application to rapid sputum detection has been
established there is a potential for further development of this diagnostic
for drug resistance screening. Creation of this prototype would lead
to further large scale clinical studies in different high burden areas
of the world including sub-Saharan Africa, South America, Eastern Europe
and Asia with eventual goal of creating a low cost and sensitive diagnostic
platform.
Medical Devices for Today's
Four Billion: The IIH Innovation Model for Accelerating High Impact
Medical Technology for Global Health
Jose Gomez-Marquez, Program Director, Innovations in International
Health Initiative, MIT, tachyonico@gmail.com
Amy Smith, Senior Lecturer, Mechanical Engineering, MIT,bee17@mac.com
The Innovations in International
Health (IIH) program has created a model of innovation for accelerating
the development of global health technologies across a wide array of
disciplines. The resulting collaboration between researchers, users,
and health practitioners has launched a growing portfolio of inventions
that are at different stages of deployment. These include an inhalable
vaccine delivery technology, RFID-enhanced disease surveillance systems,
compliance aids and low-cost incubators for rapid tuberculosis detection.
IIH has been able to assemble its collaborators and launch their projects
by taking advantage of physical collaboration spaces as well as a virtual
one. We are developing collaborative research tools that will suggest
new relationships, outline non-obvious critical path for product development,
and identify research cluster and gaps within our community.
IIH enhances sustainability by bridging the gap between the invention,
funding, and clinical trial stages of products aimed at the four billion
patients not served by current medical technology.
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