By Eliza Villarino, 27 October 2014, DEVEX

A young girl receives medicine from a health worker at a mobile health clinic in Sindh, Pakistan. How do we scale up innovative solutions for global health challenges? Photo by: Vicki Francis / DFID / CC BY

If there’s one positive lesson to learn from the Ebola scourge, it’s that there’s no dearth of solutions to global health challenges. Prior to the current outbreak, the narrative was that there was no known drug for the disease; soon, vaccines and treatments will undergo testing.

Those experimental vaccines and treatments flew under the radar until the Ebola outbreak turned into a humanitarian tragedy and, eventually, captured headlines and the attention of global leaders. Urgency has created a market for Ebola solutions.

The same cannot be said for many other promising ideas in global health. Today, quite a number of medicines, health diagnostics and delivery mechanisms are lagging behind their potential.

“What we have is only a trickle of things transitioning to scale,” said Peter Singer, CEO of the Canadian government-funded Grand Challenges Canada. “So the next great challenge in global health and development is to turn that trickle into a torrent of things to scale.”

Scaling up new ideas in global health is a challenging venture. It requires leadership, funding and buy-in from a variety of stakeholders, from patients to providers, from the public to the private sector. Cross-sector partnerships can facilitate the process, but there’s no silver bullet to sustainably scaling up new ideas in global health.

Funding new ideas

More players than ever are engaging in global health, with corporations and philanthropic foundations taking on a particularly growing role. Often, they partner with one another to develop new ideas in global health.

The use of competitive grant-making mechanisms — sometimes called grand challenges — is a favorite among the likes of the Bill & Melinda Gates Foundation and U.S. Agency for International Development, and has been taken up by governments of emerging countries like Brazil, India and South Africa. Winners of these competitions usually end up with tens of thousands of dollars in cash rewards — not quite enough to scale up a promising idea, perhaps, but a good start.

These challenges have resulted in a slew of new solutions, from a mobile phone application that can help deliver health care to the doorsteps of people in remote villages to a cheap medical device that boosts the chance of newborn survival in the developing world. But despite their lifesaving promise following testing over many years, the majority of them risk remaining at the pilot stage.

“A lot of NGOs and funders are set up to try new things, to fund pilots and small-scale efforts and they don’t necessarily follow through with funding when something is ready to scale,” said Pam Bolton, vice president for strategy and innovation at Concern Worldwide U.S.

That’s because scaling up requires huge costs, especially if it entails making the solution, whether a new drug, equipment or service, continuously available to the poorest of the poor who tend to be among the hardest to reach. And official development assistance for global health, which stood at $31.3 billion in 2013, won’t be enough to cover those costs. Fighting tuberculosis alone requires $8 billion per year, according to the World Health Organization.

Private capital may help supplement that. More and more private investors are committing capital to efforts that generate social impact, including better health outcomes. Impact investments, according to one survey, have reached $46 billion and will likely grow this year by 19 percent.

Sustaining access to new ideas and effective solutions

Beyond financing new ideas in global health, the private sector has a role in developing new ways to advance health care and making new solutions more available to those who need it.

Pharmaceutical manufacturers, for instance, have launched more than 350 treatments over the last decade and have 3,200 compounds in the development pipeline. One of those could end up being a malaria vaccine.

But developing a drug that is safe and effective comes with an expensive price tag — somewhere between $4 billion and $11 billion. Much like donor agencies seeking partnerships with corporations to stretch aid dollars, pharmaceutical and medical equipment companies are partnering with one another and others to share the risks and reward of launching new global health solutions.

“Innovation is becoming more collaborative and we have moved away from profit-alone models to profit-together models,” said Andrew Jenner, executive director of corporate strategy and legal affairs at the International Federation of Pharmaceutical Manufacturers & Associations.

Members of the federation are working to develop treatments for diseases in the developing world independently or through product development partnerships, a form of public-private collaboration, such as the Drugs for Neglected Diseases Initiative, Medicines for Malaria Venture and TB Alliance. Pledged to donate 14 billion treatments for neglected diseases between 2011 and 2020, they have affirmed the importance of a “holistic fight” against these diseases to include working with the World Health Organization and other partners to strengthen capacity in developing countries.

Like product development partnerships, advanced market commitments are designed to incentivize the pharmaceutical industry to develop solutions that can fight diseases in the developing world. In this case, donors, largely rich governments and foundations, agree to subsidize the price of future vaccines for infectious illnesses and in turn a manufacturer agrees to sell them in developing countries at an affordable price. Gavi, for instance, has this innovative financing scheme in place for pneumococcal disease — the leading cause of vaccine-preventable death among children under 5.

Another scheme somewhat akin to it is the public-private Pledge Guarantee for Health, which uses partial guarantees from U.S. and Swedish governments to enable traditional aid grantees, such as nongovernmental organizations and developing country ministries, to secure short-term, low-cost commercial credit to procure essential health supplies such as bed nets and contraceptives.

Adopting new ideas

Apart from accessibility, adoption is critical to scaling up new ideas.

Take the case of magnesium sulfate, which is proven to effectively treat pre-eclampsia, a disorder that kills 40,000 pregnant women each year, mainly in low- and middle-income countries. Yet despite its low cost — about $1 per dose — and being designated as essential medicine by the WHO the use of magnesium sulphate has been low. Studies suggest that the low price discourages mass production of the drug and policymakers are not moving to change the situation.

A number of reasons may explain why decision-makers aren’t keen on scaling up effective solutions. For some, it’s the lack of money; for others, the fear of being accountable for allocating resources to what may be perceived as a risky activity.

“As long we don’t put in place governance systems, no innovation will help us reach the most vulnerable people,” Gabriel Pictet, unit manager for community health and innovation at the International Federation of Red Cross and Red Crescent Societies, told Devex.

Rwanda, for instance, actively pursues new and effective ideas from its development partners as it wants to become more like Singapore, a city-state esteemed for its efficient public service.

Strong support from local communities can help to promote new ideas, as well. Development initiatives tend to find the most success if implementers live and listen to locals and involve them in the design and implementation of solutions.

More importantly, the new idea should strengthen health systems. And that part isn’t going to be easy.

“I think it comes down to the question of how do we build a really strong health system?” said Jessie Cronan, executive director of Gardens for Health, which partners with government-run health centers in Rwanda to help families in rural regions with the highest rates of chronic malnutrition have a diverse diet by cultivating a home garden. “How do we reframe that role that NGOs play so that we’re playing a supporting role to government institutions in these countries so that it isn’t creating parallel systems but instead how are we working to strengthen what is already there so that there is true meaningful capacity building happening which is hard. It’s a lot easier to set up your own thing than to work with any government.”

Over the next month, Devex, along with leading players in global health, will explore how we can address that dilemma, as well as other emerging opportunities and challenges in saving lives and living longer.

Healthy Means is an online conversation hosted by Devex in partnership with Concern Worldwide, Gavi, GlaxoSmithKline, International Federation of Pharmaceutical Manufacturers & Associations, International Federation of Red Cross and Red Crescent Societies, Johnson & Johnson and the United Nations Population Fund to showcase new ideas and ways we can work together to expand health care and live better lives.

This is a repost written by Archana Sinha who leads the Health and Nutrition Initiative at Ashoka India. This post first appeared  first appeared here.

From human-centered design to the lean startup approach, methods to develop innovative products and services emphasize the importance of understanding what customers really need. Here are some lessons in innovation that social entrepreneurs have learned from empathizing with their customers:

Don’t let technology take the wheel: “I used to think that the problem lies in technology. What we realized eventually was that the problem does not merely lie in the technology, but the psychology,” says Ashoka Fellow Swapnil Chaturvedi in a recent video on his work.

Swapnil, founder of Samagra, is talking about providing adequate sanitation in India, where over 50 percent of the population defecates in the open. His statement could be true anywhere else in the world; toilets installed in low-income areas often fall into disuse or end up being used for other purposes such as vegetable peeling bins. To mitigate this, when designing community toilets in Pune slums, Swapnil introduced a LooRewards system. Based on a mapping of the community’s needs, this system linked toilet use with discounts on washing and sanitation products, water purification systems or fortified, nutritional snacks sold by local producers. This helped Samagra engage over100 first-time users of toilets.

Michael Murphy, co-founder of the MASS Design Group also realized that sophisticated technology wasn’t essential, while designing the 140-bed Butaro Hospital in Rwanda. He reveals, “A common misconception is that design interventions that combat the health worsening effects of hospitals are more expensive or require advanced equipment and machinery, but we’ve seen that’s not the case. Hospitals all over the world can be harsh environments for patients—which is shocking to consider, as we think of hospitals as places people go to get better. But labyrinthine corridors, harsh lighting, and stale air can in fact jeopardize a patient’s capacity to heal. Beyond that, hospitals are actually making people sicker. According to the CDC, about 1 in 20 patients gets a hospital-acquired infection (something they did not arrive with) per year in the U.S. (CDC, 2013). In Butaro, we designed the building without hallways, instead creating open-air, comfortable waiting spaces that would reduce the transmission of infection, but still provide opportunity for check-in and interaction. MASS also incorporated ample landscaped areas for patients to have quiet space outside, or visit with their families.”

Build the solution for the most under-served customers: Your most engaged customers often come from the edges of the market. Swapnil admits, “When I started working on community toilets, I didn’t know women would become our biggest customers. However, we have observed that in urban areas, where everyone is stretched for land and privacy, men find a solution to the lack of toilets, but women can’t. They hold their urine and bowel movements, resulting in urinary tract infections.” Thus, women are keen users of Samagra’s community toilets and as its most vocal customers, they help get their friends and families to sign up. Samagra, in turn, pays special attention to their needs, by providing dustbins in each toilet stall for disposing sanitary napkins and prioritizing water supply in the women’s toilets.


Shift how the community sees you: “Hospitals should be, first and foremost, a public resource. This includes making the hospital an approachable space, where people can come to maintain their quality of life as well as receive acute care. That is why a lot of the spaces are landscaped,” asserts Michael. While building the hospital, he sought to expand its benefit beyond healthcare. “Health infrastructure requires massive investment and construction. This mobilization of resources should be transferred to the local community, by using local labor and materials, as well as providing on-the-job training. Butaro employed over 4,000 people, and transferred a few million dollars into the local economy as well. Beyond that, several masons trained at Butaro have gone on to other skilled jobs,” he states.

Focusing on positive outcomes for the community has prompted Swapnil to transform his rewards program from what he calls “transaction-based rewards” to “value-based rewards,” such as discounts on private tuition classes for schoolchildren. Samagra’s toilets also have bank kiosks that allow customers to deposit small amounts in their bank accounts regularly. This shift has resulted in increased revenue for Samagra, as “learning what customers care about through empathetic market research has allowed us to capture value and monetize it.” Transforming toilets into community connectors that allow slum-dwellers to access a broader range of services is powerful. Swapnil shares, “Since we installed a banking kiosk in the community toilets, rather than a place to relieve themselves, the toilet becomes a place to bank. People will never vandalise their bank; we’ve seen vandalism reduction by 85%. The toilet has become a place of business and a community centre of sorts.” Regular savings also allow customers to budget for the fees for using the toilet, and their payments have become more regular.

Innovations driven by empathy are now enabling Swapnil and Michael to expand the scope of their work. Michael’s MASS Design Group is currently completing construction on both a tuberculosis hospital and a diarrheal disease treatment center in Port-au-Prince, Haiti, as well as designing maternity waiting homes in Malawi and a Center for Global Health at Mbarara University in Uganda. Swapnil’s Samagra is evaluating options for adding more value-based rewards such as day-care centers for mothers who work in the informal sector and can’t afford to quit their jobs to take care of their children.


In a blog from Oxfam America, Jennifer Lentfer argues for a new interpretation of ‘innovation’ within global development and examines what we can learn from grassroots organisations.

Innovation is not a result of dictating or choosing from what is, but expanding options.” Curtis Ogden of the Interaction Institute of Social Change

Let’s face it. Some days, most days, development work is far from sexy. What’s most needed to bring about changes in ordinary people’s lives is citizens demanding fundamental services, community organising and coalition building, governments and agencies managing their budgets – i.e. the day-to-day grind of making institutions function.

So why then is the development sector so obsessed with being ‘innovative’?

It may be because we are often working in challenging, changing, and complex operating environments, within the risk-averse policies and procedures of aid agencies suffering from bureaucratic inertia. We long for a new ways of thinking and working, and new ideas are way more fun and much less political.

Nonetheless, I am often concerned that the term ‘innovation’ gets over-used and misinterpreted in the humanitarian and development sector.

Rather than the usual ‘latest and greatest idea or fad’ and ‘get-to-scale’ mentality associated with innovation, I wonder if innovation can be re-defined to identify innovation first from the ground up? In other words, can more localised, grounded means of problem-solving generate the most effective ideas, products or processes to be labelled as ‘innovative’?

This is where the DIY Toolkit can help ‘bring ideas to life’ across various sectors and settings. Throughout my experience in aid and philanthropy, I have found that local organisations are doing some of the most innovative, yet under-valued work in the development sector. Solome Lemma, Co-founder and Executive Director of Africans in the Diaspora (AiD), explains: 

“It’s often easy to forget the great amount of innovation that indigenous, grassroots organisations employ. Even more so because they often don’t frame their work within the language we understand or associate with innovation. You must listen, dig, ask questions, and reframe in your head to see that within what they describe as a regular part of their work lies ingenuity.”

Doesn’t it just make good sense to support more opportunities for ‘innovation’ closer to where the problems are occurring? Aren’t the people who intimately know a problem from the inside out more likely to see where the possibilities for innovation lie? And from small initiatives, is there not the potential to pilot and learn for application in larger programs? Ultimately, where we are looking for innovation and who defines innovation is vital.

One of the most important roles of us as development practitionersis to encourage, coach, and uphold processes of individual and collective reflection to identify and overcome obstacles, resulting in changes or adaptations in our work. If you are a development practitioner supporting community- or country-led initiatives, the DIY Toolkit is a useful tool to enhance your support of development partners to think creatively about their programs and practices at all levels. Supporting people and leaders in the developing world to enhance their own efforts with openness and confidence is what gives birth to lasting innovation.

So perhaps it’s time to re-conceptualise ‘innovation’ for global development. What if the thing really makes something innovative is not the idea itself, but the learning that made it possible?

Jennifer Lentfer is the creator of the blog, which focuses on how the international aid, philanthropy, and social enterprise sectors can be more genuinely responsive to local needs. One of Foreign Policy Magazine’s 100 women to follow on Twitter, she has worked with over 300 grassroots organisations in east and southern Africa over the past decade, as well as various international organisations in Africa and the US, including the Red Cross, UNICEF, Catholic Relief Services, and Firelight Foundation, where in her career she has focused on organisational learning.

Lentfer is currently Senior Writer on Oxfam America’s Aid Effectiveness team and editor of the organisation’s Politics of Poverty blog. She is also a lecturer in Georgetown University’s Center for Social Impact Communication

This piece is cross-posted from Oxfam America’s Politics of Poverty blog

By Kevin Starr, September 2, 2014

Through a kind of magic I don’t fully understand, some emerging poverty solutions—products, services, technologies—become shiny new objects that trigger something akin to a feeding frenzy. Celebration at CGI and SOCAP and TED, breathless articles in Wired and Fast Company, endorsements from celebrities, awards of all kinds—all that stuff is great if the thing has real potential for impact. Too often, though, the appetizer becomes the entrée and hyperbolic celebration displaces systematic evaluation.

That’s a shame, because we really do need to sort good ideas from bad, and it ought to happen before we stoke the fires of publicity. At Mulago, we’ve spend a lot of time trying to figure out if start-ups with a new “thing”—a product, service, or technology—are likely to create real impact in the lives of the people we’re trying to serve. Over time, we’ve evolved a set of four questions that help us make better predictions. Because we’ve been thinking a lot about cookstoves and indoor pollution lately, I’ll use improved cookstoves to illustrate how those questions work.

1. Is it needed?

Given the nature of the thing, is there a profound social impact to be had? Every thing ought to have a mission (preferably in one that’s eight words or less). If you can’t figure out a clear mission that matters, all you may have is a solution in search of problem—and some things ought to be killed while they’re young.

We might reasonably ascribe various missions to better stoves, including: improve health, prevent deforestation, save time and money, and decrease carbon emissions. Since indoor air pollution is a major killer and bad stoves are the major contributor, we think that the mission to “Prevent Respiratory Disease in Poor Families” is a compelling one and rises above all the others (especially since the evidence connecting the other potential missions is considerably more sketchy). So the answer to question one isyes, absolutely, we need better stoves.

2. Does it work?

If the thing is deployed as designed, under the conditions for which it was designed, will it have real impact? In the case of stoves, this is mostly about emissions: Does a given stove reduce pollutants enough to drive a significant improvement in health? Recent research indicates that most improved cookstoves don’t. It turns out that you have to reduce more than 85-90 percent of pollutants before you see any real reduction in respiratory illness (Burnett et al, 2014). A stove that emits 50 percent less pollution doesn’t accomplish much. To date, the only stoves that make the cut are the expensive “forced-draft” models that use a built-in fan to stoke a much more efficient burn. The answer for most stoves, however admirable the effort may be, is no. Really.

3. Will people use it as designed?

Behavior, behavior, behavior. Despite all that user-centered-design, iterative-rapid-prototyping stuff, people use and abuse things in ways that leave even the best designers scratching their heads. Too many—way too many—products have made their way into wide distribution without evidence that people use them as intended. Successful things, though, usually have these qualities in common: They fit well with local customs and culture, are easy to use right and hard to use wrong, and need little maintenance (and when they do, they’re fixable and you can get parts).

Everyone has heard about stoves that people use improperly—or not at all—but field researchers have handed the stove industry another fun surprise: Even when people do use that wonderful new stove, they often use the old one too (Ruiz-Mercado et al, 2011). It’s become known as “stove-stacking,” and you see it when you visit homes—there’s the new stove, fired up and roaring, and there’s the old three-stone fire still belching smoke in the corner. Oh no! If you want to fulfill the mission—prevent respiratory disease in poor families—not only do you have to provide an expensive stove, you might have to provide two! It kind of sucks, but that may be what it takes to get to yes.

4. Will it get to those who need it most (a lot of them)?

Nothing matters if the thing doesn’t reach the people it is intended to serve. If you don’t have a reality-based idea about distribution, you should hold off on the design process until you do. Three things matter above all else:

  1. Price. If it’s too expensive, they won’t buy it. Knowing the customer’s price point is your first order of business, and you need to design the thing to hit that number.
  2. Distribution channel. Poor people live in a world of market failure, and there are a finite number of ways to get things to them—the hardest is to set up your own network.
  3. Sales. Somebody has to make the transaction happen—who are they and how are they going to do it?

And, of course, if the thing costs more than about 20 bucks, you’d better think about financing, too…

This is where stoves have always struggled: The affordable ones are inadequate, and the good ones are unaffordable. Even with the (unreliable) assistance of carbon credit subsidies, stoves that can fulfill our health mission are still too expensive. Emerging technologies will almost certainly lower the price of forced-draft stoves, but for the time being, they’re mostly out of reach for those who need them most. Financing can help, but poor people often have more urgent things to do with available credit.

One organization working on the stove problem that gets to “yes” to all four questions is Inyenyeri, a Rwandan company that leases ultra-low emission, forced-draft cookstoves to households at a nominal cost (about $7 per year), and sells customers the fuel pellets to burn in them. The pellets cost less than charcoal, and people who can’t afford to buy them can trade biomass for pellets. Inyenyeri leases families two or even three stoves to account for stacking. It’s still early days and there are a lot of moving parts, but it’s headed in the right direction.

The four questions are unforgiving; getting a no on any one of them means you won’t pass go on your way to impact. That doesn’t mean that a no answer should lead you to abandon the whole effort, but it should refocus your efforts on getting to yes. Stick with R&D, and avoid the big splash until you’re pretty sure you’re there—it’s the least we owe the people we serve.

By Chris Fabian & Robert Fabricant, Aug 5, 2014

Technology is all about making new stuff, agility and adaptability, and knowing what’s next. It’s fast. It’s cool. It wears a hoodie.

International development deals in systems and measurements to help shift government policies. It’s slow. It’s big. It wears cufflinks.

Each field has its own language and ethics. How do you work with beneficiaries (or users)? How do you conduct monitoring and evaluation (or A/B tests)? What does it mean to implement (or deploy)? These lexicons don’t always connect—and when they don’t, we see wasted effort and the potential to lose real global change.

An ethical framework—“a way of structuring your deliberation about ethical questions”—can help to bridge disparate worlds and discourses and help them work well together. Ethical questions might include: “Is this platform / product actually providing a social good?” or “Am I harming/including the user in the creation of this new solution?” or even “Do I have a right to be taking claim of this space at all?” This helps us form value-based collaborations—and allows us to better assess and monitor our work.

Here, we propose an ethical framework—very much a strategy or structure—based on nine principles (operational tactics and measurements) that UNICEF and other development sector actors developed and adopted. Building on their work, our framework includes a set of four cross-cutting values and statements that innovators can use to negotiate between the competing priorities and objectives of startup business and international development.

Innovation in International Development

In the dominant model of international development, targets such as the United Nation’s Millennium Development Goals are created and managed centrally, and measured globally. International development professionals try to agree on these goals, and then work to coordinate the big systems needed to make progress against them.

In recent years, many people in international development (inside and outside of the United Nations) have added a powerful new word to their discourse: innovation. The term carries many meanings, all of which seem far from the realm of three-year project plans, SWOT analyses, monitoring and evaluation, and logical frameworks (log frames).

In development, innovation most often means:

  • Working fast and flexibly like a Silicon Valley startup (process)
  • Incorporating the latest technologies to transform the way we engage populations and measure everything (technology)
  • Taking user needs into account, make sure that solutions reflect real user needs (design)
  • New models of shared value partnership, thinking more like an ‘incubator’ than a serial-process driven system (investing)

We’ve used these appealing words and concepts extensively in pushing for new design and development models in our own organizations. But while Silicon Valley has proven that “creating multi-disciplinary teams” and “failing quickly” add value to Facebook and Google, have we been able to prove that “agility” (for example) adds real value to large-scale human development?

“Invention Saves Lives”

As the international development community draws on the technology community’s language of innovation, private sector technology community itself is starting to approach the world of life-saving innovations.

The designers and technologists that created the personal gadgets, connectivity platforms, and Internet-enabled culture of sharing we use today are creating another portfolio of inventions that have largely charitable or humanitarian aims. A significant portion of these inventions target the most basic human technologies: toilets, water filters, smokeless indoor stoves. These efforts, though new, often 1) don’t see user growth, 2) are focused on advances in engineering and manufacturing rather than systemic change, and 3) start and end as ideas or prototypes.

What happens when the preeminent tech investors and inventors of our age take on this mantle and design directly for the global poor? What are the dangers of “disruption” when dealing with vulnerable populations’ lives? Should we use the same metrics to evaluate new releases of technological platforms as we do for social change?

Bridging Two Worlds

Here is a summary of the ethical framework we propose for guiding and evaluating innovation projects:

  • Innovation is humanistic: solving big problems through human ingenuity, imagination and entrepreneurialism that can come from anywhere
  • Innovation is non-hierarchical: drawing ideas from many different sources and incubating small, agile teams to test and iterate on them with user feedback
  • Innovation is participatory: designing with (not for) real people.
  • Innovation is sustainable: building skills even if most individual endeavors will ultimately fail in their societal goals

This basic framework is helpful when it is used to spur questions about specfic initiatives, which cross the spaces of technology, business, and development—questions such as:

  • How do we take advantage of global knowledge, technology and expertise to solve enormous problems without imposing a paternalistic model on the solution or those who benefit from it?
  • How do we design in an inclusive and participatory manner, when resource and power dynamics are so unequal?
  • How do we address persistent problems that defy a single clever invention and require sustained engagement, learning, iteration, and adaptation? (Imagine if Google left its original Spreadsheets application alone, thrown up its hands, and said, “Well, people either use it or not.”)
  • How do we take advantage of capital markets as paths to scale, while recognizing that they are not inherently humanistic or ethical?
  • How do we account for the potentially destructive results of innovations five or ten years from now without completely shutting down the sort of risk-taking that is essential to the creative process?

The Journey to a Set of Values

UNICEF’s Innovation Labs provide a good example of a values-based approach to problem-solving that effectively bridges technology and development. The labs fit into a growing constellation of tech hubs in the developing world and share the space with private-sector labs. (Many technology corporations are setting up their own labs—fueled by investments from technology giants, and modeled on Bay Area startup incubators—in the belief that having a footprint in the developing world innovation space is enough to inspire network growth or turn up new opportunities for core business.)

One of the reasons that UNICEF set up labs was to create a way to engage problem solvers in a space where problems are not just about a better product or single-pointed solution, but also about systemic changes that run from individual to community to national government and beyond.

UNICEF’s labs create a translation layer between startup thinking (“If I could make this one thing better, then people would use my product”) and development thinking (“If we can create a systems-level argument and fully monitor all aspects of our change, that change will become institutionalized over time”). These are simplifications of both systems, but the dichotomy is clear.

Without pathways to scale or market, many great ideas get lost. As Steve Davis of PATH puts it, “The ‘iPods’ of poverty alleviation and literacy have likely been invented and put to use by small organizations in some corner of the globe, but there is no market for identifying these breakthrough ideas and ensuring widespread adoption.” UNICEF intends its labs to work as APIs between small local innovators, and global systems of policy-making and scale.

These labs represent an important new physical layer in the innovation ecosystem by combining private-sector entrepreneurialism with broader societal needs. Structures like this can be effective in building a community with the skills and capacity to innovate, regardless of whether individual technologies or product ideas deliver on their promise.

However, they still constitute only one layer, and the strata around them needs to be balanced to ensure that innovations from within the network are authentic, fair, and useful. Set up correctly, labs move away from hierarchical structures for solving big problems and toward more-participatory engagements with potential consumers of those solutions (inspired by our close partnership with the global product strategy and design firm frog). In many ways, they are a physical metaphor for (and instantiation of) this ethical framework.

Shifting the Paradigm

In-country innovation teams, labs, localization, and research units represent a fundamental shift in the paradigm of innovation in development by dismantling the often modern, often Western distinction between business activity and social good.

Local (but global) labs also represent a fundamental shift toward a more human-centric approach to problem solving grounded in human needs, insights, and ingenuity. People’s needs are not neatly packaged up into commerce and social good. Similarly, they are not neatly divided between saving money and getting medicine for a sick kid or transport to a job site. Building one class of products for “consumers” and another for “those in need” creates false divides, as well as products that are neither sustainable nor scalable.

Some Background: Nine Principles

The thinking in this article and the ethical framework itself stems from a set of operational principles and specific thesis statements that a group of development, design, and technology experts have been building over the past two years. They include:

  1. Design with the user.
  2. Understand the existing ecosystem.
  3. Design for scale.
  4. Build for sustainability.
  5. Be data driven.
  6. Use open standards, open data, open source, and open innovation.
  7. Reuse and improve.
  8. Do no harm.
  9. Be collaborative.

In Practice

UNICEF’s deployment of RapidPro—a flagship, open-source platform for moving information quickly using simple mobile phones—offers another example of putting these principles to work. As the organization developed RapidPro, it faced a choice: traditional development or tech-driven innovation. In an attempt to bridge the two, (and through its Innovation Labs), RapidPro is basing development on non-hierarchical, participatory, sustainable, and humanistic design:

  1. Non-hierarchical: RapidPro has a management structure that looks like a tech startup (business development, operations, sales, engineering, and design), but each part of that structure sits in a different innovation lab.
  2. Participatory: Teams develop features and applications in the field, at the point of use, with people who will eventually use the system.
  3. Sustainable: The code and platform are entirely open source (AGPL), and vendors across five continents and a dedicated open-source community will support it.
  4. Humanistic: A real-time information platform is important to the private sector (where are my shipments? customers?) and public sector (where are services? those in need?), and the problems it solves are applicable to every country in the world.

By aligning the purpose and processes behind building RapidPro, UNICEF is creating platform that seems to fit this emerging model of global development, but more importantly, it has created ecosystems around the platform (and its services) in more than 30 countries. This would not have been possible using either of the traditional approaches, or without innovation, technology, and business partners such as frog.

This is only one example of such an approach. There is a rising tide of interest from organizations such as to move beyond individual product innovations, and plug into broader platforms and systems that can have a massive impact on poverty and health.


All collaboration is difficult, because the languages and principles behind these fields have been developed independently and over time. But by working together, the fields of technology, business, and development can create bigger change than by working separately.

A framework for discourse and collaboration, and a shared ethics around approach, are necessary to make certain that there is a common vision and that great innovations can have the best impact on the world’s most marginalized populations.

UNESCO-IHE – Smart eSOS toilet for emergencies | SOURCE: UNESCO-IHE, July 2014 |

The emergency Sanitation Operation System (eSOS) concept provides a sustainable, holistic and affordable sanitation solution during the aftermath of a disaster. The eSOS reinvents (emergency) toilet and treatment facilities, and uses ICT to bring cost savings to the entire sanitation management chain. The toilet will improve the quality of life of people in need during emergency situations – from natural to anthropological disasters – and minimizes the threat to public health of the most vulnerable members of society.  esos-toilet_0

The eSOS concept was developed by UNESCO-IHE Institute for Water Education. The experimental prototype of the smart toilet was developed in collaboration with FLEX/The INNOVATIONLAB and SYSTECH and is funded by the Bill and Melinda Gates Foundation-funded project SaniUP – Stimulating local innovation on sanitation for the urban poor in Sub-Saharan Africa and South East Asia.

Smart features
The eSOS emergency toilets are easily deployable in disaster areas because of their robust and light-weight specifications. The smart eSOS toilet includes some unique features in the prototype that will shed new light on how the toilets are used in emergencies. This includes remote-sensing monitoring, an energy supply unit, GSM/GPS sensor/card, occupancy sensors, urine/faeces accumulation sensor, an S.O.S. button, and a communication system that allows for data collection by remote sensing and their transfer to an on or off-site emergency coordination center. The data resulting from the use of the toilets will allow the toilets as well as the entire sanitation management chain to be improved.

Field testing
The eSOS toilet will be tested further in a refugee camp in the Philippines in September with support of the Bill and Melinda Gates Foundation and the Asian Development Bank. UNESCO-IHE PhD fellow Fiona Zakaria from Indonesia will carry out further experimental testing in cooperation with relief agencies on the ground. The eSOS smart toilet design prototype will be manufactured based on the results and feedback obtained from the experimental application.

The Future Technologies for Water Competition (FTW) aims to identify breakthrough technologies for safe water with a sustainable business plan with wide-scale applicability. 

The first-place winner will receive $15,000, and the second-place winner will receive $5,000.

From June 9 until July 31, we will be accepting initial entries in the form of a one-page summary, via the competition website.

Entries should relate to the following themes:

  • Shortening the water cycle by looking at grey water and/or wastewater reuse
  • Rapid testing of water samples with an emphasis on in situ, online testing
  • Protecting vulnerable and sensitive populations (e.g. young, elderly, immunocompromised)

The Future Technologies for Water competition is managed by the Water Institute at the University of North Carolina at Chapel Hill and sponsored by Takata Corporation.

Visit the competition website, or email for more information.

Have a Thirst for Knowledge? Introducing the Drinkable Book | Source:, June 11, 2014.

An estimated 3.4 million people die annually from preventable water-borne diseases, and many aren’t aware that their drinking water is contaminated. Water filter technology has come a long way in recent years, but most options are still restrictively expensive for use in the Global South or unsuitable for mass distribution. Enter the Drinkable Book.

Developed by chemist Dr. Thersa Dankovick of the University of Virginia and McGill University, the drinkable book seeks to provide both cheap, clean drinking water and information on healthy sanitation practices. After ad agency DDB heard about Dr. Dankovich’s project and put her in touch with another of their clients, the NGO Water is Life. Together they developed the final product and are working to distribute the book through their programs. According to NPR, Dr. Dankovich tested the product in South Africa in 2013 and is planning further field trials in Ghana later in 2014.

Crucially, the book costs just pennies to produce, making it far cheaper than alternative systems. Each page provides an individual with clean water for a month, and a book can last over a year. It filters over 99.9% of bacteria, making it as clean as tap water in the United States. It filters out cholera, typhoid, and e. coli, as well as larger pollutants and debris.

The pages are about a millimeter thick and work like a high-tech coffee filter using silver nanoparticles. Silver causes interacting microbes to die, but has very little effect on people. Using the book is easy: simply tear our a perforated page, slide it into the included case, and pour contaminated water through it. With no other steps, the water is ready to drink safely.

The silver turns the paper a burnt orange, making it eye-catching and distinct from other books. Information is printed on each page explaining safe water habits, like keeping trash and feces away from water sources and the benefits of regular hand washing. The information is currently being printed in English and Swahili using non-toxic food-grade ink.

Using English and Swahili is a great step in accessibility, however it does restrict illiterate users or those who speak other languages or dialects. Hopefully as the project gains traction other languages can be incorporated, including Braille and non-verbal graphical systems. It is currently unclear how users know when each page is past its usefulness, though hopefully this will be incorporated into future designs.

The book is also not suited for emergency or conflict zones that may require residents to move often. The soft material makes susceptible to wear and damage, and it is bulky to carry. However, Water is Life also uses an amazing straw that picks up where the drinkable book leaves off.

For more information on the book and how to provide one for a community in need, check out the Water is Life website (specifically the blog) or this article from NPR.

A Simple Yet Brilliant $1.50 Sanitation Idea – Made by the toilet manufacturer American Standard, this “trap door” seals off open pit latrines that are a major source of disease in the developing world.

This article discusses a sanitation solution by bathroom and kitchen fixture company American Standard. Funded by the  Gates Foundation, American Standard has developed a $1.50 latrine pan that cuts down on sanitation-related disease transmission by sealing off pit toilets. american_standard-sanitation

The $1.50 pan has been a hit in field trials in Bangladesh; in addition to being more sanitary, the pan also blocks off nasty smells from the latrine. While American Standard hoped to get the price down to a $1, McHale still believes the product is affordable.

So far, American Standard has sold close to 70,000 units in Bangladesh, and in 2013, the company donated 533,352 of the pans for distribution this year. The company is now thinking about how to launch the product in India. It’s also working on a design for Africa that uses less water.

Kenya Water Sector Innovator Leads the Way with Commercial Financing | Source: USAID SUWASA, Apr 2014.

Excerpt:  This post describes an innovative financing deal, facilitated by USAID’s Sustainable Water and Sanitation in Africa (SUWASA), which is enabling a local water utility to access finance to install 23 kilometers of pipeline and provide water to more than 75,000 low-income residents in Embu, Kenya.Embu Water and Sanitation Company (EWASCO), under the leadership of its Managing Director Harim Karugendo, secured US$945,000 in commercial financing from Housing Finance for the work. Harim Karugendo, Managing Director of EWASCO, shows the map of the pipeline investment project that will bring water to 75,000 residents of Embu, Kenya.

The bank is backed by a guarantee from the U.S. Agency for International Development’s (USAID) Development Credit Authority, and the project is supported by an Aid on Delivery grant from the Kenyan Water Services Trust Fund (WSTF), funded by the German development bank KfW.

  • Read the complete article here.