Study: If the technology doesnt fit, dont donate it

Donations of used medical technologies to developing countries often represent considerable acts of generosity on the part of the givers, but many recipients experience the equipment as exorbitantly expensive to operate, inappropriate for their needs and even downright dangerous.

That’s among the conclusions presented in a study published online in The Lancet Aug. 1. Led by Peter Howitt, QEQM, of the Institute of Global Health Innovation at Imperial College London, the paper’s authors call for a renewed effort to help poor regions of the world develop “frugal technologies” that are cost-effective and designed for use in specific local settings.

Reporting that approximately 40 percent of healthcare equipment in developing countries is out of service—compared with less than 1 percent in wealthier countries—the authors cited as an example of a successful frugal technology the Jaipur foot. A durable and flexible rubber prosthetic for people who have lost their leg below the knee, it was designed in India in the late 1960s and doesn’t cost much to manufacture locally.

The paper also points to the ubiquity of the cell phone as a source of potential innovation and intervention. “Often, people who do not have adequate sanitation have a mobile telephone, which can be used to improve health,” the authors wrote. “More good quality evidence is needed for effective mHealth interventions to enable scale-up of beneficial programs” aimed at, for example, smoking cessation via text message, surveillance of disease outbreaks and virtual training for local physicians.

At the other end of the spectrum, the authors touted motorcycle helmets as a simple “health technology” that can work wonders in improving public safety—and, with it, overall health status—in the developing world.

“Most health technology is produced by companies from high-income countries for high-income markets,” said Howitt in prepared remarks. “Health technology is therefore mostly designed for an environment with high spending on health, a reliable energy supply and large numbers of trained healthcare professionals.”

“The benefits of health technology should be available to all, not only those in high-income countries,” the study concluded. “Access to life-saving health technology should not be restricted to those with the ability to pay. Tackling current market failures”—i.e., technology discrepancies—“is therefore a task for all those with an interest in improvement of global health.”