"Most health technology is produced by companies from high-income countries for high-income markets. 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,"* says Peter Howitt of Imperial College London, UK, one of the Commission's authors.
According to hospital inventories, an estimated 40% of healthcare equipment in developing countries is out of service, compared with less than 1% in high-income countries. The inappropriate deployment of medical technologies from wealthy countries plays a major part in this high failure rate.
Instead of relying on hand-me-down technologies from wealthier countries, which can be costly, inappropriate for local conditions and even dangerous, the authors urge a renewed effort towards developing what they call "frugal technologies" – cost-effective technologies that are developed specifically to cope in local conditions. Examples of frugal technologies which have been developed to meet local needs include:
Another innovative approach is to take advantage of existing information and communications technology for health purposes. The mobile telecommunications revolution has led to a situation where many people who do not have adequate sanitation do have a mobile telephone. Mobile phones can therefore be used to support healthcare efforts – from smoking cessation via text message, to surveillance of disease outbreaks. ICT can provide a virtual training environment for doctors – currently being tested by Imperial College London (UK) to assess the feasibility of training doctors from Malawi.
The report also advocates a wider understanding of what we mean by medical technologies, pointing out that technological improvements to sanitation and road condition could also have a far-reaching impact on public health in many low- and middle-income countries. Furthermore, the authors argue that advances in technology need to be accompanied by innovation in processes to have a significant effect on health – this includes the development of effective delivery mechanisms and novel approaches to financing.
Professor Lord Ara Darzi of Imperial College London, UK, another of the report's authors, concludes that: "Technology is making a substantial contribution to global health, yet it could do so much more. The benefits of health technology should be available to all, not only those in high-income countries. Access to life-saving health technology should not be restricted to those with the ability to pay. Tackling current market failures is therefore a task for all those with an interest in improvement of global health."*
Peter Howitt, QEQM, St Mary's Hospital, London, UK T) +44 (0)7715 932631 E) p.howitt@imperial.ac.uk
Professor Lord Darzi of Denham, Imperial College London, UK Contact: Neha Okhandiar, Communications Officer, Institute of Global Health Innovation, London, UK T) +44 (0)20 7594 1484 E) n.okhandiar@imperial.ac.uk
Notes to Editors:
*Quotes direct from authors and cannot be found in text of Commission
The Lancet