Years ago, I was engaged in my first study of innovation and access, working with the Harvard School of Public Health on a case study of the Mectizan Donation Program (MDP). MDP is a groundbreaking donation program established by Merck and partners to get ivermectin for the treatment of onchocerciasis out to the people who needed it. During a presentation of our findings at a conference on the outskirts of Boston, a fellow researcher asked, “But it sounds like you found that the MDP was a success because of the people. That seems to me problematic because what lessons can the global health community learn from this finding? Weren’t they just lucky to have the right people in the right place at the right time?”
As a researcher with a background in both public health and social sciences, this comment still manages to both surprise and alarm me. Access to technology and services is both a technical issue and a human issue. Technological solutions for health cannot occur without people. Ensuring access to technologies and services requires advanced planning, sufficient resources, and a lot of persistence and hard work by people. Most importantly, developing appropriate innovations and achieving access cannot occur without understanding people’s lived experiences of illness. While we love geeking out about new innovations, what we are really passionate about are the people that develop technologies and ensure they get to those who need them, along with the people who plan for, implement, and utilize such technologies in their daily lives. And we think the global health community has much to learn from their stories and experiences.
So was the MDP lucky because it had “the right people in the right place at the right time”? The short answer is “yes.” But there is nothing problematic about this finding. It simply illuminates the importance of prioritizing human solutions to critical health problems over technical ones, and placing people—program managers, practitioners, and, most vitally, patients—at the forefront of global health.
In 2008, we, the partners at Global Health Insights, wrote a book with Professor Michael R. Reich called Access. Since that time, we have been living throughout Africa (Burundi, Democratic Republic of Congo, Egypt, Uganda, and Zambia). We have become increasingly focused on the intersection of innovation, access, context, and health systems in middle- and low-income countries – as well as the social experience of disease and the people that make innovation and access happen. These are the topics that we look forward to exploring and debating on this blog with all of you!