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Meeting the President’s Challenge to End Extreme Poverty

This originally appeared on the Feed the Future Blog.

“We also know that progress in the most impoverished parts of our world enriches us all—not only because it creates new markets, more stable order in certain regions of the world, but also because it’s the right thing to do. In many places, people live on little more than a dollar a day. So the United States will join with our allies to eradicate such extreme poverty in the next two decades by connecting more people to the global economy; by empowering women; by giving our young and brightest minds new opportunities to serve, and helping communities to feed, and power, and educate themselves; by saving the world’s children from preventable deaths; and by realizing the promise of an AIDS-free generation, which is within our reach.” – President Obama, 2013 State of the Union address 

In his State of the Union address this week, President Obama laid out a challenge for our generation to eradicate the scourge of extreme poverty. We are advancing this critical agenda through Feed the Future, the President’s signature global hunger and food security initiative. Here, we examine how.

Progress in the most impoverished parts of our world creates new markets and stability. Photo credit: USAID

“A little more than a dollar a day…” By standard definition, this means less than $1.25 a day. That won’t buy a latte, let alone a healthy lunch here in the United States. Hunger and poverty are inextricably linked. Through Feed the Future, we’re working to achieve the President’s vision to eradicate extreme poverty and hunger in our lifetime. This is our generation’s legacy to leave. And reducing poverty is more than just a goal: It’s achievable, and we are already seeing results.

Since 2009, Feed the Future has supported agriculture-led growth in 19 focus countries, with investments that will lift 20 percent of the people in our targeted areas out of poverty in three years. Agricultural growth is an incredibly effective way to fight poverty – 75 percent of the world’s poor live in rural areas in developing countries, where most people’s livelihoods rely directly on agriculture, and studies show that growth in the agricultural sector has up to three times greater impact on poverty reduction than growth in other sectors.

And Feed the Future is showing results.  We have improved farmers’ access to key technologies that we know transform their lives, increasing yields and incomes. In 2011 alone, we helped nearly 2 million food producers adopt improved technologies and practices to improve their yields, and our efforts to integrate agriculture and nutrition mean that healthier harvests can also mean better market opportunities.

We’re strategically targeting our investments in countries where our support can have the greatest impact. We’re aligning our investments behind food security and nutrition priorities our partner countries have identified, and we’re helping foster the growth and accountability required to ensure that this impact lasts. And because we know we don’t have all the answers to reducing global poverty, we’re taking a rigorous approach to figuring out what works best, so we can do more of it. We’re identifying gaps in evidence and working to fill them. We’re engaging with global leaders, top scientists, business leaders, and communities to share what we learn so that we can beat hunger and poverty together.

“By connecting more people to the global economy…” Feed the Future supports countries in developing their own agriculture sectors to generate opportunities for economic growth and trade. We place particular emphasis on empowering smallholder farmers with the tools and technologies they need to produce more robust harvests and have better opportunities to participate in markets and earn better incomes.

Smallholder farmers are the key to unlocking agricultural growth and transforming economies. In supporting them, we’re also helping build tomorrow’s markets and trade partners, connecting smallholder farmers in rural areas to local, regional and global markets.

“By empowering women…” At the heart of our strategy is an understanding that investments in women reduce poverty and promote global stability. Take for example our horticulture project in Kenya, which is working with smallholder farmers, many of whom are women, to not only grow more nutritious crops to eat and sell, but to also diversify into growing higher value crops, like flowers. Higher value crops help these farmers increase their income, which in turn provides them with more money to pay for school fees for their children, medicine, and quality food. We’re also tracking women’s empowerment in agriculture and the impact our programs have on increasing it… [continued]

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Getting to Zero and Eliminating Extreme Poverty

Steve Feldstein is the Director of Policy for USAID’s Bureau of Policy, Planning and Learning

For those who spend their days focusing on international development issues, only occasionally does the full public spotlight shine on their work. On Tuesday night, near the conclusion of his State of the Union address, the President articulated a vision that represented one of the clearest, most direct calls to development action in recent years.  He noted that in many parts of the world, people still live on “little more than a dollar a day,” and called for the United States to “join with our allies to eradicate such extreme poverty in the next two decades.” This has caused a flurry of activity as the development community begins to dissect what exactly this means, how it will be done, and who will be affected. In the policy office at USAID, we’ve spent considerable time analyzing this issue and what it would take to eradicate extreme poverty.

First, while eliminating extreme poverty won’t be an easy task, it has moved from a rhetorical aspiration to a concrete possibility. The total number of people currently in extreme poverty (defined as $1.25/day) is 1.2 billion. Projections of how much extreme poverty will exist by 2035 range between 193 million and 660 million. The most optimistic scenarios assume that we can maintain our current rate of poverty reduction, resulting in 3% of the world population (less than 200 million) living in extreme poverty by 2035, a natural rate of equilibrium that most leading economists consider to be an “end” to extreme poverty. Other projections posit that poverty rate reductions in the developing world, especially in Africa, will slow down, in which case it may take us closer to 50 years to reach this threshold.   Our own analysis leads us to believe that by focusing our shared political attention and applying the right tools we can collectively lift one billion people out of poverty and reach this 3% level in the next two decades.

We should recognize that we’ve made substantial progress – more than was ever anticipated. The number of people living in extreme poverty continued to rise until around 1981, when it reached 1.94 billion people. From 1981 until around 1993, the number did not change much overall, but after 1993 – for the first time in history – the number began to fall. Over the next fifteen years, historic growth rates were achieved and the extreme poverty figure fell from 1.91 to 1.29 billion, nearly a one-third decrease. It will be challenging to maintain this rate of reduction; as poverty numbers get smaller, the rate of decline may slow as remaining pockets of poverty persist in increasingly difficult environments. But economic growth has been the main determinant of progress in poverty reduction and we believe we are well positioned to help foster such growth.

Finally, it’s important to consider where poverty will reside in the future. By 2015, we will have achieved the first Millennium Development Goal (halving the rate of poverty) in all regions of the world except Sub-Saharan Africa. 85% of global poverty is now concentrated in the following countries: India and China (combined 618 million people or 48% of the total), Nigeria, Bangladesh, DRC, Indonesia, Pakistan, Tanzania, Philippines, and Kenya.

Climate change drives population problems in Uganda. The population lives largely in poverty. And with increasing droughts and heavy, erratic rains destroying farmland and spreading disease, it is important to establish alternative livelihoods for food and create awareness of adaptation for environmental changes. Photo credit: Julie Larsen Maher, Wildlife Conservation Society

We’ve seen miraculous progress in poverty reduction in recent years, due to rapid economic growth in a small number of populous countries (China and India, especially).  Countries like China and India are still poor and have huge populations—so large pockets of poverty persist – but most economists believe the strength of their economic growth will allow them to virtually eliminate extreme poverty in the near future.  On the other hand, as poverty becomes increasingly diffuse, fragile countries (who struggle with conflict and instability) will be home to an ever greater proportion of the world’s poorest citizens.

So how will we in the global community achieve this goal? Ultimately, this effort will vary by country and region; we will need to assess the specific context and focus our efforts on that particular country’s development needs.  In order to reach these diverse and dispersed populations, we will have to employ every tool and instrument at our disposal. This includes continuing to expand and scale efforts to harness science, technology, innovation and knowledge exchange to eliminate extreme poverty. This means rallying the global community and working in partnership with international donors, non-profit and charitable resources, and galvanizing private sector investment towards this effort. It also means leveraging existing efforts, notably the three Presidential Initiatives of Feed the Future, Global Health and Global Climate Change.

As the President said on Tuesday, “We also know that progress in the most impoverished parts of our world enriches us all.” When it comes to defeating the misery and wretchedness of poverty, it is in our nation’s interest and the interest of all nations to seize the mantle of this challenge and carry it forward.

Tech Challenge for Atrocity Prevention: Introducing Our 1st Round of Winners

This originally appeared on Humanity United

In the fall, Humanity United partnered with USAID to launch the Tech Challenge for Atrocity Prevention. The goal of the Tech Challenge is to bring technologists and the human rights community together, to facilitate the development of new tools and technologies to help the human rights movement.

The first round of the Challenge opened in late October, offering prizes for the most innovative solutions to two intractable problems: how better to document evidence of atrocities on the ground, and how better to identify third-party enablers of atrocities (i.e. those states, corporations or individuals that offer support to perpetrators).

We are incredibly excited to announce the winners. The first place prize for $5,000 on the documentation challenge went to a partnership between Physicians for Human RightsDataDyne and InformaCam for developing the Kivu Link. This mobile app will equip doctors and nurses with critical tools for collecting, documenting and preserving court-admissible forensic evidence of mass atrocities including sexual violence and torture.

The second prize for $3,000 went to a mobile application that allows uses to covertly take pictures while simultaneously recording the location and time (EXIF) data during internet blackout situations in a hostile environment using an encrypted peer-to-peer Bluetooth network.

The third prize for $2,000 was split between two entries. Bonnie Feudinger, Brian Laning and Heather Vernon from the MCW Biotechnology and Bioengineering Center proposed the International Evidence Locker app, designed to collect relevant evidence, maintain a clear chain of custody of the evidence so that it’s admissible in judicial proceedings, and protect the witnesses collecting the evidence. The Signal Program Harvard Humanitarian Initiative proposed AMALGAM: Automated Mass Atrocity Algorithmic Analysis Methodology. This is a open-source platform to allow analysts to easily and systematically process and share remote sensing data specific to predetermined geospatial phenomena.

The first place prize for $5,000 for the enablers challenge went to Le-Marie Thompson of Nettadonna LLC, for her proposal for an Electronic Component Validation Tool for New Product Development, which address the challenge of companies unintentionally sourcing microelectronic components from suppliers that produce components using conflict materials.

The second prize for $3,000 went to Fiona Mati of Kenya for her app Conscious Vacations, which seeks to put pressure on state perpetrators (and those who commercial interests who support them) by helping tourists avoid countries whose leaders are implicated in human rights abuses.

The third prize for $2,000 went to the The Enough Project, for their proposal to combine front-line research with cutting-edge data mining technology to identify and stop enablers of mass atrocities.

We’re also very excited to announce that the next round of the Tech Challenge will open in late February! Stay tuned.

Michael Kleinman is a director of Investments, based in our San Francisco office.

Flower Power: How Your Valentine’s Day Bouquet is Helping Fight Poverty

This originally appeared on the Feed the Future Blog. 

The flower bouquet you bought (or are planning to buy) for your significant other today is doing more than you think. Besides showing your special Valentine that you care, flowers are also an important commodity that is changing the lives of Kenyan farmers and improving their food security.

As the head of a Feed the Future project in Kenya, I work with local partners to improve incomes, food security and nutrition for 200,000 smallholder farmers. These smallholders, many of whom are women, usually farm small plots to feed their families and generate small amounts of income. We work together to enhance productivity, improve processing, and connect these farmers directly to buyers to increase their incomes.

These bouquets were made from Kenyan smallholder flowers that are now sold in ASDA grocery stores in the United Kingdom. Photo credit: Fintrac Inc.

While most of our Feed the Future activities focus on nutritious crops, like orange-flesh sweet potato, we also promote high-value crops such as smallholder-grown cut flowers, like the ones many Americans give each other on Valentine’s Day. These high-value crops provide a valuable source of income for farmers to buy important foods, beyond what they grow on their farms, and to pay for household priorities like school fees and medicine.

More than two years ago we formed a partnership with Wilmar Flowers Ltd, Kenya’s flower exporter sourcing entirely from smallholder farmers. The company wanted to expand operations to meet growing demand in Europe and around the world. To do so, it needed to invest in more smallholder farmers.

We worked with Wilmar Flowers to find and train new farmers, link to more buyers, and attract private investment to further expand operations. As a result, Wilmar quadrupled its smallholder growers from 1,700 to more than 6,800 today. It also launched seven new products, including new flower varieties and bouquets. The added business enabled Wilmar to invest in collection centers, research and development trials of new flower varieties, and new technologies such as shade nets, charcoal coolers, water harvesting dams, and grading sheds. The company also added technical personnel to provide more extension services directly to farmers.

By expanding its own business, Wilmar is now providing services and livelihoods for thousands of smallholder farmers in Kenya. And the best part? Wilmar doesn’t need us anymore—after our initial help concluded, it continues to build a sustainable flower export business in Kenya that benefits smallholder farmers.

Valentine’s Day is a big day for the flower industry. Do you know where your flowers came from? Perhaps in buying some for your loved one, you helped make the difference in the life of a Kenyan farmer. Feed the Future is helping making that connection possible. What might seem like a small gesture of love today is actually making a big difference in the lives of farmers thousands of miles away.

Q&A with the U.S. Ambassador to El Salvador, Mari Carmen Aponte

U.S. Ambassador to El Salvador, Mari Carmen Aponte. Photo credit: State Department

This afternoon, USAID and five Salvadorian foundations today announced a partnership to combat citizen insecurity and strengthen municipal responses to crime and violence in 50 dangerous communities in El Salvador. This public-private partnership is the largest in USAID history with local partners and ever in Latin America. The Impact Blog Team interviewed U.S. Ambassador to El Salvador, Mari Carmen Aponte, for more information about the partnership and what it means for both American and Latin American citizens. 

Madame Ambassador, we know you are very passionate about crime prevention. How will the new program SolucionES(Solutions) help raise the profile of this issue in El Salvador?

Like people everywhere, Salvadorans want peace and security in their lives and a better future for their children.  I have had the privilege of meeting hundreds of Salvadorans who are working hard to make their country safer and more prosperous, and opening up new economic opportunities for everyone.

I am very proud to see the government, civil society organizations, and the private business sector come together to form the SolucionES alliance to help prevent crime in El Salvador. This new project brings together five leading Salvadoran non-profit organizations and foundations to share their expertise in education, health, research, and community and economic development in order to help prevent crime and violence in El Salvador. These organizations, supported by USAID and the Salvadoran private sector, will implement $42 million dollars in crime and violence prevention programs throughout the country.

Do citizens in El Salvador have an active voice at the crime prevention table?

This project would not possible without the expertise from Salvadoran civil society.  Salvadorans play a vital role in crime prevention and it is in fact their contributions, knowledge, willingness, and most importantly their commitment to crime prevention that give this project its oxygen. The five partners who have formed this alliance have signed up to help implement an ambitious five-year program because they believe it will make a real change in the lives of Salvadoran citizens.

Working closely with municipal councils and local residents, SolucionES will provide assistance for crime prevention plans and activities that include: training for youth and families on conflict prevention, leadership programs for youth, job training and entrepreneurship, after school clubs, and the provision of psychological counseling in schools traumatized by violence.

How does crime and violence in El Salvador affect both Salvadorans and Americans?

Salvadoran citizens are obviously the ones most directly impacted by El Salvador’s crime and insecurity, which is why every Salvadoran citizen has a vested interest in making sure that youth do not join gangs or become involved in criminal activities. The United States recognizes that El Salvador’s gangs and criminal activities have had a negative impact on the country’s ability to grow, while also supporting the growth of gangs in the United States. By implementing crime prevention programs that eliminate the ability for gangs to recruit young people, we not only help El Salvador become a more secure and prosperous country for its own citizens, but we reduce the footprint of transnational gangs in the United States.

As Ambassador to El Salvador, what are your top priorities?

My priorities in El Salvador are laid out in the Partnership for Growth (PfG) Joint Country Action Plan, which was signed by both governments in 2011. PfG is our joint, five-year strategy for expanding broad-based economic growth in El Salvador under an overarching commitment to democracy, sustainable development, and human rights. The Action Plan identifies insecurity as one of the binding constraints to El Salvador’s productivity and competitiveness. Crime and insecurity have had an incalculable effect on the potential growth of El Salvador’s business sector. They have also negatively affected the legitimacy of El Salvador’s institutions of government. The limitations of the state to combat and prevent crime can erode the confidence of the people and can undermine good governance. Crime and insecurity pose a threat to institutional and development advances and the Government of El Salvador and the Unites States are committed to advancing joint efforts under Partnership for Growth.

We know you constantly praise USAID’s work; do you have a favorite USAID project in El Salvador?

The work USAID does in El Salvador is exceptional. They have a great team of talented individuals who work every day to help countries such as El Salvador become stronger societies. They work hard at making sure every project achieves expected results and they represent the United States so well. All of their programs are incredible—from empowering women, to increasing education and economic opportunities, and preventing crime, they are achieving positive and sustainable results. I recently visited a USAID-sponsored initiative called “Youth Committed—I make a difference,” which is a strategic alliance between employers and is designed to enhance employment opportunities for youth in at-risk communities. The program, so far has 4,498 graduates from all over the country who now have the job skills they need for productive employment. Projects such as these and many others are what we as the United States Government try to achieve through the fantastic work that USAID does here.

FrontLines Releases January/February 2013 Issue

Read the latest edition of USAID’s FrontLines to learn how the Agency is helping communities become more resilient to new and long standing crises, and how training and other assistance to journalists and media organizations in developing countries helps create well-informed citizens. Some highlights from the Risk, Resilience & Media edition:

A Maasai father and son tend to their cattle in Kitengela, Kenya. Photo credit: ILRI/Stevie Mann

  • Carrying a paralyzed neighbor to safety on her back was just one of the heroic moves by a Bangladeshi grandmother whose USAID disaster training kicked in during 2007′s Cyclone Sidr, one of the strongest storms of its kind on record.
  • Since men with rifles uprooted their lives in 2000, the Afro-Colombians who lived in Mampujan have been hoping to reclaim their land — and now a ruling from the country’s high court is paving the road for their return.
  • Senegalese farmers are worrying less about fickle rains that lead to drought and instead embracing “conservation farming” to grow the food they and their country need to thrive.
  • Purchasing insurance seems an ideal tool for building resilience in developing countries — if insurers are willing to take a chance on you. That is slowly happening in places where a perfect storm of recurring weather disasters and stubborn poverty has made insurers skittish to enter the market.
  • A hip, hero hacker with a huge following is setting Kenyan youth on notice that they have the power to change not only their own lives, but the trajectory of their country. Though DJ Boyie is a comic book character, his out-sized influence has attracted high-level support, including from USAID.
If you want an e-mail reminder in your inbox when the latest issue of FrontLines has been posted online, please subscribe.

Photo of the Week: Building Peace Along Borders in East Africa

USAID has supported peace-building along Kenya’s northern borders for over a decade. The current program focuses on communities on the Kenya-Uganda and Kenya-Somalia borderlands and enables residents to take peace into their own hands. USAID helps communities on opposite sides of the border select, plan, build and manage projects for joint use. These “peace dividend” projects include schools, marketplaces, and clinics.

All photos by Aernout Zevenbergen and Abraham Ali from Pact.

USAID Promotes Good Farming Practices in Azerbaijan

Azerbaijan is proud of its exotic fruits, and the pomegranate is definitely one of them. Pomegranate production has strategic importance for domestic trade and exports.

Azerbaijan’s Pomegranate Festival is a great way for growers to learn new techniques, showcase their products, and build sales networks. Since 2006 it has been a popular autumn festival held in November in the Goychay region of Azerbaijan.

This year, USAID’s Azerbaijan Competitiveness and Trade (ACT) Project set up its own stand at the Festival to provide information about ACT project activities and achievements in the pomegranate sector. The Project’s stand offered training materials on 25 agriculture topics and displayed 100 kgs. of the seven different varieties of pomegranates produced by the farmers who received USAID assistance. Training materials were particularly in demand by Festival attendees. The Project distributed over 2,000 pamphlets and booklets.

A local TV channel interviews USAID’s pomegranate expert at the USAID stand during the annual Pomegranate Festival in Goychay. Photo credit: Anar Azimzade/ACT

For the last couple of years, USAID has been supporting pomegranate farmers and processors with technical assistance and training. The ACT Project has provided training on good agricultural practices to approximately 2,250 farmers who have subsequently rehabilitated about 200 hectares of pomegranate orchards in the Kurdemir, Goychay and Sabirabad regions. This support has resulted in a 33% increase in productivity, a 28% increase in overall production and a 21% increase in farmer profit in the three regions. Azerbaijan’s pomegranates do not compete with U.S. agriculture.

National and local media covering the Festival expressed strong interest in the ACT Project. ELTV, a local TV channel, interviewed the experts, guests and exhibitors for a TV program dedicated specifically to the development of the pomegranate sector in Azerbaijan.

Two farmers from the Goychay region praised the Project’s technical assistance and training in an interview with ELTV. They expressed their gratitude to USAID and proudly displayed high-quality pomegranates at the Festival as fruits of this cooperation.

Success in India Paramount to Ending Preventable Child Deaths Globally

Ariel Pablos-Mendez, PhD, is the Assistant Administrator for Global Health

I just returned from India‘s “Call to Action Summit for Child Survival and Development“, which took place in Mahabalipuram, Tamil Nadu.

India accounts for the largest number of deaths of children under five: nearly 1.5 million per year. This number is staggering, but there is good news. There has been a steady rate of decline in child mortality — even ahead of the global rate of reduction. As I told DevEx during the Summit, “success in India is paramount to see the global success and vision of ending preventable child deaths in this generation.”

Led by India’s Ministry of Health and Family Welfare, the Summit called for an accelerated response to decrease child mortality across the country. This event was a direct outcome of the Call to Action held in Washington, DC last year — where India joined Ethiopia and the United States with UNICEF to launch a global roadmap to end preventable child deaths globally. About 300 policymakers, public health practitioners, private sector, civil society and media representatives attended India’s Summit, including 27 international and 35 national experts. Notably 20 State delegations were present. U.S. Ambassador Nancy Powell, a stalwart advocate for child survival, addressed the opening plenary on behalf of the United States.

The Summit had several main themes related to child survival and development: quality of newborn care, interventions for preventing diarrhea and pneumonia, social determinants of child survival, nutrition, strengthening health systems, improving accountability, communication for child survival, partnerships for improved maternal and child health, and leadership dialogue. The complete agenda and speakers can be found on the Summit’s website.

There was a rich discussion at the Summit along with solid deliverables. The Government of India launched the Reproductive Maternal Neonatal Child Health Adolescent health strategy (RMNCH+A), which serves as a roadmap for the States. Also released were several guidance documents including implementation of newborn care as well as management of pneumonia and diarrhea.  A National Child Survival Scorecard was showcased, and States were encouraged to develop their own scorecards and to monitor progress.

India’s Call to Action is the beginning of a national movement. Attendees demonstrated a passionate commitment to mobilize on behalf of India’s children — and to hold each other to account. India’s leadership and programmatic success will help galvanize the global response. USAID will continue to be a steadfast partner of “A Promise Renewed”, the sustained effort led by UNICEF to reach our global goal. Working together, ending preventable child deaths will be one of the greatest moral victories of our time.

Accelerating Innovation and Impact in Global Health

This originally appeared on the Stanford Social Innovation Review.

Sad examples abound of inexpensive, lifesaving health solutions failing to reach the most vulnerable in the developing world. Whether it is amoxicillin treatment that is out of reach for the 1.3 million children under five who die each year from childhood pneumonia, or a simple and effective $0.50 oral rehydration salts or Zinc treatment inaccessible to the 1.5 million kids dying each year from dehydration stemming from diarrhea, it is clear that new solutions and approaches are needed. Given this reality, global health practitioners are recognizing the need to look beyond their traditional operating models and seek new solutions to reach the world’s most vulnerable.

At the same time, the private sector, faced with slowing economies in the US and Europe, is increasing investment and experimentation in the more challenging emerging markets as a source for new growth. These firms—whether they are medical device, pharmaceutical, or consumer-packaged goods companies—stand to learn much from global health and development practitioners who have operated at the bottom of the pyramid for years. Similarly, global health practitioners can learn much from these private sector efforts by, for example, better leveraging the rigor and well-defined processes involved in designing, introducing, and scaling products. Given the increasingly aligned incentives, the time is right for more effective and consistent collaboration between these two groups.

A child peers around the corner in the waiting room of the HIV Comprehensive Care Clinic of Meru District Hospital in Kenya’s Eastern province as two pediatricians stand in the background. Photo credit: Mia Collis, Elizabeth Glaser Pediatric AIDS Foundation

The Center for Accelerating Innovation and Impact in USAID’s Global Health Bureau launched last year with these shared incentives in mind; it aims to promote and reinforce innovative, business-minded approaches to bottlenecks in global health. An important piece of this strategy is bringing together thought leaders and frontline practitioners from both the public and private sectors to share proven and tested practices, and then collaboratively develop new global health models.

IDEO’s work developing products and services in India and Africa, for example, has demonstrated an important relevant learning for the global health community and private sector alike: innovation needs to be holistic and strategic. It’s about evaluating and targeting specific gaps in the surrounding ecosystem, with a square focus on empathizing with all stakeholders. While new technologies and products are needed, often times re-evaluating (or evaluating for the first time) the true bottlenecks in the health ecosystem can uncover new opportunities for innovation in training and education, operating/business model design, demand generation, behavior change, and other areas.

An example: In Africa, IDEO worked on a project to develop a low-cost toilet but quickly realized that developing the toilet itself wasn’t enough. To be practical and to succeed, it had to be designed for the unique constraints that existed there, including the lack of centralized plumbing. As such, IDEO designed a system with a separate container to trap the waste. Most importantly, though, the toilets, instead of being sold directly to customers, are instead sold to franchisees that then rent the toilets to customers. The rental fee covers not only the toilet but also a fee to collect and dispose of the waste properly. This way everyone wins. Customers pay a lower amount per month rather than an expensive, one-time, fixed fee. Franchisees earn an attractive return on their investment, and the system ensures that waste is removed and disposed of properly—not on some street corner where it becomes a public nuisance and health hazard. Above all, the incentives are aligned to make the system sustainable.

Another often cited yet supremely relevant example is Jaipur Foot in India. Founded in 1975, Jaipur Foot has fitted more than 40,000 Indians with leg prostheses. To reach such massive numbers, in addition to innovating on a low-cost “product” (in this case, a $45 artificial lower limb), the organization developed an entirely new operating model. It has flipped the traditional healthcare service model on its head, and it now takes diagnoses and treatment to the patient. The organization regularly organizes health camps outside of its centers in more rural locations—where most Indians live—to help patients who have financial and physical difficulty traveling to larger cities. Jaipur Foot sends everything required for treatment to the camps, including doctors, assistants, and equipment. They can even fabricate, fit, and deliver limbs on the spot.

These are just two of a growing number of examples that both global health and private sector practitioners can learn from and collaboratively put into practice. USAID’s new Center for Accelerating Innovation and Impact hopes to enable this best practice sharing as one avenue to more efficiently and effectively deliver healthcare to those at the bottom of the pyramid.

Dheeraj Batra is head of business design at IDEO Mumbai. Over the last three years, Dheeraj has worked extensively in the medical device industry in India having spent the majority of that time incubating businesses and piloting new initiatives for some of the largest companies in the sector. He was a key architect and led the on-the-ground implementation for Healthy Heart for All, a nationwide initiative by Medtronic in India.

David Milestone is senior advisor at USAID, Center for Accelerating Innovation and Impact. In this role, David leads the Market Access team in the development and implementation of market-based strategies to accelerate the adoption of priority health solutions. Prior to joining USAID, David held various strategic marketing roles at Stryker, including innovation and strategy initiatives in India.

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