Looks like this blog is taking on a book review trend of late, but lets go with the flow, shall we?
The book that motivates this post is the well-written page-turner “Viral Storm: The Dawn of a New Pandemic Age” by Nathan Wolfe. Written like “Guns, Germs and Steel” though it covers a smaller arc of history and civilization, this lays bare several issues around microbes and how they migrate from animals to humans. It speaks to how species have evolved to fight viruses, and how viruses have adapted in return to fight back. Towards the end it gives a fascinating peek into what is being done for pandemic prediction. Things such as Google Flu Trends are an amazing way to use technology and crowdsource pandemic outbreak prediction and it is heartening to see that this actually matches data that comes out of detailed analyses as well.
In the context of viruses and fighting viral outbreaks, vaccines play a pivotal role. Starting with the cowpox virus that helped solve smallpox in humans once and for all, vaccines have played a central role in the way mankind has fought viral outbreaks. Despite the availability of vaccines for several life threatening illnesses, the cruel fact remains that much of the developing world still falls prey to these diseases. Mortality from diseases such as polio and measles tells us how far we have to go to ensure that the vaccine distribution to those in need happens efficiently and in a cost-effective manner.
One critical problem in ensuring that the vaccines are delivered safely, is cold-chain preservation. The last mile, if not the last several miles, in many of these regions are off-grid, temporarily or permanently. As a result health workers have to travel for tens of miles to pick up vaccines from a central health center and transport them in ice boxes to locations where they administer them. Consequently, vaccines either exceed their temperature range, or freeze and go below their range, rendering them ineffective.
Dr. Harvey Rubin at the Penn School of Medicine came up with a unique way to address this problem. Looking at the developing world, he realized that the penetration of cell towers in these countries was growing rapidly – in some cases, faster than the reach of sub-centers for primary healthcare. Given that these are private enterprises, they are incentivized to keep their towers powered on at all times. Wouldn’t it be cool, Dr. Rubin wondered, if we could house vaccine refrigerators inside of these cell tower facilities and have the health workers pick up their vaccines from a location much closer to the ultimate delivery site?
The outcome was Energize the Chain – a nonprofit started by a passionate group of individuals with diverse backgrounds – health, technology, business, health policy – that came together to realize this vision and make it a reality. I’m fortunate to be one among such as passionate and talented group of people. Our vision is to eradicate vaccine preventable diseases worldwide. We are in the process of planning and starting pilots in Kenya, Zimbabwe and India and are actively looking for funding for this. We have great partners lined up both on the health and technology fronts. We also have great plans for the short term in ways in which we can potentially monetize these health services among populations that can afford it, making this an attractive play for last-mile health services delivery.
In the context of the book, a group like Energize the Chain can also play a vital role in what I like call the “reverse supply chain”. These remote outposts serve as great places to accumulate samples of viruses and pass upstream to be analyzed at labs for early detection of new viral strains. By combining technology like SMSes and communication between towers owned by the same company, information about new outbreaks can be quickly communicated upstream to a central research facility where using GIS mapping and other techniques, the spread of these epidemics over time and space can be monitored effectively.
Watch this space as we navigate these waters, secure some funding and start changing the world!