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Brinnon Garrett Mandel: Global Health Innovation at Work — A New Approach to Cancer Screening

Innovation is the buzzword of the decade. Touted by government officials, corporate and civic leaders and entrepreneurs, the word has become a stand-in for anything cutting edge or trend setting.

 

But for those of us working in the field of global health, innovation is the driving force behind transformational change that can propel the most promising solutions to the world’s relentless health challenges.

Innovation in global health is more than scientific breakthroughs and engineering feats, and shiny new technology — it means offering health providers in impoverished and remote communities the opportunity to save lives with safe, effective and affordable healthcare interventions.

That’s the essence of the innovation behind the “single visit approach” (SVA), a strategy for cervical cancer prevention pioneered by Jhpiego, a global health affiliate of Johns Hopkins University.

For most women in the developing world, screening for cervical cancer is rare, resulting in over 270,000 women needlessly dying every year from what is a preventable and treatable disease. The SVA is a low-cost method that uses simple vinegar to screen and offers same-day cryotherapy treatment, all at a fraction of the cost of the traditional PAP smear and saving the time and expense of making another trip to the clinic.

SVA is saving lives in 22 countries around the world where Jhpiego has supported cervical cancer prevention programs. In Tanzania, Julietha Makyala, a 37-year-old mother of three children, decided to take advantage of a free cervical cancer screening. She and 13 other women screened that day at a health facility in Njombe tested positive for precancerous lesions and were able to receive treatment quickly and safely during the same visit.

That kind of impact is exciting and energizing, but what about the millions of women who aren’t as lucky as Makyala? The success of the cervical cancer “screen and treat” programs in preventing women like Makyala and others from dying unnecessarily from cervical cancer depends on something quite simple: cryotherapy equipment that works, is affordable and empowers the healthcare workers in the outer corners of health systems worldwide to treat the women whom they screen and among whom they identify pre-cancerous lesions.

Yet in many countries, cryotherapy equipment that is cost-effective, robust and efficient for the single visit approach remains a bottleneck. It was this reality that prompted a team from Jhpiego and Johns Hopkins University Center for Bioengineering Innovation and Design to develop CryoPop — a new, inexpensive cryotherapy device that is portable and cost-effective.

Let’s take a moment to walk in the shoes of a nurse in rural Tanzania, Antonia Masinga. Like most healthcare workers in developing countries, Masinga’s job is demanding; and like the rest of us, she takes pride and ownership in the ability to do her job well and deliver life-saving healthcare to her community.

Her health clinic would like to start its own SVA cervical cancer program in her district, but the one piece of cryotherapy equipment they have cost a lot, so they could only buy one or two. One of them is now broken, and the cost and complexity to get it fixed has rendered it a dust collector in the corner of her clinic.

Now, when women come in to get screened, if Masinga detects a pre-cancerous lesion, she often has to refer the women elsewhere to get treated. As they walk out the door, Masinga worries that the woman will go home and her lesion will progress without getting treated, a missed opportunity and a tragic reality.

CryoPop is designed for people like Masinga, but costs a fraction of existing cryotherapy devices. It is also more robust and uses CO2 more efficiently — a gas that’s available wherever anyone drinks Coca-Cola. That means we will be able to see and treat more women at a lower cost to the health system.

In advanced product development stage, the CryoPop team has spent extensive time with users and clinical experts from all over the world. In addition to empowering healthcare workers like Masinga and making successful cervical cancer prevention and treatment programs a reality for women and families regardless of where they live, it turns out that CryoPop could also be an attractive alternative for clinical providers in developed or emerging markets in Asia, Europe, and Latin America. CryoPop has the potential to close the gap in cervical cancer prevention and treatment.

Developing technology for global health is not easy, with —even the simplest technologies facing a challenging course to move from idea to impact. CryoPop is simple, but transformational — empowering frontline health workers who are committed to providing quality, life-saving care to the women who need it most. And with the help of partners like the GE Foundation, we are closer to bringing this change about.

It is up to us to find the intersection of innovation, global health need, and engineering and scientific breakthroughs to deliver on the promise of global health technology.

Brinnon Garrett Mandel is the Director of the Innovations Program at Jhpiego, an affiliate of Johns Hopkins University, managing a portfolio of global health technology innovations and a team of bright engineers and public health clinicians, researchers, and practitioners. With a background in both public health and business, Mandel has worked in various roles at Jhpiego and in the private sector, with an interest in the intersection of global health, technology and business.

 

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