SEATTLE and SAN FRANCISCO — When clinicians follow best practices in the administration of oxytocin and magnesium sulfate, they can prevent postpartum hemorrhage, preeclampsia, and eclampsia — the leading causes of pregnancy-related deaths. The Seattle-based Shift Labs, Inc. developed the DripAssist Infusion Rate Monitor to administer these medications during labor. The tool was designed for — and in consultation with — women in low resources settings who are disproportionately affected by these conditions due to gaps in infrastructure, trained clinicians, and medical supply chains.
Shift Labs is one of the Round 7 Innovators for Saving Lives at Birth, or SL@B, the first of a series of Grand Challenges for Development that the United States Agency for International Development has launched together with public and private partners in order to source, test, iterate, and scale global health and international development innovations.
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Saving Lives at Birth is a partnership between USAID, the United Kingdom’s Department for International Development, the Korea International Cooperation Agency, Grand Challenges Canada, the government of Norway, and the Bill & Melinda Gates Foundation. The initiative is currently seeking innovators to answer their eighth call for new prevention and treatment approaches for pregnant women and newborns in poor and marginalized communities. But they are also increasing their investment in the innovators they have supported over the past seven years, with two new awards totaling $13 million to evaluate and scale up maternal and newborn health innovations.
USAID will grant the Global Health Innovation Center at Duke University and VentureWell, a nonprofit organization focused on supporting early stage innovators, with $10.5 million over three years. They are tasked with accelerating the scaling and impact of dozens of innovations Saving Lives at Birth has funded. While these innovators have sound technical skills, they often need support when it comes to business modeling and delivery planning in order to realize their paths to scale.
“Even the most promising innovations can face challenges in development, introduction, and scaling,” David Milestone, acting director of the Center for Accelerating Innovation and Impact at USAID, told Devex via email. “We are incredibly excited to partner with Duke and VentureWell — and their robust consortium of partners — to provide catalytic tailored support to our Saving Lives at Birth innovators and progress them towards sustainable, equitable impact.”
Duke and VentureWell will work together with five other implementation partners: We Scale Impact, Villgro Kenya, Open Capital Advisors, Villgro India, and VIA Global Health. Each of these groups have unique regional or topical specialization when it comes to supporting these innovators. Devex has written before about accelerators for global health and international development, including most recently on the work CARE is doing to support project teams from country offices, but what sets this apart is the range of perspectives from universities to nonprofits to companies to faith-based organizations coming together around a shared goal.
This effort to accelerate Saving Lives at Birth is the next iteration of its Xcelerator program. Previously, it brought VentureWell, the Lemelson Foundation, and the Gates Foundation together to provide innovators with an eight-month acceleration program. The Xcelerator program, and this next iteration USAID is calling Accelerating SL@B, complement the annual DevelopmentxChange event, an annual gathering in Washington, D.C., where finalists pitch their ideas, meet with mentors in one-on-one meetings, and participate in the open innovation marketplace.
The Duke Global Health Innovation Center, Duke Global Health Institute’s Evidence Lab, and Duke Center for International Development will also receive $2.8 million over the next five years to evaluate the impact of the Saving Lives at Birth. For the SL@B partnership, Duke is engaging with USAID through a co-development process based on a Broad Agency Accelerator, a contracting technique the agency uses to lower barriers to entry and involve new partners. The university is in the early stages of its evaluation, which will include analyzing the Saving Lives at Birth portfolio, modeling the cost and impact of specific innovations, and determining the key questions to answer for current and future grantees.
Still, even as Saving Lives at Birth announces these new partners, and opens applications for the eighth round, innovators from the round seven cohort are hoping for more open lines of communication with the teams themselves.
On Thursday, at the University of California, San Francisco, Devex spoke with Tiffany Lundeen, who is a midwife and works with the East Africa Preterm Birth Initiative and Maternal and Newborn Health Research Cooperative at UCSF Global Health Sciences. She was selected for Saving Lives at Birth for her work on a “virtual mentor” that interacts with birth attendants during a postpartum hemorrhage. But as of Thursday, she had not heard of this new effort to change the acceleration model, nor received the seed money she was supposed to as a Round 7 innovator.
“The Virtual Mentor project is a perfect fit for the Saving Lives at Birth Challenge because our idea has been called both potentially high-risk and potentially high-impact,” she wrote via email after reading more about these developments at SL@B. “I am certain that if we can find the right partners, we can build a decision support tool that could be scaled quickly. I am thrilled by the news that Duke GHIC and VentureWell will bring their significant intellectual resources to the task of accelerating SLAB investments. Once we receive the seed grant and get to work on this project, our team looks forward to mentorship from these new partners to take Virtual Mentor from idea to impact.”
This confusion is not uncommon these days at USAID, where there is a lot of uncertainty about the future of programs, with the close of applications for Development Innovation Ventures being just one example of questions regarding the future of USAID’s support of innovation and entrepreneurship.
Prior to launching VIA Global Health, Noah Perin worked as a commercialization officer at PATH, a global health nonprofit in Seattle, which has several innovations in the Saving Lives at Birth pipeline. He talked about a dynamic he sought to address with VIA Global Health, explaining how PATH would demonstrate the technology worked, do the introduction, build the capacity, “and then our funding or project would end so we’d go back to Seattle and do something else.” When a call came in that there was an issue, the hope was that these hospitals had a connection with a distributor who could reach out to a manufacturer who could supply it, but that was not always the case.
“One of the things I've come to realize is we often confuse need with demand when it comes to understanding real market opportunity,” he said.
Perin describes VIA as the Amazon of the medical supply world. The Seattle-based startup connects medical distributors with medical devices and supplies. Perrin has gone through his own entrepreneurial journey, including the Silicon Valley-based accelerator 500 Startups, which puts him in a unique position to provide advice to other entrepreneurs who want to turn ideas into impact.
“This project is core to what VIA Global Health is all about — making sure that throughout the world, the necessary and appropriate health technology is available to medical professionals in an efficient and cost-effective manner,” Perin said about VIA’s multiyear contract for this Saving Lives at Birth work. “With this funding, VIA is able to provide market data that previously was not available, leveraging our platform to ensure a scalable solution that taps local stakeholder feedback and insights, ensuring these innovations are appropriate before they enter the commercialization phase.”
“We will start by analyzing the innovations that have been funded over the past few years, categorize them by variables such as stage of development and geography, and then develop customized action plans to accelerate the scaling pathway of those innovators,” Krishna Udayakumar, associate professor of global health and medicine at the Duke Global Health Institute, who will work on both the evaluation work and the acceleration work, told Devex via email. “Types of support will include in-person workshops addressing key scaling challenges, peer and regional networking, and other direct capacity building support.”
Saving Lives at Birth innovators such as Shift Labs will get support in areas like communicating their value proposition; prioritizing customers, beneficiaries, and countries; and understanding their target market. But introducing these products, integrating them into health systems, and scaling these innovations, will not be easy, given the challenges to improving maternal and newborn health, especially in resource-poor settings, Udayakumar said. To be successful, these innovators must understand how to navigate, and in some cases create, markets; how develop and refine scalable business models that generate demand; how build a strong and diverse team; and how to continue to develop innovative products and services.
“Getting all of these variables right at the same time is very difficult, even for seasoned entrepreneurs or experts in the sector,” he said. “Hundreds of product and service innovations have shown some promise, but very few will end up being scalable, effective, and sustainable.”
This investment in Accelerating SL@B aims to benefit not only the innovators, but also the broader global health community. It is one of a growing number of efforts to reduce the barriers to scaling in low resource settings. And the Accelerating SL@B partners plan to learn as they implement and share those insights with practitioners, funders, policymakers, and academics.