Addressing ‘innovation pile-up’ to put promising discoveries into practice

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Polio vaccination teams pick up supplies at a railway station in northern India. Photo by Gates Foundation.

Putting effective public health programs to work

For hundreds of years, there’s been a gap between what we know and what we do regarding the improvement of human health. In the mid-19th century, Louis Pasteur, one of the most brilliant scientists of all time, said, “To him who devotes his life to science, nothing can give more happiness than increasing the number of discoveries, but his cup of joy is full when the results of his studies immediately find practical applications.” Pasteur was a great public health scientist and, like him, we should want our discoveries from the lab benches, clinics, communities and countries where we work to find those practical applications. That’s how we will achieve great impact—saving millions and millions of lives.

The Bill & Melinda Gates Foundation has invested in innovation on an almost unimaginable scale:  more than 100 proven innovations and more than 2,000 innovative concepts have resulted from their investments. Foundation representatives have thought deeply about how to move innovations into practice and yet they recognize that those appropriately significant investments have caused “innovation pile-up,” which occurs when promising innovations aren’t making it into practice.

Clearing the innovation pile-up so we can get on the road to health—the job of improvement and implementation science—that’s what I’m going to write about for the next few weeks. Barbara

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An infant receives oral polio vaccine in Nigeria. Photo by Gates Foundation.

The problem of pile-up

Christopher Elias, MD, MPH, president of the Gates Foundation’s Global Development Group, is among those who are talking about innovation pile-up. In 2006, when Elias was chief executive officer of PATH, an international nonprofit health organization, he published an essay in The Lancet, which reads, in part:

[M]any product-development partnerships have begun to succeed in advancing robust portfolios of new drugs, diagnostics, vaccines, and medical devices. This has created a new problem, however: the potential for an innovation pile-up. Recent investments in new technology development have not yet been matched by similar efforts to strengthen health systems in resource-poor settings. The danger is that new innovations will not move smoothly into widespread use, even in places where they are desperately needed, because of weaknesses in health systems, such as shortages of health workers, fragmented or corrupt procurement and supply chains, poor quality assurance, and lack of sustainable financing. Failure to bring new products into use could also become a disincentive for the creative partnerships that drive the development of innovations for the poor.

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