When Impact Is More Important Than Invention

Sometimes commercial viability of biomedical inventions or therapeutics exists only in developed countries, even though minor product optimisations could increase access to life-saving medical care in resource-limited settings through cost reduction and functionality additions.

*Rebekah Scheuerle [2013] is doing a PhD in Chemical Engineering. This article does not necessarily reflect the views of the Saving Lives at Birth partners, JustMilk, or the University of Cambridge. Picture credit: Salvatore Vuono and www.freedigitalphotos.net

Everyone wants to be an "inventor". Few want to be a "developer".

At an organisational level, acquisition of start-ups by large corporations to take on commercialisation of clever ideas too expensive to innovate in-house, is common. Despite the immense number of developers in industry, at an individual level the "inventor" title seems to come with more respect than the "developer" title, especially in the media.

In our society, hype around underdeveloped potentially breakthrough technology is pervasive, but in my view there is a gap in support for translation of these inventions into feasible, life-changing products by developers.

I have personally witnessed a lack of appreciation for the clever ideas and the huge time commitment required to make the pivotal, sometimes incremental changes required to launch a technology from bench to market, and a lack of resources to do so. This is especially true for resource-limited environments, where existing technology modified appropriately could radically improve quality of life for a portion of society.

I would challenge scientists and engineers to pursue the unpopular task of innovating feasible improvements for existing technology to reach those in need rather than invest time in inventive but low-impact ideas. I encourage a shift of focus from being novel to being high-impact. This may sometimes mean supporting an existing project rather than pioneering a new one.

Time investment should emulate financial investment trends

Everyone exercises extreme caution regarding financial spending, be it at an individual, organisational or governmental level.

Investors critically perform due diligence on market size and potential impact before financially investing in businesses. In the philanthropic realm, platforms which add transparency to the charity process are becoming increasingly popular because they allow donors to see how their funds can make the most impact.

At the most recent Global Scholars Symposium, I attended a talk by Dr Toby Ord, Founder of Giving What We Can, an organisation of individuals who pledge funds for high-impact charities. He discussed impact maximisation via philanthropic financial investment. He noted that for the price of training one guide dog and blind handler in a developed country, trachoma reversal surgeries could be performed to reverse blindness of 2,000 people in Africa.

This type of appraisal of health interventions via comparison of costs per health benefit, known as cost-effectiveness analysis, is a strategy which is becoming increasingly popular in informing health policy decisions. In the United Kingdom, the National Institute for Clinical Excellence uses cost-effectiveness analysis to make new drug recommendations to the National Health Service. Globally, cost-effectiveness analysis is used by the World Health Organisation CHOosing Interventions that are Cost Effective (WHO-CHOICE) project, to guide health policy makers.

Why aren't analogous impact assessments crucial to time investment decisions in research?

Unlike financial investment, time investment towards research is not driven directly by estimated impact. It is driven by curiosity.

Research often focuses on proof-of-concept work and discovery, frequently with expanding scientific knowledge as the primary aim. "Impact" in an academic research context usually is measured as an "impact factor", a metric which reflects the citation record of a journal, a study or a researcher. This may or may not correlate to the magnitude of impact the work can make in a field or on society. Even in application-oriented research, the purpose is not to commercialise a product. It is to think of one.

Therefore, I believe more "developers" as I have branded them, individuals who optimise but do not necessarily invent products, are needed to translate the proof-of-concept work from research into applicable but high-impact technologies. These developers should be mindful of how they invest their time, just as they are with their money, striving to contribute to projects which are the most influential.

Biomedical inventions especially need optimisation to maximise impact

Many effective medical technologies or therapies are too costly for all contexts.

Sometimes commercial viability of biomedical inventions or therapeutics exists only in developed countries, even though minor product optimisations could increase access to life-saving medical care in resource-limited settings through cost reduction and functionality additions.

For example, the global infant mortality rate exceeds 4.8 million annually, yet many leading infant mortality causes are largely preventable with safe and easy to administer existing medications. At the University of Cambridge Department of Chemical Engineering and Biotechnology in collaboration with JustMilk, we are developing a non-invasive device for delivering life-saving nutrients and medications to breastfeeding infants. The single-use device*, worn by a mother during breastfeeding, releases therapeutics into milk as the infant feeds. Refrigeration, potable water, and sterilisation facilities are not required, and therefore the device has the potential to increase global access to existing paediatric medications.

Analogous technologies, those which capitalise on existing methods of increasing quality of life, are in need of individuals to invest time in supporting their commercialisation into resource-limited settings.

Many brilliant ideas are lost in translation from invention to product due to lack of support post-discovery. Iteratively improving and developing a technology so that it is effective in practice and not just principle takes time and insight. I encourage scientists and engineers to strive to invest their time as carefully as they would their money, to increase impact of promising technologies through development and optimisation. I also encourage society to recognise and support these contributing developers as world-changing innovators.

*This product is made possible through the generous support of the Saving Lives at Birth partners: the United States Agency for International Development (USAID), the Government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada, and the UK Government.

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