Closing the gap between the rich and the poor and strategies to increase access to health technologies and innovations
I had the opportunity to beta test Microsoft’s newest technology, HoloLens, at their NYC headquarters. HoloLens is a holographic computer built into a headset that allows you to see, hear, and interact with holograms within an environment. This innovative technology has impressive potential in the health IT sector, allowing developers to design life-saving diagnostics and devices in virtual reality.
But, there’s a catch. Each HoloLens costs a staggering $3,000–5,000. I wondered who could access it and who couldn’t. Like many digital health technologies, the HoloLens has the potential to address public health problems, improve health outcomes, and lower healthcare costs. However, there are new concerns related to access to health IT innovations that bar the poor from accessing them. These concerns include issues of availability, affordability, and adoption.
These concerns include issues of availability, affordability, and adoption.
While health technologies aim to level the playing field, do we still see a persistent gap in access to these innovations among the poor? The current landscape argues yes.
So, what solutions can overcome these barriers for the poor, minority, and rural populations? The access framework coupled with utilitarianism provide us with strategies to deliver health technologies to the disadvantaged. J.S. Mill’s utilitarianism is a principle that advocates for actions that maximize society’s general utility (i.e. happiness, wellbeing). This lens accentuates that in order to improve the poor’s utility, that is their health outcomes, policymakers must recognize and respond to intricacies of the complex adaptive system of health tech innovations.
Product Adoption and Global Advocacy
The guiding principle of utilitarianism is to always act in a way that will produce the greatest amount of good in the world. International technical agencies such as the WHO has the authority and agency to propel health technologies forward. A prominent example is the World Health Assembly in 2001 raising the profile of schistosomiasis and soil-transmitted helminths. Subsequently, these efforts made praziquantel-related technologies widely available in Africa.
International agencies that adopt official resolutions can make strides in establishing an official acceptance of health innovation. Global level consensus on digital and medical technologies widens equitable access to life-saving devices, which in return increases population’s utility for better health status and outcomes.
Mill’s version of utilitarianism highlights that the purpose of morality is to make the world a better place. Morality is about producing good consequences, not having good intentions. Similarly, developing safe and efficacious technology is not sufficient for the poor to access life-changing innovations. Scientific evidence from the story of Norplant, a hormonal implant used for birth control, emphasizes that the outputs of safety, efficacy, and licensing are means to a complicated access end.
Norplant was one of the safest products in clinical testing, with a high contraceptive efficacy, yet its use in the field faced many hurdles. Therefore, to create access requires rigorous planning for an infrastructure that can manufacture, regulate, and deliver technologies to the right population through the proper channels. This kind of architecture will ensure that the technology’s potential benefits will be fulfilled, improving society’s health utility.
Affordability and Market Access
Utilitarianism supports that authoritative agents such as the state need to act in alignment with actions that bring the most benefit, intrinsic value, to all of humanity. To improve access requires addressing the cost of health technologies as a key barrier to access. The hepatitis B vaccine story teaches us that innovation’s affordability affects uptake.
In the 1990s, the vaccine was unaffordable in developing countries, so demand was low. Additionally, drug manufacturer were unwilling to increase production capacity for the vaccine, keeping prices high and supply low. Given this economic reality, public-private partnerships like the GAVI alliance decreased the price of the hepatitis B vaccine by establishing a procurement fund, capitalizing on patent expiration, and improving national drug regulation and clinical testing capacities in vaccine-producing countries such as South Korea. These efforts to lower product prices for governments and individuals represent a necessary effort to expand innovation access and equity value to all mankind.
The healthcare landscape of access is transforming. Beyond digital health and medical innovation, this is the story of empowering people to access technologies that allow them to actively manage their health, wellness, and disease.
Without access to the right information, devices or diagnostics, the poor’s capacity to make decisions for their own health diminishes.
Without access to the right information, devices or diagnostics, the poor’s capacity to make decisions for their own health diminishes. State actors need to mobilize on the aforementioned issues, drawing on the larger problem that innovation is built on the access framework of a complex system, and driven by the ideals of utilitarianism.