The SIU 2019 Wrap-Up - 5 Successes and Failures to Learn from in 2020
The end of the year for many of us is a time of reflection, and with 2019 being the end of the decade it heralded in this reflection at a higher frequency than years past. Did we achieve what we thought we would? Did plans go astray but lead to unexpected learnings? How can we learn from the highs and the lows? These questions are particularly pertinent in ‘innovation’ environments where the rate of failure is invariably high, and the finished solution is usually lingering just out of reach.
At the SIU we have done some deep reflection on what worked in 2019, and what didn’t quite go to plan to help us move the new decade in 2020 with our best foot forward we are sharing some of our key reflections. Read on for our top 5 insights from the year gone by:
#1 The Year of Climate Action. Scaling Solar AC’s into the wider MSF Movement
The 2019 Success Story - There is no denying that 2019 was the year that the words ‘climate emergency’ firmly entered into the zeitgeist. The need for this term to hurriedly enter into our shared lexicon is by no means a success story in itself, however, there is an inspiration to be taken from the global climate mobilisation we have seen catalyzed by Greta Thunberg and millions of people globally who ramped up their climate-related efforts in 2019.
One climate success from our own team efforts at the SIU was the Solar Air Conditioning case which has generated some serious interest from the community and is now organically being scaled throughout MSFefforts globally. During September and October alone over 54 solar aircon units were ordered from different field project leaders. To date, SIU Solar Air Conditioning units have been installed in Haiti and Malawi and ordered for future installation in Nigeria, Iraq, South Sudan, and Pakistan within the MSF Operational Centers in Amsterdam and Paris (OCA and OCP). This one innovation has so far demonstrated its efficacy in reducing MSF reliance on diesel, reduced costs, significantly reduced CO2 emissions, lowered noise pollution and increased autonomy.
The Learning for 2020 - While the process so far has been highly promising it is far from time for any of us to rest on our laurels with the stark reminder as fires range across Australia and record rainfall floods Indonesia. In 2020 we plan to implement key insights gained from the Solar Air Conditioning Case success including disseminating our findings both within and outside of MSF, partnering with external experts to iterate on the current system by getting detailed, quantitative data from the initial pilot in Haiti and combine it with qualitative information from the various installations that will take place during 2020.
We are striving to ensure that the implementation of solar aircon solutions, and other environmental efforts, in humanitarian and development context won’t stay as an MSF practice but disseminate into other organisations and movements in this space. Main learning – keep on keeping on, things can move slow but eventually, with the help of expertise, grit, and collaboration they may just gain momentum. When (and if) they do, you need to keep the momentum going!
We will be working hard in 2020 to continue the momentum of our climate and health-related cases, sharing learnings at events, disseminating useful resources and connecting with others looking to dedicate their energy to this fundamental need. Watch our LinkedIn for some exciting announcements with the Lancet Countdown coming soon.
#2 Accelerating Collaboration via Our First Hackathon
The 2019 Success Story - With any innovation development process it is important to start with real-world challenges. In the case of our very first hackathon we were successful in scoping highly tangible challenges that our patients and field workers face on a day-to-day basis, and also successful in including varied external perspectives to see things in a new way. But did we actually manage to solve all the challenges? The answer is no however we did carry two of the four challenges further into development for deeper exploration: Wound Care and Play therapy.
Although the actual outcome, around a half a year after the hackathon is still unclear, we see that knowledge around the four challenges within MSF has increased. We have managed to deliver concepts and ideas that are easier for actors to unite around – both internal and external.
With the Wound Care Case we are currently looking into ways to provide better solutions to a very complex problem. A problem that can’t be addressed with a one size fits all solution but rather a tool kit that includes both improved products as well as process management. And in terms of the second Play Therapy challenge, we are now collaborating with the MSF Operational Center Belgium (OCB) to implement recreational and therapeutic play, in a pilot project based on our early scoping efforts. We hope this Play Therapy effort will lead to easier to implement instructions and guidelines that will pave the way for the introduction of play therapy activities to MSF in a more structured and organized manner.
The Learning for 2020
The single most important component of the hackathon was that it was linked to the MSF Pediatric Days. This assured that we could involve relevant persons in the process at the same time take advantage of the brainpower that was present in Stockholm for this event. To involve the external world, through engineers, clinical experts, students, technologists, designers, and many others, was not effortless but much easier as we had the MSF perspective and support covered. The more we can find relevant ways to tap into that expertise and engagement that already exists, the better. In the end, the key to solve complex challenges is collaboration.
#3 Launched a first of it’s kind Humanitarian Health Innovation Newsletter
The 2019 Success Story - Good communication is central to any innovation effort, whether you are trying to shift the culture of an organisation, create shared understanding between previously unconnected stakeholders, or simply ask the right questions to guide your next steps in an unprecedented field. The SIU has focused increasingly on communication in the past year leveraging our LinkedIn, website and most recently our innovation newsletter to engage and inform those in the wider community. We have seen an incredible response to the bi-monthly newsletter to date with subscribers in over 20 countries globally and 60+% open rates there is a clear appetite for distilled humanitarian health innovation insights and a source for identifying engagement opportunities.
The Learning for 2020 - MSF is crowded with innovation and innovators. So, besides SIU material there are plenty of stories to be told. We have to provide these stories and persons more space so we can share learning, increase knowledge, inspire each other and stimulate collaborations. Big or small, early-stage ideas or implemented innovations. Contact us to see if your story should be in the newsletter and make sure you are subscribed to receive these insights straight to your inbox every 2 months.
#4 The Non-Insecticidal Malaria Prevention Innovation
A 2019 Failure - Two of the four-challenges that we address at the Pediatric Innovation Hackathon we hosted in April did not make it to the next stage of development despite focusing on important real-world problems - neonatal fluid management and non-insecticidal malaria prevention.
Insecticidal resistance, although not a new phenomenon, is becoming a growing concern for malaria-endemic countries. Mosquitos are steadily increasing their ability to withstand or overcome multiple types of insecticides pointing towards a need to innovate beyond these types of prevention methods. The multi-stakeholder teams assigned to this malaria challenge came up with some highly promising concepts to address this issue including community education and engagement strategies and community-based enterprise support systems to produce locally sourced natural soaps and detergents. So, we had a real problem and a handful of potential solutions but failed to move ideation into reality. What happened?
The Learning for 2020 - Complexity requires time resources to navigate. While we invested significant time scoping the challenge with malaria experts we came to the realisation that this particular solution landscape would be too complex to navigate in tandem with multiple other case commitments that were already in the works.
Finding the right balance between field perspective (MSF staff), creativity (designers), tech-savviness (engineers, coders, etc.) and organization (business) or whatever is needed to tackle a challenge is hard to predict and even when you find what you think may be the right balance may be challenging to put into practice.
#5 The Push and Pull of TB Innovations
A 2019 Failure - This one isn’t so clear cut in terms of being a success or a failure. Recent TB diagnostic and treatment developments and barriers to access are indicative of some of the complexities of bringing innovations into practice. At the SIU we have seen good progress with our Video Supported TB case having conducted an initial evaluation of the patient support technology in Belarus and engaged first patients in India with OCB. More broadly pharmaceutical companies, medical device manufacturers and others have recently made great strides in producing augmented diagnostic tests and treatments, however many of these new developments are not yet accessible in populations heavily restricted by high costs.
The JOHNSON & JOHNSON (J&J) DRUG BEDAQUILINE is one example of a pharmaceutical innovation which is not achieving scale for those who live in low resource contexts living with multidrug-resistant TB (MDR-TB). The MSF Access Campaign has been working hard throughout 2019 to change this calling for J&J to lower the cost of their drug to no more than $1 per day. Bedaquiline offers far fewer side-effects than older drugs which are far more toxic for patients. Reduced costs and increased access would ultimately mean more people cured and a significantly improved quality of life for those affected.
GENEXPERT, a rapid molecular test for TB that entered the market in 2010, is another example of innovation with the potential to significantly improve care. This test is recommended as the initial test for all those presenting with signs of TB. However, due to its high cost the majority of countries with high TB burden are unable to scale up its use. The MSF Access Campaign are working hard to motivate manufacturers Cepheid to reduce the Xpert cartridge cost to US$5, inclusive of service and maintenance.
The Learning for 2020 - Discuss and address innovation access early and often. Who pays for health innovations to achieve scale? What populations will be the beneficiaries of resulting solutions? These are questions that constantly need to be revisited as we develop humanitarian health innovations and discussions that should happen early. Access is a complex issue often determined by complex systems.
Ready for 2020
In the oft-cited words of Samuel Beckett; Ever tried. Ever failed. No matter. Try again. Fail again. Fail better. We’re looking forward to working with the wider MSF movement and external experts and innovators in the new decade bolstered by the learnings from the past year.