Over the past few years, the ICRC has strengthened its engagement with the Swiss Federal Institute of Technology (“EPFL”) with the creation of a Humanitarian Tech Hub in early 2016. This collaboration takes place in the context of EPFL’s  Cooperation and Development Center (CODEV). and focuses on designing new solutions to enhance humanitarian action. Another program of interest to humanitarians sits with CODEV, the EssentialTech Program, led by Dr. Klaus Schoenenberger. In this “Join the Conversation”, Dr. Schoenenberger presents the recent developments and initiatives of the EssentialTech Program, and how it is relevant to sustainable development and humanitarian action.

 

You work in the Ecole polytechnique fédérale de Lausanne’s (EPFL) EssentialTech program. Could you tell us more about EPFL’s approach to cooperation and development, and about essential technologies?

EssentialTech was launched in 2012 as part of EPFL’s Cooperation & Development Center. The purpose of the program is to address the need for “essential” technologies, which we define as those that can help achieve sustainable development in low and middle-income countries. Essential technologies are typically those used in medical devices, energy, water, sanitation, pharmaceuticals, nutrition, agriculture, information and communication systems, construction and transport. EPFL has expertise in all of these areas, and it is EssentialTech’s job to lead specific projects that utilize this know-how within the institution as well as outside of it. Certain projects thus involve large consortia of public and private partners both in Switzerland and abroad.

At EssentialTech, we believe that technology must be developed in close collaboration with all the key partners from the private and public sectors, but first and foremost with the beneficiaries and real users of these technologies in developing countries.

What are the deliverables of the EssentialTech program, and what is your strategy for achieving a real impact?

The main goals of the program are to develop essential technology that is robust, affordable and adapted to the context of low-income countries, and to develop sustainable business models that roll out this technology on a large scale. Also, and very importantly, the program strives to ensure that it will serve its essential purpose in the long term. What this means is that all the key components of the value chain (such as the commissioning of the technology, user training, maintenance, repair and recycling) must be included. The whole product lifecycle must be rethought in close collaboration with the people familiar with the context where the technology will be used.

In your opinion, how can essential technologies contribute to sustainable development in developing countries?

According to the World Health Organization, only 10-30% of more complex medical equipment donated to low and middle-income countries is ever commissioned. In most cases, the equipment just sits there and nobody can use it. According to another study, over 50% of medical devices in hospitals either do not function  or are not being used correctly. It turns out that this issue is mainly related to the lack of compatibility between existing technology and business models and the realities of low and middle income countries. This incongruity exists not only for medical devices, but can be found to varying degrees in all the “essential” technologies described above.

 

Having access to water, health and nutrition for example is key for development; this depends directly on having access to essential technologies such as water treatment systems, medical devices and adequate, efficient agriculture technologies respectively.

Technologies, even essential ones, are not a silver bullet against poverty. However, they can enable sustainable development, particularly if they are designed with this goal in mind.

Functional technology tends to be taken for granted in developed countries. How different must a technology be, both in its conception and in its design, in countries which might not have the systems needed to support modern technologies?

Basically, low- and middle-income contexts are plagued by what we call the five horsemen of apocalypse. The first is a lack of quality infrastructure. Electrical supply, roads, water supply, etc. are very often unreliable if not inexistent.

The second is the lack of trained personnel. This has a huge influence, for example, on maintenance and repair: when there is nobody around who knows how to take care of the technology or how to use it properly, the result is quite simply failure.

The third is a lack of financial resources: when the technology can be purchased, there are often not enough resources to buy consumables such as reagents or spare-parts. Again, the technology then becomes useless.

The fourth is harsh climate conditions, which take a toll on equipment that was not originally designed for hot, humid and dusty conditions.

Finally, there is the issue of poor governance, which has a major impact on how the technology is procured, used, maintained, repaired and decommissioned at the end of its lifecycle.

We are convinced that, because of these important constraints, technology and business models both need to be rethought in order to become sustainable in their essential functions.

Clearly, technologies need to be affordable, robust and adapted to the context as well as the needs and capabilities of their users. It is interesting to see that designing solutions that are more affordable and still effective and sustainable, is good for everyone, not just those living in developing countries.

Can you give us an example of a project you’re conducting?

Our “flagship” project addresses the need for x-ray diagnostic imaging. According to the World Health Organization, roughly two thirds of the world’s population has no access to this important medical instrument. Imagine the 50 or so million victims of road traffic accidents each year, 90% of whom live in low and middle-income countries. It is shocking to imagine such a large number of patients who cannot be adequately diagnosed for lack of access to a working diagnostic X-ray system. Our project GlobalDiagnostiX addresses this need. A complete digital diagnostic imaging system specifically designed for this context has been developed from scratch. It runs on long-lifecycle batteries to allow for continuous use despite frequent power outages. The system is rugged and can cope with any kind of power instabilities, and can be directly connected to solar panels when the latter are available. The system was designed to resist high temperatures, humidity and dust, and requires little maintenance. Its software interface was specifically designed for easy use by largely untrained operators.

The project was led by a broad alliance of over 40 partners, including researchers, engineers, doctors, technicians, anthropologists and other specialists in both Switzerland and Cameroon.

In terms of innovation, we recognized the need to innovate not only through technology, but also through a business model that was tailored to the specific context. We proposed a model that included six years of maintenance in the initial purchase price, which was still much lower than that of similar products that do not function well in such contexts. This is quite revolutionary when one considers that commercial stakeholders today all charge annual maintenance fees that are completely unaffordable. The project’s success allowed us to create a start-up company called Pristem SA, which is currently negotiating its first round of financing with investors. The company is quite unique in that its primary market is Africa. It also provides a large operation and manufacturing hub in South Africa from which the technology will be assembled and shipped.

How well would this approach work in the context of humanitarian action?

The need for affordable, robust solutions that are accessible in the long term is also very important in humanitarian action. We are very proud to say that the ICRC recognized the advantages of our approach, which has resulted in the creation of the Humanitarian Tech Hub at the EPFL. Its goal is to initiate projects involving practical solutions to facilitate operations in the contexts where the ICRC is active. The Hub recently launched an initial project that aims to design a durable foot prosthesis with advanced dynamic features for a fraction of the cost of similar solutions on the market today. The ICRC equips over 30,000 amputees each year. This new solution will allow the recipients to live more active lives. The partnership involves key contributions by ICRC experts, who bring essential knowledge on practical issues encountered in the field. We are also taking advantage of this close collaboration with the ICRC to learn how to integrate feedback from ICRC experts into all of our projects so that solutions can also be adapted to more fragile contexts and areas affected by conflict.

You’ve decided to put this wealth of knowledge into a Massive open online course (MOOC). Could you tell us the thinking behind this?

We believe that the only way to solve the problem of sustainable access to essential technologies is by creating a movement of people who try to apply our approach and help improve it. We dream of a new wave of entrepreneurs and innovators who want to have impact on issues of poverty and are ready to use an entrepreneurial approach. We feel that having robust business models is a good way to solve the issue of sustainability. The nice thing about MOOCs is that they are massive, meaning they can trigger action on a large scale.

Our MOOC presents the issues and potential of technology in a context of poverty. It proposes a practical, hands-on method for designing essential technologies and business models to solve important social issues. This MOOC is addressed to anyone interested in becoming an entrepreneur in service of social and humanitarian causes.