When I was invited to join the Grand Challenges Canada team this summer, I happily committed to four months of work as a student researcher with the Point-of-Care Diagnostics program with Rebecca Lackman. In doing so, I also committed to four months of answering, “What is point-of-care diagnostics?”
Point-of-care diagnostics is about making diagnostic tools more accessible to patients in low- and middle-income countries. For example, this could mean furnishing rural health care clinics with a diagnostic tool so that patients need not travel as far as the closest hospital to seek a diagnosis. Further still, a true point-of-care test is one that can be administered wherever patients are in need: in any home and under any tree. Bringing diagnostic tools closer to patients means designing tests that are less dependent on electricity, clean water, stable temperatures and trained personnel. As a result, technological innovation is often required to reform existing tools and design new ones.
For example, in Canada, a chest X-ray is used routinely for the diagnosis of pulmonary tuberculosis. Digital X-ray machines are bulky, high maintenance, and cost approximately $100,000 in Canada. As a result, they are inaccessible to patients in countries such as India and China, which together accounted for 40% of the global TB burden in 2012. This is why Grand Challenges Canada grantee Karim Karim is working to invent a low-cost digital X-ray – at a cost of $1000 – to accurately and rapidly detect tuberculosis in underserved populations.
However, it is important to note that the accessibility of diagnostic tools is not only limited by the pace of technological innovation. There is also great need of implementation research, in order to identify ethical, social, and cultural barriers that may prevent the widespread adoption of a particular diagnostic tool. For example, Grand Challenges grantee Nitika Pant Pai is conducting implementation research in South Africa to encourage rates of HIV screening. Bearing in mind the social stigma towards HIV in this country, Nitika is developing an online self-assessment tool so that patient concerns over confidentiality do not prevent him/her from seeking a diagnosis.
In addition to researchers, the field of global health needs entrepreneurs and policy-makers as well. This combination of scientific, business, and social innovation is recognized as Integrated Innovation, and is central to the Grand Challenges Canada approach. Integrated Innovation suggests that the myriad of actors in global health – scientists, entrepreneurs, government officials, and patients themselves – should not operate in silos, but as part of a greater collaborative network.
On a personal note, it is this concept that helped to assuage lingering doubts that I had about my own role in the field when I began working with Grand Challenges Canada. At the time of my interview for this position, my interest in global health was a shy three years old. That said, as an international relations student, I found my interest in global health quite complementary to my studies, particularly in terms of science diplomacy. However, I wondered if this connection was perhaps too abstract. Passionate though I was, my nerves asked if enthusiasm could serve as expertise. Needless to say, my concerns were quickly dispelled.
While Grand Challenges Canada encourages a multidisciplinary approach from its innovators, so too does it recruit its own employees from a variety of disciplines. For the last four months, I have been surrounded by an astoundingly diverse group comprised of – to name only a few – economists and biologists, psychologists and ethicists. It is strange to remember that before my time here, I was admittedly daunted by the challenge of breaking into a field that seemed so beyond my own expertise. Even as I prepared for my role this summer, my nerves suggested that I would be the anomaly in a sea of medical students and biochemistry majors.
To be sure, there were days this summer when doubts re-emerged. Indeed, a quick scan of my own Google history is a testament to my learning curve this summer. However, the last four months have taught me to celebrate each entry and every question as a testament to an open, more educated mind. Today I can proudly recite “visceral leishmaniasis” and “Human African trypanosomiasis.” I can also, just as proudly, admit to how many times I had to practice each phrase before I could employ them stutter-free.
The most powerful lesson from my last four months at Grand Challenges is thus the importance – indeed, the necessity – of a multidisciplinary approach to global health. In this light, Grand Challenges Canada has secured my faith in my own capacity to contribute to this field. While point-of-care diagnostics are only part of saving and improving lives, much can be learned from its emphasis on Integrated Innovation.
Leah Nosal is the Point-of-Care Diagnostics summer student at Grand Challenges Canada. She holds a BA (Hons.) in Political Science and International Relations from the University of Toronto. Connect with her on Twitter @leahnosal