No one denies that the health care situation in sub-saharan Africa is in need of new solutions. How one can come up with innovative solutions to cost effectiveness of diagnostic tools or implementation of treatments is still debated ? A frequent argument is whether the current problems related to health care in Africa require a conceptual approach or an experimental approach. In other words, do we need for instance to look elsewhere for affordable AIDS treatment or create a brand new tool to test for cervical cancer ( conceptual approach) or do we tweak and adapt what already exists (experimental approach) ?
In Malcom Gladwell's next book, he will touch on how the US health care system reform needs a Paul Cezanne ( a experimental painter ) type approach and not a Picasso ( the definition of a conceptual artist ) type approach.
I will make the argument that in the case of health care in Africa, despite the urgency of the situation, we definitely need to build on what we have learned so far, and improve upon it.
The reasons ? There are many but here is a few:
1) there are too many lives at stake to implement ideas that have not been tested previously. The concept of promoting abstinence as the main protection against AIDS comes to mind. It's not a proven method and one cannot afford to wait for the results of such programs to replace others methods that have been fairly successful so far.
2) Although the current economic reality of Africa is different from the western world, the need for accuracy in diagnosis and efficient treatments is the same. Therefore, simplifying and adapating already proven tools to the specific needs of each regions is the most reliable way to acquire acceptable cost/effectiveness of medical tools. An example of such initiative is explained here.
3) In some ways, this point of view is a derivative of the incremental infrastructure idea that Ethan Zuckerman developped here; but centered on a cost reducing effort to make it more available. Ethan states:
"These projects are atomic: A small part of the infrastructure is useful by itself,[..] The projects are financed in part by users, lowering the costs for the operator[..] these projects are providing capabilities that weren't available before"The medical tools that often provides multiple options to the health care givers will be simplified to the maximum so that they achieve 2 things: 1) can be employed by community-based care givers 2) simplifying it would significantly reduces cost of the tools.
Obviously, there are many obstacles for the practical implementation of such strategies. Another inspiration for such projects are the projects presented at afrigadget where they are " solving everyday problems with African ingenuity." They are not reinventing the wheels, they are providing solutions.
There are solutions to the health care problems back home but it will take quite a bit of ingenuity, if not from our leaders, from ourselves.
(hat tip to Tnr for starting the conversation).