(Summer ’13) Rafa Rahman
I’m Rafa Rahman, a rising sophomore at MIT, in the Biological Engineering Department. This summer, I’m diving into my interest in global health and associated technologies through an internship between MIT’s Comprehensive Initiative for Technology Evaluation (CITE) and the Center for Accelerating Innovation and Impact (CII) at the U.S. Agency for International Development (USAID). My main job is to write case studies focusing on product design for some technologies that are of interest to CII. At the same time, I get to explore Washington, D.C. and immerse myself in the dynamic atmosphere down here (not to mention the heat and humidity…). Check out my weekly blog posts below for a window into my work!
After a summer that went by extremely quickly, I find myself writing the blog post for my last week at USAID. Over the course of the summer, I’ve written two case studies: one on rapid diagnostic tests (RDTs) for malaria, and another on intrauterine devices (IUDs). Both reports dealt with product design and evolution, focusing on the initial stages of a product uptake timeline. This was done within the context of the suitability aspect of CITE’s 3S model, which looks at products through the lens of suitability, scalability, and sustainability. With the malaria RDT case study, I looked at the product design factors of antigen selection, sensitivity/specificity, cost, ease-of-use, speed, and stability. I came to the conclusion that the products are very suitable to highly endemic, low-resource settings, especially compared to other diagnostic options. For those interested in that project, I’ve attached the Final Presentation. This presentation also includes Bryan’s work, which involved collecting data to touch on the scalability and sustainability of malaria RDTs.
I’ve certainly learned a great deal these past few months. Coming from a science and engineering background, I was fairly unaware of the importance of understanding the facets of the 3S model. Without a product suitable to its setting, one can forget about it having any effect. Furthermore, it’s incredibly important to understand the market landscape for a product, in order to effectively scale it up and ensure sustainability. Through my work, I was able to talk to several individuals very knowledgeable about these topics, specifically regarding the RDT case study. From the insights I’ve gained from those conversations, and from my internship experience overall, I hope that I can eventually become what CITE calls a “development engineer,” rather than isolate myself to any one discipline.
Now it’s time to look at how the work I’ve accomplished this summer can be continued in the future. CII is looking at making the case studies available to those who might be interested in the technologies. As CITE expands from its evaluations of solar lanterns to other technologies, my case studies will form a part of the knowledge base that backs the development of a rigorous evaluation method. While malaria RDTs or IUDs may or may not be evaluated by CITE, understanding how they’ve been introduced to the world of global health can provide insight into uptake of other technologies.
There are many people I need to thank for making this internship so wonderful. First off is Joe Wilson, who served as an excellent mentor at CII and possessed an infectious level of energy at all times. He made sure to include me in the center’s activities and ensured that I had what I needed to make my internship a success. Callie Raulfs-Wang also played the role of a great mentor, and worked with both Bryan and myself to shape our projects and make them useful to both CII and CITE. Dave Milestone helped me get started and provided feedback on both the project and the future of the work. At CITE, Chris Pilcavage stayed in constant contact with me and was ready with an answer the second I had the slightest question. I have to thank Derek Brine for taking me onto the CITE program in the first place and recognizing my desire to work with global health technologies, even though I had very little prior experience on the topic. Larry Barat and Sonali Korde of the President’s Malaria Initiative provided a lot of information for the malaria RDT case study as well as insight into where the project could go in the future. I wouldn’t have had nearly as much knowledge about product design had it not been for Mary Anne Fisher at Becton Dickinson, who has been in touch with me ever since I first contacted her for her take on the development of ParaSight F. I must also thank my fellow CII-CITE intern, Bryan Ranger, who has been a really great partner in tackling the malaria RDT project we took on. Finally, I must thank everyone at both CII and CITE for making me feel extremely welcome and reaching out to me.
Bye and thanks for reading!
Week 8 Spotlight: Saving Lives at Birth Development XChange
It’s probably not an understatement to say that my mind was completely blown this week. I attended the Saving Lives at Birth Grand Challenge Development XChange, an event organized in large part by CII. The premise of Saving Lives at Birth is to identify the brightest minds working towards preventing and treating issues associated with maternal and newborn health. The program then supports these innovators as they work to scale up their projects.
The first few days of the event included talks by individuals able to provide some perspective on scaling up innovations. While these talks were geared towards the innovators, I was able to sit in on part of one delivered by Dr. Garrett Mehl, a scientist at the WHO. Garrett provided an excellent overview of mobile health in the developing world.
Wednesday’s events were the meat of the week. The first half of the day was an open marketplace-type session, where attendees were able to talk to innovators at their leisure. I spoke to way too many amazing people to list here, but I will point out a few. Given my case study on intrauterine devices (IUDs), I was delighted to see a project for a better IUD insertion method. The man behind the work was S.K. Khurana, and I was even able to get a picture with him and his novel device, below. There were several projects dealing with rapid diagnostic tests, so I was obviously very excited to learn about their work and tell them about my own case study on rapid diagnostic tests for malaria.
I’d also like to mention my discussion with m4RH, a company working to expand mobile health in low-resource setting. I talked to m4RH about my involvement with GlobeMed. Now, allow me to veer off on a brief tangent to give this conversation some context. GlobeMed is a national organization that pairs university chapters with grassroots organizations overseas. MIT’s partner is Hope through Health, which runs an HIV/AIDS clinic in Togo. Recognizing that college students don’t have the know-how to provide medical services, GlobeMed allows for students to look at other ways in which they can benefit global health. Walking around the Saving Lives at Birth marketplace, I was obviously inspired by all the projects, and was thinking about how they might potentially benefit the clinic which the MIT GlobeMed chapter works with. When I talked to m4RH about all this, they seemed extremely excited to get involved, so we might even have a future collaboration on our hands!
The next event was a forum, with talks by many individuals with some interest in global health. It was here that Susan Rice delivered her first speech since becoming National Security Advisor. Her words highlighted the importance of the innovators’ work, and it turns out that she’s also pretty funny! Other speakers included USAID Administrator Raj Shah, Princess Sarah Zeid of Jordan, New York Times best-selling author Dan Health, and Robert Fabricant of frog design. My favorite speech was probably the one given by Ron Garan, a NASA Astronaut now working with USAID. According to him, “We now have the power to solve suffering on Earth.” How? He emphasized the need for collaboration in global health and the importance of taking what he called “the orbital perspective.”
I’ll stop here, but get ready for an extensive set of pictures to mirror this lengthy post!
Until next time,
In terms of writing, this week, the focus shifted over completely from malaria rapid diagnostic tests to intrauterine devices (IUDs). IUDs are a pretty great contraceptive method, but they’re not used all that widely in the US. Worldwide on the other hand, they’ve found a higher level of acceptance. The IUD case study, while much less comprehensive (i.e. much shorter!) than the malaria RDT case study, saw a fairly similar approach. I focused on defining the issue of contraception and looked at different product design factors that go into developing and launching IUDs. I learned quite a bit from researching and writing about them, and this could be an area that merits further attention.
Other than that, Bryan and I hammered out the final version of our presentation, with some really great feedback from folks at both CII and CITE. We’ll be presenting next week, so hopefully that will prompt some great conversations with those who attend. This week was also the Saving Lives at Birth Development XChange, which gets a post all to itself. As for some visual evidence of what I’ve been up to, it’s time to put some faces to the names I’ve mentioned over the course of the summer!
One week left! (If you can count two days as a week)
Week 7 Spotlight: Talk by Dr. Muhammad Yunus
Talk about an inspiring speaker. This Monday, I had the honor of attending a talk by Dr. Muhammad Yunus, a Bangladeshi economist who received the Noble Peace Prize in 2006 for paving a path of opportunity for the poor by initiating a microfinance program. Yunus founded Bangladesh’s Grameen Bank, the organization that continues to run this microloan system, after recognizing limited options for the poor in addressing the problems which affect them. By giving them the initial loan to implement their business solution, villages have solved for themselves issues ranging from electricity and energy availability to water treatment. Yunus has termed these solutions “social businesses,” meant to help society, as opposed businesses whose goal is to maximize profits. Furthermore, Grameen Bank focuses on granting loans to the most marginalized members of society. Thus, a large majority of borrowers have been women. In fact, when I asked him what problems he’d like to see tackled next, he stated that he’d like to provide more social options for Bangladesh’s severely stigmatized transgender population, and the bank has accordingly granted several loans to transgender individuals.
You would think that someone so accomplished would display a certain manner of behavior. However, the first thing I was struck by was how humble he was for the entirety of the talk. Dressed in traditional Bengali garments, he looked extremely approachable and friendly, while at the same time maintaining an infectious level of energy. Yunus said over-and-over that when he started Grameen Bank, he knew nothing about business. He claimed that he had done everything that banks traditionally do not do, and that it worked. In Yunus’ own words, “Banks go to the rich, I went to the poor.”
What made Yunus’ talk strike a more personal chord for me was that I was born in Bangladesh. While my family moved to the states before I was even a year old, I’ve witnessed the abject poverty that so many people face while visiting. I constantly hear about government inefficiency and corruption from my parents and relatives. For me, listening to the “Banker to the Poor” helped lift the cynicism which so many Bangladeshis seem to feel, with due reason. I really couldn’t have asked to attend a more encouraging event.
Since whatever I say about my work will now be greatly overshadowed, I’ll save those updates for another post. Instead, I’ll leave you with some photos from the talk.
Thanks for reading!
It’s finished! After weeks of chipping away at writing my case study on malaria rapid diagnostic tests, I’m done! I’ll hopefully be able to share the result sometime in the near future, after both CITE and CII have taken a look at it and made their changes. Be prepared though, it’s close to fifty pages as it stands now. I learned a lot in writing this report. Coming into this global health internship after a background in lab research, I had never really realized the importance of the steps that come after the initial invention. CITE’s 3S approach hones in on this need by targeting the suitability, sustainability, and scalability of a product. My project focused mainly on the suitability, while Bryan’s work looked at sustainability and scalability.
There are a lot of people who have worked to provide me with information and connect me with the appropriate resources. Just this week, I was able to interview Dr. Larry Barat, senior malaria advisor for the President’s Malaria Initiative (PMI). He seems to be the guru on all things related to malaria RDTs, so needless to say, my case study improved drastically after my discussion with him.
This week I also got a better idea of CITE’s goals in terms of student engagement. I virtually attended a presentation by Sydney Beasley and Cauam Cardoso, who are CITE fellows working towards this goal of engagement. As an intern for the program, Sydney and Cauam’s talk was right up my alley.
As for photos this week, I realized that I showed you all the outside of the Ronald Regan Building, but never provided a glimpse of the gorgeous interior.
Talk to you soon!
It’s crazy to think that I’m already into the sixth week of my internship! I made significant gains in my work this week thanks to Mary Anne Fisher from Becton Dickinson (BD), in addition to the many people who helped connect me with her. Mary Anne worked on the development of the first rapid diagnostic test (RDT) for malaria, ParaSight-F, which was manufactured and marketed by BD. She was extremely kind and informative, and really helped me incorporate more of a narrative into my otherwise very technical case study. Not only did Mary Anne provide me with the nitty-gritty details of product design, she and I talked about some really neat applications for medical diagnostics. For example, did you know that antigen detection (used in malaria RDTs) can be utilized to detect diseases in Nubian mummies? While we weren’t able to dig up an article showcasing malarial mummies, here’s one discussing how some parts of the population were affected by schistosomiasis: http://scienceline.org/2011/07/parasitized-throughout-the-ages/
In other news, I was able to meet with a familiar face this week: Amit Mistry. Amit works with the Higher Education Solutions Network (HESN), the USAID program which encapsulates CITE at MIT. It was great to go over my project with him and talk about future steps. After our discussion, I was about to head home when I had the sudden impulse to visit the White House and become one with the tourists. While it’s just a few blocks from the Ronald Reagan Building, let me say that there’s nothing like a walk through D.C.’s infamous heat and humidity, especially while fasting during Ramadan, to make you reconsider your choice in footwear. Nonetheless, I got some nice photos, although I couldn’t get one of the albino squirrel I saw. It scampered away at the sight of my camera. White House, white squirrel, what a great photo that would have been…
Editing, editing, editing… it’s probably one of the hardest parts of writing, and something that can’t really be done enough. For me, it’s even harder with technical writing, and a case study on the product design evolution for malaria rapid diagnostic tests is definitely technical. Nonetheless, as the saying goes, “There’s always room for improvement!” Joe provided some really great feedback on the initial draft, so this past week, I’ve been working on incorporating those comments and making changes of my own.
Other than that, on Thursday, Bryan and I presented the malaria RDT project at the CITE team’s meeting at MIT. While I had to Skype in, it was great to see everyone virtually and hear their thoughts on our project! I also got to learn about one of CITE’s other main initiatives, dealing with solar lanterns in Uganda.
Since I doubt you’ll want pictures of me editing my case study draft or trying to Skype into a meeting, I’ll instead leave you with some words from Hillary Clinton, mounted in the USAID lobby.
Until week 6!
This week I realized just how great MIT alumni can be! After having written a draft of the malaria RDT case study and doing a lot of research on the general product, my mentors and I realized that talking to a company that produces the product could potentially provide some valuable information. As Joe pointed out, an employee working on the product would best be able to share the story behind its development. Of course the problem then was finding people at these companies. While malaria RDTs certainly provide many companies to choose from – just the four rounds of WHO evaluation included 169 products – it seemed most logical to contact the initial manufacturers, since they would likely have overcome the greatest challenges in product design. Thus, Becton Dickinson (BD) and ICT Diagnostics, the first two manufacturers, seemed the most reasonable options. Finding people at these companies presented a challenge. BD is huge and extremely diverse; additionally they no longer produce their RDT – ParaSight-F. ICT Diagnostics on the other hand is very small, but they are located in South Africa!
In came the MIT alumni to save the day, at least for finding folks at BD. I contacted about twenty people at BD via the alumni database. While I thought most of the requests for help were shots in the dark given that none of the contacts may have had any relation to ParaSight-F, and most were not even within the diagnostics division, I was overwhelmed by responses. While not a single one of my initial contacts worked on the project, they were kind enough to connect me to their colleagues, who connected me to others, and so on so forth until I got in touch with several people who had worked on ParaSight-F. I’m now all set for an interview, having even learned a little about the MIT from the past along the way! My search within ICT Diagnostics was a similarly successful story. I was immediately able to get in touch with the third party who lays down some of the basic foundation for the RDT and will be in touch with them soon to get more information!
While this may have been a short week, it was extremely productive. To top it all off, I got to spend time exploring D.C. with friends on the fourth, and later watch fireworks with the family from home. Multiple fireworks shows actually – we counted about 11 that could be spotted from our balcony!
Get excited… even more pictures than usual to best document our D.C. explorations! All of these photos are courtesy of the wonderful Kath Xu.
Happy Independence Day!
This was the week of meetings, or at least Monday was the day of meetings. All were very fruitful, so I’ll share pieces of each here. I started the day off with Bryan Ranger, the other CITE intern at CII. He’s working remotely from Boston over the summer, so it was great to talk to him in person and really clarify how our projects complement one another’s. I also found out that he’s doing CITE-CII work on top of full-time lab-work, and is thus basically a super-human. Props to you, Bryan!
After that, we headed to a round of quick presentations on summer projects by each of the CII interns. I was blown away by the high level of expertise on everyone’s part and was again reminded of the great impact our work can have. I witnessed discussion on products as diverse as chlorhexidine and injectable antibiotics. I even found out that one of the interns is playing a lead role in the Higher Education Solutions Network (HESN), which is the USAID umbrella program that makes programs like the USAID-CITE connection possible.
Up next, we had a discussion with the market access team, where we discussed the possibility of changing the topic of my second case study from neonatal resuscitation devices to either family planning tools or injectable antibiotics. This was followed by a presentation on CII to the Office of Country Support. Lastly, we touched base with the whole center at the weekly team meeting. In all the busyness, poor Joe wasn’t even able to catch a lunch break! Thankfully, Callie made our last event a stop at Elephant & Castle, where the nachos were almost as great as the discussion. (Seriously though, you should look up a picture of those nachos, or better yet, go get some yourself!)
Happy early July 4th!
This week was a whole lot of reading and writing. I built upon all the malaria rapid diagnostic test (RDT) research I started last week by reading plenty of scholarly articles and organization reports, and even by perusing some print material at the USAID library. This was followed by many hours at the computer, chipping away at the task of getting my case study framework filled in. I made a fair amount of progress, and have learned quite a bit about this marvelous piece of technology.
Other than that, I got to know a lot of the center’s members much better this week. I’d like to introduce some of the people I’m most closely working with. First off is Joe Wilson. Joe is the CII member I report directly to, and he serves as the Market Access Advisor on the Market Access half of the center. Even before I met him, I was informed that he was “the nicest person at the office,” and I can certainly see why. He’s been a phenomenal mentor so far, and I’m very excited to continue working with him over the summer! Callie Raulfs-Wang, the Research Advisor on the Innovation arm of CII, has proved to be another great mentor. She continues to be an indispensable source of information for me. Finally, David Milestone was my first point of contact at the CII, and he did an excellent job of getting me started. Dave is the Senior Market Advisor.
I’m clearly not doing justice to everyone else I’ve met given that I’ve only talked about three of the wonderful people at CII, but I have to bring this post to a close somewhere! Hopefully I’ll get a chance to introduce others in the coming weeks. I would however like to give a shout-out to my mentors on the CITE end of this project, Christine Pilcavage and Derek Brine. Chris and I have been in constant communication since I got to D.C., and both Chris and Derek have proved to be a bastion of support these past few weeks.
I’ll check in again next week!
After kick-off meetings at MIT and in D.C. during the previous week, the team at the Center for Accelerating Innovation and Impact (CII) has narrowed down my case study topics. By the end of the summer, I’ll hopefully be an expert on Rapid Diagnostic Tests (RDTs) for malaria and Newborn Resuscitation Devices (NRDs). I’m just getting started, but it’s both intimidating (in a good way) and exciting to think that what I put together will have the potential to impact the way USAID deals with these technologies. In fact, every day that I walk into the Ronald Reagan building, where USAID headquarters is located, I feel like I’m on my way to doing extremely important and impactful work. Here’s to hoping that the feeling never fades!
Week 1 was spent on diving into existing research on malaria RDTs. I learned a whole lot about malaria and its effects, from both a biological and economic/social perspective, how needs to diagnose and treat the disease vary by region, existing diagnostic methods, and the gap that RDTs fill. Perhaps most importantly, I started piecing together the factors that RDTs need to address, and where we stand on those challenges given the current product designs.
My first week at USAID was great, and I’m looking forward to a very fruitful internship. Everyone at the CII whom I’ve met so far seems very friendly and helpful. I’m probably biased, having grown up in the D.C. metropolitan area, but I feel like I couldn’t have asked for a better location for this internship. Knowing that I work just a block or two from the White House and countless other government hotspots is a great feeling.
Until week 2!