Innovation is sometimes presented by way of a dichotomy: modern, science-based innovation for affluent markets, and ingenious, cheap innovation for poor communities.
There is truth in this dichotomy: the ‘10/90 gap’ in health research and development encapsulates the extent to which present health research is devoted to the problems of the world’s affluent minority, neglecting the burden of disease that falls upon 90 per cent of people on earth, as stated by the Global Forum for Health Research. But there is nothing inevitable or natural about this state of affairs, and we need not accept it: The might of modern science and technology can be put directly at the service of social equity, and in particular to help improve children’s lives.
Making innovation serve equity entails, in part, changing the current orientation of research and innovation agendas. This is as important as it is difficult, given the network of power and interests within which these agendas are interwoven. Power and interests in this context imply diverse issues: power – and money – to direct research agendas toward specific topics, to determine which research topics are worthy of support and which results are published.
For small research communities in developing countries, the presence of such power and interests is overwhelming. Belonging to the international scientific community is obviously very important, but too often it comes at the price of alienation from the kinds of problems that local people face, and that few outside the local scientific community are interested in and capable of addressing. Creating new types of incentives to legitimize and make room for ‘inclusive research and innovation agendas’ is then paramount.
A complementary approach is to re-engineer the way we think about innovation. The idea is simple: Innovation is about solving problems in a given context. In contexts of abundance and where people or governments are able to pay high prices, the heuristics driving the search for solutions will be different from those followed in contexts of scarcity. The outcomes, too, will be different. The point is that innovations arising from contexts of scarcity have been able to deliver solutions that perform well and are considerably cheaper or better adapted than ‘mainstream’ ones.
The capacity to innovate in scarcity conditions is strong in developing countries, where it has grown from sheer necessity. But it is rather invisible: The way we usually measure innovation does not recognize it, and even the innovators themselves, comparing what they do with the more glamorous innovations coming from affluent contexts, are reluctant to recognize their results as true innovations. Tapping into this innovative strength by means of specific policies can give a boost to inclusive innovations that can help foster social equity.
Scarcity-induced innovations have the potential to create solutions well adapted to reach the poorest children and address the particular problems they face. Here are four examples of inclusive innovations arising from scarcity conditions:
- Newborn children with acute jaundice can be treated with phototherapy using blue light lamps. The cost of these devices is a function of the number of light emitting diodes (LEDs) they contain. Given the low intensity of each individual LED, many are needed. A Uruguayan physicist found that including an optical device that multiplies the light intensity of an LED array reduced the number of LEDs required by a factor of 10. This innovation provides a solution geared directly to a problem affecting poor people: Jaundice is more common among premature babies. Babies born to poor mothers, and particularly poor teenagers, are disproportionately likely to be premature. Poor mothers tend to give birth in public hospitals, and these hospitals ability to treat premature babies with severe jaundice depends on their access to blue light lamps that are cheap and perform well. Before this solution was found, the scarcity of such lamps was a real problem.
- A pasteurizer of human milk can be built using spare parts from common devices. Any pasteurizer needs to recycle water as a way of refrigerating; this is done with a washing machine pump. It also needs to shake the small bottles containing human milk at fixed intervals to avoid sedimentation; this is done with car windshield wipers. The automatic functioning of the pasteurizer is done by a blockbuster electronic device, a Programmable Logic Controller that can easily be programmed by an advanced student from a technical school. Designed to be cheap and easy to repair, the pasteurizer has been in use for more than 10 years in a public hospital in the Uruguayan countryside, with excellent results in terms of low newborn mortality. An international expert dubbed it the ‘Rolls-Royce of human milk pasteurizers’.
- Floods are a burden for poor communities living near rivers and small streams: People have to leave their houses in a hurry, often losing all their belongings. The Engineering Faculty at the University of the Republic in Uruguay developed a very cheap and easy-to-use system that broadcasts an alert 72 hours before a flood starts. This system was used during the heavy flooding that occurred in some parts of the countryside in 2013, allowing for an orderly evacuation and preventing material losses among the affected population.
- The Autonomous Water Purifier was developed in Uruguay to provide drinkable water to people in isolated places without access to piped water. It operates exactly as a conventional purifier plant, including all the features and functions of said plants – coagulation, flocculation, laminar sedimentation, rapid filtration and disinfection – only that its size is much smaller. The purification process does not include chemical contamination but makes ‘normal’ dirty water drinkable. The device is relatively cheap, and certainly cheaper than any centralized solution. It can be put on a truck to serve several small communities. The system was used by United Nations peacekeepers in the Republic of the Congo and in Haiti, and in the aftermath of Hurricane Mitch in Honduras, in 1998.
How can capacities to innovate in scarcity conditions be mobilized? How can the power of science and innovation be harnessed to enhance children’s lives and promote social equity? First suggestion: to think of innovation policies also as social policies. This means that innovation agendas, and the criteria by which innovations are evaluated, would be geared explicitly towards solving problems in the realm of social policy – particularly problems that exclude disadvantaged children from a better life.
Usually, innovation policies are related to the agendas of private businesses and are concerned with enhancing countries’ productivity and competitiveness – that is, they seek to promote economic growth. Even if growth is of paramount importance and contributes to social inclusion by creating good jobs in the formal sector, this is a rather indirect and not very efficient way of linking innovation with welfare.
If some innovation policies were used directly towards enhancing the quality of life of those left behind – for instance, by providing high-quality public goods – then it’s more likely that they would produce adequate solutions, in terms of price, infrastructure required and ability to solve local problems. ‘Innovation policies as social policies’ are those innovation policies that aim to orient the might of knowledge and problem-solving capacities precisely towards some of the burdens that affect the most vulnerable populations.
But where, in any country, are those who know best the problems those left behind face? Such knowledge usually resides in social policies. And here comes the second suggestion: to think of social policies also as innovation policies, pushing the demand for solutions to social problems towards the capacity to innovate in scarcity conditions, something every developing country has. Usually this is not the case; it is common to see social policies in developing countries (and not only there) halted by the huge amount of resources involved in implementing expensive solutions developed in wealthier contexts. This happened recently in Brazil, in the realm of health. A governmental policy seeking to massively expand access to health services in 2003 made the deficit in the health budget skyrocket to $10 billion in 2010, mainly because of imports of medical equipment and pharmaceuticals. To surmount this barrier to the expansion of the inclusive health policy, the Government launched a programme of endogenous innovation in health aiming at import substitution.
A third suggestion, linked to the first two, is to unite the separate agendas of innovation policies and social policies, taking children’s more acute problems as a starting point. This is easier said than done, but it’s possible to take steps in that direction. A first step is to include in the innovation policy agenda, explicitly, issues associated with social inclusion. Several countries in Latin America – Brazil, Colombia, Uruguay – are starting to do this, while important international organizations like the Organization for Economic Cooperation and Development (OECD) and United Nations Conference on Trade and Development (UNCTAD) are moving in the direction of innovation for inclusive growth. From there, it becomes possible to move towards a social policy agenda that can mobilize endogenous innovation. And at that point coordination and collaboration among these policy areas may become routine. Why not put everything behind such a win-win strategy?