The William Davidson Institute and the Center for Global Health Equity at the University of Michigan are proud to announce the winning project of the 2024 Global Health Commercialization Pitch Competition — an innovative screening device designed to detect high-risk strains of human papillomavirus (HPV), especially tailored for use in low- and middle-income countries (LMICs) where such health resources are scarce. The winning team, led by Dhanalakshmi Thiyagarajan, MD of the U-M Department of Obstetrics and Gynecology, will receive funding and additional programmatic support over the next year to further develop the device. The team will actively engage in field feasibility studies over the coming year in partnership with Korle Bu Teaching Hospital, which not only serves as a major medical hub in Ghana but also stands as a key institution for healthcare provision and innovation across sub-Saharan Africa.
The innovative HPV screening device is the brainchild of a diverse and interdisciplinary team at the University of Michigan, comprising experts drawn from a range of fields and institutions. Collaborating with Thiyagarajan are co-investigators Julia Kramer, who brings a mechanical engineering perspective with her PhD and Master of Public Health background, and Kwaku Asah-Opoku, MD, contributing insights from his experience in obstetrics and gynecology at Ghana’s Korle Bu Teaching Hospital. Additionally, the research efforts benefit from the fresh perspective of a group of dedicated students from the Michigan Health Engineered for All Lives (M-HEAL) student organization: Suraj Menon, Ariana Layne, Natasha Mehta, and Alyssa O’Brien.
“Our team is mindful of the myriad challenges faced by women in LMICs when it comes to accessing healthcare,” shared Dr. Kwaku Asah-Opoku, a co-investigator in the project based in the department of obstetrics and gynecology at Korle Bu Teaching Hospital in Ghana. “With our device, we aim to alleviate some of those barriers, although we know there’s still a long journey ahead of us.”
In low-income settings, traditional HPV screening methods such as pap smears and self-swabbing face numerous obstacles. Pap smears can be costly and require a clinic with a trained professional to administer the test, factors that impede access in resource-limited regions. Furthermore, these procedures can be invasive, causing discomfort and dissuading women from participating in essential screening. While self-swabbing offers a less invasive option than traditional pap smears, some preliminary research suggests that women in low-and middle-income countries have reservations about their ability to self-collect samples accurately without the supervision of a healthcare provider. Additionally, these women reported difficulties in finding a private and comfortable space to perform self-swabbing.
The team’s device presents a promising solution to overcome these barriers. Unlike standard urine collections which are often too diluted for accurate HPV detection, this device specifically collects the first 20mL of urine—a concentration increasingly shown to yield HPV detection rates comparable to self-swabbing. This method is economically advantageous, with the cost approximately halved from the standard $42 to around $21, making it a more feasible option for individuals in impoverished areas.
The device’s design embraces non-invasive, patient-centered principles. Women can use it within the comfort of their usual settings, as it neatly integrates into existing toilet facilities. The simplicity of the collection process means that women can gather the sample themselves at local health posts, significantly increasing screening accessibility. It’s also a boon for women with physical disabilities, eliminating the need for a speculum examination.
“We’re under no illusion that our work is a panacea, but we do believe it represents an important advancement in making HPV screening more accessible,” said Thiyagarajan. “Our hope is that this device can be a part of a larger solution to safeguard women’s health, opening doors to preventative care for women who need it the most.”
For the second consecutive year, the William Davidson Institute and the Center for Global Health Equity collaborated to present the Global Health Commercialization Competition, a pioneering initiative that invites faculty visionaries from across the University of Michigan’s three campuses to contribute groundbreaking healthcare solutions for the global stage. This annual competition is a beacon for innovative thinking in the face of daunting health issues prevalent in under-resourced regions of the world. Embracing an interdisciplinary methodology, the competition encourages the fusion of technical expertise and market-driven strategies to create interventions that are sustainable within the communities they aim to serve.
Claire Hogikyan, Vice President of Administration at the William Davidson Institute and programming leader for the competition, emphasized, “This collaborative environment is what propels innovators to traverse the last mile in healthcare delivery, ensuring that our efforts reach, and more importantly, resonate with those in need. It is this cross-sector synergy that ignites sustainable change, and we believe it’s a cornerstone for achieving global health equity.”
About WDI
At the William Davidson Institute at the University of Michigan, unlocking the power of business to provide lasting economic and social prosperity in low- and middle-income countries (LMICs) is in our DNA. We gather the data, develop new models, test concepts and collaborate with partners to find real solutions that lead to new opportunities.
About CGHE
The University of Michigan has a long tradition of international engagement and individual global health programs that have often been centered within its numerous colleges and institutes. The Center for Global Health Equity aims to enhance the ongoing work of these existing efforts by fostering connectivity to increase cross-campus initiatives and programming. Global health leaders from across our academic units provided input to help define the Center’s thematic priorities and overall approach to impact.
WDI’s Senior Director of Healthcare Delivery, Ioan Cleaton-Jones, is an independent director on the board of Shifa International Hospitals (Shifa), which is publicly listed on the Pakistan Stock Exchange. He was nominated to the board by the International Finance Corporation, which owns 12% of Shifa. Shifa’s flagship operation is the 550-bed Shifa International Hospital, an advanced teaching hospital treating complex medical conditions, located in Islamabad. This hospital is one of only four in Pakistan that are quality accredited by Joint Commission International (JCI), the international arm of the US Joint Commission which does quality assurance in US hospitals. It also serves as the teaching hospital for the private, nonprofit Shifa Tameer-e-Millat University, which has colleges of medicine, nursing, pharmacy, dentistry, medical technology and other healthcare-related disciplines. Additionally, Shifa has a second hospital in the city of Faisalabad, with another under construction in the same city. It also has outpatient medical centers, medical labs and pharmacies.
The William Davidson Institute at the University of Michigan is excited to announce the call for applications for the 2024 Global Health Commercialization Competition. This innovative competition serves as a dynamic platform for U-M faculty visionaries based on the Ann Arbor, Flint, and Dearborn campuses, who wish to contribute their scientific and technological solutions to the most pressing global health challenges of our time.
Co-hosted by the U-M Center for Global Health Equity (CGHE) and the William Davidson Institute (WDI), the competition showcases U-M’s commitment to global health equity, with a unique market-driven approach. The competition relies on interdisciplinary collaboration to create sustainable and impactful innovations, aiming to improve healthcare in low- and middle-income countries around the world.
Competition participants will present their business case within a 15-minute timeframe to a panel of industry experts, followed by an informative 10-minute Q&A session. The winning team will be awarded substantial funding of $30,000, provided jointly by the CGHE and the WDI. Additionally, the winning team will be eligible for further consultative services provided by MBA students from our Ross School of Business, as a part of the Multidisciplinary Action Projects (MAP) Program.
The competition also provides extensive proposal review, guidance, and mentorship to all its participants, increasing their likelihood of success. Each shortlisted team is also entitled to a one-on-one consultation session with a member of the Fast Forward Medical Innovation (FFMI) team, who will review the project and provide constructive recommendations to enhance its prospects.
Proposals are due by April 5, 2024, providing an opportunity for team participants to fine-tune their pitches and maximize their chances of success. Application forms, template presentations, and more information about the event is available on our website.
Read more about last year’s competition
The Global Fund works closely with countries to help them achieve long-term sustainability of health programs so they can maintain progress and continue to expand services after Global Fund support ends. WDI provided ad hoc support to Global Fund teams working with countries. Examples of this support include estimating the costs of providing specific types of services and developing frameworks that countries can use as they prepare to transition away from donor support.
ICL has been operating a successful lab in Ethiopia since 2004. In partnership with Cerba Lancet Africa and ICL, this project evaluated the feasibility of setting up a manufacturing hub and supply hub in Addis Ababa Ethiopia for diagnostics laboratories located throughout the continent.
Just over the border with Yuma, Arizona is the town of San Luis Río Colorado in Sonora, Mexico. Like many border communities, agricultural jobs dominate the local economy. In this community of around 200,000, Grupo OSME is a privately run medical clinic business, founded by Dr. Raúl Payán, focused on serving the health needs of agricultural workers and their families. Despite the success of the business, Payán explains that securing the necessary financing to expand OSME into a hospital has been a major challenge. But in early 2023, the North American Development Bank (NADB) and Grupo OSME signed a US$14.2 million loan agreement to finance construction of the medical complex. The deal was completed after WDI conducted due diligence on OSME’s expansion and business plans, which gave NADB the expert advice it needed to proceed with financing. The project includes the design, construction and operation of a private hospital with space for 67 beds, an emergency room, operating rooms, intensive care unit, medical imaging and laboratory, along with a medical specialties center. As the following video feature explains, at the time of this project, WDI was also developing a Healthcare Delivery Management Training program, following a request from the World Bank Group’s International Finance Corporation. Following a positive experience of the due diligence process, OSME requested training for its management team from WDI. As a result, OSME and a Ghanaian hospital were the first two businesses to participate in the course.
Pressing global health concerns, from undetected cancer to untreated psoriasis, require innovation to find powerful, lasting solutions. Often, that kind of innovation comes from small teams, start-up companies, and underfunded research groups — but, for these teams to be successful, they need support.
The William Davidson Institute (WDI) and the Center for Global Health Equity (CGHE) at the University of Michigan (U-M) came together recently to assist with filling in that piece of the equation.
“There is a lot of research happening at the University of Michigan that could lead to impactful products or services in low- and middle-income countries,” said Paul Clyde, President of WDI and professor at the Ross School of Business. “Assisting and accelerating that work, through both funding and technical assistance, is very much in line with our mission.”
To support that growth, Fast Forward Medical Innovation, a department at the U-M Medical School, offered a professional development course with a focus on key business commercialization principles, which began in January 2023. For the first time this year, WDI and CGHE followed this course with the Global Health Commercialization Competition. The competition invited faculty innovators to share their work on technical solutions to healthcare problems in emerging markets. Responses to the request for proposals were due on April 1, 2023. Four finalists were selected from the group, and each one presented their pitches to judges on May 22.
Ultimately, one team took home a $30,000 prize and a chance to work with MBA students at the Ross School of Business to refine their plans.
Each proposal was centered on a clearly defined, unmet need in low- and middle-income countries (LMICs) and an innovative solution to enhance the lives of people in these regions. These solutions had to be commercially viable, and teams were required to outline market timelines.
In line with similar pitch competitions, presenters had the chance to highlight the significance of their work — and their own enthusiasm for the solutions. “These pitch competitions give the proposers the opportunity to sell their idea. Sometimes, when we’re reading proposals, we’re missing some of the passion. We’re missing the background about what makes these approaches exciting and relevant,” said Dr. Joseph C. Kolars, founding director of the Center for Global Health Equity and Senior Associate Dean and Professor at the University of Michigan Medical School.
“It’s an easier way for us to understand the ‘why’,” he explained.
The first of the four teams to present at the competition, Saratani, is working to improve outcomes for cancer patients in Africa and taking aim at the lack of effective diagnostics. “One of the most important tools in ensuring better cancer outcomes is ensuring early cancer detection,” said Geoffrey Siwo, Research Assistant Professor of Internal Medicine at the U-M. His team also included Robert Karanja, Co-Founder and Chief Innovation Officer at Villgro Africa, and Deogratias Mzurikwao, AI Lead at Villgro Africa.
Saratani, named after the Swahili word for cancer, aims to diversify the biological data used to create the reference genome for molecular diagnostics, which is currently designed on Caucasian genetic data. This leaves massive gaps in the data, making it ripe for problematic diagnoses in Africa. Biobanks in Africa hold the information to fill this gap, but the bridge between them and pharmaceutical companies is missing. That’s where Saratani plans to step in. It would function as a marketplace, avoiding the overhead of running a biobank and capitalizing on the potential widespread deals that could be built between small biobanks and large pharmaceutical organizations.
While Siwo acknowledged that these biomarkers are not yet widely used for detection in Africa, he encouraged support for their preemptive and proactive work. “If we wait until these biomarkers are widely used, it will be very difficult to change, and we know they are inaccurate,” he explained.
Penicillin allergies riddle medical records across the U.S., but it could be that up to 90% of people with this notation have been mistakenly diagnosed. This particular allergy marker keeps patients from treatments that protect against site infections during surgeries and superbug infections during hospital stays. In LMICs, false penicillin allergies could make certain treatments totally inaccessible.
EpiSLS aims to make allergy testing simpler, from correcting those false positives to providing clear answers about food allergies. Parker Martin, an MD and MBA student at the U-M, and Cory Cooney, a 2023 U-M MBA graduate, created a novel optical sensing technology that is compact, portable, and safe for any patient who might get an in-office allergy test. For clinics in emerging markets, the tool — which is currently patent pending — could mean bringing sustainable allergy testing to regions where there has not ever been an allergy specialist.
Through their easy-to-administer and even-easier-to-read technology, the team is set on “bringing allergy testing into the 21st century across the world.”
Psoriasis is a chronic disease that causes psychological and physical suffering when left untreated — and, in LMICs, this is often the case. While medications can treat many symptoms of the condition, they aren’t available in emerging economies. The costs are prohibitive, the production is not available, and the administration is a challenge. The Psoriasis RX team, led by Tom Kerppola, Professor of Biological Chemistry and Biophysics at the U-M, has set its sights on changing that dynamic.
“The problem is enormous,” Kerppola explained. There are about 100 million people suffering from psoriasis at the moment, and a substantial number are not finding any relief. “Regrettably, the only drugs used in low-income countries have very low efficacy, barely better than placebos,” he said, explaining that that’s not the case in high-income countries. “It’s clear we can do better.”
His research is centered on the Keap 1 protein, which could suppress inflammatory responses in skin fibroblasts without the risks of systemic infection that often come with immunosuppressant drugs. “This is not an untreatable condition,” Kerppola said, and he’s on his way to finding a treatment that works for patients regardless of geography.
Over 70% of women around the world have not been screened for cervical cancer, and part of the reason is access to and comfort with the current medical tools required for these screenings. At the moment, the exam for cervical cancer screening requires a vaginal speculum, an exam table with stirrups, and a person who is physically and emotionally able to handle the exam. For many around the globe, those requirements just cannot be met.
In search of a way to reach these women, Marilyn Filter, a Certified Nurse Midwife and Associate Professor at the University of Michigan – Flint, and Lyn Behnke, Board Certified Family Nurse Practitioner, Psychiatric Nurse Practitioner, and associate professor at the U-M – Flint, built a new tool. The Femscope Calm Collect system is a slim cell-collection device with a scope that would replace the speculum and swab typically used. Providers can learn to use it in under an hour, it connects to a smartphone or computer, and patients can receive the exam without an exam table.
“We have made it our mission in life to improve patient outcomes,” explained Filter. Their accessible tool is less expensive, easier to use, and more comfortable for many patients — all traits prioritized to improve screening rates for people around the globe.
The team is on its way to completing its pilot study to ensure biopsy results are of the same caliber as a traditional exam, then the product will move to a full clinical trial and eventually head to market around the globe, Filter said.
Judges Ioan Cleaton-Jones, Senior Director of Healthcare Delivery at WDI, Pascale Leroueil, VP of Healthcare at WDI, Amy Conger, Managing Director for the Center for Global Health Equity, Kolars, Brad Martin, Managing Director of Fast Forward Medical Information, and Dr. Lee Schroeder, Associate Professor of Chemical Pathology at the University of Michigan, faced the difficult task of choosing a winner. They considered the presentations, asked questions of the teams, and came to a decision: The Femscope team took home the prize.
Filter and Behnke plan to use the funds to purchase a 3D printer and fund its pilot test — the first essential steps to get the life-changing product into the market. Once there, “it will certainly save lives,” said Filter.
Medicines for Malaria Venture (MMV) is a nonprofit organization that works with partners to discover, develop and deliver new, effective, and affordable antimalarial drugs. One of MMV’s current projects is to develop a long-acting injectable product to protect children at risk of malaria. To ensure the product would achieve its goals, MMV needed clear guidance on what was most important to clinicians treating pediatric patients in malaria endemic countries. Getting there required understanding the business and real-world clinical side of taking a health product to market. This is familiar territory for WDI’s Healthcare team.
To find the best path forward for its injectable, MMV sought answers from the drug’s final users. As it updated the injectable’s Target Product Profile (TPP)[CA1] , which is a compilation of the desired characteristics that will make up a product or device, MMV wanted to know what aspects of the new product would create the most value for clinicians administering it to children.
“When you develop a product, there are a number of elements that you can act on, and we wanted to know, from the local stakeholders, that is the people in the field, the decision-makers in the countries, what matters to them,” said Céline Audibert, Director of Market Research, Access & Product Management at MMV.
Audibert enlisted WDI’s help to better understand those elements. WDI’s Healthcare group wrote and carried out a survey in six African countries — some of the places that would benefit most from such a product. It was sent to healthcare professionals and public health officials, including those in charge of maintaining nationwide malaria-related efforts, in Cameroon, the Democratic Republic of Congo, Senegal, Ghana, Mali, and Nigeria. The survey covered a series of characteristics in an injectable product, including duration of protection, efficacy, number of injections, volume per injection, needle size, and tolerability. It laid out various options with different levels of each characteristic and asked participants which ones they would choose.
This method of choosing various combinations of parameters, rather than simply asking for a ranking, was intentional. It forced a choice, thereby providing a deeper understanding of the importance of various elements. When a large enough group of participants are pushed to make trade-offs, researchers can uncover what truly matters to the population.
Uncovering preferences for the product characteristics was the objective of the study — and key to developing an injectable that would be both adopted and effective. “In the past, there wasn’t a focus on the needs of a particular group of people, at the country or regional level,” said Pascale Leroueil, Vice President of Healthcare, who led the research. “The more we build Target Product Profiles specific to the countries where we’re introducing new products, the better.”
WDI didn’t need to reinvent the wheel to develop its survey and methodology. The Institute has been gathering and analyzing data for decades to support business-centered solutions that drive economic growth and social freedom in low- and middle-income countries. In this case, it applied a well-tested system in a space where it had been rarely used.
“There are tried-and-true methods that are utilized in the private sector that we can apply to this area, and WDI does that better than most,” said Leroueil.
Leroueil and Ben Davis, WDI Senior Research Fellow, proposed the methodology to Audibert, who was familiar with it from her previous private-sector work. They both understood the core purpose behind the answers they sought. “There are reasons people want something,” explained Leroueil. Supply issues, cultural preferences, and geographic needs can drive the acceptance or denial of treatment — and no amount of after-the-fact adjustments will bring the same benefits as early-stage consideration.
The results were promising. “This research has confirmed some of the things we believe. There were characteristics where we had a lack of understanding internally and needed information from the field, so we had very clear answers on what matters and what doesn’t,” Audibert said.
The value of getting these answers at the start of the development process is broad and inclusive. Investors and donors can be sure their money is being put to effective use, drug development teams can focus their energy on the aspects of a product that matter most, and patients can get the drugs that serve them best.
Efficiencies in development matter to nonprofits like MMV. “When you have a restricted amount of money to invest, you need to know where you’re going to put that money,” said Audibert. MMV is currently working on funding for the continuation of the project, so this information will be used, in part, to demonstrate how the injectable can better meet the needs of the populations they plan to serve.
The research also makes a major difference for scientists, developers, and those in the business of drug delivery. Audibert expects that having these answers will help optimize the time and investment spent on drug development and support better-informed decisions. With a focus on what counts, researchers can create the best possible product for the population.
Finally, patients are more likely to accept treatments that fit their needs, and that acceptance can support healthier families, communities, and countries.
“Businesses that know how their customers will use their products usually have the edge over those that wait for feedback after a product is launched,” Leroueil said. “It’s exciting to see organizations like MMV take this approach.”
WDI’s Healthcare Delivery sector is offering an online pilot program to equip management executives of private hospitals, clinics, and healthcare delivery enterprises in low- and middle-income countries with the skills to improve efficiency through better processes, and to allocate costs more accurately for better strategic and pricing decisions. The program includes modules on Process Analysis and Optimization and Time-Driven Activity-Based Costing. The program consists of online, asynchronous training for each of the two modules; synchronous remote class sessions via Zoom; and a team-based action learning project based on a real business challenge at the participating institutions. Participating hospitals to date include Nyaho Medical Center in Ghana and the OSME Hospital in Mexico.
WDI’s Healthcare Delivery sector is offering an online program to equip management executives of private hospitals, clinics, and healthcare delivery enterprises in low- and middle-income countries with the skills to improve efficiency through better processes, and to allocate costs more accurately for better strategic and pricing decisions. The program includes modules on Process Analysis and Optimization, Time-Driven Activity-Based Costing, and Healthcare Supply Chain. Modules on Cost Management and Control, and Due Diligence are in development. The program consists of online, asynchronous training for each of the two modules; synchronous remote class sessions via Zoom; and a team-based action learning project based on a real business challenge at the participating institutions. To date, six hospitals from Mexico, Ghana, Nigeria, Kenya, and Pakistan have participated in the courses. They are: Nyaho Medical Center, Ghana; Grupo OSME, Mexico; Evercare Hospital Lekki, Nigeria; AfyA Care, Nigeria; Avenue Healthcare, Kenya; and Evercare Hospital Lahore, Pakistan.