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
Q&A
with Pascale Leroueil, WDI Vice President for Healthcare
As the pandemic has revealed, vaccine coverage in low- and middle-income countries is well below that of higher-income countries. And while global attention tends to focus on a vaccine’s efficacy through R&D and clinical trials, there is less understanding about what factors lead to people ultimately receiving a vaccination. This knowledge discrepancy led WDI Healthcare Vice President Pascale Leroueil and fellow researchers to hone in on the role a particular technology may have in the overall success of a vaccine in terms of population coverage. This can include factors such as how vaccines are administered (needles versus orally administered vaccines, for example), and cold-storage supply chains. In a recent study, Leroueil and co-authors present a method for estimating the impact of vaccine technologies on vaccination coverage rates. They designed the method to help decision makers better assess the most value for their money, with the goal of improving vaccine coverage for vulnerable communities.
We wanted to help donors think about the potential impact of their research, manufacturing and deployment decisions related to vaccines. The wonderful thing about research and product development is that the options of where to invest are nearly endless. But money and time aren’t endless, even for donors. We had been asked by a global donor to help them think about the relationship between a given vaccine technology and its associated vaccination coverage rate. For example, if countries had access to a microarray, patch-based vaccine delivery system that could replace the standard syringe and needle delivery system, what might that do to vaccination coverage rates across the world? As a first approximation you might answer, “not much.” However, if you start to think about the operational implications of what it means to move from something that requires a mid-level skilled healthcare worker such as a nurse to a less skilled healthcare worker such as a community health worker, then you can start to see how changing the delivery system could lead to higher vaccination coverage rates. We thought an approach that could quantify the potential vaccination coverage rates that could be achieved with different vaccine presentations would be useful to many types of stakeholders, including donors, manufacturers and country-level decision makers.
We started with the assumption that vaccination coverage rates are a function of two things: (a) the barriers to vaccination in a given environment and (b) the characteristics of the vaccine presentation. As I alluded to earlier, some vaccine technologies could mitigate or remove some barriers in some contexts. For example, one barrier in a given context might be lack of refrigeration. Therefore, a vaccine that doesn’t require refrigeration would remove this barrier to vaccination for the people in this context. We ended up defining six barriers to vaccination that we felt could be overcome by changing the vaccine presentation, or how it’s administered to a patient. From there, we had to think about how we would turn our relatively simple assumption into numbers that would allow us to say something to the effect of, “If Country X had access to Vaccine Presentation Y, they could achieve a vaccination coverage of Z%.” We turned to something called, “probability theory,” which is something you likely learned in middle school. Basically, it says if the probability of A happening is a, and the probability of B happening is b, the probability of both A and B happening is a x b. The math we used is slightly more complicated, but the general idea is the same. Namely, the probability of a person in Country X with access to Vaccine Presentation getting vaccinated is the product of the probabilities of a person overcoming each of the six barriers we defined.
One of the neat things about our approach is that it can be used at any point along the vaccine development pathway. From someone thinking about research & development to someone considering vaccines, this approach allows them to estimate the maximum demand for a particular vaccine presentation.
The quick answer is that it could help vaccine manufacturers forecast potential demand for a particular vaccine presentation. Vaccine manufacturing is a complex and expensive business that relies heavily on scale to make it work. Realistically, a manufacturer needs to have a pretty good understanding of how many vaccines they will be able to sell and at what price before they decide to start manufacturing. This approach allows them to understand the former, while another approach we are developing allows them to understand the latter.
Donor organizations in the vaccine-related space would use this approach to guide their investments, whether that’s at the research and development stage, or manufacturing stage. For example, say a donor has five vaccine presentations in the pipeline, all against the same disease. Now say they want to move only two of those vaccine presentations forward. How do they make the decision about which vaccine presentations to move forward? While there are probably a few parameters that go into that decision making process, one of them is most certainly the potential vaccination coverage that each of the vaccine presentations could yield. In many ways, the Ministries of Health are making similar decisions—for a given disease, which vaccine presentation should the country purchase? Again, there are likely a few parameters that go into that decision making process but one of them is most certainly the potential vaccination coverage.
Absolutely. The approach we outlined in the paper can be used as-is for any vaccine-related technology. In principle, one could extend this approach to almost any product or service, whether it is health-related or not. What would need to change is the ‘barriers.’ For example, if we’re talking about an ultrasound, access to refrigeration is probably not a barrier to treatment but access to power probably is a barrier to treatment. Although vaccines are near and dear to our heart, we intentionally developed an approach that could be adapted to other products or services.
The importance of considering the contexts in which a vaccine presentation will be deployed. I want to be clear and say what was done in terms of vaccine development, manufacturing and deployment was nothing short of a miracle. Having said that, the pandemic shined a huge spotlight on the barriers to vaccination that exist for many people across the world. The refrigeration requirements for some of the presentations were a significant barrier in many countries, as was the need for multiple doses and access to skilled health workers. The result? Staggering levels of Covid-19 vaccine inequity. That vaccine inequity would exist at all is terrible, but that it still exists is unforgivable. Those with resources in the vaccine space should be actively developing more platforms that help reduce the barriers to vaccination for those with the fewest resources. Although our approach could help decision makers estimate the potential impact of doing this, I can only hope it’s now self-evident that identifying ways to address these barriers before the next pandemic is critical to our survival.
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. This is what we mean by Solving for Business — our calling since the Institute was first founded as an independent nonprofit educational organization in 1992. We believe societies that empower individuals with the tools and skills to excel in business, in turn generate both economic growth and social freedom — or the agency necessary for people to thrive.
WDI’s Education team works with world-class instructors from leading universities — including our home at the University of Michigan — to develop and deliver programs. Through our rich faculty network, cultivated over the past 25+ years, we deploy experts with both deep subject matter expertise and relevant regional experience.
Medical Access Uganda Limited (MAUL) is a premier healthcare supply chain management organization in Africa whose mission is to enhance human health by providing efficient and sustainable healthcare supply chain management solutions. WDI completed a benefit-cost study to understand the impact of a procurement investment MAUL recently made.
WDI collaborated with Aceso Global on a project for the Global Fund to Fight AIDS, Tuberculosis and Malaria to examine how the organization might engage more with the for-profit private health sector in multiple low- and middle-income countries (LMICs) to help achieve its objective of eradicating the three diseases and inform the development of its next five-year strategy.
WDI and Aceso Global conceptualized and carried out a landscaping study of multiple aspects of the for-profit private health sector in LMICs, including health service delivery, supply chain, how care is paid for, and digital health. The team analyzed challenges and barriers to engage with the for-profit private health sector. Recommendations based on the research were presented in a final report on how to expand the Global Fund’s engagement with the for-profit private health sector. Additionally, six case studies were developed to give the Global Fund deeper insights in selected countries, of which WDI developed case studies on South Africa and Kenya.
With a grant from the Bill & Melinda Gates Foundation, the WDI Healthcare team explored the feasibility and potential structure of an affordable insurance product that protects against loss of Gavi- and Global Fund-supported health commodities and contributes directly to broader supply chain risk management and incentive alignment. WDI conducted desk research, interviews, and an online survey to complete this analysis and proposed a number of potential solutions.
An effective and efficient supply chain is critical to building a strong health system, however, identifying and implementing high-performing supply chain designs can be a challenge for many healthcare leaders. Data on supply chain costs and performance are often lacking, as are benchmarks for understanding how much a supply chain should cost. Analyzing potential future design improvements is difficult without expensive, specialized modeling software.
WDI’s Healthcare Team, in collaboration with VillageReach, is addressing this gap by developing and disseminating an Excel-based rapid supply chain modeling tool. The goal of this tool is to simplify the process of creating, testing and analyzing different supply chain design scenarios within a given country context. Through this simplified approach, WDI’s tool can help health program leaders more quickly and easily identify ways of improving the efficiency of their supply chain.
The global reproductive health community is increasingly seeking to engage the private sector in meeting the needs for reproductive health in low-resource regions of the world. Countries such as Malawi in Eastern Africa have a high level of donor dependence and market conditions which inhibit commercial sector development, particularly for serving the more rural and remote areas.
In this project, WDI’s Healthcare team conducted a contraceptives distributor landscape analysis and delivered actionable and stakeholder receptivity-tested concepts for stimulating the private sector provision of family planning products and services in rural, remote and other underserved populations. The landscaping assessment involved field research and in-country discussions with market actors, but also utilized a stakeholder-centric methodology to generate ideas for market building. The results and recommendations are being shared with Malawi country stakeholders, as well as with funders and implementers for potential market building efforts, in Malawi and similar countries.
Vaccines play a critical role in improving global health. While the return on investment of vaccines is on average higher than any other health intervention, there is a still a critical need to evaluate the expected return of each individual vaccine presentation. The key driver of the expected return on investment of a vaccine is the price of the vaccine relative to the value that it is expected to generate through increases in coverage/equity. While simple on its face, estimating price and value is often complex since both are multifactorial.
The objective of this work was to provide the Bill & Melinda Gates Foundation (Gates Foundation) and partners (buyers) with a structured way of evaluating and negotiating potential investments related to the manufacturing of specific vaccine presentations. WDI team members hypothesized they could facilitate negotiations between buyers and manufacturers of vaccines by developing a flexible tool that incorporates their respective investment decision drivers and key levers related to price and value. To accomplish the objective, WDI had three aims (1) Understand the investment decision drivers for the Gates Foundation & partners, and potential manufacturers; (2) Identify the key levers that would form the basis of a contract that the Gates Foundation and partners could use in negotiations with potential manufacturers; and (3) Build a tool that the Gates Foundation and partners can use to evaluate scenarios with potential manufacturers. The output of this work is currently being applied to Gates Foundation-related investment questions.
An effective and efficient supply chain is critical to building a strong health system, however, identifying and implementing high-performing supply chain designs can be a challenge for many healthcare leaders. Data on supply chain costs and performance are often lacking as are benchmarks for understanding how much a supply chain should cost. Analyzing potential future design improvements is difficult without expensive, specialized modeling software.
WDI’s Healthcare Team, in collaboration with VillageReach, is addressing this gap by developing and disseminating an Excel-based rapid supply chain modeling tool. Funded by the Reproductive Health Supplies Coalition (RHSC), the goal of this tool is to simplify the process of creating, testing and analyzing different supply chain design scenarios within a given country context. Through this simplified approach, WDI’s tool can help health program leaders more quickly and easily identify ways of improving the efficiency of their supply chain.
Populations in low-and-middle-income countries face a variety of barriers to receiving vaccinations, such as vaccine stockouts, cold chain breakdowns, difficulty traveling to a clinic or a lack of sufficiently trained clinic staff. New vaccine technologies have the potential to reduce or eliminate many of these barriers, but the impact of such reductions on actual immunization rates is not clear.
To address this gap, WDI’s Healthcare Team is developing a model to estimate the change in immunization coverage rates associated with a new vaccine introduction. The model includes six main barriers that can be addressed by new technologies. It first considers the prevalence of these barriers in the target population and then considers how effectively a new technology can address those same barriers. Those two factors are combined to estimate the change in population experiencing a barrier, which in turn influences overall immunization coverage levels. This model will help inform donor investment strategy by identifying high-priority new vaccine attributes and pairing them with high-impact target populations.