Low-cost treatments are being developed for poor countries
Written by Rebecca Richards-Kortum and Lauren Vestewig Gray
Last May, for the first time ever, a team of 45 public health experts from 11 countries compiled national estimates of preterm birth. The results are contianed in a report entitled Born Too Soon, and the findings are sobering. Each year, 15 million babies are born prematurely, and 60 percent of these births are in the developing world. More than one million premature babies will die from complications within a month of birth, and babies in poor regions are much more likely to die. Ninety percent of babies born at less than 28 weeks of gestation in low-income countries die within days of birth. By contrast, in high-income countries, few than 10 percent of these babies die.
The tools that have revolutionized infant care in wealthy countries have failed to turn the tide on infant mortality in the developing world, where many hospitals lack infrastructure, medical and maintenance personnel, consumables and often the basic necessities of reliable power and water. However, many premature babies could be saved without sophisticated, high-tech nurseries. Simple low-cost solutions can make a significant difference. Kangaroo Mother Care, for example, in which a mother keeps the baby warm through continuous skin-to-skin contact, could save 450,000 babies per year.
Today, engineers and clinicians around the world are developing a new generation of robust and inexpensive technologies to improve infant care in in poor countries. Columbia University, for example, is developing a low-cost test for HIV and syphilis in Rwanda that links information to a central database of health records, and promotes early detection and treatment. The device holds promise to prevent stillbirth and other ill health effects for mothers and babies. D-Rev has developed a device that treats jaundice in low-resource settings with phototherapy using LED bulbs. The bulbs do not require extensive power and last three to five years. The group estimates that its phototherapy device would sell for less than $150; conventional phototherapy lights can cost up to $3,000. Rice University is working with the University of Malawi, Baylor College of Medecine and Texas Children’s Hospital to develop a Nursery of the Future for hospitals in the developing world. The nursery is an integrated set of technologies designed to combat the most common causes of newborn death. The goal is to create a nursery that a hospital serving 250,000 people would implement for $5,000.
Engineering new technologies for newborn care in resource-poor environments is an important step toward addressing the global health crisis of premature birth. But innovating new technologies is not enough. Creating a framework and mechanisms for the sustainable delivery of these technologies is also critical. Public-private partnerships are esential. A successful model can be found in the partnership that is implementing Helping Babies Breathe, a package for neonatal resuscitation. The partnership brings together the United States Agency for International Development (USAID), the National Institute of Child Health and Human Development, Saving Newborn Lives/Save the Children, Laerdal Medical, the American Academy of Pediatrics and USAID implementing partners. It integrates expertise in training, technology development, advocacy and scale up. Helping Babies Breathe has been introduced in 34 countries, 10 of which adopted national roll-out plans. Saving Lives at Birth, funded by USAID, the government of Norway, the Gates Foundation, Grand Challenges Canada and the UK’s Department for International Development, has also changed the landscape of technical innovation for neonatal care by supporting private, academic and nonprofit partnerships that developing novel newborn health interventions for low-resource settings.
Today, Nov. 17, the world will observe World Prematurity Day. This observance is especially poignant for families who have experienced a preterm birth. For all of us, it is an opportunity to reflect on the contributions we can make to preventing preterm birth and saving the lives of premature newborns.
This commentary was first published in the Houston Chronicle.
Richards-Kortum is the department chair and Stanley C. Moore Professor of Bioengineering at Rice University, and Gray is executive director of Rice 360°: Institute for Global Health Technologies at Rice.
This blog is part of a series on HNN marking World Prematurity Day, November 17, that discusses preterm birth and highlights the actions needed to prevent and reduce preterm birth, the leading cause of newborn deaths. Join us as we discover that everyone has a role to play. To get involved and learn more, please visit www.facebook.com/WorldPrematurityDay.