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Reducing the Nation’s Waste Line

A "super flour" product displayed on a table.

According to the EPA, organic waste is the largest component of landfills. Researchers are working with businesses to develop innovative ways to reduce this problem.

By Charles Ward

Bertha Jimenez wasn’t a beer drinker when she came across spent grain for the first time.

A mechanical engineer by training and now the CEO of Rise Products, Jimenez recounted her tour of Brooklyn Brewery, a craft beer brewery located in the Williamsburg section of Brooklyn, N.Y.

“I’m interested in how waste from one industrial activity is usable in another,” she said. “So as we walked around the plant, I wanted to know what happened to the source grains after the beer was made.”

Within a year, Jimenez founded Rise, a start-up that converts spent grain into specialty flours sold directly to bakeries. Rise developed a proprietary conversion process, slogged through prototypes and proof-of-concepts, and learned about food safety standards. She built a regional B2B customer base, secured grants, raised private capital, and signed a Service Provider Agreement with Anheuser-Busch.

“People like to feel like they’re doing something sustainable, something good,” she said. “But at the end of the day we don’t eat ideology, you know?”

Jimenez is just one example of the way the scientific community has deeply engaged with the challenge of food waste: as entrepreneurs, researchers, academics, regulatory policy specialists, or NGO advisors.

The U.S. Department of Agriculture (USDA) estimates 31 percent of food produced in the U.S. is loss, with an annual economic value of $161.6 billion. Globally, the U.N. Food and Agricultural Organization (FAO) estimates 1.3 billion tons of food are lost every year in agricultural production, post-harvest storage, processing and distribution, and consumption.

New policy priorities reflect an emerging consensus among food production experts that these are unacceptable numbers for a global food system already stressed by a growing population and climate change. Goal number 12 of the U.N.’s Sustainable Development Agenda is to “ensure sustainable food consumption and production patterns.” Targets include cutting per-capita global food waste in half at the retail and consumer level by 2030, and reducing food loss from production and supply chains. The U.S. Environmental Protection Agency (EPA) and USDA share a similar goal, to cut food loss and waste in half, also by 2030.

Multiple Missions

Upcycling spent grain from breweries.
Photo credit: Rise Products, Inc

For Elise Golan, Ph.D., Director of Sustainable Development for the USDA, food waste is a resource efficiency challenge. She works closely with colleagues at the EPA, and references the EPA’s well-known “Food Recovery Hierarchy” inverted pyramid, which visually represents the flow of food from “upstream” agriculture source to “downstream” table, and the parallel opportunities to conserve resources at every stage of the chain.

“We look at reasons for waste, and ask if there are cost-effective ways to reduce it,” she explained. “If we’re producing food that is wasted, [by reducing it] we can conserve the land, water, chemical- and non-chemical inputs that go into that food.”

The USDA’s more active food recovery interventions, Golan notes, are prompted by opportunities to create efficiency all along the value chain. As one relatively upstream example, she points to a pilot collaboration between the USDA’s Agricultural Research Service and The Wonderful Company, a California-based producer of pistachios. The project has the potential to turn mountains of discarded pistachio shells into “carbon black” for use in plastics as an alternative to petroleum-based compounds.

“They’ve done it in a very cost-effective, energy saving way,” said Golan. “It is really is a big win for the environment.”

Food Waste as an Economic Catalyst

If the USDA is working on food waste from the top down, Juan Guzman, Ph.D., is working from the bottom up. Guzman is the head of Capro X, a Cornell University spin-off that uses bioconversion technology to turn the acid whey left over from Greek yogurt production into specialty chemicals. In commercial terms, Capro X is what is classically called a “category creator.”

Guzman thinks of himself first as an entrepreneur, and speaks in terms of business cases: return-on-investments, stakeholder buy-in, and use of science-based innovation to create entirely new markets. When he started Capro X, the commercial imperatives were self-evident: New York yogurt manufacturers needed cheaper ways to get rid of large quantities of acid whey, which they had to truck long-distance for waste-water treatment.

At the same time, dairy farmers, generally, were under pressure to develop new products as milk consumption declined. And global agribusiness giants, like Nestlé, Archer Daniels Midland and Cargill, are always seeking alternative sourcing for industrial products, like commercially farmed palm oil, which Capro X intends to produce.

“I just see so much opportunity in using biology to extract value out of things that people are willing to pay to get rid of,” said Guzman, pointing to the historic precedent of ethanol, which made the planting of corn on previously surplus or marginal farm acreage a hugely viable commercial proposition. “For yogurt manufacturers, we’re talking about waste streams measured in the millions of pounds, with one facility alone generating a quarter of a million pounds a day of pure lactose sugar for conversion,” Guzman continued. “And there are hundreds of plants in the U.S.“.

For the market to scale, investor interests will have to see the opportunity, and put in capital. In the meantime, Guzman is building his new market one customer at a time. Capro X’s value proposition includes installing the acid whey treatment equipment at dairy farms. He keeps the specialty products, and farmers are spared the expense of trucking away waste. Guzman said he has learned that farmers like the idea of sustainable waste practices, but they are not necessarily willing to pay a price premium for them.

Identify, Measure, Attempt to Solve

Mary Muth, Ph.D., is an agricultural economist who serves as the Director of Food, Nutrition, and Obesity Policy Research at RTI, a not-for-profit organization dedicated to using science for good. Muth has conducted food waste research from every angle: malnutrition, resource efficiency, economic impact, and ethical imperative. She believes that scientific interest in the problem of food-waste is still cresting.

She also points out that that commercial application of food-waste research is still largely voluntary. Some companies see it as a reputation management opportunity, a way to promote corporate social responsibility. A few others have developed niche products. Seismic economic incentives for waste-aware practice don’t yet exist.

“It will probably take some significant disruption in the food supply to bring around big scale change,” Muth said.

Christine Beling, a project engineer and New England regional director of Brownfields and Sustainable Materials Management at the EPA, is as good a witness as any to what seems to be an incremental and steady advance towards reduced food waste. The EPA prefers composting as an alternative to landfills for food waste, and Beling says that a sign of progress is landfill bans of organic waste by four of the six New England states in her region. She notes that in 2015, the EPA calculated that just 5.3 percent of 39 million tons of food waste was diverted for composting; two years later, the figure was 6.3 percent.

“That’s a relatively big jump,” she observed. “If you go back to the late ’90s or early 2000s, it was one percent. I think you can see the trend.”

Beling points to a variety of legislative, academic, and NGO attention on food waste and recovery. In 1996, President Bill Clinton signed the Bill Emerson Good Samaritan Food Donation Act, which provides liability protections to nonprofit organizations when they donate food. In 2019, Harvard University launched its Food Law & Policy Clinic, which trains students in the use of legal and policy tools to address food system issues.

Beling also calls attention to the birth of new NGOs like ReFed, founded in 2015, to bring data- and economics-driven tools to help solve food waste problems. And in 2016, the Ad Council and the Natural Resources Defense Council co-sponsored the “Save the Food” national public service campaign.

“The emphasis may be different depending on what part of the world you’re in, but overall there’s a whole shift,” said Beling. “Ten years ago, people didn’t want to deal with food waste. Now, everybody’s dealing with it because it’s in the mainstream conversation.”

Read more:

The Cutting Edge: There’s An App For That

A graphic illustration of a smart watch and its various medical/health applications.

Researchers are making greater use of the increasing computational power found in smartphones — meaning apps may soon be able to help improve human health outcomes.

The Apple Watch Series 4 helps users stay connected, be more active and manage their health in powerful new ways.
Photo credit: Apple Inc.

By Charles Cooper, Academy Contributor

Apple CEO Tim Cook has major ambitions to “democratize” the health sector. In a recent interview with CNBC, Cook said that “health will be the company’s greatest contribution to mankind.” He’s also enlisted an important ally to help Apple make that happen.

Atrial fibrillation, which affects 33 million people worldwide, can lead to blood clots, stroke and heart failure. But later this year, Johnson & Johnson (J&J), which developed a heart health application, will carry out a study of volunteer patients 65 and older wearing an Apple Watch to understand whether smartphone technology can help enhance the accuracy and speed of clinicians’ efforts for earlier detection, diagnoses and treatment of the malady.

“Five years from now — and certainly within a decade — wearable devices will be an integral part of healthcare diagnosis and delivery,” said Paul Burton, MD, PhD, FACC, Vice President, Medical Affairs, Janssen Scientific Affairs, LLC, noting that the app will work in conjunction with the Apple Watch Series 4’s irregular rhythm notifications and ECG feature.

The diodes on the back of an Apple Watch Series 4 essentially look for a pulse to check blood flow and applies an algorithm to determine whether the pattern pulses are irregular. It has the capability to take a high-fidelity ECG reading which is then sent to a physician. That kind of real-time data is crucial when you consider that around 20 percent of individuals who experience a stroke are not aware of their underlying AFib condition.

The widening availability of digital tools, paired with advances in technologies like artificial intelligence and machine learning, is raising hopes that history will repeat itself. In the last decade, business applications helped organizations become more efficient and to better engage with their customers. Now researchers are making greater use of the increasing computational power found in smartphones and it’s no longer a stretch to imagine a future in which there’s an app for nearly every step in the research process.

Burton expressed excitement at the potential of apps to make changes in behavior and improve health outcomes in ways that were unimaginable less than a decade ago. “I think this is an amazingly exciting point bound only by our imagination. I think the possibilities are endless,” Burton said. “AFib is treatable but you need definitive, compelling data to really make a difference in healthcare.” At the same time, Burton cautions that “apps don’t work if people download them but can’t be bothered to use them.” The point being that all the technology in the world won’t help, if the people who need it most don’t incorporate the tools into their lifestyles.

Promises and Reality Checks

That challenge was faced head-on by University of Southern California research scientists Susan Evans and Peter Clarke, as they tested out a mobile app they developed to help low-income people who use food pantries to obtain fresh vegetables, which, while often plentiful in supply, may be limited in variety.

Though the use of health-related mobile apps are now common, the promise and the performance often don’t match up. Clarke noted that fewer than one percent of the estimated 330,000 apps available on the Apple and Android download stores have been subjected to rigorous testing for effectiveness.

“Getting people to incorporate devices and apps into their lives is a whole separate science,” he said.

In developing their app, Evans and Clarke made sure the design incorporated user input early in the process, just as if they were creating a consumer app. For example, even though food banks collect fresh food and vegetables, many low income people aren’t incorporating those offerings into their diet because they may not know how to cook and/or preserve the food that’s available.

Evans and Clarke, who started the project with certain assumptions about what was needed, were forced to refine their ideas about how to change dietary habits and that came only after extensive field research and speaking with the people they hoped would ultimately use the app.

“We had to customize the app in order to meet clients’ needs and not impose this on them from the top,” said Evans. “It took years of tinkering. In terms of functionality and navigation, we designed it over and over again to try and get it right.”

Technology Is Only as Good as the User

An app recipe for broccoli burritos. This user wanted Latino-flavored and kid-friendly recipes.

As scientists and researchers struggle with the alchemy of user engagement, they have the advantage of being able to lean on the experience of software developers working in the consumer and business markets. Unfortunately, there’s no one size-fits-all answer explaining how to get a target audience not just to download the applications, but to also use them consistently.

University of Michigan computer scientist Kentaro Toyama struggled to understand the nuances surrounding successful user engagement when he worked as assistant managing director of Microsoft Research in India. Toyama’s team built several different digital apps in areas like healthcare and social services that performed well in the labs. But few survived the test of time after they were released to the public.

“When we did these research projects in relatively constrained contexts, we could show how technology has a positive impact,” he said. “However, when we scaled those projects, we found that it did not have the same impact. Technology can be extremely good at delivering what people want,” he said. “It’s not so good when it comes to encouraging [people] to become better versions of themselves.”

Marissa Burgermaster would probably agree. As an elementary and middle school teacher she became interested in how food and nutrition influenced the lives of the students she taught. Ultimately she decided to pursue a doctorate in behavioral nutrition.

During the course of her research, she also discovered a seeming contradiction: As a whole, nutrition education interventions didn’t produce tremendous results, but anecdotally they did appear to work for at least some students.

“What kept coming across from the data was … that different groups of kids … responded quite differently to the intervention,” she said. “That explained why an average intervention didn’t get great results — even though for some kids, it was exactly what they needed.”

Burgermaster said it underscored the importance of accumulating as much data as possible before the fact. She went on to do her post-doctoral research in biomedical informatics and nowadays teaches in the Department of Nutritional Sciences at the University of Texas, Austin. Burgermaster kept the lesson in mind when she set out to develop an app that provides nutrition information to underserved communities.

“The reason why I was drawn to intervening via technology was not just to use data, but also it’s about meeting people where they are and get them to where they need to be. And let’s be honest: people are stuck in their phones,” she said.

The app, which is rolling out this spring in Austin, offers users personalized recommendations with tailored nutritional recommendations and interventions to help them reach their goals. Like J&J’s test project with Apple, it’s another indication of the potential for health practitioners to use smartphone and wearable technology to generate data about their patients to help with diagnoses.

A Mobile Lab in Every Home

Mobile Instruments — Ozcan Lab

When Aydogan Ozcan talks about the potential of smartphone apps to effect transformative changes, don’t expect to hear him riff about cool new ways to arrange virtual candies on a screen or share adorable cat videos. He has a far bigger goal in mind.

Over the years, Ozcan’s lab has focused on developing field-portable medical diagnostics and sensors for resource-poor areas, coming up with relatively inexpensive ways to equip smartphones with advanced imaging and sensory capabilities that once were only found in expensive high-end medical instruments.

In the last decade, he has come up with ways to exploit the functionality available in contemporary smartphone hardware and software to further bio- and nano-photonics research. For example, one technique allowed a smartphone to produce images of thousands of cells in samples that were barely eight micrometers wide — and at the cost of less than $50 in off-the-shelf parts.

More recently, Ozcan demonstrated how the application of deep learning techniques can generate smartphone images that approach the resolution and color details found in laboratory-grade microscopes using 3-D printed attachments that cost less than $100 apiece.

“Instrumentation is very expensive. The cost of advanced microscopes, for example, can run to hundreds of thousands of dollars,” said Ozcan, a professor of electrical and computer engineering and bioengineering at the UCLA Samueli School of Engineering, and a three-time Blavatnik National Awards for Young Scientists finalist.

Smartphones are relatively inexpensive with more than 3 billion people using them around the world, encouraging Ozcan to envision a future where resource-poor nations will have expanded access to advanced measurement tools, that provide data for local residents to better treat medical conditions. Think of the average smartphone one day functioning as a mobile medical lab.

Ozcan also believes that people in their homes will soon be using a growing assortment of advanced mobile technologies and apps for preventive care, particularly when it comes to monitoring an aging patient or someone with a chronic condition.

“In the U.S., five percent of patients cause 50 percent of health expenditures per year. We can reduce that cost with better preventive care but for that, the home needs better technology. We should be able to provide that with mobile cost-effective systems so you can do some of the measurements that would normally require sending people to the hospital to take a sample, wait for the results and then go to the pharmacy with a prescription.”

We may not be there yet, but the world is fast approaching that tipping point where mobile apps lead to a veritable explosion of powerful, cost-effective alternatives to some of the most advanced biomedical imaging and measurement tools now in the market.

An Illustrated History of Science Denial

A political cartoon from the 1918 flu pandemic.

Published June 06, 2018

In an age where instant communication can immediately spread misinformation, the consequences of scientific denialism are more serious than ever.

Still, it’s important to maintain perspective and remember that scientific denialism is not a new phenomenon. For as long as scientists have challenged our understanding of the world, there have been science denialists who oppose new consensus. Below is a brief illustrated history of some of the most notable instances of science denial.

Cultivating Better Health with Science

Researchers across the globe are doing their part to both fuel and sustain a healthy planet.

By Hallie Kapner

Patrick Schnable

To the untrained eye, the black dots speckling the corn leaves in the greenhouses at Iowa State University’s Plant Sciences Institute could be anything — blight, mold, rot. But to Patrick Schnable, the Institute’s director and the C.F. Curtiss Distinguished Professor and Iowa Corn Endowed Chair in Genetics at ISU, the dots are the future of precision irrigation — a simple and inexpensive window into how plants use a precious global resource: water.

Dubbed the “plant tattoo,” the dots are bits of graphene oxide deposited on a gas-permeable tape to form an easily applied sensor that precisely measures transpiration — water loss — on an individual-leaf basis. As leaves lose water, the moisture changes graphene’s electrical conductivity. By measuring those changes, Schnable and his collaborators can observe transpiration in real time.

“If you have a plant under drought stress and you water it or it rains, you can track water moving up through the plant,” Schnable said. “For the first time ever, we can observe plants reacting to an irrigation event as it happens.”

The plant tattoo is one of countless research initiatives underway worldwide that aim to conserve and maximize natural resources, improve access to nutrition, prevent and treat disease, and boost the health and well-being of the planet’s people and wildlife.

Schnable and his collaborator, Liang Dong, associate professor of electrical and computer engineering at ISU, envision a day when farmers can use plant sensors to guide irrigation decisions and breeders can use them to create drought-resistant varietals. The researchers are already adapting the technology for use beyond the Iowa cornfields. While the current version requires connection to a control box to provide both voltage and transpiration rate analysis, plant tattoo 2.0 will be wireless and smartphone-compatible. Such refinements will drop the cost of the system even further, making the sensors accessible for areas of the developing world where every drop of water counts.

Cultivating “Black Rice”

Ujjawal Kr. S. Kushwaha

Maximizing efficiencies in breeding and irrigation of agricultural crops is one key part of meeting the global goals related to hunger, nutrition and stewardship of the land. Equally critical are efforts to identify and promote staple crops that pack maximum nutrition, explained Ujjawal Kr. S. Kushwaha, PhD Scholar in Genetics and Plant Breeding at G.B. Pant University of Agriculture and Technology in Pantnagar, India.

More than half of the world’s population relies on rice for at least 20 percent of their daily calories. If Kushwaha had his way, the typical white rice of subsistence would be replaced by black rice, an heirloom variety sometimes called “forbidden” rice, and one of nature’s nutritional powerhouses.

“No other rice has higher nutritional content,” Kushwaha said. “It’s high in fiber, anthocyanins and other antioxidants, vitamins B and E, iron, thiamine, magnesium, niacin and phosphorous. Consumed at scale, it could have a significant impact on malnutrition.”

Decades of effort to boost the nutritional content of rice have yielded biofortified varietals rich in iron, zinc and provitamin A. While addressing these highly prevalent micronutrient deficiencies is critical, Kushwaha contends that black rice could address both a broad spectrum of nutritional deficiencies as well as provide anti-inflammatory and anti-atherogenic benefits.

However, black rice is not widely cultivated outside of China, and most varietals are relatively low-yield, which drives the crop’s high cost. Kushwaha is working to shift that equation, spreading the black rice gospel with the hope of boosting demand and incentives for farmers to develop higher-yield varietals, which could make a crop once reserved for royalty as affordable as white rice.

Anticipating the potential hurdles of acceptance — factors such as taste and color often determine whether new varietals are adopted or rejected — Kushwaha and others cultivating nutrient-rich rices have determined that black rice could be bred to minimize color while preserving much of its nutritional value. “Some of the qualities could be reduced, but it’s still far better than white rice,” he noted.

Plant Power

Plants already do far more than just feed the world — we derive fuel, fabrics, medicinal compounds and much more from them. Yet over the past two decades, a new role for plants has emerged — one that may revolutionize one of the most important pipelines for global health: vaccine production.

Conventional vaccine manufacturing relies on primary cells — like chicken eggs — mammalian cell lines, yeast cells or bacteria. These approaches have well-known limitations, such as long production times, variable yields and risk of contamination by other human pathogens. As Kathleen Hefferon, a virologist and Fulbright Canada Research Chair of Global Food Security at the University of Guelph explained, plants are not merely viable alternative bioreactors for many types of vaccines — they are production superstars.

First-generation plant-made biopharmaceuticals were derived from transgenic crops, but public concerns about GMOs, as well as variability in the amount of vaccine protein produced per plant, drove the development of a second — and now dominant — production method. Plant virus expression vectors are used to deliver genes for producing vaccine proteins into the leaves of plants such as tobacco and potato, turning common crops into factories capable of churning out huge quantities of vaccine protein faster and more cheaply than any other method.

Plant-made vaccine proteins carry no risk of contamination with mammalian pathogens, and better still, plants can produce similar post-translational modifications to human cells, which increases biocompatibility. Hefferon believes plant-made biopharmaceuticals will grow exponentially over the next five years, due in part to increased interest in stockpiling vaccines against pandemic flu and other diseases.

“It’s hard to stockpile vaccines produced in mammalian systems, and it’s very hard to produce enough vaccine in time to be helpful in an outbreak,” she said. “Plants offer a clear advantage here.”

Several pharmaceutical companies have plant-made vaccines and therapeutics in clinical trials, but the public is already familiar with one experimental drug that made headlines in 2015 — ZMapp, which was used to treat several Ebola-infected healthcare workers in West Africa. Hefferon is also quick to emphasize that the lower-cost profile of plant-made vaccines has special relevance for cancer prevention in the developing world, where rates of cancers linked to vaccine-preventable viruses, including HPV, are skyrocketing.

“We’re already in the running to advance the science toward pharmaceutical production in plants,” she said. “The current systems have so many limitations and plants are an incredible alternative.”

On Land and Sea

Just as human health is inextricably tied to the health of the air, soil, water and environment, so too is the health of the animals we rely on for work and food. In the tropical regions of Mexico, scientists including veterinarians Felipe Torres-Acosta and Carlos Sandoval-Castro, and organic chemist Gabriela Mancilla, of Universidad Autonoma de Yucatan (UADY), are studying how sheep and goats regulate their own health through diet.

The team at UADY has been devising strategies to improve the health of ruminants in tropical environments for 30 years. One of their standout findings is that malnourished animals are less resilient to native parasites, and while farmers can boost resilience with supplemental food, access to native flora is critical for keeping the host-parasite relationship in balance.

The UADY team showed that sheep and goats left to forage on their own in the Mexican jungle feast on an astonishing 60 different plant species per day, adjusting their food choices based on seasonal availability. Diving deeper into the connection between diet and immune resistance, Torres-Acosta’s team collected samples of ruminants’ preferred foods, analyzing them for nutritional content and the presence of anthelmintic activity.

Stephen Frattinii
Photo: Hudson Rivers Fisheries Unit Staff

Analysis reveals that most local flora do contain anti-parasitic compounds, and Mancilla is working to discover the mechanisms by which they act to control parasite load. The team is investigating whether animals intentionally seek a diet rich in plants that naturally limit parasite infection. This work, as well as similar research in sheep and goats around the world, is already impacting how some small farmers treat infections.

“If animals have access to their native foods, they can keep parasites in check, which reduces the need for medication and allows farmers to treat only the sickest animals,” Torres-Acosta said. “The most interesting things we’re learning come directly from observing the animals — given the choice, animals know what they need to eat to stay healthy, and we can learn so much from their innate wisdom.”

Off the shores of Long Island, New York, Stephen Frattini, founder of the Center for Aquatic Animal Research and Management (CFAARM), is trying to bring a similar sensibility to the seafood industry, which supplies three billion people worldwide with their primary source of protein. Frattini, a veterinarian, focuses not just on how fisheries and aquaculture operations could improve fish welfare, though his passion for that subject runs deep.

His goals are bigger, and include uniting experts in animal welfare, engineering, health management, feed development and consumer psychology to transform the seafood industry from a profoundly siloed one, rife with inefficiencies and transparency issues, to an integrated one that places the health of the environment, people and fish front and center. Frattini believes that a more integrated seafood industry could revitalize coastal communities both in the United States and developing countries, as well as advance production strategies already known to improve fish health, such as emphasizing diversity over monoculture.

“We still need a much better understanding of fish behavior in captivity and what we can do to create happier, healthier animals, but I’m convinced we can increase efficiencies while increasing fish contentment, which is a win for animals, the environment and the industry,” he said.

A Matter of Will

William Haseltine

Decades of fast-paced discovery in medical research, coupled with high-tech advances in equipment, procedures and information technologies have yielded many of the solutions necessary to provide high-quality healthcare to all. No cohort in history has been better equipped than ours to identify problems, connect patients with preventative and acute care and measure and understand the outcomes. Yet nations around the globe, from the most developed to the least, struggle to manage the cost, logistics and delivery of basic human health services.

A desire to identify best practices and help spread their adoption drove William Haseltine, a biologist and former professor at Harvard Medical School, known for his pioneering research on HIV/AIDS and the human genome, to found the nonprofit ACCESS Health International 10 years ago.

ACCESS Health has since partnered with nations in every region of the world to better understand the systems that improve primary care, lower maternal and child mortality, and meet the needs of an aging population while maintaining affordability. From a revolutionary emergency-response system in India that serves 700 million people each year with greater efficiency and lower cost than any system in the West, to hospitals using information technology to implement radical transparency and accountability systems that are improving patient safety, Haseltine and the ACCESS Health team have found no shortage of strategies that save and improve lives within budget. Bringing them to bear on the global problem of healthcare access is mainly a matter of will.

“We have a lot of knowledge that can be deployed broadly across the globe, but there has to be a desire and incentive to change,” Haseltine said.

The 17 SDGs can be viewed as a tally of ways people and planet can suffer and struggle. But they can also be viewed as vision of hope, a commitment by 193 nations to alleviate pain and work toward a healthier, more equal future.

“We have come to the point where we have the ability to dramatically improve health outcomes, whether it’s in environmental health, or improving maternal and infant mortality,” said Haseltine. “It all comes down to the question: do we have the will to do it? When the answer is yes, it’s transformative.“

Drone Delivery Takes Off In Rwanda

Delivering goods via drones is not a new idea, but it’s providing an important sustainable lifeline to rural communities in Rwanda that are benefiting from the technology.

California-based automated logistics company, Zipline and the Government of Rwanda have collaborated on the world’s first national drone delivery service for on-demand emergency blood deliveries to transfusion clinics across the country. Since its launch in October, 2016, Zipline has flown more than 7,500 flights covering 300,000 km, and delivered 7,000 units of blood to physicians and medical workers in Rwandan villagers nationwide.

Zipline’s technology was developed for longer-haul flights than typical drones and have a round trip range of 160 kilometers. The drones can carry 1.5 kilos of cargo and cruise at 110 kilometers an hour.

More importantly the craft are built to handle the challenges of Rwanda’s mountainous terrain and extreme weather conditions. They look more like fixed wing airplanes than the typical quadcopter image, but it is one of the reasons why they are capable of flying faster and farther than standard craft; imperative for speeding-up the delivery of life-saving medical supplies to remote communities.

The airplanes are powered by lithium-ion battery packs. Two twin electric motors provide reliability at a low operating cost. Redundant motors, batteries, GPS and other electronics provide the safety features, in addition to a parachute-enabled landing system. The planes fly on predetermined routes and are monitored by a Zipline operator.

Also see: Innovation Challenge in Rwanda on “Green Schools, Green Homes, Green Communities”

Alternative Therapies and Clinical Trials

A healthcare works comforts an elderly patient.

Two publications from the New York Academy of Sciences examine pre-approval access to investigational drugs from a range of stakeholders and perspectives.

The Food and Drug Administration (FDA) has granted the use of investigational drugs outside of clinical trials for decades, but in the past several years this practice has attracted significant attention in the news and on social media.

Under expanded access (also called compassionate use), patients who suffer from serious or immediately life-threatening diseases for whom no comparable or satisfactory alternative therapy is available can access drugs and medical devices that are not approved by the FDA and are currently being tested in clinical trials. A total of 29 states have also passed “right-to-try” laws allowing terminally ill patients to access experimental therapies, but there are many questions about the safety and efficacy of such treatments that are not FDA-approved.

Recently the FDA announced significant changes to shorten and simplify the application process used by physicians to request expanded access to investigational drugs for individual patients. Some are predicting that the FDA may not approve a drug to treat Duchenne muscular dystrophy that is currently under review, but will allow compassionate use while additional studies are conducted.

Regardless of the FDA decision, the debate over compassionate use will continue and evolve as additional treatments are brought to the forefront of experimental medicine and research.


Bioethics Meets R&D: The Ethics of Pre-approval Access

June 2, 2016
Patients with life-threatening illnesses face challenges in accessing potential therapies at the cutting-edge of R&D which have not yet been proven in a clinical trial. This podcast will explore the provocative and emotional stories of patients, family members, advocates, researchers, physicians, and the regulators charged with keeping medicines in the marketplace safe and effective.