4. Transformative Technologies & Institutions

Thematic Area Research & Innovation Goals:

Discovering, developing and delivering transformative technologies, including design of innovative platforms, financing mechanisms, and reengineering the healthcare value chain (design, market, produce, deliver and support healthcare services and products, emphasizing quality of care and incorporating efficient use of resources). Apply community-user perspectives and systems thinking to improve processes, infrastructure and institutions that enable successful introduction of new technologies focused on reducing health inequities

Image credit: Henk Badenhorst/Getty Images


Concept Summary

Rationale for Prioritizing Transformative Technologies & Institutions

Technologies and institutions have the potential to transform the health of populations and to narrow the disparities between those who have and those who do not have access to such health care. By transformative, we refer to changes in one or more dimensions of health equity--measured in milestones of lives saved, disability averted or improved quality of life. In some cases, the transformation is in how we detect or even prevent disease, and in other cases, in how we treat or cure the disease. The work of TTI bridges to each of the other thematic areas. A female condom can give women greater control over their reproductive decisions—an issue of gender equity. Ready-to-use therapeutic foods not only can effectively treat severely malnourished children, but also shifted such care from hospital to community-based settings, thereby enabling many more children to be treated as outpatients. Better designed cookstoves can not only reduce indoor air pollution, but also save households on energy costs. In each case, whether technology succeeds or fails depends on the institutional context.


In moving from bench to bedside, for example, technologies face barriers to therapeutic, financial or structural access. Therapeutic access focuses on whether research institutions and industry undertake or prioritize the research and development (R&D) to address public health challenges. Do research priorities align with public health priorities, or not? Their misalignment results in neglected diseases. Financial access relates to the affordability of the product by those in need when it enters the marketplace. This can be influenced by how knowledge is owned and shared as well as how public sector funding requires fair returns. And structural access considers how the delivery system brings a technology to those whom it may benefit--last-mile challenges. Availability of the products might be limited by stockouts; access, by limits to local infrastructure from the lack of laboratory facilities to shortages of human resources; and quality, by substandard or counterfeit drugs or thermal instability of the product. These three hurdles roughly correspond to different parts of the value chain, and institutions can help lower or raise the height of these hurdles. For the benefits of a technology to be realized, all three hurdles need to be surmounted.

African children using a laptop inside classroom in very remote school. There is no light and electricity inside the classroom. School is located in very remote area in southern Kenya. Image credit: Bartosz Hadyniak/Getty Images

African children using a laptop inside classroom in very remote school. There is no light and electricity inside the classroom. School is located in very remote area in southern Kenya. Image credit: Bartosz Hadyniak/Getty Images

Biochemist decants fluid in flask. Image credit: Jaco Wolmarans/Getty Images

Biochemist decants fluid in flask. Image credit: Jaco Wolmarans/Getty Images

Institutions can shape access to technologies that advance health equity. But technologies can also shape institutions that do the same. New diagnostic tools – simple enough to be placed into the hands of ordinary citizens – could give us a readout on whether the run-off from a factory farm carries drug-resistant pathogens or whether the grocery shelves have retail meat contaminated by these bacteria. Collecting the results from such diagnostic technologies can empower consumers with tools to monitor and hold accountable those in the food supply chain for safety of their products. We see significant potential in such citizen science efforts.

Giving shape to such strategic interventions, the AHW will enhance the impact and reach of University-based research, policy work and education. By focusing on opportunities where there is transformative potential, the AHW can help identify priorities for research, position existing research for more rapid translation, or show how solutions might cross-apply from one context to another. By serving as a convener, the AHW could recruit multi-disciplinary talents to a research project, set the stage for meaningful dialogue among stakeholders that is critical to overcoming an access barrier, or incubate new partnerships or business models. By training the next generation of researchers and policymakers, the AHW can share a vision of systems thinking across disciplines, inspire social entrepreneurs and researchers alike to tackle big societal problems, and create platforms for engaging larger communities of practice in this work.

Johns Hopkins University has consistently led all other academic institutions in the country in total research dollars, and with that public funding comes also significant responsibility to provide returns to benefit humanity and to ensure health equity. TTI provides a framework by which the University can harness the fruits of such research to benefit the most disadvantaged.

Proposed Research Priorities

areas needing further focus

  • Establishing target product profiles for technologies that benefit the poor

  • Creating innovation platforms that favor technologies that benefit LMICs and poor populations

  • Designing innovative financing mechanisms to better address public health needs

  • Reengineering the value chain to address neglected conditions affecting the poor

  • Developing citizen science projects and accountability technologies

Anthony So

Anthony So

Theme Lead

Anthony So is the AHW Theme Leader for Transformative Technologies & Institutions, Director of IDEA Initiative, and Professor of Practice in the Department of International Health in the Bloomberg School of Public Health

Further updates & resources about this AHW thematic Priority

Articles & Media Coverage