Frugal innovation

Solutions to Pakistan’s health challenges need innovation that is both inclusive and frugal.

The writer is associate professor in the departments of Biomedical Engineering and Medicine at Boston University

New developments in biological sciences have made a profound impact on our understanding of human biology. One such technological advancement is our ability to sequence a human genome. Human genome sequencing has given us the ability to comprehensively understand human genetic information. The implications on genetics, medicine, clinical practice and public health are profound. Yet, historically, the cost of sequencing the human genome has always been a bottleneck. About a decade ago, the cost of sequencing the human genome was in tens of millions, if not hundreds of millions of dollars. About 11 years ago, the US National Human Genome Research Institute issued an open call to researchers to bring down the cost from tens of millions of dollars to a mere thousand dollars. This was considered absurd by some and material of fairy tales by others. Not anymore. This week, the premier scientific journal, Nature, reported that this nearly impossible target had been met successfully. Scientists, engineers and innovators have come up with ingenious tools and methods that now enable us to sequence the human genome for under $1,000. Such was the success that the X-prize target set for human genome sequencing was met even before the competition started, cancelling the competition. This major achievement will hopefully transform our understanding of human genetics, physiology and will have a substantial effect on improving human health, as well as in our battle with stubborn diseases.

As we process this remarkable feat in science, there are many important lessons for innovation in Pakistan and the ability to meet huge targets at an affordable cost. First and foremost, it is important to have a clear target and goal. The target in the case for human genome was a precise question, a timeline and a price target. We in Pakistan have no shortage of national priorities that require innovation and creativity. Certainly in health, there are unfortunately, more targets than we can count. But the missing ingredient here is the ability to rally the troops and the lack of leadership to set a target. This needs to go beyond the lip service we pay on health and poverty issues. This requires a clear target, with resources, energy and an unwavering commitment to back it up. Empty political rhetoric just won’t do anymore. We have made plenty of promises but have never set clear, concise goals and targets, and have certainly lacked the national will to achieve them. This is more than just the Millennium Development Goals or the so-called national five-year plans. This is about a clear target, a deadline and the will to make it happen. A clear goal can send a man to the moon even when you don’t know how to do it.

Given the long history of false promises and breathtaking incompetence that graces our governments, it is also important to start with a target that is a balance between ambition and reality. We certainly need to create national goals and targets, but we should have an extreme aversion to failure. The last thing we want is the repeat of promises on ‘end of load-shedding’.


Finally, equally important with identification of clear goals is the creation of platforms that are inclusive. Achieving great feats in science is hardly the domain of scientists alone. Engineers, doctors and even economists and policymakers from both the private and public sector have to be engaged at multiple levels. Frugal innovation in Pakistan has to rise above party, sectarian or ethnic differences, just as they have to rise above domain feudalism. Inclusive innovation would also allow everyone to feel that they have their skin in the game and that they have an important part to play.

The solutions to Pakistan’s health challenges need innovation that is both inclusive and frugal. We have no shortage of high impact problems to work on and neither do we have any lack of intellect to solve those problems, if only we can get a national will to address them.

Published in The Express Tribune, March 25th, 2014.

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