Vulnerable populations

This added capacity would allow us to improve and scale up our existing service. DIG would eventually like to see every primary school in Kenya have an early childhood feeding program and a school sustainable agriculture program. We do not currently have the capacity to work on a national level but DIG is now working with the MOA and MOE to develop pilot projects on the district level then hopefully with added support we can pilot it regionally and nationally in the future.

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We address 3 current problems that are contributing to the perpetual rising costs of health care:

1) Finding out pricing information prior to treatment is insanely difficult.
2) Uninsured patients pay the most for medical care.
3) Medical prices within the same geographic area have a tremendously wide variability.

Oftentimes more affordable health providers are nearby, but patient/consumers have no way to know their options. We see this an information problem. Consumer's would make different choices if they had actionable information. OkCopay is tearing down this information barrier that prevents people from accessing the care they need. By providing choice and clear actionable info, OkCopay allows people to avoid getting hit with surprising and often life-changing medical bills.

OkCopay is the first open service that allows people to find and compare routine medical care on the basis of price, convenience, and doctor credentials. At OkCopay.com users can search for providers based off the procedure they need and their location. We display all of the practitioners in their area and reveal actual provider prices (or details on the appropriate health clinic). We do for patients what kayak.com does for travelers. We also recognize that for some procedures you shouldn't choose a doctor solely on price. So you can filter your results based off of a doctors credentials (board certifications, years of experience, etc), proximity, and even office hours. We currently cover 72 routine procedures, as well as offering searchable data on free and sliding-scale health clinics.

OkCopay generates revenues by connecting highly cash-paying patients with health care providers seeking to grow their businesses. Immediate revenue streams include Promotional Advertising and transaction fees. The OkCopay Deal Board is a designated area where providers can list promotions or specials for a fixed fee. A provider's basic listing is free and our native search results reveal prices regardless of whether they are paying us or not. This promotes trust for our users. The promotions are clearly marked and strictly reserved for our "Deal Board" section of the website. These deals reinforce our mission. OkCopay’s unique position as a pricing platform makes it well suited to eventually facilitate transactions on our site and to receive both transaction fees and referral income.

While there are many sites that offer doctor listings, ratings, and reviews none provide comprehensive pricing data. Visitors to the site come to OkCopay because we are the only ones collecting, verifying, and providing this data free to the public. Even Google or other search engines can't help you find provider prices.

For providers, OkCopay uniquely offers the unique ability to reliably reach targeted higher-margin consumers in the final stage of their purchasing process.

Its important to point out that even with the Affordable Care Act, there are expected to be over 20 million uninsured Americans in 2017. Furthermore, gaps is coverage will remain. For example Vision & Dental will remain outside of mandated coverage. Additionally, elective care will continue not to be covered.

OkCopay is for people with gaps in insurance coverage who are paying out-of-pocket for health care. The website covers routine non-urgent medical procedures. OkCopay is focused on 3 distinct segments of self-pay patients:
1. Of the 49 million uninsured Americans, we estimate 50% have the ability to search online and pay for routine health services. Most are working as hourly employees, part-time, freelancers, artists, or in other jobs that don’t offer health coverage.
2. People with gaps in their insurance coverage. For eg, there are over 130 million Americans without either vision or dental insurance.
3. Patients seeking elective care such as LASIK eye surgery or cosmetic procedures. Elective care is not covered by insurance. Over 9.5 million cosmetic procedures performed in 2012.

OkCopay reaches our target market in a number of ways. We have already developed promotional relationships with local government agencies, non-profits, and professional employer organizations. This is to reach people without care.

We have also partnered with benefits brokers in one market to reach those people who are employed, have health care, but lack vision or dental coverage. We have built and deployed an "embeddable widget" on their pages to allow their users to conduct searches of our database directly from their website. This helps us gain tremendous traffic while adding a unique feature to our distribution partners.

We are also very strong on Search Engine Optimization and generate about 40% of our traffic via this medium.

OkCopay’s search platform empowers people to “shop” for health care based on price, convenience, and doctor qualifications. OkCopay’s database includes over 70 common medical and dental procedures.

We have a created a unique data collection process. We gather data from a number of different sources. Then we verify and validate all of the information ourselves.

Our database platform was created to help people quickly find the information they are looking for. The filtering system is similar to other highly popular comparison shopping services in other industries.

Defined broadly, our competitors are any resource that people use to help them find doctors. Online that has tended to be search engines, directory sites, and increasingly ratings and review sites. Our challenge is to acquire significant "Share of Voice" to compete with them. Most poeple do not know they can shop on doctor prices. All of the above could be potential partners.

Internal-
- Building a high-quality team on a limited budget
I am focusing on hiring based off of attitude and passion. Many people have contacted me with a strong interest to work with OkCopay, so starting in March, I will dedicate a few hours a week to recruiting.
- Finding like-minded investors
- Raising awareness is a major obstacle
In every other industry, people shop around before they make a purchase, whether it’s buying groceries, a car or an airline ticket. This is expected behavior. But this is a new concept for many in the US health system.
Shopping for medical providers is a revolutionary concept in the US health system. The hurdle of changing norms and behaviors will be challenge for us to overcome. Forunately, aligned monetary incentives will promote change.

-Form Distribution Partnerships with state and local gov't agencies, private employers, and local non-profits. Continue innovating on product development, including mobile apps, telephone call center, and other resources to make it easy for people to find the care they need.
-City by city rollout

OkCopay has already developed promotional relationships with local government agencies, non-profits, and professional employer organizations. We have over 75,000 prices in our database across 8 US cities. OkCopay is well-positioned to become a central platform that supports the consumer-directed health movement.

Reach more people via geographic expansion. Cover additional medical procedures and ancillary services where it makes sense.

15 cities by end of 2013.
35 cities by 2014.
Add technical and sales staff
Execution on Advertising/Marketing/User Acquisition Strategy
Ongoing product development

We are trying to solve the issue of over-medicalization of the elderly with chronic conditions, which tends to lead to worse quality of life and not always translate into longer lifespan.

We aim to provide care through the whole healthcare continuum for those patients, minding their real needs and mantaining their quality of life. However, we understand that health care resources (financial or other) ar finite and that it is important to identify the real needs of each patient according to their wishes and realistic health care condition.

We are able to provide all instances of care.
Such patients are referred based on their diagnosis of chronic or life-threatening conditions such as diabetes, cardiac failure, cancer, dementias, neurological sequelae and so on.
Upon referral, patients are evaluated by a nurse and a physician, usually at home or at an acute care hospital. This evaluation begins to determine which members of the full multiprofessional team might be needed.
Patients are then closely followed by phone monitoring and recurrent visits by the assigned members of the multiprofessional team,
Whenever a problem occurs, the patient can be promptly seen by our team and referred for our hospital admission or even our hospice/LTAC admission.
As mentioned before, open education activities happen continuously.

Our vision is to be the most reliable expert service catering for the elderly population in Brazil in the next 3 years.

Our overall objective is to provide care through the disease continuum for elderly patients with chronic conditions.

We believe that providing elderly patients individually-tailored care is the only pathway for quality of life maintenance. We firmly base our care decisions on evidence-based medicine and open communication between the team and patients/family members. The type of care we provide is always guided by the Palliative Care WHO definition (care that improves the quality of life of patients and families who face life-threatening illness, by providing pain and symptom relief, spiritual and psychosocial support to from diagnosis to the end of life and bereavement.) and by very strong ethical principles.

Our customers are the health care insurance companies at this moment.
Public-private partnerships are being negotiated and if prosperous, this will broaden our customer base to include public health providers.

Direct marketing focusing health care insurance companies.
Participation in health care fairs and symposia.
Advertisement focused on geriatricians and gerontologists.

Care delivery:
- Ambulatory setting
- Home care setting
- Phone monitoring
- Inpatient hospital admissions for short-term treatments (ie. symptom control or IV antibiotic treatment)
- Inpatient hospice treatment
- Long term care admissions for select patients

Patient population analysis for integration of care

As mentioned, in the very specific niche of holistic care for elderly patients with chronic conditions, our peers/competitors are not exactly in the same business as we. They are very specific health insurance companies which focuses in the same population. Even though they are not exactly competitors, they have an unfair advantage since they are providers and payers at the same time, being able to exert expense control very effectively (and sometimes not very ethically...) - We believe that even though posing a dangerous conflict of interest, it anyway can be an obstacle for our success, Especially if patients migrate from other health care insurance company for which we provide service for those specialized companies.

Availability of adequately trained personnel for the multiprofessional health care team: physicians, occupational therapists, physiotherapists, nutritionists, psychologists, speech therapists. We must have professionals trained in geriatrics AND palliative care, and those are scarce in Brazil.

We aim to reach around 500 patients from a variety of insurance companies in the near future. We have been intensifying our efforts to obtain patients from other insurance companies, and we plan to obsessively intensify even more such efforts in the coming months.

Our company is built to be scalable, so technology-wise we are ready for growth whenever it comes. Our leadership comes from the home care industry, where we ran one of the biggest home care patient bases in the country some years ago - more than 600 patients at a time, country-wide. This puts us in an advantage position to be able to function with a larger patient base.

Reach a patient base of at least 500 patients.

We plan to reach 500 patients in a 2 year timeframe. The key activities for reaching this number are:
1. Increase marketing and networking efforts
2. Intensify our educational actions so that we can obtain prepared personnel.
3. Reach out for the health care professionals community with great salary+benefits packages so that we can recruit and retain great professionals.

While we have received many requests for training and setting up of new units, there are some (mainly NGOs) that lack funds for training and/ or infrastructure. In order to provide EI to all children across the country and elsewhere it is important that we set up units that are self sufficient with adequate trained manpower.To facilitate this process we need a permanent building with adequate facilities to cover the wide range of activities. In addition, we would like to build a committed group of researchers who with mentoring from senior researchers in grant writing and fund raising, will eventually develop more large scale projects and sustain themselves in future by raising independent funds.

Provision of accessible, affordable, high quality, intensive early intervention with a clear target of maximizing chances for every child of inclusion and retention in mainstream schools; spreading the reach of the program by increasing awareness for identification and early intervention, scaling up the model across the country and providing training at different levels for different stake holders both face to face and through the distant mode and eventually enabling easy and affordable access to clinical services and guidance through the internet.To build a data base in hitherto understudied populations with ASD in order to address their issues more specifically.

The vision is to develop Communication DEALL program as a viable model, that with training can be replicated as and where needed, to make it available on a larger scale without our continuous involvement, in order to serve the requirements of an ever- increasing number of children with developmental language disorders including those with the Autism Spectrum Disorders, within their community. We have moved beyond providing purely clinical service to becoming a resource for others in terms of materials and training.We have produced a host of low cost indigenous material for use by trainers and families.Our goal now is to set up as many Com DEALL units as possible with as far a geographical reach as possible and address the needs of children beyond the EI program into school years.

Our USP is the opportunity we provide to every child in the program to join the mainstream.76.5% of our children who were followed up in a ten year retrospective study were continuing in mainstream schools (2-7) years post intervention with us. Mainstreaming the child reduces the demand for sustained care which is critical in resource strapped emerging markets.The multidisciplinary nature of inputs ensures that all the child's needs are met under a single roof.A major strength is the self sustaining nature of the model. Establishing more Com DEALL units and exploring alternate models of service delivery will ensure that families can avail services within their own communities . Continuous evaluation ensures that the requirements of evidence based practice are met.

Families of children with ASD, Government agencies ,NGOs,Clinics,Hospitals,Professionals and schools that cater to children with developmental disabilties are our customers.We are looking to reach out to people interested in setting up Com DEALL units. Our training programs are geared towards parents, graduate students and professionals in the field. The material department caters to the needs of our clinical population and the training program.Ultimately it is the children with communication disorders such as Autism Spectrum,Disorder,Specific Language Impairment and Developmental Verbal Dyspraxias .

i) Our website which is updated regularly,( ii)workshops and conferences, (iii)publication and distribution of public education posters and research publications (E.g. Karanth, Shaista and Srikanth.2010 Efficacy of Communication DEALL — An Indigenous Early Intervention Program for Children with Autism Spectrum Disorders Indian Journal of Pediatrics, Karanth,P and Archana S,2013 exploring Pre requisite learning skills in young children and their implications for understanding Autistic behavior.in Kar,,B,R(Ed),Cognition and Brain Development, APA, NY.) (iv)Outreach to other organizations. ( v) Families of children who have received intervention with us are by far our best advocates.

Clinical-providing intensive early, multidisciplinary intervention to children with developmental disorders through our existing model.
Designing new clinical programs to address additional needs.
Care giver support-counselling and training .
Awareness-on early identification and early intervention through workshops and production and distribution of public education material
Inclusive Education -through workshops and building of school networks which support inclusion
Training-at the PG diploma level and short term courses for professionals,school teachers and care givers
Preparation of low cost,culturally sensitive assessment and intervention material
Scaling up , providing training and assistance in setting up Com DEALL units at different geographical locations

Government organizations,NGOs, and other practitioners who provide early intervention within other models emerging largely from the west are our peers. The theoretical framework for our intervention program has been developed indigenously and lacks the face value of better established programs from elsewhere. Our peers and competitors could question the scientific validity of the program. We are trying to address this by conducting and encouraging others to conduct scientific studies of our model.

The program was started as a response to the urgent need for services expressed by a group of parents .Over the last decade, it has grown extensively in diverse areas. The current infrastructure is totally inadequate and inappropriate to serve the needs of the organization as it is today and as it grows. For example, we function out of rented premises in a residential area and receive complaints about issues such as children crying,no parking space etc.Hence there is an urgent need to have a place that is tailor made to accommodate our clinical training and research needs in a suitable non residential area currently estimated at US$ 3 million. This has necessitated spreading our scant professional manpower to the additional target of fund raising for infrastructure.

Scaling up across the country and outside by setting up a very large number of Com DEALL units with as wide as spread as the current Montessori preschools. The number of units that are functional on the ground and their outcome in terms of numbers of children successfully mainstreamed will be the measure of our success.

Post documentation we are ready to scale up within and outside the country. We have conducted awareness programs in neighboring countries like Dubai and Bangladesh. Overseas teams have also visited us. These and several others have expressed interest in duplicating our setting up units.We are confident we can work through some country specific challenges such as local licenses and trained manpower

To emerge as a comprehensive resource provider for those interested in providing long term services for the overall well being of the child with developmental disabilities such as ASD, before and across the school year.We have accomplished he targets we set for ourselves in 2004, from being a purely clinical service with a narrow focus on EI to a multifaceted organization for children with ASD.

Training-
i) replication of units-3-5 units per year during 2011-12, 2012-13 and 2013-14
ii) Certificate Programs – minimum of 2 /year from 2011-12.
iii) Awareness Programs - approximately 5/year from 2011-12.
Clinical
production and release of the four new clinical programs that are currently under trial,by December 2014
1. Pre DEALL
2.Social Coommunication program
3.School Transition Program
4.Family Mediated Intervention Program
Research
3-5 minor research projects with minimum of 5 publications/submissions from 2012 – 2013
Administration
Setting up of Management Integrated Systems to enable documentation,dissemination of training and material, outreach to other organizations, caregivers and support for inclusive education, orientation and in service training.

- Boys and girls’ families without proper information, regarding main care and other important topics during treatments.
- Lack of alternative support programs to stimulate children with cancer in a psycho-neuroimmunology sense.
- Lack of strong education support strategies during the treatment (which can be helpful for building a life project).
- Lack of recreational activities tailored to boys and girls with cancer’s needs.
- Few medical staff trained to assist these types of cases from a comprehensive approach.

The “Sobrevivir Program” aims to create a childhood cancer approaching methodology, which actively involves boys, girls and adolescents, as well as their parents and other relatives, in their treatment’s process. It would focus on empowering people to acquire knowledge about the disease, the best ways to lead the treatment and how to provide effective cares and maintain a positive mood, through recreational stimulating activities.

Vision: to be a pioneer organization in the psychosocial approach of childhood cancer, offering a platform of effective support for boys, girls and adolescents with cancer and their relatives.

Goals: to create an approaching methodology for childhood cancer, that encourages the well being of patients and their families, contributing to the children survival.

A new strategy to support childhood cancer’s treatment to improve its impact, the empowerment of the parents and the involvement of medical staff, in order to increase the impact on the boys and girls’ survival.

The target population of the “I survived childhood cancer” Program consists of three groups:
1. Boys, girls and adolescents with childhood cancer diagnosis.
2. Their mothers and other relatives or carers and
3. Health and Social workers (doctors, oncologists, pediatricians, immunologists, teachers, educational psychologists, psychologists, social workers, etc.), working with cancer patients, especially with children.

Face to face hospital intervention
Social networks
Internet
Mobile phones

1. Editing five (5) Manuals for mothers and families who accompany the process of their children disease.
2. Designing a web site in Venezuela with relevant information about childhood cancer, chats, on line support groups, debate forums, videos, researches and reliable documented material.
3. Implementing the Mother and Families Support Project (Apóyame), through talks, support groups and job listings.
4. Implementing the Boys, Girls and Adolescents Support Project (Sobreviví), through psycho-immunology, special education, counseling, vacation plans, laughter therapy.
5. Creating a Professional Support Network for the Sobreviví Program, to encourage the health staff’s training in our particular approach.

Peers:
- Fundación Amigos del Niño con cáncer
- Fundación Sana
- Fundación Ideas
- Productive sector (job listings)

The primary challenge is related with the impossibility of me leaving my actual job, to dedicate myself completely to this initiative. With Ashoka’s support I’d be able to focus on the initiative and strengthen the project activities.

Only in Venezuela, 1500 new childhood cancer cases are annually diagnosed, and more of 50% of them are economically underprivileged families. This demand will be met thanks to the initiative Business Plan’s fundraising, with several activities and an annual growth prospect of near 30% in incomes and assistant.

1. There is a demand to meet.
2. There are technical potentialities to meet the demand.
3. There is a Business and a Working Plan for the next three years.

1. Assisting more children and their families
2. Recruiting more health professionals into the organization’s activities.
3. Shed light on other options to deal with childhood cancer and make them possible to work on other childhood chronic illness.

The growth plan, based on the designed Business Plan, has a first period of three (3) years; then, we foresee a shares growth of 80% in 5 years and 200% in 10 years.

Every year over half a million children develop cancer, leukemia or are born with life-threatening hereditary blood disorders. As a group, they represent the most common Non-Communicable Diseases in many emerging countries. Most are curable but only a minority of children have access to appropriate care. A lack of trained personnel and/or financial resources are these children's major barriers to a healthy life.

At C2C our goal is to ensure that local medical centers are available to offer an affordable and reliable cure to children in their community suffering from cancer and other blood disorders. We also contribute the development of worldwide evidence-based diagnostic and management standards that improve a cure for all children regardless of geographical and financial barriers.

Cure2Children improves global access to a safe and affordable cure from thalassemia, sickle-cell, and forms of pediatric cancer for patients who would otherwise die or lose everything trying to afford a cure.

Cure2Children promotes screening and prevention of these life-threatening hemoglobinopathies.

Cure2Children develops context-appropriate sustainable and scalable models to strengthen tertiary health care, improve cost-effectiveness, biomedical research and higher medical education in developing countries.

It does this, in part, by helping health centers in high burden areas offer an affordable and reliable cure locally. Our model is that of: Target -> Understand -> Teach -> Transfer.

Our aim is that every child, whether suffering from leukemia, cancer, thalassemia, or sickle cell disease, has the chance for an affordable and reliable cure, locally.

Our mission is (1) to ensure that local medical centers are able to offer an affordable and reliable cure to children in their community suffering from cancer and other blood disorders; and (2) to contribute to the development of worldwide evidence-based diagnostic and management standards that improve a cure for all children with cancer regardless of geographical, financial and cultural barriers.

As part of our vision, each individual center will be linked to a global network allowing for consolidated research and for anyone anywhere in the world to find an affordable cure as close to home as possible.

Cure2Children assists local medical systems in implementing and sustaining tertiary care procedures (such as bone marrow transplantation) that cure children with life-threatening disorders. These resulting medical units are able to offer a reliable cure that is not only affordable for the local population but is globally competitive.

Children with uncured blood disorders (such as thalassemia) either die, usually before the age of 10, or require expensive lifelong treatment, such as monthly blood transfusions. Curing children with these disorders is not only a life changing procedure for the family of the child, but also a savvy investment on the part of the local government. Cured children no longer need treatment and are able to become contributing members of society.

The customers of our core business are both local medical centers and governments in areas highly populated with genetic blood disorders and cases of childhood cancer but no cure offered locally.

Cure2Children works directly with local medical centers to help them set-up self sustainable tertiary care centers that meet the local community's need for tertiary care.

Cure2Children also works directly with governments and ministries of health to fill the gap in their delivery of care and cure for children with sickle-cell anemia, thalassemia, leukemia, neuroblastoma and other non communicable diseases.

Customers of our peripheral services are parents of children affected. We have provided loans for parent groups looking to start social business style houses and stores.

Initially, Cure2Children's (C2C) Medical Team proactively sought out centers in high-burden areas to assist them in meeting local need for treatment. However, as the success of C2C's established (and now autonomous) centers became known, C2C has been on the receiving end of a market pull. Currently, Cure2Children has received requests from medical centers and ministries of health in Iraq, Zambia, Vietnam, India (Bangalore), Afghanistan , and SriLanka to help them establish self-sustainable tertiary care units that cure children with cancer and genetic blood disorders at an affordable cost and globally competitive standards of care.

While some of the above are able to provide their own start-up funds, many are not. Funds are C2C's limiting factor for meeting all of the above requests.

Cure2Children's primary activity is that of assisting health centers open bone marrow transplantation (BMT) units to cure children suffering from forms of cancer and genetic blood disorders at locally affordable rates and with globally competitive results.

Our model is that of: Target -> Understand -> Teach -> Transfer -> Success

'Teach' involves training the selected local professionals to sustain the BMT unit. C2C's medical team spends 2 week rotations for more than 3 months ensuring that the local team is able to conduct the procedure and manage the center autonomously. When it is time to begin curing patients, the C2C medical team leads local staff through the 1st BMT, assists with the second, and steps back to observe as local staff conducts the 3rd.

At Cure2Children, our peers are other professionals and individuals interested and involved in increasing global access to cures for children with blood disorders and cancer.

Often times, non-governmental organizations (NGOs) can see other NGOs as their competitors. This is no different for Cure2Children. Other NGOs applying to similar funding sources and resources are both our programmatic allies and our financial competitors. Other competitors include local private institutions providing bone marrow transplantation. While it might be strange to consider a neighboring hospital offering a BMT for $25-40,000 the competitor of a clinic offering the same for $10,000 with the same success rates. However, this is at times the case until the new center has time to prove its reliability.

At present, Cure2Children's (C2C) biggest challenge is fundraising for the organization itself.

C2C helps local governments and/or health centers create sustainable bone marrow transplant units that offer a reliable and affordable cure. Due to our growing success rates and network we are being solicited by countries, such as Iraq, that can afford to pay for our services. However for many countries that cannot, C2C must provide the start-up capital. As an organization we do not have trouble finding local funding for the particular health center, but we do have trouble finding enough funds to sustain our own internal nonprofit operations.

After C2C has pulled-out, its BMT units have gone on to sustain their operations and continue to offer a reliable cure to children, locally. Our goal, at the moment, is to scale this model to other continents such as Africa, where rates of sickle-cell anemia are very high.

Our goal is also to begin using innovative techniques to reliably cure children through BMT with a semi-compatible donor.

We have tested it and it works! Our first two BMT centers were in India and in Pakistan. Both centers are now financially independent, operating on their own, and curing children at a subsidized or affordable charge, with a success rate of 97%! These centers conducted over 100 BMT independently. C2C also has the technological infrastructure and personnel needed to support a large scale network.

C2C's key objectives for growth are:

(1) to assist in the development of 15 bone marrow transplant centers by 2015, all part of a global network;

(2) to conduct BMTs from mother to child in 2013; and

(3) to create global standards for addressing noncommunicable diseases locally and through socially responsible means.

Cure2Children will see a milestone when it has opened a self-sustainable bone marrow transplant unit in: Eastern Europe, Asia, and Africa; decreasing the distance that anyone should have to travel to be cured. We plan to open a center in Africa before the end of 2014; and to assist in the development of 15 independent bone marrow transplant centers globally by 2015, all of which will be part of a global network of centers.

Cure2Children also plans to submit at least one peer-reviewed publication annually, sharing findings from its database on improved standards of care, for example, to reduce rejection or post-BMT infection in low-resource settings, etc.

The WHO estimates that 11% of the world’s global burden of disease can be addressed by basic surgery. Maternal and infant morbidity/mortality can be reduced through the use of sterile materials during routine births and the availability of safe and clean obstetric surgery for more complex ones. Preventable surgical site infections and other HCAIs cost hospitals, clinics and Ministries of Health billions of dollars. In a world where 3 billion people lack access to power and clean water, there is a need for an affordable, portable, low-tech solution that will allow healthcare workers to perform surgery and deliver care safely in low-resource settings. Economic development focused on Eniware consumables production and resupply will further empower low-income people in the healthcare space.

Our business model replaces an out-dated standard of medical practice with an integrated co-created product, co-designed end-user training and education, economic development through “last-mile” value chains for production and resupply, and an elegant, cutting-edge new technology that is affordable, user-friendly, and adaptable to any setting where healthcare is provided. The current standard of sterilization for most healthcare settings is the steam autoclave, invented in 1879. Low-resource providers must often resort to boiling medical supplies or cold treatment with bleach, which disinfects, but is not an adequate substitution for full sterilization. Eniware’s low-cost, portable sterilizer will be designed for easy use and efficacy, and is functional without water or power sources.

Eniware strives to be a recognized leader and trusted partner in bringing innovative,
self-sustaining, public-private healthcare solutions designed to meet the unique challenges faced by the developing world. We envision a world where every man, woman and child will have access to state of the art healthcare, including infection-free surgical, maternal health and other medical procedures, whether they need care in New York City, a rural village in Uganda or on the frontlines of a natural or manmade disaster. We believe our low-cost, energy-independent, portable technology that sterilizes surgical and medical instruments will help make this vision a reality.

Eniware’s outcome-driven value lies in lives saved, diseases treated, and disability avoided through expanded access to healthcare. For local economies, improved health leads to greater potential for education and productivity. For health workers, increased capacity to work effectively within infrastructure constraints enables and incentivizes the provision of care in resource-poor settings. For health systems, the ability to affordably sterilize re-usable instruments and reduce the harms of medical waste increases safety and sustainability, decreasing reliance on disposables and reducing exposures to biohazards. Lastly, hospital and national healthcare budgets will realize reallocatable savings from reductions in expensive extended/repeat hospital stays for healthcare-related infections.

Hospitals, clinics, and mobile healthcare workers in areas where power grids are non-existent or unreliable are all potential users of Eniware units sold to government health ministries and private health care systems. Humanitarian/disaster response organizations providing emergency medical care comprise another robust customer sector. Healthcare professionals, including members of our Global Ambassador Corps, who travel to low-resource settings on medical missions could sponsor the purchase and resupply of Eniware units. Additional customers include dentists, veterinarians, and proprietors of businesses that are potential vectors for disease transmission including beauty salons and barbershops, particularly those in countries where risk of infection with HPB, HPC and HIV remain high.

Eniware will cultivate customers through our co-creation partnerships with end users, NGOs, global health organizations, and academic centers for Public Health. Eniware has a signed MOU with Population Services International, and has been invited to develop rural mHealth programs in Kenya with the Mawingu Project. Discussions have been initiated with potential partners ICRC, UPS/UPS Foundation, CAMTech, MSF/Nigeria, Mercy Corps,and AmeriCares. Sterilizer units and consumables will be also distributed to hospitals and clinics through National Ministries of Health, Education and Gender. Finally Eniware units and consumables will be manufactured locally in the countries where they are sold, and will be easily accessible and affordable to health providers at every level of care provision.

Eniware’s activities are ultimately integrated into our core goal of collaborating with diverse partners to achieve global health equity by expanding access to primary healthcare, including basic surgery. The sterilizer is an essential piece of this expansion, but Eniware will have maximum impact when implemented alongside other innovative systems and solutions that address the unique challenges of low-resource healthcare in the developing world. To this end, our activities include the facilitation of design and evaluation processes that incorporate input from users in the developing world, development of a training program that introduces sterilization as one component of good hygienic practice, and cultivation of partnerships that support local production and re-supply chains.

In resource-limited environments, NO2 sterilization uniquely provides the ability to sterilize supplies independent of clean water and electrical power/other fuel sources. Academic institutions and companies are experimenting with designs for solar-powered autoclaves, but these are still in trial phase. Whether or not these experiments result in effective, low-cost, electricity-independent sterilization systems, they still require daylight and access to clean water to function, and most, while moveable, are not truly portable. Eniware’s effective and adaptable system requires minimal training, and can be used in any setting at any moment, providing singular advantages over potential competitors when it comes to economy of acquisition/use/maintenance, user acceptance, and business growth.

Fundraising in the impact-investing sphere has been, and continues to be challenging, but addressing this issue has positively pushed the company to expand our vision and to more clearly define potential impacts and goals. Also, because health care in the developing world is provided across a diverse array of systems and structures, there is no cookie-cutter go-to-market strategy that will effectively reach all potential customers. A network of on-the-ground local and international organizations will be key to getting the Eniware sterilizers to those who will most need and use them. The Eniware Global Ambassador Corps, health professional sponsor/advisors with extensive experience in low-resource countries, will also help the company understand and access remote health systems.

Marketing and distributing Eniware requires a phased strategy. Initial penetration of markets will be through NGO partnerships. Partners will acquire products for their own use and local distribution, and train humanitarian responders and local healthcare staff in product use/maintenance. Support and acceptance by Ministries of Health will expand Eniware’s reach to public clinics/hospitals.

The need is urgent. With Eniware’s core technology and essential system design proven and patented, regulatory hurdles overcome and CE/FDA/EPA certifications on track, and with partnerships in place for initial market penetration, our next step is working with identified beta sites collecting baseline data and end-user input to “hack” an acceptable and appropriate vehicle for the technology.

Our immediate growth objective is the initiation of the user-centered design process in partnership with academic research centers and healthcare providers in the developing world. Subsequent objectives include verification of the co-created product design by Noxilizer and field testing and evaluation at selected beta sites.

Eniware’s goal is to have a CE-marked, ISO-verified, affordable and user-friendly product within 18 months. Short-term growth milestones include a finalized agreement with a university-centered or private design team, and executed MOUs with end-users and beta testing sites collaborating in the co-creation process. Financial milestones include completed capitalization raise, and MOU agreements with select NGO partners and Ministries of Health for pre-orders of units and consumables. Supply chain establishment and distribution development will evolve concurrently, supported by micro-business economic development of consumables production and resupply. By Year Two we expect to see income growth from pre-orders and sales, and to realize a net profit of $3-4 M by Year Three.