The Human Powered Nebulizer

The Human Powered Nebulizer

El Salvador
Organization type: 
nonprofit/ngo/citizen sector
Project Stage:
Start-Up
Budget: 
$10,000 - $50,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

The Human Powered Nebulizer is a low-cost, electricity-free, global medical device for treating respiratory illnesses among the poor.

About Project

Problem: What problem is this project trying to address?

Respiratory diseases pose a major global health challenge. Lower respiratory infections (LRIs), chronic obstructive pulmonary disease (COPD) and tuberculosis (TB) are major causes of mortality, ranking 3rd, 4th, and 8th respectively (killing 3.5, 3.3 and 1.3 million persons/year). They primarily strike in regions where electrification is a distant dream and there are no doctors. As such, they differentially affect the poor. Respiratory technologies like inhalers exist, but they are one-condition-one-device solutions and have drawbacks. Instead, what is needed is a single, simple low-cost platform that can aid in the diagnosis, treatment and prevention of respiratory diseases. This platform needs to be electricity-free and designed for operation by community health workers (CHWs).

Solution: What is the proposed solution? Please be specific!

The Human Powered Nebulizer (HPN) can address this global health problem. The HPN is a low-cost, electricity-free jet nebulizer. A nebulizer converts liquid medicine into a mist that can be inhaled deeply into the lungs, targeting the lung tissue. The HPN can be used to: aid intensified case finding in TB, to treat reactive airway diseases, administer vaccines safely, and potentially treat lower respiratory infections with hypertonic saline. The HPN is easy to use and can be operated by a CHW to treat patients. It either operates at the right rate or not at all, with minimal effort. Patients do not have to be trained to use a nebulizer. Our partners in developing countries argue that CHWs are ready for the HPN; they are eager for it to be deployed, in order to save lives.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

Of the many applications of the HPN, perhaps the most immediate is assisting in intensified TB case finding, particularly in asymptomatic individuals. While only the 8th cause of global mortality, TB is hyperepidemic with HIV in Africa, is highly communicable, and is increasingly drug-resistant. Some estimate that 30 million people in HIV+ communities need to be screened for TB. Recent advances in TB diagnosis, notably Gene-Xpert and Hero Rats, are important. However, these technologies require a sputum sample, which is difficult to collect in asymptomatic individuals. Proposed biomarker-based TB screening technologies (like the E-nose) may not work with this essential cohort of asymptomatic individuals and are years away from possible deployment. Meanwhile, people are dying from TB today. There is no superior alternative to nebulized hypertonic saline for sputum induction. Asymptomatic patients inhale nebulized hypertonic saline for two minutes and cough up a sputum sample which can then be tested. Testing can still occur in a centralized facility—transport of sputum samples is feasible—but sputum collection must still occur in remote, electricity-lacking regions for both practical and public health reasons. Therefore, electricity-free sputum collection remains a key missing piece to intensified TB case finding. The HPN will fill this gap. It is a simple, working, tested technology key to diagnosing asymptomatic patients today. Our goal is to put an HPN in the hands of every CHW in Africa and enlist them in TB screening, training them in safety and best practices.
Sustainability

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

The chief competitors to the HPN in the treatment of reactive airway diseases are inhaler devices like metered dose inhalers and dry powder inhalers. These technologies may be preferred in certain contexts, but our research suggests that patient compliance, especially in developing contexts, is problematic. Training time for CHWs is valuable as well—with the HPN, CHWs will be trained on one device rather than a myriad of different technologies. Thus, a single platform has advantages over the one-disease-one-device model. Electric nebulizers, even ultrasound ones, cannot be truly electricity free and available all the time and would require costly adjuncts like solar panels. There is no other single alternative to diagnose, treat and prevent diseases in global contexts other than the HPN.
Team

Founding Story

In 2003 and 2004, Dr. Olson went to Central America and observed several things. First, especially during the rainy season, respiratory illnesses and exacerbations are common and people of means owned their own electric nebulizers. The poor had to walk sometimes for hours to a regional clinic for nebulizer treatments. They had to travel at a time when they were suffering from breathlessness. Moreover, he noticed that electricity was unreliable or absent in rural areas even in countries committed to electrification. In the intervening years, many different HPN designs were studied, culminating with two very successful designs. The first design—a bicycle version of the HPN used in Africa—came from conversations with bicycle manufacturers (Trek and Sram). In the Americas, our partners indicated that bicycle technology has some cultural acceptance issues, especially among women who will be the likely CHWs. They proposed a hand-cranked version of the HPN, which we subsequently developed.
About You
Organization:
Marquette University/The Human Powered Nebulizer Project
About You
First Name

Lars

Last Name

Olson

About Your Organization
Organization Name

Marquette University/The Human Powered Nebulizer Project

Organization Country

, WI, Milwaukee County

Country where this project is creating social impact

, CH

How long has your organization been operating?

More than 5 years

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Innovation
How long have you been in operation?

Operating for 1‐5 years

Which of the following best describes the barrier(s) your innovation addresses? Choose up to two

Access, Cost.

Social Impact
Please describe the goal of your initiative; outline what you are trying to achieve

The goal of the HPN Project is to give life and breath to the world’s poorest communities. Overall, we want to deploy the HPN worldwide. We seek to put an HPN in the hands of each of the world’s current 1.3 million CHWs and train them to use it. Specifically, we want to deploy the HPN to aid in intensified case finding of TB in HIV+ communities in Africa. We also want to deploy the HPN to treat reactive airway diseases like COPD. Importantly, COPD incidence is co-located in regions without electricity, so putting an HPN in the hands of African CHWs will meet both goals. We further want to potentially treat babies with LRIs across the globe using the HPN and hypertonic saline. Eventually, we want to deploy the HPN for safer and more effective vaccine delivery.

What has been the impact of your solution to date?

We have shown that the HPN works in South African townships and that it compares favorably with an electric nebulizer in aiding TB diagnosis. Health professionals, community health workers, and community members from El Salvador have expressed their interest and urgent desire to have the HPN deployed in their communities. The HPN project has been endorsed by the Minister of Health of El Salvador. A study of the equivalence of the HPN to an electric nebulizer in the treatment of asthma in El Salvador is pending IRB review and will be completed by Spring 2012. Critical partnerships with global health groups and networks of CHWs have been developed. Training programs for CHWs are also being developed for 2012. The design of the HPN has been through several iterations and is close to being ready for scale up manufacture.

What is your projected impact over the next five years?

Each HPN deployed for TB diagnosis, collecting 10 sputum samples per day, could find 100 new cases of TB in five years. That same HPN could provide 3 COPD treatments/day, potentially treating and extending the lives and productivity of 100 individuals with COPD/year. Our most conservative projection is to deploy 2000 HPNs in 5 years ($200,000) would find 150,000 new cases of TB and treat 750,000 individuals with COPD, assuming some overlap use. (With scale-up production, the cost of each HPN will decrease to our target price of $25/unit). We anticipate deploying 100 units with the Salvadoran Ministry of Health in 2013, for treating COPD and asthma. In five years, we expect to have performed the clinical research on how to treat LRIs with the HPN and to deliver vaccines with the HPN

What barriers might hinder the success of your project? How do you plan to overcome them?

The main challenge to this deployment plan is convincing potential investors that this is a sustainable, practical solution to global health. Also, training programs that ensure sanitization of nebulizer mouthpieces and minimizing risk of the spreading of disease will need to be coordinated with existing community health worker training programs. We plan to address design for manufacture issues with our scale up of production. Chiefly we are paying attention to robustness, portability, hazard minimization, and cost. Supply chains will tap into already existing medical supply channels, but we expect that we will have to adapt to new ways depending on logistical barriers that are common in global transport.

Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact

Within six months, we will have developed an HPN manufacturing plan that can scale for production.

Identify three major tasks you will have to complete to reach your six-month milestone
Task 1

Our new low-cost, easily manufactured piston/manifold system will be finished and tested.

Task 2

Our industrial design team will have finished their new smaller design for manufacture.

Task 3

We will have identified manufacturing partners who can build our components.

Now think bigger! Identify your 12-month impact milestone

In one year, we will have achieved a revenue stream from carbon traders

Identify three major tasks you will have to complete to reach your 12-month milestone
Task 1

We will have completed the life cycle assessment of the HPN needed for voluntary carbon markets.

Task 2

We will have identified partners willing to invest in the carbon market this way.

Task 3

We will have collected our first revenue for HPNs from a voluntary carbon market.

Sustainability
Tell us about your partnerships

We currently have over 14 formalized partners. We have many partners from the user side including the Ministry of Health of El Salvador, the Desmond Tutu HIV Foundation, and the London School of Hygiene and Tropical Medicine. We are also beginning a partnership with Partners in Health. Their expertise in and existing network of community health workers throughout Africa would be help greatly. We recently met with PATH, who has expertise in global technology deployment. We have been pursuing partnerships with corporations and other investors.

Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?

We are actively pursuing markets for LRIs and vaccine delivery. With LRIs, we are pursuing clinical trial partners. With vaccine studies, we are pursuing funding. In addition to those, we are reminded of other current markets for COPD and TB which exist but for which we have yet not penetrated. COPD in central Asia, including India, is perhaps more a more acute situation than even Africa. TB in rural China is also a major issue, and we have begun conversations with some partners there. Our penetration into the Americas begins with El Salvador, but will include Central and South America.

What type of operating environment and internal organizational factors make your innovation successful?

We are relying on existing infrastructure in the early growth phase. Institutional infrastructure at our University partners and Ministries are being offered for this tremendous life-saving idea. We have found incredible institutional commitment among our partners. We think our chief organizational advantage lies in our value proposition to our partners. We are working to fund the medical devices that will help our end users so that it is free to them. We are going to take carbon out of the sky and give our carbon-producing partners a way to continue their operations and still fight climate change. Because we have such straightforward value propositions, our collaborative model, which depends on other organizations, is feasible.

Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list

Our main need is funding and assistance with developing details about our business model. Additional experience with regulatory and manufacturing will also help us accelerate our goals. We have an innovative team with international research and engineering experience and are happy to collaborate with others.