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Inspire: a low-cost breathing assistant for infants in rural settings (www.inspiremedical.org)

Noor is a three-year old girl suffering from respiratory distress in rural Bangladesh. It took Noor and her 22-year-old mother two days of travel via buses and trains to get to a hospital. Having previously lost two infants to respiratory distress, Noor's mother is acutely aware of its symptoms and is determined to get Noor the help she needs. Unfortunately, the rural hospital doesn't have enough oxygen to treat Noor. For her age and weight, Noor needs 15 L/min of oxygen flow. Unfortunately, the hospital she is at only has two oxygen tanks left, and doesn't know when more will arrive. As such, they need to conserve the oxygen supply. Left to fight her respiratory distress on only 2 L/min of oxygen flow, its evident from the extreme movements of her chest that Noor is losing her fight to breathe. Her charts indicate she is losing a kilogram each day due to the physical effort required to expand her lungs. It's only a matter of days until her vital organs start to fail.

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Written by DeletedUser

Bubble CPAP's fatal flaw is its reliance on oxygen tanks... without the tanks, there is currently no CPAP treatment. Patients like Noor are left to their own wiles to expand their lungs.

It doesn't have to be this way.

By converting room air into pressurized gas to expand patients' lungs, Inspire costs less than 1% the cost of traditional bubble CPAP. If doctors believe it's necessary for patients to receive an oxygen supplement, they can bleed the oxygen into the Inspire device, custom blending the oxygen in a way that saves money. Given that 100% oxygen in excess doses causes retinopathy (blindness) and asthma, Inspire has the added benefit of improving the safety of traditional bubble CPAP treatment.

How do you envision this idea making money?

In Bangladesh, urban hospitals have ample oxygen tanks and a centralized oxygen line. Without this line, however, urban hospitals would need more than one million tanks to adequately treat infants in respiratory distress. Rural hospitals would need, on average, more than 50,000 oxygen tanks each year, costing $1.5 mm, nearly 80% of their average operating budgets. Nearly 40% of the cost of delivering oxygen stems from the transportation costs associated with getting the tanks to rural locations. As an oxygen-independent device, Inspire costs less than 1% the traditional bubble CPAP treatments. For example, for a rural hospital treating 275 patients, it would cost $22,000 to administer bubble CPAP. Inspire without oxygen would cost $200, and Inspire with oxygen bled in to deliver 50% oxygen would cost $8,000.

How does this idea create social impact, particularly around improving health?

Pneumonia is the leading killer of children in the world - more than measles, malaria and AIDS combined. More than 2 million children die from pneumonia each year, and more than half of these deaths result from inadequate access to affordable treatment options.

How does this idea add social value at every step of the process?

Inspire has the potential to reach thousands of children currently suffering from respiratory distress in rural settings, where there are no treatment options in the absence of oxygen. Our hope is that the device would treat infants in respiratory distress and aid progress towards the UN Millennial Development Goal of reducing child mortality. We also hope that our device will improve the quality of life and productivity in Bangladesh and other countries with high incidences of respiratory distress, like Venezuela.

What are the short term steps we could take to implement this idea tomorrow?

Our device needs to undergo technical feasibility training and conduct further user testing in Bangladesh. We have already received funding to travel back to Bangladesh and develop our prototypes for the next nine weeks. Thereafter, we aim to find a research partner to oversee the clinical trials. To this effect, we have already built relationships with physicians at the Lucile Packard Children's Hospital at Stanford, Oakland Children's Hospital, Boston Children's Hospital, ICDDR,B in Bangladesh, and the University of Melbourne, among others. Finally, we will seek regulatory approval via the CE mark to bring our product to market in the developing world.

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Photo of Meena Kadri

Very interesting, Pamela – Inspire is clearly doing great work! Any thoughts on how this product could fit into a social business venture which is the cornerstone of this challenge? Anyone got any builds to extend on what Inspire have already developed which might make it even more relevant to our focus area of Caldas in Columbia?

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DeletedUser

Thanks for your support, Meena! We are aiming to produce a medical device that can be sold to hospitals for use in a critical care setting. Given that the product is designed specifically for rural settings that struggle to maintain a steady oxygen supply, it has the potential to address a market typically untapped by traditional medical device companies. As such, Inspire is a social business. I hope that answers your question.

Photo of Meena Kadri

I guess I'm wondering more about what kind of service ecosystem might be devised around this product? (thinking distribution networks – maybe through alliances with producers of complimentary products, awareness-building and marketing, maintenance delivery, etc) And what happens to the eventual profits from the business? Given this is an (excellent) existing product – maybe Inspire and others might take the opportunity of this challenge to brainstorm beyond the product itself.

In case you're confused about the service ecosystem – an unrelated example would be Zip-car: http://www.zipcar.com/ Instead of thinking about the product (cars) they considered what people actually needed out of flexible private transport – and devised a service around that. It's very different from the context we are exploring on this challenge – but I feel illustrates the power of thinking broadly about how needs might be met. Hope folks have fun taking this kind of approach to extend their concepts even further! And remember there's our Brainstorm-in-a-Box toolkit to add to the mix: http://bit.ly/grameen-storm

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DeletedUser

Ah, now I feel I understand what you were getting at! We have actually explored partnerships with two other child health technology needs: photo-therapy for jaundice, and infant warmers for prematurity. There are several companies, collegiate projects, and non-profits addressing these markets, many of whom are our collaborators. We think there is a tremendous opportunity for an organization that sells all three units to make child health ecosystem that could really change the lives of women and children in places like Caldas. The eventual profits of such a business could be used to generate scale and reach more patients in increasingly rural locations.