Equalize Health

If there is anything that became abundantly clear in 2020, it is that health is crucial to society. 

In spite of incredible medical advances in recent decades, millions of people suffer and die from preventable or treatable conditions every year. 

Led by globally-recognized visionary leader, Krista Donaldson PhD, Equalize Health is a not-for-profit medical technology company on a mission to change that.

This funding will support our work to create a just world where we all have access to world-class medical treatment, no matter where we live. We prioritize our work where health inequities are the greatest. The funding would therefore; 

1. Accelerate developing world-class, innovative, medical technology to treat more than three million mothers and babies, and reduce maternal and newborn deaths in underserved communities; and 

1. Provide nurses, doctors, and specialists the skills and technology they need to deliver specialized care to more than two million patients, as we respond to and recover from the pandemic.

We must prepare for the challenges climate change and future health crises will bring, otherwise underserved communities will continue to bear the brunt of the burden. Health inequity will continue to worsen. If selected as a winner, we will fight to end health inequity.

Originally from Nova Scotia, Canada, I was one of only four women in a Stanford graduating class of 75 mechanical engineering students. I have always been driven by designing solutions for the world’s biggest challenges. My research took me to Nairobi working on water pumps. Then, my first job was in Iraq during the war, working with the State Department on electricity reconstruction. This early work taught me three valuable lessons that still influence me today as I design for global health equity: 

1. Put the wants and needs of people front and center in design

2. Innovation needs a sustainable model for reaching end users

3. Design not just for the product, but for the entire system

Above all I learned that without good health, everything else suffers. So, health is where I decided to turn my focus. As the CEO of Equalize Health (formerly D-Rev) over the last ten years, we have launched five medical innovations and treated more than one million patients. This impact is significant but nowhere near fast enough. My goal is to accelerate reaching the next five million patients by 2025 and to create a more equitable global health ecosystem while doing so.  

Each year, more than 2 million newborn babies die within their first month of life.  Annually, more than 300,000 mothers die in childbirth. Instead of making progress we are moving backward. Maternal and newborn health rates have worsened during the pandemic. We directly address the leading causes of maternal and newborn deaths, Postpartum Hemorrhage (PPH),  Respiratory Distress Syndrome (RDS), and overburdened healthcare workers by equipping doctors and nurses with the medical innovations and resources they need: 

1. Blood Loss Monitoring Device will provide early detection of postpartum hemorrhage after childbirth and accelerate time to treatment for mothers in South Asia and Sub-Saharan Africa (42% of the world’s deaths due to PPH occur in Nigeria and India alone). 

2. FlowLite, nCPAP (neonatal continuous positive air pressure) will ensure high-quality newborn RDS treatment is within most countries' capacity to implement and save more newborn babies' lives.

3. Tele-mentoring clinical sessions will equip overburdened clinicians with peer support, knowledge, confidence, and practice to increase quality care to patients. 

To date, we have launched 5 medical devices (a portfolio of phototherapy devices to treat jaundiced newborns and the ReMotion Knee for increased mobility for amputees) that have treated more than one million patients. 

Innovation is at the heart of everything we do.  Not only do we develop innovative medical technology, our business model is designed to build a more equitable ecosystem. 

Our global team invests in communities to deeply understand local-user needs and markets.  We then find inspiring local innovators and partner with them to license or acquire the concept, and develop it for the market. We leverage our partnerships with established medical device companies for branding and accelerated distribution. Our agreements recognize corporate goals, but  are always structured for impact. By disrupting the current ecosystem, our vision is that in the near future we will see many affordable, user-centered solutions - not those just developed by us - improving health outcomes. This type of partnership is pioneering as we bring diverse global health actors together in a way that leverages all of our strengths, and aligns everyone with a clear goal to impact. 

Lastly, we take a portfolio approach, so that our learnings can be leveraged to address multiple challenges across various health issues. It is this strategic focus on maternal and newborn health that will accelerate our goal to get more products on the market and improve health outcomes faster. 

We aim to not only sustain this level of impact, but accelerate it.

How and Why? What we have learned:

1. Impact requires innovation: To save lives and prevent health loss, our intervention has to be different or better than what already exists.

2. Impact is human-centered and global: Our design process and products must be user-centered from end to end. We challenge who the sector traditionally thinks of as the investor, the designer, and the inventor and are inclusive from the beginning to the end of the design process.

3. Impact means global scale: From day one, we design products to have enough commercial and customer-driven appeal to scale through the market for years after launch.

4. Impact metrics are critical: We go beyond monitoring units sold. We work hard to learn from our impact on health providers’ and patients’ lives.

Next Steps

1. Launch 2 medical devices  1) to detect postpartum hemorrhage and 2) FlowLite nCAP to treat newborn RDS (potential impact 3M patients)

2. Partner with local innovators to identify 2+ new high-impact technologies to improve maternal and newborn health ( sustainable impact)

3. Providing 100+ telementoring sessions for overburdened clinicians in South Asia and East Africa (potential impact 2M patients)

~1 million per year.  

Equalize Health recently surpassed a significant milestone. In 2020 in the midst of a pandemic, our medical products treated more than 1 million patients. Of these patients, the vast majority live in low- and middle-income countries (LMICs).  Furthermore, our tele-mentoring programs to strengthen health ecosystems have trained more than 2,400 doctors, nurses, and specialists in India and Kenya. With increased knowledge and confidence, these healthcare providers have in turn have treated more than 1 million patients. 

We are at a catalytic moment. With two new, high-impact maternal and newborn medical devices scheduled to launch to market in the next twelve months, and an increase in demand for our tele-mentoring support services, we anticipate reaching ~1 million patients in the next year, ~2 million the year after, and even more the next.  Ultimately, we estimate we will reach 5 million patients by 2025.

Our primary goal is to help achieve SDGs 3.1 & 3.2 

• By 2030, reduce the global maternal mortality ratio to less than 70 per 100 000 live births.

• By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1000 live births.

We will do this by working towards the following 2025 Equalize Health impact goals: 

• Design and launch 3+ medical products that address leading causes of maternal and newborn mortality

• 5M patients treated by EH medical products 

• 5M disability-adjusted life years (DALYs) averted from patients treated w/ EH medical products

• 5,000 healthcare workers trained by our tele-mentoring clinical sessions

Funding is the biggest barrier for Equalize Health to achieve our goal of accelerating medical technology to everyone. 

We believe in not only designing products, but designing for the entire end-to-end process - from problem identification to treating a newborn with respiratory distress or a mother who has lost too much blood during delivery. This ensures our products are used effectively in the places that need them the most. Supporting this user-centered, ecosystem approach requires long-term, flexible funding which has become even more scarce in the current COVID context. 

We are mitigating this challenge by leveraging the best in global health innovation. We partner with local innovators, build on their promising concepts, then partner with medtech to manufacture and distribute our products at scale.  Using existing ideas and channels helps cut down R&D time and accelerate delivery.

Winning the Elevate Prize would be catalytic in elevating this issue to public consciousness and help to attract other like minded supporters who seek new models. COVID laid bare the urgent need for equitable access to medical technology and philanthropy responded. We need to ignite this same urgency in other health areas that have been historically neglected, especially maternal and newborn health.

2020 rang alarm bells across the world.  Without health, everything suffers. The pandemic now threatens to reverse progress made in education, health, climate change, women’s rights, economic empowerment, and more. We must accelerate health equity today, and we cannot do this alone. The Elevate Prize would be a catalyst in building a cohesive, diverse, inclusive force for change in global health. Not only will this partnership accelerate Equalize Health’s medical innovations and support services reaching millions of patients around the world, but it will also be a platform to share learnings and collaborations to accelerate innovation reaching patients being treated in the toughest of circumstances. 

With additional resources, we can identify local innovators more quickly. We can develop more medical innovations, faster. We can train more doctors, nurses, specialists, biomedical engineers.  We can reach more patients and prevent death and disability. We can bring world-class healthcare care closer to the homes of patients.

Equalize Health CEO, Krista Donaldson’s leadership is recognized across the globe. She is a sought-after speaker and mentor to the next generation of innovators and engineers at universities and social networks in Africa, Asia, and North America. As a female in a predominantly male sector, she promotes the inclusion of all voices, especially those Equalize Health seeks to serve. She inspires us to challenge who we and society traditionally think of as the “social entrepreneur”, “engineer”, and “inventor”. 

Her leadership threads her commitment to human-centered design throughout the organization’s structure. She has thoughtfully and intentionally built a global team with Africa, Asia, and the Americas being represented at the leadership level. She leads by her ethos that we are in this together, one humanity.  We work side by side with healthcare workers, patients, innovators, engineers around the world. She builds equity into her leadership with a strong emphasis on data and a rigorous evaluation of our impact.

Equalize Health is a global team of designers, engineers, medical professionals, and business minds, based in India, Kenya and USA. We are united by our belief that no matter where you live, you should have access to world-class medical treatment. Our colleagues are experts in their fields and have deep lived-experience in the markets we serve. Collectively, our team has launched over 60 global health innovations, has 85+ years of experience in global health, and speaks 12+ languages.

We embody design-thinking in all aspects of our work. We consider every stakeholder in a product’s value chain when setting strategy and making trade-offs. We design products with local healthcare workers and only launch products they love.  We find manufacturers and distributors who are motivated by social impact and work with them to align incentives for impact at scale. We partner with governments and medical associations to build communities of practice that facilitate peer-to-peer learning. If you are a healthcare worker or patient that can benefit from our technology, you are part of our team. It is this locally-driven, global collaboration that ensures our products treat as many patients as possible, where it is needed most, and for many years to come.

In 2009, I met an Indian doctor who was dangerously treating jaundiced babies with direct sunlight. He understood that the standard of care for treating jaundice is phototherapy but his hospital could not afford the devices. This learning led to our first project.

 After conducting extensive user research, we confirmed phototherapy was one of the highest needs of low-resourced NICUs. The problem was that global health experts didn’t see it as a priority. Treatment was readily available in the US. Big medtech wasn’t solving the problem either - they had no incentive to serve low-income markets because they weren’t sufficiently profitable.

The lack of a user-centered approach to understanding global inequities motivated me to work with local experts to develop a solution. Lacking broad support, I recognized we couldn’t bring a product to market alone. We partnered with a for-profit Indian manufacturer and distributor, Phoenix, who shared our mission. At that time it was a first-of-its-kind partnership in global health innovation. Together, we launched Brilliance. 

Today, Brilliance scales through the market. It has treated over 1 million patients and is available in over 70 countries. And since Brilliance’s launch, the average global price of phototherapy has more than halved.

Equalize Health intro video

McKinsey: Designing for Social Impact

99U: Designing Products that Change the World

New York Times: Light Bulb Moment for a Non-profit

TedTalk: The $80 prosthetic knee thats changing Lives

USAID: 8 Inspiring Women Changing the Landscape in Global Health

GLG: Bringing Design Thinking to Medical Technology

World Economic Forum 2014 Technology Pioneer: Meet Krista Donaldson

BBC World Service’s Click: D Rev & Phoenix feature

This funding will support: 

• Acceleration of market launch of portfolio of medical innovations to detect and treat the leading causes of maternal and newborn mortality (Postpartum hemorrhage (PPH) and Respiratory Distress Syndrome (RDS)

  • FlowLite CPAP for newborns to treat RDS

  • Blood Loss Monitoring Device for early detection of PPH in new mothers

  • Uterine Suction Tamponade (UST) to safely treat mothers w/ PPH 

• Expansion of our tele-mentoring clinics to areas of high-need such as East Africa, West Africa and South Asia

• Build capacity of our user intelligence “UQ” teams working alongside healthcare workers and patients to identify the largest health gaps and best solutions for patients living in the toughest circumstances

Fundraising:

The Life You Can Save (TLYCS) - We were selected by TLYCS as a “recommended charity” because we “save or improve the most lives per dollar” and are radically transparent in our evaluation. TLYCS raises money on behalf of its recommended charities. 

Commercial:

Draeger - a leading medical device company, partnered to commercialize our neonatal CPAP. This is a novel partnership in that a global MedTech giant and a non-profit medical device company are partnering to leverage the best of both to serve hard-to-reach populations and doing it in a financially sustainable way.

Phoenix Medical Systems (PMS) - our manufacturer and distribution partner for Brilliance.

Joint Medical Store  - a local Ugandan distributor, partnered to strengthen reach of Brilliance in East Africa. 

Ecosystem support:

Vermont Oxford Network & Ethiopia Neonatal Network - tripartite to improve CPAP use for the care of newborns with respiratory distress in Ethiopia, where infant mortality rates are highest in the world

We partner with governments and local medical professional associations to identify the biggest gaps in healthcare worker knowledge and then collaborate to create tele-mentoring programs that strengthen these skills. Example partners:

• India Academy of Pediatrics

• Nursing College, AIIMS, Delhi

• UNICEF

• Government of Chhattisgarh