Illustrative cases

Diseases in both the developing and the developed world seem to offer ample opportunities for new biomedical technologies. And during the next 20 years, novel treatments for AIDS, malaria, cardiovascular diseases, diabetes, and cancer will emerge. However, their ultimate success—whether the local healthcare system will adopt them—will depend on how well they fit with the criteria previously defined. It will be hard to judge whether a new technology or a novel approach to treating cancer will succeed unless we can assess the specifics. The devil is very much in the details. To illustrate the framework, let’s examine several promising solutions for some of the diseases discussed earlier.

AIDS and malaria

Prevention is currently the most cost-effective approach for dealing with the burden of AIDS and malaria in the developing world. It can reduce new HIV infections among men and women at high risk. Given enough time and financial resources, biomedicine might one day produce an effective AIDS or malaria vaccine. However, the widespread adoption of new vaccines could be slowed by a lack of infrastructure as well as political or moral objections. Logistical issues of getting vaccines to at-risk populations in remote parts of the developing world could also be daunting, especially if the vaccines require refrigeration or other special handling. In Africa and elsewhere, patience will be required of financiers and social entrepreneurs who want to....patient capital.⁷