Scaling impact: The next great challenge in global health and development innovation

In the decade since Bill Gates kicked off a new movement in Grand Challenges innovation for global health and development, we have made a lot of progress and learned many lessons. Successes have been achieved and many partners have joined - these developments will be covered elsewhere. In this blog, we want to zero in on the next major barrier to success and how to overcome it. In our view, this barrier is optimizing the path to scale in a sustainable manner for thousands of innovations that have been supported at proof of concept.

Ten years ago the problem was that there was very little innovation in global health and global development. The pipeline of innovations was simply not available, a point made clearly in the 2012 Acumen-Monitor report which referred to this as the "pioneer gap."

Today, although perhaps not widely appreciated, the world has a robust pipeline of innovations approaching proof of concept. Grand Challenge programs at the Bill & Melinda Gates Foundation, Grand Challenges Canada, and USAID alone have supported close to 2000 innovative concepts, many of which are working towards proof of concept!

Compared to a decade ago, the challenge today is different: there is no easy or systematic path for the subset of innovations that should move forward to be able to access the attention and resources needed to achieve scale.

Compared to a decade ago, the challenge today is different: there is no easy or systematic path for the subset of innovations that should move forward to be able to access the attention and resources needed to achieve scale. You can think of this as an innovation pile up at proof of concept.

One solution to this problem could be a global innovation marketplace to accelerate the quantity and quality of innovations transitioning to scale in a sustainable manner. What might be the characteristics of such an innovation marketplace?

On one side of the marketplace there is a growing pipeline of innovations from Grand Challenges partners, which includes Bill & Melinda Gates Foundation, Grand Challenges Canada, USAID, a growing network of countries such as Brazil, India, South Africa, Israel, Peru and others. The marketplace would aggregate this pipeline of innovations independent of the provenance of the funding source, but instead based on merit and potential impact.

On the other side of the marketplace, there is the active engagement of investors whose resources - both funding and expertise - are critical in helping the pipeline of innovations achieve scale. Some of these investors are private and some public but all share the value that they are interested in impact first and not purely economic returns.

Between the innovations and investors, to paraphrase TS Eliot, "falls the shadow." We feel the critical functions that an innovation marketplace would need to link innovations to investors are curation and brokering.

A curator could serve several important roles including:

• To make sure the innovations are investment ready. One of the things we have learned is it is difficult to truly reach proof of concept and there is insufficient attention to entrepreneurship in this pipeline of innovations. An innovation marketplace must include a role for the curator to not only validate those innovations that have achieved proof-of-concept and are investor ready, but be able to identify promising innovations that are not yet investment ready and facilitate their access to additional angel and grant funding to permit these innovations to continue on the path towards proof of concept. Beyond just funding, many of these innovations also need access to incubators and accelerators, such as the NCIAA-Lemelson initiative, to help develop business plans, and many others to fill skill gaps on the team developing the innovation.

• To help learn from failure. Naturally, many of these innovative projects will fail and not reach proof of concept. In many ways this is a success - especially if failure is fast, inexpensive, for the right reasons and we learn from it - because without failure there can be no innovation. A curator could facilitate this process and capture lessons learned.

• To conduct comparative analysis. Often the question is not only whether an individual innovation is ready for scale but also whether it seems more promising than other related innovations in the pipeline. This analysis could also identify synergies, complementarities, gaps, and barriers at the level of industry sectors (see next point).

Complementing the curator, a broker would then need to be able to:

• To catalyze collaborations across innovations and in some cases facilitate the creation of new social enterprise and industry sectors. Echoing the 2014 report supported by Omidyar Network called "Beyond the Pioneer" (referring to the Pioneer gap discussed above), we have found that in the pipeline of innovations, entire industries begin to emerge. These are clusters of innovations on topics such as sanitary pads, newborn interventions, sanitation, etc. There are often synergies across the portfolios of individual organizations. A broker could recommend support not only to individual innovations but also to clusters of innovations and identify the supports and conditions required to make those clusters thrive and provide benefit for the poor.

• To serve the critical role of linking clusters of investor ready innovations with networks of investors public and private. There are websites attempting to do this but we believe innovation is a social process and the human element is key. (This point was made clearly to us in a recent meeting on the proposed global innovation marketplace by Julie McDowell of Taris Inc. and Katie Wehr of the RWJ Foundation to whom we are grateful for it.)

Naturally, it is less efficient to approach investors on a "retail" basis - linking one innovation at a time to one investor - compared to having a marketplace of innovations linked to networks of investors. Topic specific individual innovations or clusters of innovations could be linked with networks of investors. An example of a pre-existing network in maternal, newborn and child health which could be an invaluable network partner is the Innovation Working Group of the UN Secretary General's Every Woman Every Child initiative.

A defining feature of the grand challenges approach is that innovation is the highway and impact is the destination. We have successfully built the first half of the highway by creating a pipeline of proof of concept innovations. Now we need to finish the second half by building a system that help promising innovations move more easily to scale in a sustainable manner.