Walking the Talk
GSK Building Better Business from the Inside Out by Bringing Low-Cost Diagnostics to Africa

Last month, Ashoka Changemakers announced four winners of its League of Intrapreneurs: Building Better Business from the Inside Out competition, honoring initiatives within organizations that are pioneering game-changing models for business and society. Global healthcare company GlaxoSmithKline (GSK) was chosen for its work in developing simple, cheap, paper-based devices capable of diagnosing infections and saving millions of lives.

Here, Graham Simpson, principal scientist at GSK, discusses his breakthrough project, Low-Cost Diagnostics for Africa.

What were your biggest challenges in getting this project off the ground?

Building a sustainable business model around low-cost point-of-care diagnostics is a challenge for every company and this project is not alone. The biggest challenge has been finding the suitable therapy area and sponsoring business unit that can see a viable way to build the platform we are developing. As we are all scientists on the team we have focussed on developing effective tests and have learned a lot about the place for making a clear value proposition within the company.

In what way does your project create a business value in addition to social change?

There is a need for companion diagnostics to medicines to ensure they are given to the patients who are most likely to benefit and to avoid adverse side effects. We have ensured that we partner our diagnostics with medicines where there is a clear advantage in having a companion diagnostic alongside. We have a number of partnerships with NGOs in the developing world where we are keen to hugely increase access to medicines and we imagine that innovative business models which can take advantage of the distributed nature of health care in e.g. Africa could partner well with the diagnostics. For example, micro-franchise pharmacies in rural areas provide local people with a way to access safe and effective medicines which are not counterfeited or contaminated, as well as providing an income for the proprietor and stimulating the local economy. These could be perfect distribution channels for our diagnostics.

What impacts have you already seen? What metrics are you using to assess that impact?

The projects are still in the early phases of testing and are moving to field tests later in the year with our partners Jhpiego and Johns Hopkins University. The impact we have seen internally is around the spurring of other intrapreneurs to take up the baton in creating new projects following in the wake of the diagnostics programme. The individual projects have milestones based around progression to the next stage – e.g. filing with regulatory authorities. We will ultimately determine the viability of the business model by the impact to patients’ lives and how many patients we can access in our distribution.

What do you see as the future for your project?

We are currently undergoing an internal review of the space and determining the most appropriate role that we can play in the projects partnering with the right organisations to be effective. Ideally I would see that we can offer our expertise in a number of phases of the projects (e.g. early R&D, distribution) while partnering with more appropriate diagnostics companies who can provide the manufacturing capabilities.

How has your company fostered your project in a way that other another company could not?

GSK has a science focus, always trying to make discoveries which can benefit patients. We are also leading the industry to develop medicines and improve access for patients in least developed countries. Our work on the malaria vaccine Mosquirix, efforts to eradicate neglected tropical diseases and continued R&D into developing world illnesses (TB, malaria, leishmaniasis) show the commitment the company has to this space. Our CEO and all of the senior leadership see the potential in building our business in developing countries and this has given support for us to continue the project.

How does your project engage both environmental and social sustainability?

The diagnostics are paper-based which are extremely cheap and cost-effective to manufacture, even in developing countries. Our colleagues at Jhpiego have developed a sustainable business model developing social entrepreneurs who can sell the tests to local people, making an income for themselves and creating a small enterprise. My own experience in Africa, in Western Kenya, showed me that it is essential to build income generation into projects or they will fall flat on their face when the funding is withdrawn.

On the Changemakers website you mention interventions for antenatal and malarial diseases. For what other diseases are you sponsoring diagnostics or developing tests?

We are also looking into sickle cell anemia diagnostics to partner with research in this space and also other infectious diseases.

What sort of training are locals given in continuing these programs?

This will be carried out by our partner Jhpiego in the first field trials – initial studies show that the tests are extremely simple and reproducible for non-professionals to carry out.

Once diagnosed with a disease, how likely is it that people in these areas will have the resources for treatment? If not, what are their other options?

This is a very pertinent question and one that is essential to consider — we should not diagnose diseases without a link to the treatment regimes. For the antenatal screens, the treatments are simple, cheap and available at local hospitals — the goal here is to highlight cases of mothers with antenatal complications who have not had antenatal checks at their own homes and send them on to the health centres. For the malaria diagnostic, the test would come alongside the medication. In the majority of African countries there is coverage for life-saving medicines through national governments, ministries of health sometimes supported by international institutions. Health insurance programmes operate in some areas although this is being expanded. Over time we see that the improvement in national GDP of countries through increased productivity due to less time off with illness should lead to growth and improved ability to finance national health services.

Read about the other winners and finalists in the Changemakers’ Better Business from the Inside Out competition.