Can the Developing World Spur Tech-Driven Healthcare Revolution?
STORY INLINE POST
Healthcare has improved a great deal everywhere in the world, and yet, the phrase by William Gibson, “The future is already here, it’s just not very evenly distributed,” is particularly apt when thinking about the state of healthcare in the developing world. As a consequence of this current unevenness, it would be easy to assume that rich nations are the best candidates to fully embrace the existing possibilities that technology offers in the realm of healthcare. I propose that the developing world might actually offer better conditions for a tech-driven healthcare revolution.
It’s hard to overstate the potential impact that some of the technologies on the verge of coming out of the lab and into the real world will have. The clearest example of this are mRNA vaccines. Just a couple of years ago, the techniques used to develop the Moderna and Pfizer vaccines sounded more like science fiction than medicine; today, as we approach 1 billion doses administered, it’s as obvious as it can be that this technology is real. There are several examples of technology-driven therapies that share this almost science fiction-like characteristic with COVID mRNA vaccines. Some notable examples are gene therapies, AI-driven diagnostics and ever more complete and continuous biometrics monitoring.
Another characteristic that these technologies share is that, very often, they are developed in ways more similar to software and silicon than those of traditional biology. In particular, they are subject to exponential progress in the literal sense. To grasp that this is not just techno babble hyperbole, it suffices to see how the cost of genome sequencing has dropped:
And yet, even though we’ve been on this exponential trend for some time now, healthcare is often still practiced in very traditional ways. Part of that is that as exponential as these trends might be, it still takes time for technology to reach maturity and be widely adopted. But there is a more pernicious issue at play here: healthcare delivery is a task that is profoundly influenced by the coordination dynamics around it; you could even say that at its core, healthcare is really a social coordination problem. It is true, of course, that unlike food, there’s also a real supply issue in healthcare: there simply aren’t enough healthcare professionals in the world to care for all of us (and when healthcare systems get saturated as happened in several phases of the COVID pandemic, this issue is even more acute). But the gap between what is possible with the latest technology and what is actually happening is better explained as a coordination problem. To see why this is the case, the example of how reimbursement codes in the US work is clear. For a therapy to have a shot at being commercially successful, it has to not only prove that it is clinically efficient, but it also has to go through the process of obtaining a reimbursement code from the healthcare bureaucracy and if it fails to do so, it doesn’t matter how miraculous that therapy is, it won’t reach mainstream adoption.
Here is where the developing world has an edge. Even though our healthcare systems are clearly not as developed as those in rich nations, the very relative thinness of this bureaucracy creates an opportunity space in which a new type of healthcare system can emerge. To put it in an overly simplistic form, the Mexican healthcare reality is much more of a blank slate in comparison to that in the US, and this comparison is likely true in several pairs of developing nations with developed nations. The coordination problem is less complex in developing nations in comparison with its equivalent in the developed world. This presents an opportunity for developing economies to embrace the cohort of exponential technologies in healthcare to a degree and with a speed that the developed world might not be able to handle.
This sounds overly optimistic perhaps, but the fact that there are examples of this trend that are already happening proves that it is possible for this to be seen elsewhere too. In China, Ping An Good Doctor’s AI diagnostics tool was used more than 500 million times in the first half of 2021.
As the technology adoption wave keeps expanding through Latin America, reaching both new industries and new groups of users, it is extremely exciting to think of the possibilities of the digital jump that healthcare can take.