Wednesday, January 29, 2014

Pete Seeger and Government Violation of the First Amendment

If you think that some of us are being overly upset about the recent revelations of illegal NSA spying, remember our recent history. One is HUAC.  For more than 30 years the US House had a "House UnAmerican Activities Committee" which by itself is pretty much a violation of the Constitution. Led by various Chairmen and members who did not understand or agree with the First Amendment (e.g. Richard Nixon in the late 1940s), it ruined a lot of lives and careers.  

In this case in 1955, Chairman Francis Walter (D-Pa) and HUAC were after Pete Seeger for singing at communist, labor, and civil rights events.  I just read the full transcript, which is wonderful and scary at the same time. This began 7 years of prosecution for Seeger, who was convicted of contempt of Congress for refusing to answer questions about where he sang.  In 1961 he was sentenced to 10 years in jail (ultimately overturned). He paid a heavy financial price.

He said a version of the following, over and over:

"I decline to discuss, under compulsion, where I have sung, and who has sung my songs, and who else has sung with me, and the people I have known. I love my country very dearly, and I greatly resent this implication that some of the places that I have sung and some of the people that I have known, and some of my opinions, whether they are religious or philosophical, or I might be a vegetarian, make me any less of an American. I will tell you about my songs, but I am not interested in telling you who wrote them, and I will tell you about my songs, and I am not interested in who listened to them."

A picture and the full transcript are at this link.

Friday, January 24, 2014

The mobile information revolution in Africa

Most of you are not techno dweebs like me.  However, we all need to understand the information revolution that is going on in Africa because, for those of us who work there, it will touch everything we do in major ways.  It is the same story in India.  Here are some easily accessible articles, the first from today on CNN.  Bottom line: almost everyone has a cell phone or access to one; the information platform (smart handsets and powerful mobile networks) are happening and happening fast.  This enables things we could only dream about before, most importantly in giving ordinary people access to information and knowledge to improve their well being, from agricultural information, to job listings, to personal vitality. 

Story from CNN today on the mobile explosion in Africa

From last fall, the smart phone is coming fast in Africa.  18% of the market last fall and moving up (as their price falls), just as the capacity of the networks is improving fast. 

And a broad look from 2012 on the 7 ways the mobile phone is changing Africa.  All still true, except much more

Wednesday, January 22, 2014

Monsanto's latest: better veggies?

Imagine what these guys would do if consumers had a clear, easy way of measuring nourishment outcomes: in the food and in themselves. They would follow the demand and create nourishing food instead of high sugar corn. Nutritional content and outcome is not the metric today; but it is coming, along with consumer devices to measure those.  Read this highly informative article from Wired.

Monsanto’s gene chipper “maps the parts of a genome that might be associated with a given trait, even if that trait arises from multiple genes working in concert. Researchers identify and cross plants with traits they like and then run millions of samples from the hybrid—just bits of leaf, really—through a machine that can read more than 200,000 samples per week and map all the genes in a particular region of the plant’s chromosomes.

“They had more toys too. In 2006, Monsanto developed a machine called a seed chipper that quickly sorts and shaves off widely varying samples of soybean germplasm from seeds. The seed chipper lets researchers scan tiny genetic variations, just a single nucleotide, to figure out if they’ll result in plants with the traits they want—without having to take the time to let a seed grow into a plant. Monsanto computer models can actually predict inheritance patterns, meaning they can tell which desired traits will successfully be passed on. It’s breeding without breeding, plant sex in silico. In the real world, the odds of stacking 20 different characteristics into a single plant are one in 2 trillion. In nature, it can take a millennium. Monsanto can do it in just a few years. And this all happens without any genetic engineering. Nobody inserts a single gene into a single genome.”

Tuesday, January 14, 2014

Door Step Vitality: the Antidote to the Failings of Sick Care

Taking advantage of the information revolution to deliver evidence-based integrated vitality programs

The primary mission of healthcare for disadvantaged populations to date has been to treat disease and reduce death. The primary mission of feeding programs has been to fill bellies. These are worthy, but limited, goals. Merely keeping a malnourished mother and her stunted infant alive consigns the baby to a life of hardship and failure. Instead, our objective should be vitality: the capacity to achieve the full human possibilities, the capacity to be a success as a changemaker. 

Vitality is physical strength and mental vigor. Vitality requires physical and mental health; sanitation and full nourishment; personal empowerment/education and care from skilled professionals; and nourishment of humans and communities and their environment.

Achieving vitality requires new leaders with radically different goals, approaches and systems. These must be explicitly designed to transform from sick care to vitality, from expert-centered to person-centered, from siloed services to holistic, and from facilities-based medicine to “door step health.” What are the “holistic person solutions” to deliver vitality? The essential elements include full nourishment, primary healthcare, behavioral healthcare, safe drinking water and sanitation, and detailed outcomes measurement using modern technology from the global information revolution. 

Give people knowledge and control by personal education/empowerment about these elements, with information in their hands. Build a community that nourishes around them. Lift them up before they get sick; you get less sickness, and you can manage chronic illness better.

“Door step health” means using mobile ICT and diagnostics to enable services in people’s homes, where they work, and at local wellness centers, while connecting them to typical medical care when needed. Experience with this model indicates that it broadens access to care; it creates better compliance and behavior-change; it addresses the shortage of doctors and nurses by empowering lay health workers with IT-based protocols, mobile diagnostics, and interactive patient education tools; we believe it will achieve better outcomes at far lower cost than Western-style, facilities-based care; and it captures more comprehensive information (enabling far richer and faster research, including big data analysis).

This model also addresses the growing global malnutrition crisis, visible in both the hundreds of millions of stunted children and the worldwide obesity epidemic among adults. In addition, new scientific evidence shows that a seriously malnourished mother will give birth to a child with an altered profile of activated genes and far higher numbers of fat cells—and a lifelong propensity toward obesity, diabetes, and heart disease. Still other evidence shows the key role that insufficient or inappropriate nutrition plays in triggering the onset of chronic illnesses like diabetes, heart disease, and depression. At the same time, evidence is mounting that combining medical treatment of even severe diseases such as TB and HIV/AIDS with full nutrition can markedly enhance recovery.

So how do we enable and empower people to demand these changes? The most powerful creators of demand for vitality (and thus key target populations) appear to be (1) infants and children (1000 days of pregnancy and infancy, and schoolchildren) and (2) working adults. If they achieve vitality, we believe there will be large, measurable outcome changes: babies will develop far better, schoolchildren will learn more, and workers will be more productive and less apt to get sick – whether they own a small business, or work on a farm or construction site, or in a mine or factory.

The combination for disadvantaged populations of vitality programs and modern ICT systems holds the promise of effective and highly disruptive innovation solutions, and exciting new business, humanitarian, and ongoing rapid learning/research opportunities. Entrepreneurs have demonstrated successful innovations for each of the components of integrated vitality solutions described above. What is needed now is to combine the best into integrated packages that can be locally contextualized and trialed, producing the critical evidence to both improve the approaches and fuel growing demand.

Once tipped towards vitality, this new ecosystem should unleash waves of innovation and investment at which we can only guess. Vitality and nutrient measurement and accounting for consumers and businesses will be provided by new devices and systems. We will see new generations of apps, tools and instruments, and new places where services are dispensed. Successful companies will lead the charge so they have the most vital staff. All the while, new information capture, analysis and distribution systems will generate a spiral of rapid, evidence-based improvement in each of these. New capabilities, professions and business will emerge. People will be empowered to consume wellness/health services effectively. Collections of entrepreneurs will build communities that nourish, including shifting agriculture companies and farming communities toward nutrient generative farming and land management practices.

That is down the road. So what are the challenges today? We need to show what is possible both in outcomes and cost from basic vitality programs. What are the content, business models, and partnering approaches – encompassing but not limited to earlier discovery and treatment of disease – that can achieve widespread vitality, and do so far more efficiently than traditional Western approaches? How is behavioral health done where almost nothing exists? What are the relationships between social entrepreneurs, the citizen and private sectors, and government that can transform the delivery of health to pursue this higher goal? How and where can we catalyze the launch of the multi-partner systemic trials needed to produce the compelling data which will drive change?

We have work to do – together.