The Africa Health Ventures Podcast

Rowena Luk

Unlocking access to quality healthcare in Africa by 2030 will require radical innovations. Join veteran digital health / healthtech entrepreneur Rowena Luk in conversation with healthcare industry leaders and innovators every quarter to strategize on what the future of healthcare in Africa will look like. This podcast is for social entrepreneurs, impact investors, and global health professionals who need to stay ahead of the rapidly changing landscape of healthcare in Africa.

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Episodes

The Medicine Supply Chain in Africa, Part 2: The Next 10 Years
30-11-2023
The Medicine Supply Chain in Africa, Part 2: The Next 10 Years
In 10 years, the medicine supply chain in Africa will look very different than it does today. In Part 2 of this podcast, we examine four key trends which are going to re-shape the medicine supply chain in Africa over the next decade - and shout out to a few of the entrepreneurs that are leading the charge. From regulatory changes spearheaded by the African Union to biomedical innovation requiring new pathways to patient, the medicine market is both growing and changing in Africa. Our lineup includes:* Mila Nepomnyashchiy, Lead Advisor, Center for Innovation and Impact, USAID* Sidharth Rupani, Senior Advisor for Supply Chain, The Global Fund* Yusuf Rasool, Director of Global Market Access at MSD/Merck* Clinton De Souza, former Director of Public Health for Imperial Logistics (now DP World), Managing Partner at Celsian Consulting* Dr. Prashant Yadav, one of the world’s leading scholars on healthcare supply chains. Dr Yadav is a Senior Fellow at the Center for Global Development, Affiliate Professor at INSEAD and Lecturer at Harvard Medical SchoolListen now wherever you get your podcasts (Apple Podcasts, Spotify, Overcast, etc.).In case you missed it, don't forget to check out Part 1 of this episode, where we trace the movement of a pack of medicines from a factory in India to the shelves of a mom-and-pop pharmacy in Zambia. Connect with Africa Health Ventures📰 Sign up for our newsletter to stay informed about what’s going on with healthcare ventures in Africa🪙 Nominate a startup for seed funding👍 Follow us on LinkedIn🎙️ Subscribe to this podcastShow NotesPart 2 of The Medicine Supply Chain in Africa covers 3 segments:1. The Outsized Role of Global Donors(3m22s) - There’s a world of difference between the private sector medicine markets and the ones supported by billions of dollars of international donor funding. We hear from Mila Nepomnyashchiy of USAID about two different worlds: one for the medicines endorsed by global funding… and one for everything else. 2. Four Trends That Will Dramatically Change The Medicine Supply Chain in the Next 10 Years(5m45s) - Trend 1: Clinton De Souza, former Director of Public Health for Imperial Logistics (now DP World), on regulatory changes from the African Union that will massively expand the size of the market.(9m44s) - Trend 2: Yusuf Rasool, Director of Global Market Access at MSD/Merck, on vertically integrated supply chains that will reduce costs and increase access to consumers.(13m28s) - Trend 3: Dr. Prashant Yadav of the Center for Global Development on omnichannel distribution that will meet patients where they live and work. (16m46s) - Trend 4: Sidharth Rupani, Senior Advisor for Supply Chain at The Global Fund, on the golden age of biomedical innovation that will challenge our existing ideas of both ‘medicines’ and ‘supply chain’.3. Social Entrepreneurs Leading the Charge (20m31s) - Dr. Prashant Yadav highlights a handful of social enterprises that are leading the charge for change.Learn More* USAID’s Global Health Supply Chain Program is a US$9.5 billion program with support from PEPFAR. The follow-in contract may be as much as US$17 billion.* The Global Fund provides extensive support to countries in procuring low-cost, priority medicines. Every year it spends about US$2 billion to procure medicines for HIV, tuberculosis, and malaria.* The Africa Medical Supplies Platform is a pooled procurement mechanism spearheaded by the African Union* The African Medicines Agency seeks to create a common regulatory environment for medicines across Africa* The African Continental Free Trade Agreement could create the largest free trade area in the world* mPharma provides medicines to pharmacies, but does not require payment until those medicines are sold. This helps pharmacies to stock more medicines by de-risking the need for upfront cash.* Maisha Meds is providing forecasting, sourcing, and other technology support to small retail pharmacies in rural areas.* Kasha is bringing health products to women and girls at home, giving them the privacy they need while increasing their agency and choice. * Xetova supports the government in Kenya to use its health supply chain data to create insights on consumption, distribution, procurement spending, supplier and payment performance.* Pendulum Systems (formerly Macro-Eyes) is providing AI and machine learning tools to African governments to help them optimize their medicine supply chain.* How Local Innovation Can Drive the Global Development Agenda - This 2023 piece from Dr. Prashant Yadav highlights the importance of new social entrepreneurs in addressing gaps in the private and public medicine supply chain.* Innovations in Digitizing Health Supply Chains in Africa - This 2023 market intelligence report from Salient Advisory highlights some of the key areas of the medicine supply chain where startups in Africa are most active. Thank you for tuning in to Africa Health Ventures. This podcast is public so feel free to share it. Get full access to Africa Health Ventures at rowenaluk.substack.com/subscribe
The Medicine Supply Chain in Africa: from Manufacturer to Pharmacy (Part 1)
21-11-2023
The Medicine Supply Chain in Africa: from Manufacturer to Pharmacy (Part 1)
What does it take to move a pack of medicines from a factory in India to the shelves of a mom-and-pop pharmacy in Zambia? In this episode, we explore the world of the medicine supply chain in Africa, as told by the people who run it. Along the way, we unpack the market dynamics which limit access to low-cost, essential medicines.Our lineup includes:* Yusuf Rasool, Director of Global Market Access at MSD/Merck* Clinton De Souza, former Director of Public Health for Imperial Logistics (now DP World), Managing Partner at Celsian Consulting* Michael Moreland, CEO and Founder, Field Intelligence* Sidharth Rupani, Senior Advisor for Supply Chain, The Global Fund* Mila Nepomnyashchiy, Lead Advisor, Center for Innovation and Impact, USAID* Dr. Prashant Yadav, Senior Fellow at the Center for Global Development, Affiliate Professor at INSEAD and Lecturer at Harvard Medical SchoolListen now wherever you get your podcasts (Apple Podcasts, Spotify, Overcast, etc.).Stay tuned for Part 2, when we look at the future trends which are going to dramatically change this supply chain and highlight a few of the new ventures which are leading the way.Connect with Africa Health Ventures📰 Sign up for our newsletter to stay informed about what’s going on with healthcare ventures in Africa🪙 Nominate a startup for seed funding👍 Follow us on LinkedIn🎙️ Subscribe to this podcastIn this episode, we cover* (2m54) - Setting the stage: we introduce several of the key actors in the medicine supply chain, including manufacturers, distributors, and pharmacies. Dr. Prashant Yadav highlights the key role of Ministries of Health as well as the disruptive influence of social entrepreneurs. * (8m27s) - Yusuf Rasool of MSD/Merck describes the role of large pharmaceutical companies and why it is difficult for a large multinational to operate directly in 54 different African countries.* (10m57s) - Clinton De Souza digs into two of the structural problems in the medicines market which makes it difficult for distributors to deliver low-cost essential medicines. * (19m07s) - From the perspective of Five Star Pharmacy in Zambia, we look at the working capital gap which prevents small pharmacies from making the full range of medicines available to people.* (21m49s) - Michael Moreland of Field Intelligence describes the role of social entrepreneurs and embedded financing in allowing small pharmacies to increase product availability. * (29m17s) - Recap of the episode so far and teaser for Part 2Learn More* Health Product Supply Chains in Developing Countries - This 2015 paper from Dr. Prashant Yadav summarizes the key actors and common challenges of medicine supply chains in Sub-Saharan Africa.* How Local Innovation Can Drive the Global Development Agenda - This 2023 piece from Dr. Prashant Yadav highlights the importance of new social entrepreneurs in addressing gaps in the private and public medicine supply chain.* Innovations in Digitizing Health Supply Chains in Africa - This 2023 market intelligence report from Salient Advisory highlights some of the key areas of the medicine supply chain where startups in Africa are most active. * How MSD/Merck is improving access to healthcare - This page highlights a few of the affordability solutions that MSD/Merck’s Access to Medicines team is working on around the world.* Imperial Logistics is one of the largest medicine distributors on the African continent.* Five Star Pharmcies is a chain of retail pharmacies in Zambia founded by Lloyd Matowe with the support of Clinton De Souza.* Field Intelligence is a social enterprise providing planning, fulfilment, and financing of pharmaceuticals to over 35,000 points of care in Nigeria and Kenya, including government clinics, retail pharmacies and drug shops, hospitals and telehealth providers. * Was the $9.5B health supply chain 'a waste of USAID's money'? - Earlier this month, Devex published a(nother) searing indictment of USAID’s global health supply chain program. The controversy surrounding this highly centralized, donor-funded program is one of the reasons why now is a good time to take a look at what’s working (and what’s not) in private sector medicine supply chains. In Part 2 of this episode, we’ll touch on a few of the differences and linkages between what we describe in Part 1 and certain donor-driven supply chains.Thank you for tuning in to Africa Health Ventures. This podcast is public so feel free to share it. Get full access to Africa Health Ventures at rowenaluk.substack.com/subscribe
Chuck Slaughter of Living Goods: Digital First Healthcare Saving Lives at the Last Mile
05-09-2023
Chuck Slaughter of Living Goods: Digital First Healthcare Saving Lives at the Last Mile
Chuck Slaughter is the founder of Living Goods, which supports over 10,000 digitally-empowered community health workers who are reducing child deaths by over 25% at an annual cost of under $4 per person. As a Senior Advisor to TPG Rise (a $10 billion impact investing platform), Director of the Horace W. Goldsmith Foundation, and a successful entrepreneur, Chuck has a rich perspective on how digital is reshaping aid and development work. Tune in today to hear Chuck’s guidance on whether to ‘build or buy’ tech, why nonprofits struggle to deliver the best technology products, and how governments and the private sector need to work together to scale high-impact innovations.Chuck serves on the boards of Yale’s School of Management, Tidepool, Reach Health, and the Horace W Goldsmith Foundation. He received a Skoll Award for Social Entrepreneurship, an Ernst and Young Entrepreneur of the Year Award, a Draper Richards Kaplan Fellowship, and is a World Economic Forum Social Entrepreneur of the Year. A Few Highlights(6m27s) - How Chuck and Living Goods became digital first(13m45s) - The DESC metaphor of Living Goods: Digital, Equipped, Supervised and Compensated(22m01s) - Working with new technologies: the 'build or buy' debate(28m24s) - Why nonprofits struggle to build great tech(32m09s) - The digital transformation of aid: grantmaking through the Horace W. Goldsmith Foundation(37m08s) - Financing scale: how governments and the private sector need to work together(40m19s) - Rapid fire questions, shoutouts, and recommendationsYou can learn more about Living Goods on their website at livinggoods.org.  Let us know what you thought of this episode on LinkedIn or Twitter (@AidEvolved). You can also access show notes at AidEvolved.com. Get full access to Africa Health Ventures at rowenaluk.substack.com/subscribe
Investing in Healthcare with the World’s Largest Pure-Play Impact Investor
23-05-2023
Investing in Healthcare with the World’s Largest Pure-Play Impact Investor
Dr. Biju Mohandas has led investments at not just one but three different household names in impact investing: LeapFrog Investments, the International Finance Corporation (IFC), and Acumen. Tune in today to hear about his take on the upcoming global healthcare crisis, the competitive edge of entrepreneurs in Africa and India, and the catalytic role of impact investors. Hear the investment priorities of a man who's been leading impact investments in healthcare in Africa as long as the term "impact investing" has existed. Dr. Biju Mohandas is a Partner at LeapFrog and the firm’s Global Co-Leader for Health Investments. Prior to LeapFrog, Dr Mohandas led the IFC’s Healthcare and Education investment team in Sub-Saharan Africa and was the Global Sector Lead for Medical Devices after also serving as head of Acumen in East Africa and as part of their founding team in India. We’ll cover:(2m35s) – The coming global healthcare crisis(8m45s) – How Africa and India are poised to leapfrog ahead(12m11s) – Investing in asset-light healthcare (15m09s) – Goodlife Pharmacy’s re-emergence after the Westgate Attack in Nairobi(18m08s) – How Redcliffe Diagnostics is bringing the lab closer to people in India(21m38s) – Pervasive technology, IoT, and wellness(23m04s) – HealthifyMe, the largest digital wellness app in India(26m13s) – How investors exit from ventures in emerging markets(30m10s) – Rapid fire questions Submit a question to our mailbag and we’ll discuss it on a future show. Emails or voice recordings can be sent to podcast@aidevolved.com  Connect with us on LinkedIn or Twitter (@AidEvolved) and access Biju’s latest synthesis on the state of healthcare in Africa at https://AidEvolved.com.  Get full access to Africa Health Ventures at rowenaluk.substack.com/subscribe
Technology, Innovation, and the Global Fund
09-05-2023
Technology, Innovation, and the Global Fund
John Fairhurst is the head of Private Sector Engagement at the Global Fund. As such, he is the link between this global institution and innovators ranging from Microsoft to Zenysis. Tune in today to understand how the largest financier of HIV, TB, and malaria programs works with Big Tech, emerging startups, and other innovators to achieve its global goals. In its 20 years of existence, the Global Fund has channeled $55 billion to support the fight against HIV, TB, and malaria. Prior to joining the Global Fund John was an Executive Director at UBS Optimus Foundation and COO at the Global Alliance for Improved Nutrition (GAIN). He helped establish the portfolio of one of the largest private foundations in international development, the Children's Investment Fund (CIFF). He oversaw development and humanitarian programs for Oxfam in various geographies including the Democratic Republic of Congo, Eritrea, and Afghanistan. A few highlights:(2m13s) - Introducing John Fairhurst(6m06s) - How the Global Fund works with Big Tech(16m19s) - How the Global Fund works with emerging technologies and startups(21m38s) - The partnerships that don't work out(26m56s) - Guidance for other donors in "the valley of death"(31m41s) - Rapid fire questions Submit a question or comment to our mailbag, and we’ll discuss it on a future show. Emails or voice recordings can be sent to podcast@aidevolved.com Connect with us on LinkedIn or Twitter (@AidEvolved) and access show notes at https://AidEvolved.com Get full access to Africa Health Ventures at rowenaluk.substack.com/subscribe
Curt LaBelle, M.D., Managing Partner of the Global Health Investment Fund and the AXA IM Global Health Fund
11-04-2023
Curt LaBelle, M.D., Managing Partner of the Global Health Investment Fund and the AXA IM Global Health Fund
GHIF was a "first-of-its-kind investment product", the fund was created in 2012 through the surprising alliance of the Gates Foundation and JP Morgan Chase. Its supporters include a stellar cast of characters such as Grand Challenges Canada, AXA Investment Managers, the development finance institution of both Germany and the World Bank, GSK, Merck, and Pfizer. Its mission is two-fold: generating attractive financial returns to its investors, and improving lives for millions in low- and middle-income populations. This is accomplished by providing late-stage financing for innovative drugs, vaccines and diagnostics, and working with companies to introduce the products globally. The new AXA IM Global Health Fund is expanding the model with a larger fund and wider mandate that includes both communicable and non-communicable conditions.  In this episode, we'll touch on:The kinds of global health innovations Curt financed through GHIFCurt's guidance for innovators seeking growth capitalLessons learned for emerging fund managersCurt's call to action for the global health community to ensure life-saving products are effectively delivered to communities as far as the last mile This conversation was recorded live at the IFC Global Private Health Conference 2023 in Cape Town, February 2023. IFC is a development finance institution and the private sector arm of the World Bank Group. Access show notes at https://AidEvolved.com and connect with us on LinkedIn or Twitter (@AidEvolved).Submit your questions or comments for a future episode to podcast@aidevolved.com. Get full access to Africa Health Ventures at rowenaluk.substack.com/subscribe
Joseph Ssentongo of the Global Innovation Fund
28-02-2023
Joseph Ssentongo of the Global Innovation Fund
As the Senior Vice President of Impact at the Global Innovation Fund, Joseph Ssentongo works at the challenging nexus of innovation, evidence and impact. He sits down with Aid, Evolved today to share his efforts to generate evidence even from early-stage innovations; how to measure impact even when that impact might not mature until 10 years in the future; and how Big Aid can evolve to be more innovative by adopting the right model of risk.The Global Innovation Fund (GIF) is a non-profit, impact-first investment fund which has invested over 100M USD in innovations with the potential to improve the lives of those living on less than 5 dollars a day. It is backed by grant capital from UK, Canadian, Swedish, US and Australian governments as well as corporate and philanthropic donors. This interview reflects the personal experiences and views of Joseph Ssentongo and does not represent the position of GIF or any of its partners.Conversation Highlights(4m35s) - Joseph recalls his work with the Investment Climate Facility for Africa working with government to improve private sector investment across 14 countries(13m08s) - What is the Global Innovation Fund (GIF)?(18m19s) - How does GIF remain accountable not just to its major donors but also to the people and communities it claims to serve?(20m33s) - Joseph unpacks the tricky balance between delivering world-class evidence and also investing in novel innovations which may not yet have a strong track record of evidence(23m04s) - Joseph shares his personal experience and the unique contribution of GIF to the waste pickers of Mr. Green Africa, a new kind of recycling company in Kenya(26m49s) - How GIF strives to be a catalyst that can lead the way for other donors to invest in risky innovations(30m20s) - What's next for GIF? Joseph describes the launch of GIF's Innovating for Climate Resilience Fund as well as the Innovating for Gender Equality sub-fund(31m22s) - Joseph tackles our Rapid Fire questions, from people who inspired him to his favourite podcasts To find out more, access the show notes at https://AidEvolved.com Let us know what you think of this episode on LinkedIn or on Twitter (@AidEvolved)A note from our sponsor: this episode is brought to you by idealist.org. Are you looking to hire dedicated and talented professionals? Idealist is the #1 job board for the social impact sector. Sign up to start posting jobs today! Go to idealist.org/aid to get a credit for one free 30-day job listing. Get full access to Africa Health Ventures at rowenaluk.substack.com/subscribe
Creating New Ways to Fund Innovations in Global Health with Rebecca Distler of the Patrick J. McGovern Foundation
15-11-2022
Creating New Ways to Fund Innovations in Global Health with Rebecca Distler of the Patrick J. McGovern Foundation
Join us in conversation with Rebecca Distler, Strategist for AI, Data, and Digital Health at the Patrick J. McGovern Foundation. She shares the trials and tribulations of a decade spent funding and fund-raising for innovations in global health - and how she's working to change the game, from supporting the Gates Grand Challenges initiatives through her work at the Foundation to advance digital health equity. In this far-ranging conversation, we touch on ethical AI, private venture capital vs. public funds, and even the New York City Ballet. Rebecca's prior work includes advising on digital ID for COVID-19 vaccination and testing, leading a $3M+ portfolio of AI and digital ID for health projects, and supporting the launch of government partnerships to fund and advance early stage technology and R&D in global health. Rebecca holds a Masters in Health Policy and Global Health from the Yale School of Public Health and a BA in Political Science from Yale University. She is a Term Member at the Council on Foreign Relations, a World Economic Forum Global Shaper, and was selected as a Forbes Ignite Impact Fellow, AI XPRIZE Semi-Finalist, and Gavi INFUSE Pacesetter. The Patrick J. McGovern Foundation is a 21st century philanthropy committed to bridging the frontiers of artificial intelligence, data science, and social impact. Note: This interview is about the personal experiences and perspectives of Rebecca Distler. Nothing said in this interview should be construed as the position of the Patrick J. McGovern Foundation, the Bill and Melinda Gates Foundation, or any of their affiliates. To find out more, access the show notes at https://AidEvolved.com  Is there a donor or investor you’d like to hear on this show? Let us know on Twitter (@AidEvolved) or by email (hello@AidEvolved.com)Today’s episode was brought to you by idealist.org. Sign up to start posting jobs today on the number one job board for the social impact sector. Go to idealist.org/aid to get a credit for one free 30-day job listing. Get full access to Africa Health Ventures at rowenaluk.substack.com/subscribe
BongoHive: Building the Zambian Tech Sector from the Ground Up
04-10-2022
BongoHive: Building the Zambian Tech Sector from the Ground Up
Lukonga Lindunda is a startup ecosystem builder. He is Executive Director and co-founder of BongoHive, an award-winning innovation hub and tech incubator based in Lusaka, Zambia, that is changing the landscape of entrepreneurship in the region.Lukonga is a Mandela Washington Fellow and has 15 years of experience working with entrepreneurs and development partners. He began his career providing technical assistance in aid sector programmes with Education Development Center (EDC) and VVOB. In 2011, he founded BongoHive with three colleagues after noting a gap in the support young entrepreneurs needed to bring their innovative business ideas to life. Since then, Lukonga has steered BongoHive to nearly 1300 Startups and MSMEs harnessing over $2 million in resources to support their growth since 2016. BongoHive have been featured on global and regional media outlets such as CNN, BBC, Al Jazeera, TechCrunch, and many others.In today's conversation, Lukonga recalls the founding story of BongoHive. He looks back on the early approaches he took to generate revenue and pay the bills, as well as the different sectors and services BongoHive has offered over the years. The story of Lukonga and BongoHive is also the story of how the tech sector in Zambia has evolved over the past ten years. It is a case study that illustrates many of the challenges of building the tech sector in low-income countries in Africa: the essential pieces of missing infrastructure, the limited options for funding and talent, and above all the unfaltering grit of its founders.To find out more, access the show notes at https://AidEvolved.com Let us know what you think of this episode on Twitter (@AidEvolved) or by email (hello@AidEvolved.com) Get full access to Africa Health Ventures at rowenaluk.substack.com/subscribe
Robert Karanja, Villgro Africa, and the Next Frontier of Genomics Startups in Africa
06-09-2022
Robert Karanja, Villgro Africa, and the Next Frontier of Genomics Startups in Africa
Dr. Robert Karanja recalls how he founded Villgro Africa, a tech incubator and impact investor focused exclusively on health innovations in Africa. Stick around for the end when Robert shares his predictions for the future of genomics on the continent and his hopes for a new kind of pharmaceutical company for Africa. Robert began his career with the dream of eradicating malaria. To this end, he completed a PhD in medical parasitology and spent almost a decade at Kenya's premier medical research institute, KEMRI. But over the years, he realized the problem with malaria wasn't scientific - it was financial. It was inextricably linked to the poverty and inequity of the communities most affected. So Robert started to grapple with the question: "how do I use cutting-edge science not just to tackle biology, but also to create opportunity? How can we generate wealth and launch viable health ventures that will fix the gaps in coverage?" This question would lead him first to launch a bioentrepreneurship program at one of Kenya's leading universities, and then to join forces with Villgro, one of the world's first impact incubators. In 2015, Robert co-founded Villgro Africa, a franchise offshoot of the global Villgro model focused exclusively on health innovations in Africa. Robert shares how he launched Villgro Africa, and how he needed to adjust the traditional incubator approach to match the economics of Africa. Towards the end of this conversation, Robert hints at the next great venture he is turning his attention towards. He sees a massive untapped opportunity for the pharmaceutical sector in the genomic wealth of Africa paired with modern mRNA technology. He argues that clinical trials and precision health studies could be delivered here in Africa. These would deliver pharmaceutical products competitively to the global market and also provide more appropriate health solutions locally. He points at the gap that exists in the global pharma industry, and how Africans will rise to fill this gap. Of course, Robert is paving the way, with the launch of an innovation hub that will bridge the gap between biotech researchers and a new kind of pharma company for Africa. To find out more, access the show notes at https://AidEvolved.com Let us know what you think of this episode on Twitter (@AidEvolved) or by email (hello@AidEvolved.com) Get full access to Africa Health Ventures at rowenaluk.substack.com/subscribe
Digitizing the Largest TB Program in the World with Andrew Cross of Everwell
31-08-2022
Digitizing the Largest TB Program in the World with Andrew Cross of Everwell
Like another airborne disease we are all familiar with, tuberculosis (TB) spreads invisibly through the air. If you catch it and you don't treat it, you're likely to die. India has the largest TB burden in the world, with millions of cases diagnosed and over 500,000 deaths every year. Consistent, continuous treatment and management of care is essential to a healthy recovery. This is why the work of Everwell Hub is so critical. Everwell Hub is a comprehensive digital solution for the management of tuberculosis. 1 in 5 newly diagnosed TB patients in the world are managed through the Everwell Hub - making it the most widely adopted solution of its kind in the world.  Andrew co-founded Everwell and has been CEO for most of its existence. He sits down with Aid, Evolved to share what the journey to scale has been like, from the hallowed halls of Microsoft Research to the messy realities of public clinics. At Microsoft Research, he was able to work with cutting-edge tech and world-class researchers. In this environment, Andrew experimented with solutions in computer vision, augmented packaging, and cellular technology. Then, in 2014, one of his innovations started to stretch beyond the domain of a research lab. 99DOTS, a tool for medication adherence, was seeing significant interest and uptake both by donors and government. Andrew and his small team knew that a research lab would not be the place to scale this technology. So, they set off on their own. This was how Everwell was born. Everwell's journey to scale arose from a unique confluence of factors: it was built on a foundation in research and evidence. Andrew's spin-off from Microsoft was catalyzed by early buy-in from the government. And, serendipitously, Everwell's birth coincided with a change in health policy around TB treatment which created new demand for Everwell's solutions.  But the journey to scale is riddled with challenges. Compared to the research environment, Everwell needed to adapt to support populations at scale which revealed new and different obstacles than at a more limited scale. As one example, their initial approach using incoming calls was blocked by the telecom operators (telcos) because the system enabled patients to call for free, so they had to innovate further to accommodate millions of toll-free calls coming into their system. In today's conversation, Andrew shares the many ways in which Everwell has needed to adapt and change in order to support the holistic, end-to-end needs of TB caregivers in India and around the world.  One key learning from his experiences: if you’re scaling innovation, you either need to find environments with the right infrastructure to accept that innovation OR you need to build an organization that is able to develop the infrastructure needed to support your innovation. To find out more, access the show notes at https://AidEvolved.com Let us know what you think of this episode on Twitter (@AidEvolved) or by email (hello@AidEvolved.com) Get full access to Africa Health Ventures at rowenaluk.substack.com/subscribe