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Anurag Mairal

Associate professor and director of the Stanford Biodesign Global Exchange Program 

After spending two years at PATH, an NGO focused on creating innovative solutions in the health arena for developing countries, Anurag Mairal has returned to Stanford, where he is an associate professor and director of the Stanford Biodesign Global Exchange Program. He is also a member of the d·HEALTH Barcelona Advisory Board.

Anurag Mairal: "Innovation must address local needs and to do so local teams and the local ecosystem must be deeply involved"


In recent years, Anurag Mairal has traveled the world with two messages. First, that innovative medtech solutions can only be sustainable if they arise from the place where they are needed, led by local teams. And, second, that if the innovation puzzle is missing pieces due to lack of practice, those who have ideas about making the world a better place can always look to biodesign to successfully bring their ideas to market.

Anurag has spent these past days in Barcelona and seen the advances of d·HEALTH Barcelona, the Biocat master in innovation and entrepreneurship in the life sciences, for which he is on the Advisory Board.


You’ve been at PATH for two years. What does this organization do?

It’s a global health NGO that works in 70 countries and develops drugs, vaccines, medical devices and digital health solutions. PATH focuses on the lowest part of the pyramid, in parts of Africa and Asia where medical systems aren’t developed enough and patients don’t get the medical solutions and therapies we’re accustomed to. My team of 120 people developed products in 5 areas: solutions for woman and children, for water treatment, vaccines, and new diagnostic, eHealth and mHealth tools.

Innovation often comes out of wealthy countries and is exported, but you’re fighting for just the opposite. Why is it important for innovation to come out of the place where it will be applied?

Innovation must address local needs and to do so local teams and the local ecosystem must be deeply involved. Without that on-the-ground reality check, the innovation won’t be sustainable. That’s why we took our biodesign program to India, for example. They come to Stanford, we train them and they go back to their country to apply the process to the needs in India.


What challenges are involved in developing a product in these countries? 

In the United States or Europe we have a long history of innovation, of thinking up new products and taking them to market. But that doesn’t exist there because they haven’t needed it. Now they have intelligent people, serious clinical needs and societies that have started to invest in innovation. But they have to learn how to understand the need, design the right product, protect it, test it, market it, distribute it and prepare people to use it. There’s a lot of pieces missing in that puzzle. But innovators there are starting to put it together.


How can we boost the innovative talent in these countries?

In South Africa, Brazil, Kenya, China and India there are people with the right training to understand the technical aspects involved in innovation and who have also grown up there, have extensive knowledge of their society, culture and even the “cracks” in the system. They understand the existing needs better than anyone, so that’s half the battle. From there, they have to create a product to address those needs, and that’s where we come in: we can teach them to optimize the process.


Can innovators be made? Isn’t part of it innate?

You can't teach creativity but you can teach innovation. Innovation is understanding a problem, breaking it into little pieces and thinking about how to solve it with the knowledge at hand. There's a method that can be taught. But yes, character is important, especially in the multidisciplinary team that we encourage in our method. Because a strong personality can be what brings a team together or what breaks it apart.


When we talk about Africa or Asia we always talk about challenges. But what can we learn from them?

Ten years ago that question wouldn’t have made as much sense as it does now. Things have changed because our healthcare systems don’t have money and we have to find a way to maintain quality healthcare at a lower price. And that has always been the main aim of innovation: doing the same things faster, more effectively, more easily and more cheaply. We’re forced to innovate. We live in a new regime of innovation. And in these countries that has always been the case, living with restrictions, so we have a lot to learn from them.


How can technology help us overcome global challenges like the Zika virus?

Technology in itself is never a complete solution. We knew that the Zika virus existed, like many others, but these countries don’t have primary care systems and there’s no global map of where the cases are occurring, drugs to treat them or vaccines to prevent them. It’s important to approach these global health problems from a holistic standpoint, with different types of technology and from different geographic areas. We can’t just think about how to protect ourselves because that’s impossible. The solution has to be global and based on prevention.

Could you highlight a product developed in these countries?

PATH developed a low-cost meningitis vaccine, MenAfriVac, specifically designed for countries in sub-Saharan Africa that make up what is known as the “African meningitis belt”. This was possible thanks to a mega-agreement among all the stakeholders involved: manufacturers, industry, health ministers, etc. It took us nearly ten years but now we’re close to eradicating it completely because we’ve vaccinated more than one hundred million people.


You work with partners in the United States, India and China to develop medtech products. What is the main difference between launching a product on a developed market and on a developing one?

The greatest challenge is the gap between the medical need and the market need because, even through there are 50 million diabetics in India, not all of them measure their blood sugar levels every day. It’s a long process and we’re very used to it. Everything flows and everything is connected. There you have to educate politicians, suppliers and the end users.

You're on the advisory board for the d·HEALTH Barcelona program. What do you think of its evolution over the past three years?

When it was launched, it had the promise to become a great initiative because Europe was experiencing cutbacks and it was seen as an opportunity to develop innovative products for everyone, including developing countries. Plus, innovation always leads to economic growth. But three years later, I’m very impressed. The first 2 or 3 years are very complicated but, even so, there have been great successes, with some projects even getting funded. Now, the program has to come into its own, because the model was exported from Stanford but each city is different and should apply the program in its own way. I’m sure we’ll also be learning things from d·HEALTH Barcelona soon.

Are we missing any of those puzzle pieces you mentioned earlier?

In the BioRegion of Catalonia you have all the seeds. But you need to strengthen the ecosystem because that’s where the full success of innovation lies. Plus, I hope you have the economic, political and social stability these processes require.


The d·HEALTH Barcelona fellows spend 9 months in the program to detect an unmet need, make a prototype and market it. Is that enough?

Not really, but apart from the fact that they can continue development after the program is over, the main goal of both d·HEALTH Barcelona and the Stanford program is to create the future leaders of innovation. Only 450 people in the world have done this training and 20 of them are here, in Barcelona. That is extremely important because they’ve acquired a mentality for approaching problems in a different way, which is not only useful in the program but also for anything else they choose to do after.

You’ve been using biodesign for 15 years now at Stanford. What have you learned in this time?

We’ve learned to adapt to change, to repeat to stay relevant. Also that the people in the program have a greater impact that the technology they develop.