Making Health Care Innovations Work: Standardization and Localization in Global Health

Abstract

Global health is becoming an increasingly political, professional, and academic field of its own. New actors and forms of collaboration across borders have emerged to solve some of the world’s most daunting public health problems. Central among these efforts are a multitude of global health care innovations (drugs, diagnostics, and vaccines as well as policy initiatives and service delivery strategies) designed, developed, and implemented by a range of actors across very different institutional and cultural settings. Underlying these innovations is the common assumption that universal solutions can be found and brought to scale if implementation challenges of different contexts are overcome (e.g., function in weak health care systems where infrastructure, staff, and capacities might be absent). Standardized drug delivery programs are such a universal solution that allows participants to use the same training modules, delivery strategies, technologies, and logistics across very different contexts. These programs promise efficiency and the ability to reach large populations quickly while generating comparable global data through the same reporting and recording guidelines and standards. These are clearly beneficial aspects of universal solutions, and the belief in such magic silver bullets persists; however, global health technologies and solutions are not easily transferred to different local contexts.