Last month I participated in the Hult Prize, a start-up accelerator competition funded by the Clinton Global Initiative and Hult International Business School to identify and launch social businesses that tackle the toughest health and development problems faced by the world’s most vulnerable. This year’s challenge was to design a business plan for a sustainable and scalable social enterprise to address non-communicable diseases of 25 million people living in urban slums by 2019.

 300 teams selected from 10,000 applicants in over 150 countries pitched their ideas at the Hult Prize regional finals on March 7 and 8 in Boston, San Francisco, London, Dubai, Shanghai and Sao Paulo. The Hult prize competition was initially designed for MBA students and aspiring entrepreneurs but in its 5^th year, the challenge has grown to also draw participants from diverse backgrounds including public health, medicine, engineering, public policy, environmental science and others.

 As a public health graduate of the University of Wisconsin School of Medicine and Public health I teamed up with 4 MBA students from the University of Wisconsin to design an ambitious plan to improve access to palliative care for urban slum dwellers. The palliative care landscape is extremely complex and opioids are some of most effective analgesic medications for the management of severe pain in end of life care. Several opioids are included on the World Health Organization list of essential medicines; however, due to restrictive regulations, gaps in medical knowledge and supply chain challenges, approximately 80% of the world’s population lacks adequate access to opioid medications for pain control.¹ Our team’s goal was to develop a system that would better track and control opioid distribution with the hope of improving forecasting and country level supply. While we came up short at the regional finals in San Francisco, this experience gave us the opportunity to work closely with the UW Pain & Policy Studies Group and the group’s director Dr. Jim Cleary, a global leader in worldwide palliative care reform.

 In the public health community, the prevention of non-communicable disease is paramount for improving the health and well-being of the world’s population. However within the confines of this competition that focused only on treatment and care, the fundamental concept of prevention was off the table. As a health science researcher I am accustomed to attending conferences and meetings with likeminded people. The Hult prize experience, however, created a unique opportunity to bring together individuals from diverse backgrounds who all approach global health and development problems in very different ways.

I found that the nature of the competition highlighted an observed tension in global health between the desire to quickly address an urgent need with the value of an evidence based and evaluated intervention that requires great amounts of time and resources. The concept of an accelerator competition was quite new to me. In the grants based work of academic research, awards come when you have the science to back up your idea and clear roadmap of how to get there. The Hult prize judges, however, were looking for a  “million dollar idea” that they could throw support behind and help you figure out how to get there at a later time. For some teams, including my own, the product of this was a business model based on assumptions, speculation, and imagined benefit.

 However not all ideas were conceived with the Hult Prize in mind. Worldwide Innovative Health care or WiCare, a women-led team from MIT presented a simple and easy to manufacture negative pressure wound pump to treat open wounds and infections that cause severe complications and sometimes death. This team is already well on their way to operating a successful business and has support form Massachusetts General Hospital, Partners in Health and Médecins Sans Frontières. WiCare’s pitch to the Hult judges was polished; they had an idea, a plan, efficacy data, and evidence of a clear demand for their product. They effectively convinced the judges that with Hult Prize support, their wound pump could scale up to improve the health of millions across the globe and they won the San Francisco regional round. WiCare along with 5 other teams will participate in the summer accelerator program. All six teams will meet in NYC on September 22, 2014 at the Clinton Global Initiative annual meeting and pitch their finalized ideas in front of President Clinton and other leaders in global health and innovation. One team will walk away with $1M in start-up funds.

 Many non-governmental organizations (NGOs) are already under pressure to perform in an increasingly competitive funding environment and numerous well-intended NGOs close up shop as soon as the funding dries up. The global health and development landscape needs to shift away form donor-based organizations to sustainable social enterprises to reduce or eliminate dependence on cash injections. And while Hult offers only one prize per year, this event fosters an environment where passionate individuals with diverse perspectives on health and innovation gather to debate a better way to improve health across the globe.

1. WHO Global Atlas of Palliative Care at the end of life, 2014