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Recent years have witnessed the emergence of a new paradigm in global health. Though by no means unprecedented, the notion that improvements in global healthcare must involve developed and developing countries learning from each other, rather than the one-way transfer of knowledge, now represents a core principle of the organizations at the forefront of UK planning and policy.
In fact, the contemporary ‘buzz’ surrounding this concept of mutual exchange emerged not in the space of global health policy itself, but within the literature on business management. Over the last decade, a number of important works have argued that product innovation is a process better suited to low-income countries, where costs are lower and market bases higher, which can then be deployed in high-income contexts. This model of so-called ‘reverse-innovation’ has emerged as an important aspect of several multinational corporations’ commercial strategy. [1]
Influenced by such approaches, key thinkers and organizations in the global health arena, particularly those invested in the workings of International Health Partnerships, have also promoted the concept of ‘reverse innovation’. Unlike the commercial model, which is both specific and internal to corporations, ‘reverse-innovation’ is here conceived as the general process of learning from practices and experiences in developing countries. It is a process to be engaged in simultaneously by governmental and non-governmental organizations, social entrepreneurs, and businesses working towards improvements in global health. [2]
The permeation of these ideas has thus opened up a broader discussion on the multifaceted benefits that might be derived by developed countries paying closer attention to what is happening in the developing world. But it is also a process fraught with the potential for confusion and cross-purposed action. For example, the language used to describe this new approach is by no means agreed upon by its exponents. A review of the literature produced by leading UK organisations points to the use of a wide range of terms, many of which appear to be used interchangeably. Alongside ‘reverse innovation’, the terms ‘co-development’, ‘reciprocity’, ‘shared learning’ and ‘mutual interest’ are also frequently invoked. [3]
It is also clear that not all organizations necessarily approach the concept of ‘mutual benefit’ from the same perspective. For some, the most important way in which the UK can benefit from developing countries is through high-level international monitoring of policy, best practice and research. [4] Others meanwhile, place more overt emphasis on the assignment of individual health workers to developing countries, wherein they can face new challenges and develop new capacities for leadership and innovation, which can then be fed back into the UK health system. [5] These differences of approach influence not only the key terms used, but also the meaning ascribed to those terms.
A lack of definitional precision and conceptual clarity is no trivial matter. It brings with it potential for genuine confusion around the end goal, however well-intentioned. The consistency with which organizations approach this expanding frontier of global health practice will therefore be crucial to its success. What is more, research has already demonstrated that the connotations attached to certain key terms, such as ‘reverse innovation’, could have important bearings on the way in which initiatives are received and responded to by stakeholders. [6]
As the first G7 country to meet the UN’s target spend of 0.7% of GDP in overseas aid in 2015, the UK had a lot to gain from investment in partnerships, and also a lot to prove to the taxpayer. [7] But with little consideration given to the linguistic and conceptual choices currently being made, it is difficult to judge whether the great potential of ‘reverse innovation’ is in danger of being undermined by problems of inconsistent communication. There is therefore a compelling need for careful review of the way in which organizations are approaching this new frontier. Together with researchers at Imperial College London, Polygeia is now engaged in a project designed to address these important questions.
References:
[1] V. Govindarajan and C. Trimble. ‘Reverse Innovation: create far from home, win everywhere’. Boston: Harvard Business Review Press; 2010
[2] N. Crisp, Turning the World Upside Down. London: RSM, 2010
[3] In the UK, the organisations that commonly drive the IHP agenda are: the NHS, THET, Health Education England, DfID, PHE, DoH, the royal colleges, APPG-Global health and The International Health Coordination Centre (Wales).
[4] Department of Health, ‘Health is global: an outcomes framework for global health 2011-2015’, 2011.
[5] All Party Parliamentary Group on Global Health, ‘Improving Health at Home and Abroad: How overseas volunteering from the NHS benefits the UK and the world’, 2013.
[6] M. Harris M, E. Weisberger, D. Silver, V Dadwal, J Macinko. That’s not how the learning works – the paradox of Reverse Innovation: a qualitative study. Globalization and Health. 2016;12:36.
[7] http://www.dailymail.co.uk/news/article-3510811/Stop-foreign-aid-madness-12bn-taxes-splurged-hand-outs-terrorists-killers-care-UK-s-spending-Foreign-Aid-sign-petition-now.html
Joe Francombe is a Ph.D candidate in History at the University of Cambridge. His research explores the application of social science in thinking and practice on ‘development’ in post-independence India.