make 100,000 of them and give them to an NGO who would distribute them for free, but then there would be no loop at all, nobody who is going to stand up and say, ‘This thing is shitty.'”
Donaldson says that as far as she knows, D-Rev’s licensing deal with Phoenix Medical Systems is the first ever between a U.S. non-profit and a foreign medical equipment maker involving royalties. Phoenix agreed to sell the device for roughly $400, about an eighth the cost of a traditional bili light. That puts the device within reach for typical rural clinics in India, which typically get about $3,000 per clinic per year from state governments for discretionary equipment purchases.
D-Rev will collect minimal royalties on sales in India. But Phoenix also has a non-exclusive right to market the device in other countries, and for units sold to private or high-income hospitals, D-Rev will earn higher royalties. Donaldson says Phoenix has solid distribution channels in Europe, the Middle East, and even Africa—though creditworthiness is a concern for African hospitals. “There are creative ways we can address that, such as microloan guarantees,” says Donaldson. “We will solve the issue.”
True to her original point about quality, Donaldson says the Brilliance design is actually more effective than bili lights made by American manufacturers. And in principle, D-Rev would be happy to see the device distributed in the U.S. But there are a couple of big barriers. One is the intellectual property issue: no U.S. manufacturer will touch a design without the proper patent protections. While D-Rev is pursuing a patent for Brilliance first in India, she says seeking a patent in the United States is a lower priority.
On top of that, advertising and marketing the device in the competitive U.S. sphere would be hugely costly. And under current reimbursement rules, hospitals have few incentives to economize on equipment costs. For all of those reasons, “The U.S. medical market is kind of a sideline for us, just like the developing world is a sideline for U.S. manufacturers,” says Dawson.
Brilliance will be D-Rev’s first product to hit the market, but not far behind is the JaipurKnee, a device already worn by 2,700 amputees as a more stable alternative to traditional prosthetic legs with simple hinge joints; the Global Scope, a low-cost microscope for detecting the microorganisms that cause malaria and tuberculosis; Access for Agriculture, a talking book with flexible programming aimed at improved farming practices; Rise Solar, a solar concentrator that can provide off-grid power to charge cell phone batteries and the like; and an electro-chlorinator that can be used to sterilize the milk transport containers used by dairy farmers in East Africa.
In each case, Donaldson and Dawson emphasize, D-Rev has identified both a need and a demand. Too often, they say, Western designers and engineers get excited about fulfilling a perceived need, without ever bothering to check on whether people actually want the thing they’re building. As Exhibit A they point to Nicholas Negroponte’s One Laptop Per Child project,which has flourished only in a handful of countries where governments have spent millions of dollars to subsidize the machines. The big information technology product transforming the developing world, says Dawson, isn’t the laptop; it’s the cell phone. “Laptops are useless in that context, and you can tell because people won’t pay for them. They have to be given away or they don’t happen,” he says. “But even poor people will pay for access to a cell phone.”
Meeting demand is “the most sustainable way of developing products that lead to impact,” says Donaldson. The questions she says designers should be asking, even if they’re targeting unfamiliar or underdeveloped markets, are “Does this help people earn more money and live a more productive life?” and “Would people here buy it?” If not, they shouldn’t be too surprised when consumers in developing nations also turn up their noses.
