Millions of people die from preventable or treatable illness each year in poor countries, and while the developed world is increasingly joining the battle, a big obstacle remains in many areas: no stable source of electricity.
Lab equipment has to be plugged in, after all. Certain medicines must be kept cool.
Now, three area research teams have had sparks of inspiration to address the power problem.
A University of Pennsylvania professor wants to operate refrigerators for vaccine storage by using the leftover juice from cell-phone towers. A father-and-son team from Drexel University is developing a device to treat infant jaundice that will run on solar power. And a Pennsylvania State University chemist is working on disposable "chips" that can diagnose disease without any power at all.
Such efforts are just a taste of the increased attention being devoted to diseases in the developing world. The amount that wealthy countries spent on health aid for needy nations nearly quadrupled between 1990 and 2007, from $5.6 billion to $21.8 billion in inflation-adjusted dollars, according to a University of Washington study.
Yet it has leveled off in the current economic crisis and still falls far short of what's needed, said Julie McLaughlin, a sector manager for health, nutrition, and population at the World Bank.
Much of the increase is due to the Bill and Melinda Gates Foundation, which has committed $13.8 billion to global health projects since 1994. The Microsoft cofounder's philanthropy provided funds for both the Penn State and Drexel projects, for example. Some of the heightened focus also comes from the governments of industrialized nations, due to humanitarian reasons, concerns about fast-spreading threats such as flu, and even basic security.
"If people don't have access to basic services such as health, it creates an environment in which further unrest is fostered," McLaughlin said.
The Penn State project is led by Scott T. Phillips, an assistant professor of chemistry, who recently announced he had developed a key improvement for so-called lab-on-a-chip devices.
Scientists and companies have made chips that allow for a quick diagnosis of certain conditions, just by placing a drop of urine or blood on the surface. As with a home pregnancy test, the patient's condition is revealed by whether a spot on the chip changes color.
Yet for some of these, the colored spot must be scrutinized at a specific length of time after the fluid is applied. Examine it too soon or too late, and the chemical reaction will yield different results - identifying a sick person as healthy or vice versa.
But what if no stopwatch is available? Phillips came up with what he calls a fluidic timer: a timekeeping device built right into the chip itself, no electricity needed.
Here's how it works: While the patient's fluid is percolating through the chip to the little window where the color-based diagnosis occurs, it is also working its way through to an adjacent timer window. Just before it reaches the timer window, the fluid flows through a spot of dried food coloring. When the color appears, time's up.
In a recent issue of Analytical Chemistry, Phillips described how he could make the timer last longer or shorter, as needed, by impregnating that portion of the chip with different amounts of paraffin wax.
He and coauthor Hyeran Noh made prototype timer chips that measured glucose and cholesterol - no battery required.
Another potential application is a chip that would measure liver function, said Patrick Beattie, a scientist at a Cambridge, Mass.-based nonprofit called Diagnostics for All. The organization is in the midst of developing just such a chip to help HIV patients, whose medications can cause their liver enzymes to be out of whack.
Though the aim is to help developing countries, Phillips said, certain chips would make sense here as well. A simple chip could be made to detect the flu, for example, which would prove useful even in state-of-the-art emergency rooms.
"If it turns purple, it means they have the flu," Phillips said. "You can triage them immediately for pennies."
Still, certain elements of medicine cannot get by without power.
One is phototherapy - the treatment of infant jaundice by bathing the child's skin in blue light, enabling their bodies to break down a potentially toxic substance called bilirubin.
For locations that lack electricity, Drexel engineer Arye Rosen and his son Harel, a neonatologist, are developing a portable light source - a light-emitting blanket - that can be charged with flexible solar panels.
It began as an idea for any jaundiced baby, not just those in poor countries. Arye's wife, Daniella, visited Harel at work and saw babies who had to lie under banks of blue lights.
"They couldn't be held," she said. "It bothered me."
So Arye Rosen, a Drexel professor of biomedical and electrical engineering, began to work on a solution with Harel - who has a research appointment at Drexel and also works for Voorhees-based Onsite Neonatal Partners, providing neonatal care at Riddle Hospital in Media.
They made a prototype blanket embedded with dozens of blue LED lights, reasoning that an infant could be wrapped in such a blanket and not have to be separated from her mother. They later added the idea of charging the blanket with flexible solar panels, in their application to the Gates foundation, and were rewarded with a $100,000 grant.
The family has formed a small business, AMT Inc., to work on this and other projects.
"When you put an engineer and a physician in the same room, ideas go flying all over the place," Harel Rosen said, referring to himself and his father.
Harvey Rubin, a professor at Penn's medical school, also was struck by a chance idea that could help the developing world.
It started when actor David Morse, a friend of Rubin's, e-mailed him this year to ask about the problems in getting medical care to people in earthquake-ravaged Haiti. Among other issues, Rubin explained how vaccines had to be kept cold to remain effective.
Weeks later, Rubin was at Penn's 2010 graduation when he saw David L. Cohen, chairman of the school's board of trustees and a senior Comcast executive, sitting near Paul Farmer, a public health pioneer and an honorary degree recipient.
The juxtaposition of people from the worlds of communications and public health gave Rubin an idea: Why not use the leftover energy from cell-phone towers to power refrigerators for vaccines?
Rubin and colleague Alice Conant proposed just that in New Scientist magazine, and have been getting response from around the world, he said.
People have previously tried to come up with ways to refrigerate vaccines in rural Africa, but Rubin said such efforts had not caught on. Rather than rely on nonprofits or governments to invent a new system, he said, far better to rely on something that's already mushrooming across the developing world: the fast-growing cell-phone business.
One industry study projects the construction of 640,000 off-grid cell towers by 2012, powered by diesel generators. Such stations typically have 5 kilowatts of excess power available, plenty to run a fridge, Rubin said.
"There's an incentive for the private sector to build these cell towers," the Penn professor said. "There's an incentive to get them out to the most rural parts of the world."
Rubin has enlisted the aid of Penn engineers and Wharton students and is seeking funds for the idea. He has already spoken to cellular companies in India and aims to have a test site in place next year.
If these three projects bear fruit, they would be electrifying ideas, indeed.