malaria

Lorrayne Ward is starting her second year of an MPP/MBA joint degree at Harvard Kennedy School and Harvard Business School. Prior to graduate school, Lorrayne worked at the Clinton Foundation HIV/AIDS Initiative, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and McKinsey & Company.

For most of us, a mosquito bite is an itchy annoyance – a small price to pay in exchange for warm weather and lazy days outside. But in much of the world, a mosquito bite can be a life-or-death issue. For the hundreds of millions of people living in malaria endemic areas, fighting mosquitoes, and the deadly parasites they carry, is a daily struggle. Controlling malaria isn’t rocket science, and for the price of a sandwich in New York City you can equip a family with an effective set of tools for preventing and treating malaria: a long-lasting insecticide-treated bed net (LLIN) and artemisinin-based combination therapy (ACTs), a drug used for the treatment of malaria. Both of these products only came to market a few years ago, as a result of focused efforts and collaboration by various public and private sector organizations.

Acumen Fund had a significant role to play in scaling up the global production of LLINs, through its investment in A-Z Textile Mills in Tanzania. It helped to broker a technology transfer partnership between chemical giant Sumitomo, who had developed an innovative way to weave durable polyethylene fibers with a time-release insecticide, and A-Z, who transformed itself from a producer of simple bednets to more complex, higher-value LLINs. A-Z is now one of the largest global manufacturers of LLINs, and one of the single biggest employers in Tanzania.

Voila, Acumen Fund’s appetite for malaria investment was born! The A-Z investment was followed by a deal with Bio-Extracts EPZ in Kenya, the only African manufacturer of the active ingredient in ACTs; and DART, a new joint venture between Vestergaard-Frandsen, Richard Allan and the Acumen Fund to develop and market an insecticide-treated wall lining.

But since Acumen’s original loan to A-Z, the malaria space has changed dramatically. Global funding for malaria has increased exponentially, to over a billion dollars per year. Coverage of key methods to prevent and treat malaria has also grown substantially. Challenging these positive developments are looming threats like the parasite’s growing resistance to the active ingredients in LLINs and ACTs, the economic crisis curtailing donor outlays, and climate change making more areas of the world potentially susceptible to malaria.

So, Acumen Fund asked itself what role its “patient capital” approach could play in the marketplace for malaria products and services. That’s where I came in, since I had some background in malaria through my pre-Acumen Fund experiences. “Think big,” said Chief Investment Officer Brian Trelstad when asking me to conduct this market review. “Leave no stone unturned – there have to be innovative opportunities out there that would benefit from our capital and management assistance.”

With those words in mind, I started my analysis. What companies, big and small, are active now in the market? What are the major gaps? How could small and medium enterprises like those that Acumen Fund supports be better represented in this space? What new innovations could change the market? I asked over 30 leading stakeholders in the malaria world these and many other questions. I expected a wide range of responses, but with very few exceptions, I was surprised by the experts’ consensus, and the resulting short list of potential opportunities for Acumen Fund investment.

After presenting my findings to the team, there was nothing patient about moving from proposal to action. The Acumen team has already set about to perform preliminary due diligence on some interesting companies as well as explore ways to leverage our connections in the international policy and funding worlds to raise the profile of several innovative small and medium enterprises.

Personally, it was exciting to see my summer’s worth of work being so enthusiastically embraced and translating into concrete actions. For me, it represented Acumen Fund’s modus operandi at its best – sourcing ideas from an eclectic base, thinking creatively about how to best apply its resources towards resolving an issue of global social importance, and moving swiftly to capitalize on opportunities.  Hopefully, through the actions of Acumen Fund and all the other stakeholders striving in this space, the millions around the world currently suffering from malaria can have the luxury of someday writing off a mosquito bite as just a pesky side effect of an otherwise perfect summer day.

Acumen Fund has learned over the years that its most successful entrepreneurs listen constantly to the needs and the nuanced preferences of their customers. A killer new product will certainly fail if it is not designed around the customers’ behaviors and desires. We’ve seen it happen.

As part of Acumen Fund’s monthly breakfast series, we were joined last Friday by Richard Allan, Director of the MENTOR (Malaria Emergency Technical and Operational Response) Initiative, who spoke about a thoughtful new technology for preventing malaria: insecticide-treated wall lining (shown at left, with a customer in the foreground). Imagine a flexible wall-lining that you can unroll in long sheets and attach to the inside walls of a home. Only it is impregnated with an insecticide that kills mosquitoes (and many other pests) on contact. A new company called DART (Durable Activated Residual Textiles), a joint venture between Richard, Acumen Fund, and Vestergaard Frandsen, will produce the product for distribution throughout malaria endemic regions Asia and Africa.

We’ve seen a lot of sexy, new product designs, and we’ve decided not to invest in most of them. So why are we so excited about this new wall lining (think wallpaper)?

For starters, it combines the best features of the two most popular malaria prevention products: the long-lasting insecticide-treated bednet and indoor residual spraying (IRS - this is where the interior walls of a home are sprayed periodically with insecticide). The best nets last about 5 years without needing re-treatment, but they require you to sleep underneath a net every night, which is a significant behavior change and a challenge for any distribution scheme. Indoor spraying requires no behavior change once the walls are sprayed. Unlike with nets, a family does not have to decide to sleep under protection; the spray ensures that they are naturally protected anytime they’re inside the home. Misuse is not really possible. However, the spray’s effectiveness only lasts about 6 months and there are complicated logistics and persuasion required to do the spraying in the first place.

Introducing wall lining. Wall lining will remain effective at least as long as bednets and likely longer, since it will likely see less wear and tear. And, like spraying, it does not require any behavior change once the walls are lined – if you’re in the home, you are protected. In this sense it is the best of both worlds – years of protection without the struggle to change people’s behavior.

Yet, beyond these technological advantages, the product seems to appeal to the customer better (at least as evidenced in early trials). Printed in many different colors and patterns, the wall lining is designed to appeal to the desire for beauty and home improvement that exists in all of us. Who wouldn’t want beautiful blue walls instead of the drab brown of sticks or mud? In fact, this is how Richard got the idea in the first place. In Cambodia, he noticed homes lined with wallpaper for purely aesthetic reasons. Why not combine the customer’s desire for beauty and home improvement with addressing a critical health issue?

Of course, there are many challenges ahead, but in a market dominated by multilateral & NGO distribution schemes, it is rare to see a product so thoughtfully designed with the customer in mind. With ~2 million deaths per year due to malaria and 1/4 of the world population living in malaria endemic regions, we owe it to the customers to design products that work for them but at the same time are as effective as possible.

Editor’s note: Guest blogger Linda Segre is Managing Director of Google.org. Full disclosure: Google.org is an Acumen Fund Leadership Partner.

By Linda Segre

In many ways, Wednesday, November 5 was like any other day at the office. I came into work, powered on my computer, grabbed a coffee, and sat down to start the day. As usual, a host of unread e-mails awaited me. But that’s where my day ceased to be usual and instead, became truly memorable.

Innocuously nestled in with all the other messages was a note from Samuel Onyango. I first met Samuel in 2006, while traveling in Kenya with Acumen Fund’s CEO, Jacqueline Novogratz. That day, Jacqueline and I left Nairobi for western Kenya, where one of Acumen’s investments, Advanced Bio-Extracts, operates. Advanced Bio-Extracts is a for-profit company that processes raw Artemisia annua into artemisinin, the active ingredient in Coartem - one of the world’s most effective anti-malarial drugs.

ABE doesn’t source the raw Artemisia annua from just anywhere, however - they’ve invested in farmers who grow the plant and sell their yields to ABE. One such farmer is Samuel Onyango; I had the honor of meeting him and hearing about how his lifestyle had improved once ABE began to buy his Artemisia.

In January this year, I received an e-mail from Samuel - the post-election violence in Kenya had made its way to his small farm; looters and rioters had burned his house and fields.

It’s amazing how much has changed in just a few short months. Two Wednesdays back, I heard from Samuel again. His e-mail radiated hope, and brought a tear of joy to my eyes. I won’t do Samuel the injustice of trying to summarize his e-mail; instead, I’ll copy it in its entirety below:

Dear Linda, I take this special opportunity to congratulate you and the entire population of America as you celebrate the victory of your new president. Whether you supported John McCain or Barack Obama, the victory that has been achieved is the victory for the whole of America, the victory of Kenya and a victory of the whole world. Barack Obama, being a son of a Kenyan father, has made as Kenyans proud for having produced the president of the most powerful nation in the world. To that effect, the president of Kenya, H.E. Honorable Mwai Kibaki has announced that tomorrow - Thursday - will be a public holiday so that we can celebrate the Obama victory, unlike in January when he himself was controversially declared the winner, and instead of celebrating we went to war. Your elections and Obama’s victory are big lessons for us. Linda, I am so excited by Obama’s victory. Not only because he comes from Kenya, and not only because he is black, but because Onyango Husain Obama - the grandfather to Obama - and Rebecca Abongo Obama - my own grandmother - ware a brother and a sister. I have never met Barack nor will I. But I am humbled and feel greatly honored that a man who shares some blood with me is indeed today the most powerful man in the world. May God bless you. May God bless America. May God bless Kenya and may God bless ABE. I hope and pray that he will make America and Americans greater. I am praying and hoping that he will make your life more comfortable and make you proud to be an American. Thank you so much as we celebrate, SAMUEL FROM KENYA.