The Queen of England has bestowed an exalted honor on PATH’s top gizmo guy.
“She said global health was a rather big subject and must involve a lot of travel,” said Michael Free, chief of technology for PATH, who had in fact stopped off in London to be received by the Queen before embarking on a month-long trip of global health travel.
Last week, Free was made an Officer of the Order of the British Empire in recognition of his team’s many inventions and innovative approaches aimed at helping solve health problems in the developing world. It’s not quite as prestigious as a Knighthood but better than a sharp poke in the helmet.
One of Free’s inventions was the single-use, auto-disabling syringe — a device now in common use worldwide, here in the U.S. as well, aimed at reducing the transmission of disease through accidental needle sticks.
But Free was also likely honored for his much broader and critical role in helping give birth to PATH in the 1970s.
How this British farm boy, raised in creamy Devonshire, ended up in Seattle working on some of the most innovative solutions to developing world health problems offers insight into the evolution of PATH and, to some extent, the entire field of global health.
“In the beginning, our approach was not well-received by either the public or private sectors,” said Free. “It was a bit out-of-the-box.”
In the 1970s, the field of global health (it wasn’t called that then) was dominated by public sector groups like the World Health Organization, UNICEF and government agencies like the U.S. Centers for Disease Control or U.S. Agency for International Development (USAID). Civil society – “non-governmental organizations” and humanitarian groups like Save the Children – were aligned with WHO and the like.
On the private side were the industries that manufactured the drugs, vaccines or other health products purchased by the public sector or humanitarian groups to deliver to those in need.
“In general, the public sector either didn’t understand or trust the private sector,” said Free, adding that industry often was similarly ill-disposed to work with the public or civil society sector.
From training dogs to condom technology transfer
After a stint in the British army training dogs and some travel which eventually led to Free obtaining a PhD in animal physiology at Ohio State University, he fell in with a small group of researchers at Battelle Northwest labs headquartered in Richland — with a satellite office in Seattle.
Gordon Duncan, Richard Mahoney and Gordon Perkin were at Battelle working on methods and technologies aimed at improving contraception and family planning in poor countries (such as perfecting a female condom). Though motivated to achieve a social and health good, they believed engaging industry was key to success.
“In a way, it was the beginning of public-private partnerships in development,” Free said.
In 1977, Duncan, Perkin and Mahoney started a non-profit organization aimed at helping poor countries launch manufacturing businesses to produce basic contraceptive products such as birth control pills, condoms and IUDs.
They called it the Program for the Introduction and Adaptation of Contraceptive Technology (or PIACT). The name eventually changed to the Program for Appropriate Technology in Health (PATH). Free was there at the beginning, helping launch projects like a condom factory in Vietnam (as pictured)
PATH’s approach of creating new health technologies, licensing them to industry or helping poor countries start their own manufacturing industry “made a lot of people nervous,” said Free. It confused those who felt the profit motive conflicted with the humanitarian imperative.
“Here we were, a non-profit organization dedicated to working on the health needs of poor countries working comfortably with for-profit industry,” he said. Suspicion of and resistance to PATH at WHO persisted well into the 1990s, Free said.
Then, in the late 1990s, came the Bill & Melinda Gates Foundation.
PATH’s public-private approach appealed to the Gates family, which originally considered making family planning and population issues its highest philanthropic priority. The Gates Foundation’s focus soon shifted to children’s vaccines, in part because immunization rates had declined globally and millions were dying of easily preventable diseases.
Free and the gang at PATH had been working on vaccine technologies – single-use syringes, heat-sensitive labels for vaccine vials, freeze-dried vaccines that didn’t need refrigeration – aimed at making immunization in poor countries easier, more effective. Here’s a longer list of their projects.
PATH’s strategy of creating new technologies and working with industry to improve the health of the poor almost seemed tailor-made for Bill Gates’ new philanthropy. The Gates Foundation first gave them a grant of $25 million, then $100 million and then $750 million to launch a massive global vaccine initiative now known as the Global Alliance for Vaccines and Immunization (GAVI) aimed at improving vaccination rates.
And so, to make a long story short, this once somewhat obscure Seattle-based non-profit organization is now widely and simply known as PATH, and as a world leader in global health.
Michael Free, O.B.E., had a lot to do with that.
Many more people know of PATH today, he said, but it’s still sometimes hard to accurately describe what PATH really does. It’s not just gizmos anymore.
“The elevator description of PATH is difficult,” Free said. “What we do is find innovative ways to solve problems in global health. It can be new technologies, behavior change or systems change.”
What hasn’t changed, he said, is why PATH does what it does.
“What’s quite remarkable is that the original spirit of PATH, its principles and way of operation, are the same as they were at its founding,” said Free. It’s an organization dedicated to fighting the diseases of poverty, thinking creatively and collaboratively, he said, and is no longer viewed as renegade.
One could even argue that PATH is now helping to set the global health agenda (backed, as it is, by Gates Foundation money and clout) rather than having to struggle against it.
“Brilliant,” he said, sounding a bit more British than usual.