Kvetching

With the end of 2010 in sight, writers of all sizes, including self-published ones like me, cut themselves some slack and write year-in-review retrospectives, maybe as a way to get more time for the family or online shopping.  As my shortcut retrospective, I reviewed my ’10 posts and graded them on their degree of kvetching (aka whining).  Kvetching is the least informative and helpful form of blogging and just a step above ranting which, unless humorous, is a sign of pathology, and since my goal is to learn by writing and have a reader learn something, too, a lot of kvetches mean I need to do better.  (Of course, a review may encourage reading of my past posts, and help me remember what the heck I’ve written about.)

So here my first annual review and sorting of posts into:

  • Kvetch- complaint or criticism without a proposed solution or improvement;
  • Critique- criticism with (hopefully thoughtful) proposed improvements; or
  • Kudo- praise and the reasons for it.

Kevtch:  I had 9 posts in this category starting in my post of 2/25 when I criticized PATH:  “… PATH is well-funded and has improved health for some (e.g., those receiving vaccines and HIV counseling in 2008), but as a current investor (through my Federal taxes), I question whether their business model is sound and if they are delivering on their mission.”  On 3/25, I noted that the Critical Path Institute will have problems in implementing its big grant to test drug combinations for TB but did not offer any solutions.  On 4/29, I criticized the Report of the Center for Strategic and International Studies (CSIS) Commission on Smart Global Health Policy as one of several “more money and more bureaucracy” approaches.  In my 5/27 post I pointed to the need to improve the commercialization of global health products but provided only a few vague remedies.  On 6/17, I kvetched about Commons Capital and the Institute for OneWorld Health in delivering publicity but little progress.  In my 7/9 post I cited the NIH clinical trial fund which didn’t seem well-thought out or supported.  On 7/29, I pointed out that sickle cell anemia is another neglected disease but not what can be done, and on 8/5 I complained that Unitaid’s  focus on decreasing intellectual property protection is not helpful.  In my 11/18 post, I did not think much of the new Massachusetts General Hospital Global Health Center:  “So my perspective may be biased, but based on what I heard, MGH/Partners should rethink the Center and its mission to reduce “health disparities” through research, education, and service, the first two of which seem self-serving.”

Critique:  it seems to me that I am making a good effort at offering alternatives and improvements, mostly original ideas, which was not the case when I endorsed William Easterly’s points for improving the international development system in my 1/7 post.  In my 1/14 comment on the Gates Foundation’s possible use of “program-related investments,” I recommended it invest in starting companies rather than handing out research grants:  “Given that the foundation had made multimillion dollar grants to academic groups with no plans or experience for actually implementing their innovations, a multi-million dollar bet on turning one of these [Grand Challenge] projects into a company seems pretty sound.”  In my 1/21 post, I proposed four improvements to the GAVI Alliance/IFFIm/AMC approach to create a market for global health products.  On 2/4 I offered 7 ideas for steps the US government could take to support global health product development (hey, it’s a big target).  On 2/11, I proposed several sources of methods for the evaluation of the performance product development programs (PDPs) including using the techniques of the pharma industry, and in my 2/18 post on social venturing I suggested a few ideas for supporting these entrepreneurs.

I also offered ideas for improving international, inter-company collaboration in global health (3/4), USAID support of global health product development (4/1), vaccine development by companies (4/8), the contract system for treating AIDS/HIV in Africa (4/15), the US State Department’s role in global health (4/22), diagnostic development (5/13), and Boston University’s medical technology conference (5/20).  In my post of 9/2, I reviewed the appropriate technology distribution site, the Kopernik, and proposed a similar online market place aimed at middle of the pyramid purchasers like regional or national non-for- or for-profit health care providers (like hospitals, clinics, or medical mission NGOs) and selling low-cost but non-regulated products.  On 9/7 I offered ways to improve the Center for Health Market Innovations, and on 9/16, ways for the Mind the Health Gap group to improve their conferences:  “Innovation is needed in addressing global health problems and the meeting’s speakers represented a valuable cross section, but, if MTHG wants its future workshops to “harness untapped social and creative potential,” they will need to herd the cats better and have less presentation, more debate, and specific outcomes.”

In my 9/23 post, I criticized Rezaie and Singer of the McLaughlin-Rotman Centre for Global Health for proposing new (bureaucratic) supports for innovative companies in the developing world, and offered 8 counter ideas.  On 9/30, I criticized the pharma/biotech industry focus on developing drugs for only a handful of infectious diseases and advised them “to realign the research program for indications where there is less competition, greater need, and a developing market.”  Similarly on 11/11 I criticized a management consulting report on the industry for missing the big picture:  “So my take-home recommendation is that the biopharma industry should ramp up their participation in the existing PDPs and start some of new ones to find affordable drugs for the other neglected diseases including the coming worldwide epidemic of non-infectious disease.”  In my post of 12/9, I reviewed the assessment of r and d funding pools by the Center for Global Health R and D Policy Assessment and offered several improvements.  Overall, there were 20 posts in this category.

Kudo:  I gave a thumb’s up to 11 actors in global health (but unlike Facebook I provided substantiation).  On 1/28 I noted that GlaxoSmithKline is leading the big pharmas in pursuing global health products, and, on 3/11, described an “accelerated proof of concept” approach in the industry that is worth imitating in global health product development.  I also praised:

  • Brazil’s Fio Cruz for striking license deals that include technology access (7/15);
  • Affordable Medicines Facility- malaria (AMFm) for bringing down the cost of better meds (6/10);
  • Progress on a therapeutic TB vaccine by the company, Archivel (6/24);
  • Cash transfer programs to mitigate poverty (7/22); and
  • Big pharma’s de-emphasis of patents (8/12).

In my posts of 10/14 and 10/28, I noted progress in addressing affordability of health care in under-served regions:  “It looks to me that, to meet the huge needs in the developing world, some drug companies and an emerging mix of government, not-profits, and for-profits payers are working on the affordability problem with some success.  Maybe there’s a lesson here for the big pharma companies and the US health insurance industry.”  On 12/2 I praised the progress made on AIDS therapeutic vaccines, and, on 12/6, the launch of a vaccine for epidemic meningitis (with a kudo to PATH).

The bottom line:  75% not kvetches so I’ll give myself a passing grade for 2010.

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