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According to a World Economic Forum report, The Workplace Wellness Alliance: Delivering on Health and Productivity, released at the United Nations this past month, workplace wellness councils are emerging as one of the most powerful leaders in reducing health care costs and improving health around the globe. The report makes the case that business has a reach that the nonprofit sector does not: “Employers are uniquely positioned to improve health, as they have access to over 50 percent of the world population through the workplace.”

The business sector in Mexico is highlighted in the report as a leading example of workplace innovation strategies.

A little background: Mexico’s health care model resembled that of the United States until 2004, when it began offering universal health coverage. In response to a spotty public health care system, corporations developed their own internal health care systems, often hosting doctors and clinics on site. Then health care costs began to surge.

As U.S. fast food culture spreads around the world, diseases such as diabetes, obesity, and heart disease follow closely behind. Last year, Mexico beat out the United States as the most overweight nation—69 percent of Mexicans over the age of 15 are clinically obese. Combine that with a tobacco epidemic where thirteen million Mexicans smoke, and you have a health care cost crisis.

Over the last decade, Mexican businesses have found themselves in a quandary. Skyrocketing health care costs are taking their toll on companies’ bottom lines. Shareholders have been pressuring businesses to cut their private health care models, placing their workers in the already-overwhelmed government system.

Last May, Mexico’s health minister joined 70 leading corporations to launch Mexico’s Workplace Wellness Council. The council’s aim is to share best practices, implement cutting-edge disease prevention campaigns, and train HR staff to help educate and incentivize employees to improve their health—all with the goal of reducing health care costs for employers.

It’s working. Just this month, a national vaccine company, MedicRAMA is offering Mexico’s Wellness Council member companies a dramatically cheaper group rate on flu vaccines. The idea of offering the vaccines to employees at work is a new idea for companies.  Yet this best practice provides employers a low cost way to provide an additional benefit to employees, saving them money and time, reducing the effect of flu related absenteeism on the company’s productivity, and demonstrating the company’s commitment to employee wellness.

Another example is innovation around stress management. Mexico has a very young workforce and the leading self-reported health issues for employees under 35 are stress related. Mexicans work longer hours than anyone in the world—10 hours, according to the Organization for Economic Cooperation and Development. Council members are now encouraging their employees to take daily breaks and insisting they leave work at a reasonable time.
The council is also working together on a website that will offer incentives such as health food gift cards for employees who read information on prevention measures.

Dr. Humberto Gracia, medical director of Latin America for General Electric and co-chair of the Wellness Council’s Medical Committee, sums up the value to companies, saying: “As more companies across Mexico take action to improve employee health, the need for best practices has increased. Since no single company has all the answers, it is smart for companies to take advantage of the Wellness Council to figure out what works and what does not work.”

Dr. Gracia is backed up by a 2010 Harvard Business Review study, “What’s the Hard Return on Employee Wellness Programs?”, which reported that “Workplace wellness decreased health costs, increased productivity, and heightened morale.”

After just one year, the council members estimate that wellness programs have positively impacted more than one million individuals.

Abner Mason, the council’s director, sees a model that can be replicated: “Mexico’s Workplace Wellness Council is a simple model with powerful results that can be scaled quickly in developing countries around the world. We don’t have to wait for governments to enact healthcare reform. The private sector can move ahead and lead the way on this. Mexico is leading the way here for other countries.”

Ultimately, governments will need to figure out how to cut costs while improving healthcare for citizens. Business leaders don’t need to wait. Global wellness councils offer a chance for businesses to put aside competition and share best practices.

It’s time for global workplace leaders to follow Mexico’s example.

Stephen Friend is an Ashoka Fellow in the United States working to transform the culture and practice of closed information systems present in biomedical research to align with and support health outcomes by establishing a commons. He is president of Sage Bionetworks.

Roshan Paul and Alexa Clay: What is the problem with the current health care research and development (R&D) community, and how are you addressing it? Stephen Friend: The medical information system is closed. Scientists get funded to generate data, then they publish it, and only then do they talk about it. The same is true for R&D in pharmaceutical and biotech companies. The current system is a primitive model, a sort of hunter-gatherer approach. A single researcher or closed team of researchers go after a molecular target or cure in isolation. It’s a them-against-the-world mentality. The “medical-industrial complex” is not incentivized to share amongst each other, let alone with patients.

At Sage Bionetworks, we are building a system where molecular knowledge about diseases can be pooled together from patients, scientists, and physicians. As a result, communities with a specific interest in a disease—say Parkinson’s or Alzheimer’s—can bring their data together. Once brought together, the data and models for the disease can evolve as more data is collected. For example, if someone is interested in Parkinson’s, she will be able to track and follow the evolution of the disease model. Imagine a world where citizens could follow disease-related projects, become fans, and join as followers or even funders.

Q: What challenges do you face in building communities of users?
Given that much R&D in the health care sector has happened within the proprietary domain of big pharma or biotechs, there is a cultural shift that will need to happen. Moving from an attitude characterized by competitiveness and proprietary information to one that is pre-competitive and collaborative is a challenge. The good news is that the patients who want better therapies are poised to put pressure on the current siloed, closed system to open it up to exponential open sharing approaches.

Q: You are at the early phases of developing this platform. But what is your vision for it ultimately?
Once there is enough information on the platform, patients paired with doctors will start to shape their own treatments. Take muscular dystrophy (MS), for example. We are considering projects that will bring together hundreds of patients to collect information about the deep molecular characteristics of their diseases, along with all the information about which molecular characteristics respond to which existing therapies. We hope this will allow us to detect molecular classifications that can get the right drug to the right patient. Thus, patients can start to see themselves as active agents in their own treatments, an evolution toward being self-responsible citizens. This will be “the democratization of medicine.”

Q: How are you using open source principles to scale your platform?
For the platform to work, traditional definitions of what a scientist or doctor is, what a citizen or patient is, and what a funder is, need to shift. We’re building a commons—a place where everyone can contribute data, and shape new methods of disease funding and treatment. Eventually, we’ll move beyond just data sharing and create a “virtual marketplace” where funders, scientists, and patients can work together across disease classes.

Q. How do you distinguish between quality and noise?
Similar to Amazon’s Reader Reports and standard consumer reports, we assume that the data that people first enter should not be trusted. We give it all an initial neutral rating. But as people use it over time, the better data has the opportunity to get more popular, acquire a higher quality rating, and thus gain more visibility.

Q: What inspiration do you take from the open source movement?
There’s a great attitude within open source communities that if you assemble enough individuals to collectively problem-solve, you’ll be able to identify amazing solutions. That’s the spirit we have at Sage Bionetworks. We’re inviting all sorts of different participants to collaborate and share clinical/medical information in a collective space. Together with citizens, scientists, and funders we ask: Why can’t we, together, build models of disease in ways similar to those in other open source communities?

Read an interview with Stephen Song on his open source approach to scaling innovation through communications technology.

Kids from my daughter’s school come home talking about things you can make with kale, what is in season, and how squash actually tastes good on pizza (yes, made with whole grain crust). My son never talks about the food at his school except to demand that we pack his lunch. This would only be of personal interest, except for the fact that opting out of school lunch is not an option for many kids: About 57 percent of kids in the US rely on free and reduced-price school lunches for their main meal of the day. The nutritional impacts of what is served at school, and the expectations and habits these food choices create about eating have both lifelong implications for kids and public health, and equity implications for us all.

Every day we hear about the growing crisis of obesity-related disease and the ticking time bomb that childhood obesity represents for the US. Approximately 17 percent, or 12.5 million US children and adolescents (ages 2-19), are obese. This does not even include kids who are overweight. The human and economic costs are significant. Diet-related diseases are among the top causes of death and cost more than $1 trillion annually. And while what students eat at school is just one of many contributing factors, the combination of direct nutritional impact with the social reinforcement of eating habits created by school lunches offers a clear opportunity to address a key social issue.

So, what is getting in the way of seizing this opportunity?
Cash-strapped school districts are primarily responsible for school lunch programs. Support from the National School Lunch Program (administered by the US Department of Agriculture) in the form of cash and surplus food serves as a primary revenue source for schools—and thus, it comes with regulations. Meanwhile, state and county public health agencies develop and implement obesity prevention programs and educational outreach to encourage healthy eating habits and prevent dietary causes of disease. Responsibility, funding, and expertise are divided, making a systems approach to the issue challenging. The current economic model funds health treatment, not prevention. It provides money for prescription drugs, inpatient services, and emergency room visits, but not for healthy food or health education.

The excellent examples of farm-to-school, healthy school kitchen, and school garden programs generally have a key, non-replicable aspect in common. They require entrepreneurial and resourceful advocates who are willing and able to seek waivers; garner exceptions to rules; establish site-specific partnerships with farmers, cooks, and health educators; and raise grant and other money—none of which is sustainable or scalable. These are all common factors to piloting new models, but the scale of the public health need and the economic costs of childhood obesity require that we rethink the divide between school nutrition services, public health, and health care.

But, what can we do?
We must shift from seeing the improvement of children’s access to healthy food at school as a cost we cannot afford to a savings we cannot afford to miss. And this scale of change can only happen if voices from many sectors demand innovation and provide the political and social capital necessary to counter the territorial and economic incentives to maintaining the status quo.

Imagine:
• What would the food expectations of the 30 million kids served by the National School Lunch Program be if we drove the design and funding of the program from a health and wellness perspective?
• What would the funding system look like if we established monthly funding of better school lunches as a prevention benefit (a monthly payment similar to a prescription drug benefit) that contributes funding for the preventative benefits of healthy food?
• What if we put in place a market-based solution to fund better school lunches - increase the quality and health of school lunches, increase demand and, if needed, increase the cost per day for families that can afford it, creating a sliding scale that improves life for all kids?
• What if we used the millions of acres of surplus public land in transportation right-of-ways, and the millions of hours of mandated community service and corrections labor to grow food for our schools?
• What if we passed public health opportunity bonds that funded preventative approaches to health and wellness, including healthy school lunches, and paid back the bonds with future public health savings?
• What if we established soda and high-fat snack taxes that funded healthy school lunches?
• What if education, public health, economic equity, and childhood development advocates placed as much priority on impacting the farm bill as commodities and agribusiness advocates do?

We must imagine and act on possibility because there is a generation in the balance. The trend lines of obesity, diet-related disease, and its treatment costs keep going up. But prevention that can reverse this trend line is in our control—if we put in place equitable access, education, and the supports that establish lifelong habits of healthy eating. And what better place to start than with our kids?

But a venture based in Mumbai has broken the ice: Mirakle Couriers offers standard courier services and employs only deaf adults. Its entire staff—including the couriers themselves—suffer from extreme hearing loss. Twenty workers manage data entry, package tracking and scanning, and other branch operations. The other 44 staff members navigate the complex landscape of Mumbai to deliver packages.

The company offers a sign language program to all new employees, and everything from pick-up to delivery is carefully planned at the firm’s branches in sign language. Unlike other courier services in India, couriers communicate with customers via text message rather than by phone, and since they aren’t allowed to drive, they must use public transportation for delivery. The couriers must also receive training on how to deal with the social stigma of deafness.

The most unique thing about Mirakle is that it believes in a model of development through enterprise and not charity giving. These employees gain confidence and financial independence that would be otherwise unavailable to them—they are able to support their families rather than having to be helplessly dependent on them.

Founder Dhruv Lakra was motivated to start Mirakle after meeting a deaf person on the bus. “I thought, why should people with this disability be confined to doing odd jobs?” he says, “Mirakle Couriers was born out of my desire to help the deaf find a path to a dignified life. And being a courier is a job that requires minimal interaction, so this was the best idea I could think of.”

Mirakle Couriers has won various awards, including the Hellen Keller Award in 2009 and the National Award for the Empowerment of People With Disabilities in 2010, handed over by the President of India.

This spring, I met Rye Barcott on a book tour for his memoir It Happened on the Way to War: A Marine’s Path to Peace, and learned about Carolina for Kibera (CFK). Celebrating its tenth anniversary this year, CFK’s mission is to develop local leaders,
catalyze positive change, and alleviate poverty in Kibera. One of CFK’s core beliefs is that community problems require local solutions run by local leaders.

In 2000, as a 20-year-old, Rye was drawn to learn more about ethnic violence and spent a summer in a 10-by-10-foot shack in Kibera. While there, he met a nurse, Tabitha Festo, and a community organizer, Salim Mohamed, both of whom had powerful visions of how they could effect change in Kibera. Together, the three of them cofounded CFK with the broad goal of developing a new generation of leaders. The on-the-ground work in Kibera fell under the leadership of Tabitha and Salim. Rye worked from afar while he attended the University of North Carolina at Chapel Hill (CFK is a program of the Center for Global Initiatives at UNC). He continued to participate from afar while he served as a Marine in Iraq, Bosnia, and the Horn of Africa, and earned a master’s in business and public administration from Harvard.

Although Rye’s personal story is extraordinary, what attracted me most to CFK was its commitment to participatory development—the local community appears to have been the focal point of all that CFK has done from its founding to today, and that is apparent in its mission and operations. I believe, as many do, that one of the reasons so many efforts in global poverty alleviation have failed is that change hasn’t come from the community. CFK seems to walk the talk, and to put the community front and center in all things.

CFK’s entire staff in Kibera is Kenyan—many are from Kibera—and CFK’s office is in Kibera. The only full-time staff person in the US is Executive Director Leann Bankoski, who put me in touch with George Kogolla, the executive director in Kenya. George invited me to come to CFK’s office in Kibera when I visited Nairobi this summer.

After the adventure of finding CFK’s walled white and blue cement office (“drive to the Olympic Estate, it’s close to Chief Camp, park, and just ask someone to point you to CFK, everyone knows where it is”), my companions and I wedged ourselves into George’s back office. His office is attached to the small main room of the building, which was crowded with tables and computers where five staff members worked busily. Others bustled in and out.

George, soft-spoken and intent, spent a generous 90 minutes with us, describing CFK’s challenges and local orientation. CFK continues to grow its original initiatives (first two below) and has added new programs:
• The sports association teaches healthy life choices and promotes peace across gender and ethnic divides in Kibera. Over 5,000 children participate in the annual soccer tournament each year. (Chasing the Mad Lion is an upcoming documentary on the tournament.)
• The Tabitha Clinic is a community-based medical clinic and one of the few permanent structures in Kibera. More than 40,000 patients visit the new three-story clinic every year.
• Other programs for Kibera youth focus on reproductive health and women’s rights for 11- to 18-year-old girls; empower youth to talk about sex, HIV/AIDS, and reproductive health; and offer financial assistance to attend school. (Fifty percent of Kibera residents are under the age of 15.)

On one hand, the issues George discussed were unique to CFK; on the other, they seemed emblematic of executive directors and social entrepreneurs everywhere. “We are moving from a ‘doing’ to an ‘impact’ organization,” he told me firmly. He struggled to find local leaders. He was looking for a Kenyan to help with a strategic plan for Trash Not Cash, a community-managed solid waste management and recycling program that was intended to be a profit-driven social business. He was trying to create an effective program to develop local social entrepreneurs, who, he said, often didn’t understand the microlending concept. He had trouble transitioning local volunteers who received small stipends to full-time employment outside of CFK. He also spoke about fundraising hurdles and the challenge of increasing giving from Kenya.

While managing all these activities and many more, he hosts college student groups and western visitors like me. As we left the office to walk to the clinic, I met students and a professor from the UNC School of Social Work, who were conducting an intense few weeks of health research—just one of many university groups that have worked with CFK, including MIT and Stanford.

Woven through our conversation was the theme of community, which was certainly underscored by the office’s location. I can’t imagine a better place for an organization that “recognizes the youth of Kibera as resilient, wise, innovative, and eager to lift their community above the poverty and violence that plagues it.” CFK’s community focus promises to effect change that will stick. Seeing CFK in action gave me a much richer understanding of what community engagement really means.

Ms. Ridley joined the Stanford Social Innovation Review in 2006 as publishing director. Previously she was group president at CMP Media, where she ran a division of technology publications, events, and websites. Ridley is also founder and board chair of Friends of Timboni Feeder School, a nonprofit that supports a K-5 school in Kenya. She holds a B.A. in political science from the University of Connecticut and a Masters in International Management from the Thunderbird School of Global Management.

Today’s fee-for-service health care system is part of the reason health care costs continue to rise. Why? Because insurance companies continuously drive down reimbursement rates, forcing providers to perform unnecessary visits, procedures, and lab work to survive. Unless something changes, this upward cost trend will continue.

Employers use a number of tactics to manage these skyrocketing health care costs, including switching plan vendors; raising contributions, deductibles, co-pays, and other employee cost-sharing provisions; implementing wellness and other health-promotion incentive plans; and eliminating or reducing retiree medical plans. But recent history shows these approaches do not work—employers and employees have absorbed double-digit increases over the last 5 years.

What has been missing is large-scale innovation that introduces higher-quality, lower-cost medical providers that can improve the health care experience, and ultimately break the cost trend for employers and employees.

What does this innovation look like? It is mobile, digital, and efficient, and has low overhead. It brings health care services to patients, is available pretty much on demand, and can match the talent and expertise of the health care workforce with the immediate needs of patients.

Mobile health care delivery cuts down on overhead costs, saves time, and is less disruptive for both the patient and the provider. Mobile care also means less out-of-pocket costs for individuals and businesses. My company, WhiteGlove Health, provides its members with just such a service. Nurse practitioners visit our members at their home or workplace to provide primary and chronic medical care, and the services are provided for a fixed cost plus an annual membership fee, with no costs passed on to insurance providers. By delivering services directly, we save on the cost of maintaining a clinic—savings we pass on to the patient. The patient also saves the time and money they normally would spend on transportation and associated disruptions, including trips to the doctor’s office, the pharmacy, and even the diagnostic lab.

Mobile health care has the added advantage of removing common medical ailments out of already-crowded ERs (crowded hospitals have been tied to both increased death rates and a waste of resources when a standard physician would suffice).

One type of emerging mobile health care is mHealth—health care solutions that employ mobile technologies such as smart phones and tablets. mHealth applications are particularly useful in rural areas or impoverished communities where access to health care is slim. However, mHealth also has many implications for the industrialized world. For example, nurse practitioners can use iPads to access medical records, perform charting, and provide forms for patients to sign; patients can request appointments and access medical records via a mobile app. These methods cut down on time and resources needed to manage data and process forms, and we have seen the cost savings firsthand. Mobile health applications also make services timelier and better informed.

Advances in mobile technology are creating other opportunities as well. Many telecom providers are starting to invest in telemedicine: health care services provided over wireless, networked, or cloud-based mediums. New software technologies give patients remote access to health care services; for example, Anthurium Solutions Inc. produces solutions that enable nurses, pharmacists, and other health care professionals to engage in long-distance consultations with patients.

The rise of mobile technology and the cloud are creating new opportunities for innovations that simplify health care delivery, and in this age of rising health care costs and uncertain health care reform, health care innovation is perhaps our one hope for controlling costs. However, innovation can’t and shouldn’t be limited to new medical technologies; we also need innovation in delivery models and process optimization. Until we create leaner, more-efficient health care delivery systems with fewer middlemen, we’re never going to see a true reduction in the health care cost curve.

Read a related sponsored supplement article, “Opportunities in Mobile Health.”

See the complete health care sponsored supplement.

Bob Fabbio is CEO and co-founder of WhiteGlove Health, Inc., headquartered in Austin, Texas. Bob has more than 30 years of experience in all aspects of business: company formation, board oversight, and day-to-day operations. His past startups include Tivoli Systems, which was acquired by IBM, and DAZEL Corporation, which was acquired by Hewlett-Packard. Fabbio also spent nearly 6 years in the venture capitalist industry with Austin Ventures, as a Venture Partner, and with TL Ventures, as a Managing Director.

Program Background

The volunteer project that sparked this partnership is IBM’s Corporate Service Corps, a program in which IBM sends select employees into emerging markets on short-term pro bono assignments to build capacity for international NGOs in areas such as IT, finance, marketing, human resources, and project management. In the case of Cross River, the Corporate Service Corps (CSC) teams were asked to assist in carrying out Projects HOPE and Comfort, a state-driven initiative designed to address the crisis.

Health data management was one of many challenges. Local clinics had no electronic database to track patient’s health and medical history. Rural women often sought medical care from roadside chemists and local birthing attendants—people they trusted but who were untrained in pre-natal and pediatric care. The CSC teams’ recommendations for addressing this problem included digital technology to monitor health trends and capture patients’ medical status, a communications plan to engender trust among a population unaccustomed to government support, and a change-management strategy designed to inspire both employees and community members to participate in the program.

Upon hearing the recommendations, Cross River’s Governor Liyel Imoke recognized the value of corporate expertise. Projects HOPE and Comfort have since evolved into a business partnership between IBM and Cross River State, grounded in the common goal of saving lives. IBM provides counsel on a biometric identification system that registers program participants, while giving hospitals and doctors the intelligence to make life-saving decisions. Solar panels have been installed in free health clinics that experience frequent power outages, and Projects HOPE and Comfort are on track to increase school attendance by 80% and reduce infant and mother mortality rate 50% by this year’s end.

Why Did This Cross-Sector Partnership Work?

I ask myself what is needed for government and business to innovate together to solve social challenges every day. In environments as diverse as Ghana, India, and the Philippines, my organization, CDC Development Solutions, works with corporations and their employee-volunteers to spur local social and economic development.

Several factors help explain the success of the IBM-Cross River State partnership:

1. Private sector support. The short-term Corporate Service Corps projects were a fertile learning ground that provided IBM with an understanding of Cross River’s cultural dynamics, while relationships with local communities and government organically developed. IBM’s senior leadership team well understands the value of this type of relationship. When C-Suite leaders understand the business value that accompanies a social contribution, this helps them to view it with a different lens and support the project.

2. Government committed to transparency. Cross River State’s Governor Imoke was a fervent supporter of the partnership. He demonstrated political will that went a long way in engendering the trust and cooperation of those beneath him, as well as transparency at all levels. 

3. Coordination and connection. When two parties with different languages and processes collaborate, the need for an intermediary cannot be underestimated. Working with a third party resource brings an on-the-ground network that fosters trust, while saving both parties a valuable resource: time. It also leads to results that can scale quickly, as we see in the case of Cross River.

4. Skills-based support. The engagements utilized the professional skills of employee volunteers from all over the world, bringing together a diversity of skills and perspectives. The projects were ones that required strategic thinking, not brute physical force. The team members were able to successfully apply their expertise to the tasks at hand.

In a world of increasing globalization, there is a need for best practices to guide partnership between government and business. International corporate volunteer programs offer an initial lens into principles that can guide these partnerships.

It seems that more and more engineering and management students want to use their skills to tackle problems like poverty, lack of access to clean drinking water, and indoor air pollution. Maybe this shift came with the corporate-world disillusionment brought on by the financial crisis. Maybe it’s due to the increased funding and recognition from organizations that support these causes. Regardless, some academic institutions are responding to and encouraging this shift by increasing their service-based learning opportunities.

Service-based learning is “a pedagogy that integrates academic learning with community-based work.” Products of service-based learning include innovative technologies that target social problems. Stanford’s Entrepreneurial Design for Extreme Affordability brings together students from different disciplines to design comprehensive solutions to problems facing the world’s poor, and Engineering Projects in Community Service (EPICS), which started at Purdue University, matches teams of engineering students with community-service organizations that need technical assistance. Then there is MIT’s series of classes collectively known as D-Lab, which “fosters the development of appropriate technologies and sustainable solutions within the framework of international development.” D-Lab’s offerings fall into the three broad categories: development, design, and dissemination. Students learn about development issues through field visits, design prototypes that address problems they observe, and disseminate their completed innovations.

The dissemination phase can be tricky. There are generally two types of dissemination: Students either disseminate the technologies themselves by setting up a nonprofit organization or social enterprise from scratch, or they work with community partner organizations to disseminate the technology.

When students disseminate technologies themselves, as alumni they might create social enterprises that spin off from classroom projects. Both Embrace and Global Cycle Solutions have evolved this way.

But while this model sounds great, the reality is that most student inventors will not become social entrepreneurs. Long-term dissemination requires students to commit more time and energy than most are able or willing to give up. As a result, a technology may only end up in one place, the location of the class project, because no students commit to taking it elsewhere.

There are other obstacles too. Sometimes, a student’s community partner organization stops using the technology because it breaks and no students are around to fix it. Or a promising technology is left incomplete after a semester because no students wanted to continue working on it. Or relationships with community partner organizations fizzle out. This means that a lot of people will not benefit from inventions like MIT D-Lab’s pedal-powered maize shellers to shell corncobs, biosand filters to purify water, off-grid coliform field test kits to test for water contaminants, mobile phone technologies that connect farmers to information about market prices, and hand-powered tricycles.

What can we do with these innovations now—how do we keep them from going to waste? One answer is to develop partnerships between academic institutions and nonprofit organizations.

MIT’s International Development Initiative (IDI) began offering Technology Dissemination Fellowships to students. In addition to supporting students’ self-initiated dissemination efforts (such as social enterprises), IDI keeps track of student-created technologies and shops them around to new community organizations. If a community organization is interested in having students implement a technology, IDI recruits students for the summer.

IDI’s Technology Dissemination Fellowships have the potential to improve the long-term dissemination of student-created technologies because IDI, not the students, maintain long-term relationships with the community partner organizations. Additionally, IDI can supply new students to community partner organizations on an ongoing basis, so if a senior student graduates and moves on, new students can take over where they left off. (That said, IDI should consider requiring student engineers and disseminators to document their inventions and dissemination process much more thoroughly so that new students can more easily learn how to use, create, teach, and adapt the technologies.)

Community partners play an important role in dissemination, and their responsibilities depend on the project context. They work with students because they share the same goal and need the students’ technical expertise. For example, in MIT’s Kanchan Arsenic Filter project, students teamed up with Canada’s Centre for Affordable Water and Sanitation Technology (CAWST) and Nepal’s Environment and Public Health Organization (ENPHO) to disseminate low-cost, arsenic-removing water filters to Nepal. CAWST specialized in training NGOs and local entrepreneurs in filter construction methods. ENPHO gave feedback on the design, provided a local water-testing laboratory, and helped establish national policy regarding arsenic contamination through their involvement with Nepal’s National Arsenic Steering Committee (NASC). MIT students came up with the basic idea, tested the filter in Cambridge, and traveled to Nepal to test it in the field. After graduating, the student team leader moved to Nepal as a CAWST employee to work with ENPHO. ENPHO continued training sessions after students could no longer enter Nepal due to internal turmoil.

Sometimes, technology builds the community partner organization. Another example: MIT students created a data collection system for a Salvation Army homeless shelter. After the technology was delivered, it was the Salvation Army’s responsibility to continue implementing it. With other projects, community partners are on-the-ground design collaborators; they promote networks and do reality checks. One Earth Designs (OED), an NGO established by an MIT alumnus, works with community partners who implement small development projects in Himalayan agricultural and nomadic communities. OED’s community partners have connected OED to villagers who collaborate in the design process of technologies like solar cookers. In return, OED has trained community partners in skills like water testing.

Whatever the community partner’s responsibilities are, its commitment to the student teams is important to dissemination. A long-term project needs an advocate, or it can easily fall through the cracks.

On the university’s end, there needs to be a commitment to service-learning as evidenced by hands-on, project-based classes, student funding for service-based projects through fellowships and competitions, the active pursuit and maintenance of relationships with community partner organizations, and mechanisms to maintain the flow of new students into community partner organizations over short amounts of time. These academic-nonprofit, cross-sector partnerships have immense potential to positively influence long-term development, dissemination, and diffusion of technologies.

A new social enterprise aims to provide a unique sanitation service to shantytowns. San+Co. produces mobile toilets that fit in slum dwellers’ homes. Waste is stored in a cartridge, which is collected every few days, and sent to a facility that produces and sells fertilizer. The facility also converts methane from the waste into electricity. In return for the cartridge, each family receives a rechargeable battery they can use to power a light bulb or two, and charge a mobile phone.

The system addresses many different issues. It provides a dignified, safe, and hygienic solution to a basic human need. Off-the-grid electricity translates to increased productivity for adults, extra study time for students, and additional safety. The fertilizer is an organic option for local farmers that helps increase their yield per acre. And the system reduces disease by keeping waste out of the local water supply.

San+Co. is in the very early stages, with 50 pilot families. The group is still working on unit economics and scoping partnerships, but the idea is great and the dedication and passion of the team is palpable. I saw them present this past week at the Kellogg School of Management’s KIN Global Prize Competition. Four social enterprises pitched to senior leadership of global corporations, and each audience member was given $500 to award to the idea or ideas they thought had the most promise. San+Co. earned $40,900—the majority of the KIN Global prize money. The McCall Foundation kicked in an additional $10,000, and IndieGogo, an online platform for crowd-sourcing support, offered its services for free. San+Co. has been doing remarkably well at social business plan competitions across the US, and just this past week, it received a $75,000 investment from Village Capital.

What is the secret of San+Co.’s success? For one, its business model does not rely on infrastructure—a luxury that most slums do not have. San+Co’s toilets do not need a sewer system, and the electricity service does not rely on a grid. Its tagline is apt: “Offgrid utility platform.” The system is designed for the poorest of shantytowns, ones that receive no city services.

The other reason for its success points out a truth about entrepreneurship: To succeed, you need a great idea, great execution, and a great leadership team. San+Co’s leaders know how to give a great presentation. With humor and intelligence, they clearly describe the system and business model. They also humanize the results: San+Co. ultimately delivers dignity, health, and safety—basic human rights—in a way that’s accessible, affordable, and aspirational. Once one family on the block can light their home, all the other families want in on the action.