Between 1970 and 2000 the proportion of global R&D occurring in low income economies rose from two percent to more than 20 percent. However, this rising commitment to R&D does not easily translate into the emergence of a family of innovations meeting the needs of low income consumers "at the bottom of the pyramid", since much of these technological resources are invested in outdated structures of innovation. A number of transnational corporations are targeting these markets but it is our contention that much of the previously dominant innovation value chains are either ignorant of the needs of consumers at the bottom of the pyramid, or lack the technologies and organisational structures to meet these needs effectively. Instead, the firms and value chains that are likely to be most successful in these dynamic new markets are those that are emerging in China and India and other developing countries, disrupting global corporate and locational hierarchies of innovation.
This article considers the factors that determine the ability to innovate health technologies in order to make them available to those who need them most in developing countries and rid populations of disease. It uses the case of Tanzanian bed/mosquito nets particularly those treated
with insecticide which are promoted as a key prevention mechanism in the fight against malaria. Reviewing the success story of Tanzania in the production, distribution and use of bed nets, the article asks questions regarding the future ability to sustain progress. Using the concept of social
technologies, the article highlights the importance of understanding the social context of the bed net innovation process. It therefore highlights the need to consider the bed net story as one not merely of effective distribution but, more significantly, of the whole innovation value chain
from inputs to the textile factories making the nets to consumer needs and demands. It enriches our understanding of the complex nature in which the physical technologies (bed nets) are accessed by the poor and how this relates to the overall health system.
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