White Paper series: Technical assistance support for health innovations in low and middle-income countries
Creators: name: Devadas, Deepika
name: Theriault, Annie
name: McGahan, Anita M
name: Govani, Sweta
Publisher: name: Gates Open Research
Year: 2021

description: Innovation serves as an important tool in addressing Sustainable Development Goals (SDGs) in new and accelerated ways. Particularly in the case of SDG 3 (which is dedicated to “Good Health and Well-being”), significant issues such as equity and impact are at stake in low- and middle-income countries (LMICs), that critically translate to actual lives and the quality of these lives. This makes the scaling of innovations beyond the proof-of-concept stage a crucial priority. However, to scale beyond the proof-of-concept stage, innovators must overcome multiple barriers related to fragmented and immature markets, varying expectations of partnerships and customers, regulatory and legal barriers, team bandwidth, capability and expertise. To successfully unlock these barriers, innovations in global health require funds. This four-paper series focuses on the different tools available, as well as organizational decisions innovators need to make regarding financing opportunities and strategies.<br> <br> While critical to each and every step of scaling an organization, the financing plan – as a strategy to scale innovations – often receives little attention in the early stages of growth. In most cases, decisions about accelerators to attend, initial financing mechanisms to use and organizational structures to implement are opportunistic, as opposed to strategic. Lacking both a full understanding of financing tools and approaches available as well as access to experts and/or networks to secure the appropriate form of financing, innovators often end up with ad hoc or suboptimal financing strategies, which in turn limit their opportunity to scale. Their struggle often becomes evident when attempts are made to move between growth stages and/or types of financing. Funders and stakeholders in the innovation ecosystem are representative of the interests and risk appetites of a wide variety of actors, ranging from governments to private sector corporations, donors and foundations, return-motivated investors and banks, or researchers, academic and multilaterals. To succeed, innovators must meet the expectations of multiple groups that do not always agree on the ranking or emphasis of priorities. At the same time, the landscape and strategies of funders are continuously evolving. Who will serve as an innovator’s guide through this journey with multiple critical partners? What is at stake if an innovator is not supported?<br> <br> The <i>Every Woman Every Child </i>Innovation “Marketplace” is a collaborative, ecosystem platform that works across the spectrum of innovators, funders and partners to help global health innovations grow and scale their impact and success. Since 2016, the Marketplace – supported by Grand Challenges Canada, the Norwegian Agency for Development (Norad), the United States Agency for International Development (USAID) and the Bill &amp; Melinda Gates Foundation – has provided innovators with support during critical transition-to-scale stages and helped mobilize funding for innovations ($42M USD, at the time of this report) that serve beneficiaries in 62 countries.<br> <br> This white paper series shares insights of the Marketplace approach of hands-on support to mobilize capital. In the first paper, we discuss the barriers to scale that programmatic technical assistance support platforms can help overcome, including insights on when and how to leverage these programs to support a strong and intentional financing strategy. In the second paper, we provide an overview of the unique financial landscape in the global health sector and address opportunities for blended financing for innovations transitioning to scale. The third paper covers the business models available to technology innovators in global health, and the bidirectional relationship between these choices and opportunities for financing growth. Finally, the fourth paper dives deeper into the dual market approach and its underutilized potential to unlock financing for many innovations with aims of global reach and impact.