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Three Mundane but Insidious Barriers to Global Health Startups

As a small departure from our usual blog, we thought it would add some insight about the kinds of barriers that small global health startups face. These are the mundane, day to day issues that can actually make or break you in the end. While we try to be relentlessly positive about the exciting new technologies coming down the pike, sometimes one has to be just brutally honest about obstacles faced.

**1. International shipping**

Oh, let us count the ways that international shipping can sneak in and foil best laid plans--wet packages left out in the rain in Bali? check (zip loc is your friend) hemoglobinometers stuck in customs and then returned from the Ukraine? check. Bribes and fees? Our partners face them all the time.

First and foremost, the weight and volume of every single technology matters and it matters a lot. Say you are considering a new kind of solar light or a scalpel or a little handheld device to detect malaria. The weight of your material or your end product matters for every stage of the journey. Think your device is lightweight? Make it lighter. Thinks it's cheap at $1 a cassette? Make it cheaper because you'll need to add on 30-50% for shipping.

**2. Exhibit Booths**

This is a particularly understudied barrier to innovation. An innovator in global health or in other fields as well is typically in a bootstrapped enterprise, often right out of school. What is one of the best ways to get feedback on an early prototype or spread the word about your product?-=-global health conferences. And how much are exhibit booths? $3-5.. what? $3-$5000? Even conferences which purport to be all about innovation often have restricted, expensive, unaffordable opportunities for exhibitors. Some of the exhibit booths by industry are nicer than my living room-- it costs extra for the couches and even the wireless. We believe that a certain set of all conferences should be set aside for miniature booths or stands for startups. We think it would change the game.

**3. Medical Device Regulations and the FDA**

"Sometimes a toothbrush is not a toothbrush." I have been trying to think of a way to process a recent call with the help line in which we were told that 'when a toothbrush is put in a toiletry kit it is no longer a toothbrush as it was intended to be used'-- it is now part of a 'convenience kit'. What a startup needs is a medical device expert who costs upwards of $300-500/hour, a sizable barrier for young startups. If you are pushing into new categories, into humanitarian devices and other innovative spaces, this is an area that needs a lot of careful consideration up front, budget setasides and we wish, a 'medical device' fairy who would show up and explain everything with the wave of... a toothbrush?

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