Partnerships & Coalition

Partners

1. Dr. Cheedy Jaja
– Heard of him from the SickleScan website, got in contact b/c one of Prof. Cheng’s contacts and one of Khanjan’s contacts from Sicklescan
– We received feedback on the usability of our device and how cost, over everything, is the most important and the biggest distinguisher for a medical device.
– Our device is another option to use in the future for sickle cell screening. If we join the effort to try and have the medical system adopt a sickle cell protocol we could help write/develop the protocol and be the man power behind the effort.
– We need to bring back a working device ready for clinical testing that can be compared to the devices Dr. Jaja is testing now in order to receive more feedback.
2. Sia Evelyn Nyandeno (SCCAN)
– Traveled to Kono to meet Dr. Jaja at the Jarbario Clinic. Sia is the founder of SCCAN (Sickle Cell Carers Awareness Network), an awareness program that helps care for children and adults who suffer from sickle cell disease in Kono. Sia met Dr. Jaja on Facebook and asked him to come support the SCCAN program at the Jericho Road clinic.
– SCCAN runs a program at the Jericho road clinics which diagnoses and treats patients. Although they are currently using the SickleSCAN device, they are very open to trying another device which is cheaper and more effective.
– This partnership has the potential to be symbiotic, and can be better, once we have a functioning device. Specifically, they will help us with the on-the ground expertise, and we will help them diagnose more patients for a cheaper price.
3. Sickle Cell Society (Specifically: Mrs. (Sister) Amelia Gabba (Sickle Cell Society) and Dr. Gibrilla Fadlu-Deen (Sickle Cell Society/Congought Hospital))
– Found the Sickle Cell Society website and mission online, on their website. Made contact with the Sickle Cell Society through a publication involving a study run by heads of the Sickle Cell Society in Sierra Leone.
– Met with Ms. Gabba and Dr. Fadlu-Deen to learn more about there program for people with Sickle Cell Disease, said they would possibly be open to running a clinical trial with us
– If they chose to adapt our device in the future after a clinical trial and manufacturing they will be saving a lot of money because they are currently paying $25 for each diagnosis making our partnership symbiotic in the long run.
4. Prof. Martin Grobusch (Masanga Hospital)
– Prof Martin Grobusch is the director of the medical research unit at a hospital in Masanga. Masanga is the only hospital in Sierra Leone that has its own electrophoresis machine (the gold standard for diagnosing sickle cell).
– Since the Masanga hospital is research-driven, and already has an electrophoresis machine, this partnership has the potential to be very symbiotic once we have a functioning device. Specifically, they could serve as a location for clinical trials, since they have sickle cell expertise and a mechanism for comparing our device, while we would be providing them with additional research, publication, and prestige opportunities.
5. Dr. Sandra L Lako (Aberdeen Women’s Hospital)
– Dr. Sandra Lako is a pediatrician at a major hospital in Freetown. She is also doing her MPH dissertation on sickle cell. We met with her in order to learn more about sickle cell at her hospital in Freetown. Although at the time this partnership was very one sided (we were learning about sickle cell conditions in Freetown), there is a lot of potential for the partnership to become symbiotic in the future.
– Since Dr. Lako is focused on helping her patients, and has an academic interest in sickle cell, once we have a functioning, proven device, we can form a strong partnership. Specifically, we can provide her with a device which will help her patients, and she can provide us with feedback and information on the local healthcare system.
6. Dr. Abu Bakarr Bah (Children’s Hospital)
– Dr. Abu Bakarr Bah is a pediatrician in Freetown with an interest in sickle cell, who was recommended to us by Dr. Lako. Like with Dr. Lako, this relationship has so far been very one sided (we were learning about sickle cell conditions in Freetown).
– During our meeting, Dr. Bakarr Bah expressed his enthusiastic interest in working with us in the future. Specifically, he hopes to use our device to improve the wellbeing of his patients, and believes that by having more people in Sierra Leone pushing for a national screening program, the problem can eventually be addressed. Similarly, Dr. Bakarr Bah would be helping us by using our device, and working towards our mutual goal of reducing the childhood mortality associated with sickle cell.
7. Hasan & World Hope International
– Our main partner in Sierra Leone, connected through GSIF organizer Khanjan. World Hope has helped us get our foot in the door to a lot of these other possible partnerships. Hasan is currently working for Ukweli and was a recourse to all teams, providing insight on locations in Sierra Leone and meaning fully questions that need to be asked
– Our team specifically does not have a symbiotic relationship with World Hope, however Lehigh does. The relationship with Lehigh is symbiotic because they provide us with resources on the ground and we are bringing them more manpower and ideas.
8. Dr. James Bunn (WHO Child Health Specialist)
– Dr. James Bunn is a Child Health Specialist at the WHO, who has experience working with sickle cell. We were put into contact with him by Anna Vines and the Sickle Cell Society. During our meeting, Dr. Bunn was very helpful to us in talking about next steps, and ethics.
– In the future, this relationship has the potential to become mutually beneficial, as our device has the potential to make a national screening program cost-effective. Therefore, we could help him advance his goals of improving child health in Sierra Leone, while he provides us with policy help.
9. Faye Simmonds (E-health)
– Was introduced to E-Health and Faye Simmonds by Dr. Mary Hodges who was unfortunately not in Sierra Leone during the time we were there. Was able to talk to Ms. Simmonds and her colleagues in Nigeria about their SCD programs.
– Learned a lot about how all the partnerships above are connected and was added to the SCD google group. Learned more about their monthly meetings and their push to start a SCD screening program and treatment program. Heard about their program in Nigeria and the deice they are currently using there and how their treatment program runs.
– This relationship is not directly symbiotic however we were added to the google group through Ms. Simmonds, and in the future we could possibly have something to share that would benefit the group as a whole.
10. VentureWell
– Applied the the E-Team Stage 1 grant and were one of the teams to win, just sent in our E-Tram Stage 2 grant, and are waiting to hear back. This partnership is mainly a funding partnership. They are not only providing us with funding but also advice and training at their workshops. This is not a totally symbiotic relationship, we learn and gain a lot from them and they gain the ability to say they have funded our team which could possibly benefit them in the future but right now they are not receiving a lot out of this partnership.

Coalition: Stop Sickle Sick aka. Triple S, S cubed, SSSSSSSSSS (sound it out)
– Mission: To lower sickle cell mortality, specifically during childhood, by implementing a low-cost screening device partnered with a treatment program for all sickle cell patients.
– Key Partners: When we were in Sierra Leone, we found out that there was a google group for all individuals in the country who were interested in sickle cell. Because it was such a small community, we were able to meet everyone who is working to improve the lives of individuals with sickle cell in Sierra Leone, and would want all of these people to be our partners in the coalition. These partners are:
1. SCCAN (opinion leaders, resource partners, signaling partners) – including Dr. Jaja and Sia; a sickle cell clinic in Kono district; have sickle cell expertise and program in place for those diagnosed
2. WHO (opinion leaders, policy makers)- in particular Dr. James Bunn, a child health specialist with an interest in sickle cell; as a powerful, policy setting organization, having a partner from the WHO will be essential.
3. Sickle Cell Society (opinion leaders, resource partners, signaling partners) – including Dr. Gibrilla Fadlu-Deen, the medical director; a sickle cell program in Freetown; have sickle cell expertise and program in place for those diagnosed
4. E-Health (resource partners) – has experience setting up sickle cell programs in other LMIC countries, and is trying to do the same in Sierra Leone; also have experience with clinical trials and low cost technology

Team Goals

Goals:

Personal goals:
Jannah: I hope to push the project forward and make a contribution towards improving the lives of individuals with sickle cell anemia in Sierra Leone. Additionally, I hope to work on my team work, leadership, and presentation skills.
Maria: My personal goal is to learn valuable lab, entrepreneurship, presentation, leadership and teamwork skills all while working on a project that I truly care about and has the possibility to truly make a difference/impact (isn’t just a simulation).

Project goal: To improve the lives of individuals with sickle cell anemia in Sierra Leone (and other LMICs) through the design and implementation of a low-cost screening device and program.

Scaled project goal & metrics for success: Because of constraints, this goal will take at least 5-10 years to be achievable, and will take many outside resources and connections. Within the next few years, our current team will work towards several scaled goals.

First, we hope to design a low-cost, sensitive and specific lateral flow device to diagnose sickle cell anemia. Success of this goal will be evaluated based on an estimated scaled-up production cost below $1 per test strip, and a proven sensitivity and specificity above 98% (meaning there are very few false positive and negative test results).

Second, we hope to establish connections who can help the team scale-up and implement in the future. Success of this goal will include networking with doctors in the US and Sierra Leone who can help with clinical trials, programs and healthcare professionals in Sierra Leone who can help with program design and implementation, and NGOs who can possibly help fund the advancement of the project.

Roles:

Currently our device is divided up into three teams (team is 10 people total):
Production Scale Up (3)
Assay Development (4)
Assay Optimization (3)

The production scale up team is focusing on rapid, simple and consistent ways to build our device. Their number one goal right now is to design and build a test line printing machine that will allow us to have more consistent read outs of positive and negative results. In order to truly start optimizing our device we need this machine to be up and running as soon as possible.

The assay development team is mainly focusing on the test lines. They are continuing the development of the sickle cell test line and working to find sensitive and specific antibodies. They are also working on determining the dynamic range of the test strip which is incredibly important data that is a main selling point for our device.

The assay optimization team works very closely with the assay development team. Their goal is to determine the optimal amount and volume of each material we should be using in order to minimize cost. Materials that are optimized first go through the assay development team and are compared to other materials based on their sensitivity and specificity. The assay development team and the assay optimization team works together on some experiments in order to work more efficiently. Communication between the teams mainly travels through the three main leaders of the two teams.

There is at least one leader on each team who has been on the project for at least a semester. We have a meeting as a whole research team once a week where we go over/share the progress each team made. At the meeting any experiments that need to be run by multiple teams in conjunction that week are planned. Goals for the week are laid out at the meeting therefore it is very clear what each group needs to get completed by the next meeting.

Procedures:

Decisions on experiments and next steps forward (grants, publications, prodacols) are mainly proposed by the 3 team leaders that have the most experience with the project. The decision proposals are then brought to the group at the team meeting and any feedback is discussed. At this team our PI also provides feedback and new insights. The final decision and how it is going to be carried out is made at the meeting.

Our meetings are guided using powerpoints; each team makes their own slides covering what was accomplished the past week, outcomes, and plans for the next week. The power points are used to keep us on track and insure that everyone is prepared. We like to have a different person from each group each week present what has been accomplished in order to insure everyone is engaged and understands what is going on with the project.

Are meetings are on Monday nights which is very convenient because we are able to plan additional meeting times if necessary then. All other communication is mainly done through email or text messaging.

Relationships:

Currently, there is very little diversity on our team. All of our members have engineering backgrounds, and are focused on the design of the physical test strip. Despite this, we have significant team diversity in terms of strengths. For example, Maria has very strong networking skills while Jannah has a lot of experience working in a lab. Additionally, our team hopes to recruit new members who have business experience, who can help with the scale up process.

Our team has spent a lot of time thinking of a team name and has yet to decide on one. Some ideas have included: SScreen, SSave, and SickleStick.

Neem

Part I

Step 1:
– Azadirachta indica (Neem) is a tree indigenous to India
– Neem is sacred
– Neem has been used for over 2,000 years for medical purposes, food production, toiletries, fuel, and pesticides
– Over 100,000 people in India are employed in the Neem industry
– Chetan lives in Agra, India and operates a small business making and selling Neem products
– Chetan’s business employs 60 people
– Chetan does not know the exact name of the neem seed extract, Azadirachtin
– Tom Johnson is developing neem seed pesticides as part of his company OOPS
– Johnson’s company invested $5 million to conduct safety and performance tests over last decade
– Tom’s company has a worldwide patent for the pesticide use produced from neem seeds
– Tom has made profit of $12.5 million during his first year
– OOPS wants to sell their neem products in India
– Because of their patent, OOPS is demanding a royalty from Chetan’s business and other small industries that make neem-based pesticides
– Ethical dilemma: Is it ethical for OOPS to charge Cheetan and other Indian business for their use of neem, even though they have been making the products for centuries? What rights does Cheetan have? Is it ethical for a US company to enforce patent rights in this situation?

Steps 2 & 3: Define the stakeholders and assess their motivations
1. Cheetan
– Wants a successful business
– Wants to be loyal to his employees and customers
– Doesn’t want to pay royalties on a product his family has been selling for decades
– Wants to support his family
– Wants to maintain the dignity of his family legacy (the company) and his culture (neem is sacred)
2. Cheetan’s employees
– Want to provide for their families and maintain jobs
3. Tom Johnson (OOPS)
– Make money
– Expand into Indian market
– Have his patent and investment in safety testing respected
– Make royalties off of patent
– Consumers of Neem products in India
– Want the purchase neem products for the lowest cost

Step 4: Formulate alternative solutions

1. Cheetan pays the patent royalties to OOPS
– Pros: Tom and his company get the patent royalties which they are legally owed, and which they spent a lot of time and money investing in. Tom’s product is a cheaper option for customers.
– Cons: Cheetan loses a lot of money on paying the patents, and may have to lay off employees who he can no longer afford to employ.

2. Cheetan does not pay the patent royalties
– Pros: Cheetan can continue selling his products, although he may still have increased competition from Tom. Although this would be illegal, ethically it would be okay. Ethically, neem is sacred, a natural product, and has been used for years, therefore, it wouldn’t be unethical to keep selling the product. This option gives the best chance for Cheetan to keep his employees, and maintain those relationships.
– Cons: Tom would lose money on royalties, but could still make money selling the product. The customers may not be able to access the product for as cheaply as option 1.

3. Cheetan works with other Neem-based companies to get the patent revoked in India.
– Pros: Cheetan could continue selling his product without paying royalties, legally.
– Cons: This may be a very expensive, timely process for all stakeholders. Therefore Cheetan may have to layoff employees.

Step 5: Seek additional assistance
During class discussion, Prof. Cheng mentioned that it was illegal to patent a natural resource.

Step 6: Select the best course of action
Cheetan does not pay the patent royalties. Although this is technically illegal, it is ethically okay. It is unethical for OOPS to charge Cheetan and other Indian business for their use of neem, since it is a natural, sacred product, and they have been making the products for centuries.

Step 7: What are the implications of your solution on the venture
– Technological: no impact, both Tom and Cheetan can continue making their product
– Economic: This is the cheapest option for all parties involved, except that Tom will not make money off of the royalties
– Social: Cheetan may face backlash from the government for ignoring the patent laws. Socially, this is the best option for – – Cheetan and his employees, since Cheetan will lose the least amount of money and can keep his employees.
– Environmental: no impact, neem has already been proven environmentally friendly.

Part II

Step 1: Determine the facts of the situation:
– See Part I
– OOPS launched 6 months ago and has expanded throughout the Indian market
– Neem-based soap is their most success product
OOPS wrapper features a photo of Tom Johnson
– Cheetan’s wrapper features a photo of the founder’s great grandfather
– Chetan has tried to convince Tom to leave the market, but Tom will not. He is open to collaboration, however, if it will make him money
– Cheetan’s business if suffering because of the reduced market share
– Because of the lost revenue, Cheetan will have to lay off half his staff if nothing is done
– Cheetan is very loyal to his employees, since the employees and families have worked with him for centuries
– Chetan will not suffer as much from declining business because of his investments
– Cheetan’s employees know he met with Tom and believe he has cut a deal with Tom/OOPS

Step 2: Define the problem and stakeholders:
Problem: Tom’s company is dominating the market, and Cheetan’s business is suffering. Unless something is done, Cheetan will have to layoff half of his employees, with whom he has very deep-rooted loyalties.

Step 3: Determine and distinguish between the personal and professional motivations of the major stakeholders
1. Cheetan
– Personal: wants to maintain family legacy, and help his employees as much as possible
– Professional: Wants to keep is business afloat
2. Cheetan’s employees
– Personal: want to provide for their families
– Professional: want to feel respected by their employer, Cheetan
3. Tom Johnson (OOPS)
– Personal: Wants to run successful business
– Professional: wants to keep business going, keep control of market, and keep making money

Step 4: Formulate alternative solutions
1. Cheetan closes his business but negotiates with Tom to find jobs for his employees at OOPS
– How does it solve problem:
– Pros: Cheetan’s employees have jobs, Tom keeps making money, Cheetan feels good maintaining loyalty to employees
– Cons: Cheetan’s family legacy dies
– Implication on relationships: Cheetan maintains relationship with employee since they stay employed.
– Implications on venture: Cheetan’s business closes, but Tom’s business thrives.

2. Cheetan leverages his brand to make a mutually beneficial deal with Tom, keeping his business afloat with all employees, while Tom makes money. (Specifically, let Tom use his brand for the soap, while focusing on dominating other parts of the market).
– How does it solve problem:
– Pros: Cheetan’s business stays open and he doesn’t have to lose any employees, Tom makes more money using Cheetan’s brand power, Cheetan maintains relationship with employees, Cheetan keep this family legacy alive.
– Cons: This solution may not be accepted by Tom or may still result in Cheetan needing to lay off employees in the future.
– Implication on relationships:
– Short term: best option for Cheetan’s relationship with employees since they keep job and stay employed by Cheetan. Tom and Cheetan start working together instead of against each other.
– Long term: If the deal is not as beneficial as expected, could hurt Tom’s and Cheetan’s relationship in the future.
– Implications on venture:
– Short term: Cheetan and Tom’s business stay afloat.
– Long term: If the deal is not successful, Cheetan’s business could still be forced to close.

3. Cheetan lays off employees as needed, but helps them find new jobs.
– How does it solve problem:
– Pros: All of Cheetah’s employees are able to continue providing for their families, Tom takes control of market and makes more money, Cheetan maintains relationships with employees.
– Cons: Cheetan loses business and the respect of some of his employees, Cheetan still has negative relationship with Tom
– Implication on relationships:
– Short term: Some of Cheetan’s may be mad about the transition
– Long term: When Cheetan helps his employees find new jobs, he will hopefully be able to rebuild their trust
– Implications on venture:
– Short term: Cheetan’s business gets smaller and Tom’s business thrives.
– Long term: Cheetan’s business may continue to suffer as Tom’s continue’s to grow.

Step 6: Select the best course of action
Option 2: Cheetan leverages his brand to make a mutually beneficial deal with Tom, keeping his business afloat with all employees, while Tom makes money. Although this is the riskiest option, it will grant potential for Cheetan to continue his business and keep all of his employees. Additionally, it is the only option which will help to build a positive relationship between Cheetan and Tom, which could be beneficial in the future to Cheetan, his employees, and his business.

Step 7: Sequence of actions to implement solution
1. Meet with Tom to negotiate
2. Explain and prove how using his brand for the soap will allow Tom to make more money
3. Negotiate with Tom to allow Cheetan to dominate other parts of the neem market
4. Cheetan keeps employees as his other neem products sell well
5. Tom makes more money off his Chetan-endorsed soap