Home' Technology Review : May June 2011 Contents Q&A
TR: What makes Diagnostics for All’s
business model unique?
Ryan: We have created a nonprofit and
a wholly owned for-profit. That will allow
us to take the technology and work with
partners who want to make money. But
we will get royalties and put them back
into a fund to allow Diagnostics for All to
do more tests and develop more prod-
ucts. I am trying to build sustainability in
terms of delivery to people in the develop-
ing world, but also for DFA. I want it to
be here long after I am gone.
How will you work with companies? Will
you license the technology or work with
them to develop products?
We can envisage different models being
suitable for different relationships, includ-
ing straight licensing deals, joint ventures,
and shared development. We have several
ongoing corporate relationships but have
not announced anything publicly.
What kinds of diagnostic tests are you
In addition to the liver function test,
we already have a pregnancy test and a
glucose test [for diabetes monitoring].
But one of the biggest advantages of the
technology is that the applications are
broad. We can test food products. We can
put the technology into thread to look for
infections in wounds, we can put it in dia-
pers. The cost of the test is not limiting—
it’s all about what you do with the test.
This is a very good way of accurate intelli-
gence gathering on health and disease.
You previously headed a public company.
Why did you decide to take on the job at
Diagnostics for All?
DFA represents an opportunity to
fundamentally change the way we look at
health care worldwide. If one can make
a device that meets the qualifications for
success in the developing world—one that
can be produced at low prices on a mas-
sive scale, that is easy to use, portable, and
disposable—it will likely be a dynamite
product for the developed world as well.
Many attempts to bring technology to
poor countries have failed. Health clinics
are littered with broken centrifuges and
other instruments. How do you plan to
avoid these problems?
You have to have the right technol-
ogy, one that is intrinsically low cost. The
second thing you have to have is the right
business model. You can get a lot of stuff
worked on or researched—students will
work on a project for one summer, or
people will make donations during the
holiday season—but to get to the end user,
we need something scalable and sustain-
able. I have done many experiments with
dual markets [which sell one product to
poor countries and a related product to
wealthy ones] and tiered pricing [with
different prices for different markets], but
I think this is a winner.
What have been the biggest hurdles in
achieving your vision for Diagnostics for
Initially, it’s getting unrestricted fund-
ing. A lot of grant funding often excludes
legal expenses, consultants, or overhead
for paying employees. The other hurdle
is always the regulatory one. Satisfying
regulatory bodies all over the world is
expensive. We have made something that
is almost zero cost to make—a 300th of a
cent to print them. But by the time it goes
through the regulatory process, we have
to add a few cents.
How will you deliver the technology?
Initially, we will work with hospitals
and clinics where there is already some
infrastructure, because we don’t have feet
on the ground all over the world. One
thing we can do is deliver them at scale.
And they are portable enough to be deliv-
ered by someone on a bicycle. We also
want to go more nontraditional routes,
such as small NGOs and e-health clinics.
I would like to see these paper diagnostics
available at a convenience store, just like
chewing gum. In South America, we might
work with generic pharmacies, which tend
to be next to doctors’ offices.
As the head of Diagnostics for All, a
nonprofit founded in 2007, Una
Ryan has one goal: to change the way
health care is delivered in poor countries.
The organization is developing paper
diagnostics—cheap, portable, easy-to-
manufacture tests that can be used in
environments with few resources and
little infrastructure (see “TR10: Paper
Diagnostics,” March/April 2009).
The key to the nonprofit’s success is an
innovative business model. Diagnostics
for All has won grants and philanthropic
funding to support early development
of its technology. But Ryan knows that
these types of funds are inadequate for
deploying new medical tests over the long
term. So Diagnostics for All has created
a for-profit subsidiary, Paper Diagnos-
tics, which will partner with companies
to develop tests for use in wealthy nations.
After taxes, the proceeds will be invested
back into the nonprofit.
The organization’s most advanced
test, for liver function, is designed to help
people who take HIV and tuberculosis
medications that can cause liver dam-
age. A doctor can use the test to quickly
determine when a patient’s drug or dos-
age should be changed. Emily Singer, TR’s
senior editor for biomedicine, asked Ryan
how she expects to deploy this technology
in poor countries.
Photograph by mark ostow
A biotech executive explains her
innovative business model for
funding diagnostic tests in poor
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