SPAN Edition 1 2025 by SPAN magazine

SPAN EDITION 1 2025 Rs. 20

Advancing Health Through Tech

Never Miss a Dose | A Mental Health Buddy | Transforming Respiratory Diagnostics

SPAN Edition 1 2025

V O LU M E L X V I I N U M B E R 1

https://spanmag.state.gov

CONTENTS 3

* AI for Smarter Air Monitoring

5 Hope on the Horizon 8

* Never Miss a Dose

10 * Innovations for the Greater Good 12 * Making Cancer Care Accessible 14 * Tackling Wastewater

With Eco-Friendly Tech

16 * Mobile Solution for Health Care 18 * A Promise for Better Health Care 20 * Innovating Medical Diagnostics 22 * Decoding the Human Heart 24 * A Mental Health Buddy 26 * Expanding Health Access 28 * Transforming Respiratory Diagnostics 30 * Bringing Health Tech From Space 33 * Investing Through a Gender Lens 36 * Taking HIV Care Online 38 Gaming for Growth

Editor in Chief Nicole S. Holler Editor Deepanjali Kakati English Associate Editor Charvi Arora Hindi Associate Editor Giriraj Agarwal Urdu Associate Editor Syed Sulaiman Akhtar English Copy Editor Krittika Sharma Urdu Copy Editor Zahoor Hussain Bhat Art Director/ Production Chief Hemant Bhatnagar Deputy Art Directors/ Production Assistants Qasim Raza, Shah Faisal Khan Front cover: Young women in New Delhi are breaking the silence around sexual and reproductive health through a USAIDsupported app called Go Nisha Go. Photograph by Soumi Das for USAID. Printed and published by Gloria F. Berbena on behalf of the Government of the United States of America and printed at Thomson Press India Ltd., 18/35 Delhi Mathura Road, Faridabad, Haryana 121007 and published at the Public Affairs Section, American Embassy, American Center, 24 K.G. Marg, New Delhi 110001. Opinions expressed in this 40-page magazine do not necessarily reflect the views or policies of the U.S. Government. * Articles with a star may be reprinted with permission. Those without a star may not be reprinted. Contact SPAN at 011-23472135 or editorspan@state.gov

With U.S.-India grant support, PAQS uses artificial intelligence for hyperlocal air pollution monitoring to safeguard health.

AI for Smarter Air Monitoring Sudarshan Jha / Shutterstock.com

BY MICHAEL GALLANT

Above / Bengaluru-based Personal Air Quality Systems Pvt Ltd. provides users with AI-powered interpretations of air quality data to help them make the best, individualized choices for their health.

ir pollution is a silent killer,” says A. Vaidyanathan, founder and managing director of Personal Air Quality Systems Pvt Ltd. (PAQS) in Bengaluru. “Health costs in India due to air pollution are estimated at around $80 billion per year, and the people at the bottom of the pyramid are the most impacted.” With vulnerable communities at risk across the country, PAQS is dedicated to the vital work of protecting people from the dangers of air pollution. The company’s efforts were recently boosted when, in October 2024, it was chosen to receive the “Quantum Technologies and Artificial Intelligence (AI) for Trans-

forming Lives” grant, a prestigious award supported by the governments of India and the United States. Vaidyanathan says that the grant will increase visibility for PAQS’ life-saving work, and support new levels of international AI research. As part of the U.S.-India Science and Technology Endowment Fund’s (USISTEF) “Quantum Technologies and AI for Transforming Lives” grant, 11 AI projects and six quantum projects will receive nearly $120,000 each, totaling more than $2 million. The grants are a milestone in joint research and development in quantum technologies and AI under the U.S.-India Initiative

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on Critical and Emerging Technology (iCET).

Photographs courtesy PAQS

Seeking a solution Driven by the belief that “my air is my health,” Vaidyanathan and his team have developed a wide range of cutting-edge products to help people tackle the dangers of air pollution. These products help users understand the composition of the air around them and take control of their personal health decisions. The innovations include a clean air helmet that uses smart technology to remove pollutants from the air, a smart inhaler that uses sensors and data analytics to help people suffering from asthma, and a digital babysitter system developed to empower caregivers and protect babies from harmful airborne pollutants. Ram P. Rustagi, professor at the University of Maryland, Baltimore County (UMBC), advises PAQS on AI and has been focusing on an exciting project—the same promising innovation that helped the company win the “Quantum Technologies and AI for Transforming Lives” grant. Rustagi describes the project as a “hyperlocal air quality monitor with AI-driven modeling.” In practice, that means using low-cost sensors to monitor local air quality and making it easy for users to look up the air quality index (AQI) anywhere. Most importantly, the project provides users with AI-powered interpretations of air quality data to help them make the best, individualized choices for their health. PAQS believes that the information captured by its air quality sensors, and the analyses that its complex AI algorithms provide, will make a big difference in people’s lives. “Different people have different sensitivities to

Above and above right / PAQS uses low-cost sensors to monitor local air quality, making it easy for users to look up the air quality index anywhere.

air pollution, and while some people may feel okay with certain levels of smoke in the air, others may not,” Rustagi says. “Our technology lets people look at the area right around their house, or wherever else they are, know what the pollutants are, and understand how the air quality could impact them.” Thus far, the company has developed a promising prototype, says Rustagi. The grant funding will let PAQS dive deeper into what Vaidyanathan describes as “predictive intelligence”—using customized computer algorithms to analyze air quality data, predict where air pollution problems will occur in real-time, and share that information with people across India to help them stay healthy. Within one to two years, Rustagi continues, PAQS will develop even more new aspects of the project. Partnering for cleaner air “As a technology start-up, we were scanning for awards and opportunities to leverage our effort and journey,” says Vaidyanathan. The search for funding and partnerships led Vaidyanathan to begin working with Rustagi and to discover the “Quantum Technologies and AI for Transforming Lives” grant. Vaidyanathan says that he is grateful to the governments of India and the United States for creating such an exciting opportunity. “The U.S. has the technology and leadership, while India has aspirational youngsters and a great talent pool—an ideal combination to work together.”

Michael Gallant is a New York City-based writer, musician and entrepreneur.

Amy Cotter Fowler for USAID

Above / Sanajana Tumria with her newborn at Bagli Community Health Center in Madhya Pradesh.

USAID’s impact in reducing postpartum hemorrhage risk in India.

Hope on the Horizon COURTESY USAID

n an early morning in December, Sanajana Tumria delivered a baby boy at Bagli Community Health Center in Madhya Pradesh. Mom and baby were healthy, and they spent the night recovering under the supervision of the midwifery staff. Every story about a new baby should sound like this one. Unfortunately, there are too many risks that can

get in the way of that happy outcome. For Sanajana, heat-stable carbetocin, a heat-stable drug to prevent excessive bleeding after delivery, was a key factor in preventing a life-threatening emergency. Heat-stable carbetocin is a relatively new drug formulation, and was added to the World Health Organization (WHO) essential medicines list in 2019 and approved for prevention of excessive bleeding due to

Right / Mary Thomas is a nurse midwife at District Hospital Dewas and a mentor to midwives at Bagli Community Health Center. She visits once per month and regularly answers questions and shares insights on a WhatsApp support group about the benefits of carbetocin. / Far right / Carbetocin does not have to be kept refrigerated, which means it does not rely on the cold chain, which can be challenging for some facilities to maintain or even access.

Photographs by Amy Cotter Fowler for USAID

childbirth wherever the cold chain is unclear. Despite that, applied evidence is scarce, and many countries are hesitant to introduce the new model in the absence of context-specific evidence. Like many rural health facilities, Bagli Health Center is two hours away from the nearest public referral hospital, and much of that drive is done on bumpy dirt roads. Given as a single shot immediately after delivery, heat-stable carbetocin helps contract the uterus to ensure women stop bleeding. It prevents the need for an emergency referral, and associated transport, to a far away referral hospital to treat postpartum hemorrhage. Staff like it because it’s easy to use—it takes one injection, and they can see instant results. Importantly, it does not have to be kept refrigerated, which means it does not rely on the cold chain— which can be challenging for some facilities to maintain or even access. And since it can withstand higher temperatures, it is a strong example of how the U.S. Agency for International Development (USAID) is adapting its programs to be more climate resilient, especially in increasingly hot climates, like India’s. In most places, the norm for preventing deadly postpartum hemorrhage is oxytocin, which requires consistent cold temperatures to ensure that it works in

the critical moment after delivery. This means that previously when a midwife at Bagli was delivering a baby, potentially alone and late at night, she was relying on the fact that the oxytocin was kept cold between the production factory and the national warehouse, and onward to the local pharmacy. The midwife is assuming that the pharmacy kept the drug cold, that it was carried in a cooler to the facility, and that the refrigerator at the facility has worked consistently. Many providers and suppliers are not educated on the need for cold temperatures for oxytocin, so in areas with inconsistent electricity supply, it is more of a hope and less of a guarantee that the drug will work as intended. In talking about carbetocin, the head of gynecology for District Hospital Dewas in Madhya Pradesh, Dr. Sadhna Varma says: “After carbetocin, our confidence that the bleeding will stop has increased. We don’t have to worry, we spend less time monitoring, and we spend less money on additional drugs.” This is why USAID is partnering with the government of Madhya Pradesh to roll out heat-stable carbetocin across all public facilities in the state. By developing training modules and generating evidence, USAID is partnering with the government to prove the

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effectiveness of the drug in reducing postpartum hemorrhage (PPH) in the public sector. The midwives at Bagli are such champions of this effort that they began to draw their own column in the register where they track births in order to document use of heat-stable carbetocin. This will help generate data that will benefit other states, and countries, especially as they explore the benefits of this drug in reducing postpartum hemorrhage. Heat-stable carbetocin is being delivered in Dewas alongside a larger government health initiative called LaQshya, which focuses on delivering quality and respectful care for improved outcomes around birth. In Madhya Pradesh, the introduction of this commodity is already showing significant results. Since heat-stable carbetocin was introduced last year in Dewas, there have been no deaths due to PPH in mothers who received carbetocin, compared to several deaths in previous years, prior to the drug’s introduction. Now, the government of Madhya Pradesh is working on incorporating heat-stable carbetocin into their budget for the entire state, so they would take up the cost of the medication after this demonstration period. USAID also worked with the drug producer to ensure

that costs are manageable for public facilities, securing a 95 percent discount on the market price. Demonstrating the impact of carbetocin to prevent postpartum hemorrhage is one part of USAID’s efforts to validate new models, respond to government requests to fill gaps in evidence, and help target government resources toward sustainable improvements in health, with the potential for global application. Following the success of this approach in India, USAID has shared job aids created in India with Madagascar to support health provider learning and retention, and build the evidence base to drive widespread use of heat-stable carbetocin to prevent postpartum hemorrhage.

About the Author USAID’s Office of Maternal and Child Health and Nutrition, which works to ensure that all women and children have the same chance of a healthy life, regardless of where they live or are born. About the Partner IPE Global is a USAID partner based in India that provides urban planning, urban management, and sustainable infrastructure development solutions that focus on human development and poverty alleviation.

USAID is adapting its programs to be more climate resilient, especially in increasingly hot climates, like India’s.

Redicine Medsol, a Nexus-trained start-up, has developed a smart pill box to support medication adherence.

Never Miss a Dose

BY CHARVI ARORA

hronic diseases, which are long-lasting and often require ongoing treatment, pose significant challenges to patients. One of the most pressing issues is adherence to the prescribed medication. Low adherence rates can lead to poor treatment outcomes, increased health care costs and even mortality. To address this problem, Redicine Medsol has developed smart pill boxes, which send timely reminders to patients and help doctors monitor whether patients are taking the right doses at the right time. Kush Prajapati, Dhaumil Parmar and Raj Shah launched their start-up to address the World Health Organization’s (WHO) Third Global Patient Safety Challenge: Medication Without Harm. Redicine Medsol was part of the 11th cohort at the Nexus Startup Hub, a partnership between the U.S. Embassy New Delhi and the Alliance for Commercialization and Innovation Research. Nexus connects start-ups, innovators and investors, offering access to networks, trainings, mentors and funding. Kush, one of the founders, witnessed the impact of medication errors firsthand when his aunt, diagnosed with cancer, suffered complications due to medication

Photographs courtesy Redicine Medsol

Right / Redicine Medsol co-founders (from left) Kush Prajapati, Raj Shah and Dhaumil Parmar.

non-adherence. “When my aunt struggled with medication challenges, I realized just how critical adherence is,” he says. In its early stages, Redicine Medsol conducted extensive research, consulting with over 100 health care professionals and patients to fully understand the scope of the problem. This deep understanding of the challenges surrounding medication adherence helped the team develop the smart pill box. Smart tech The Redicine device works by connecting a smartphone to the pill box’s Wi-Fi and organizing medicines into designated compartments. Patients can use the Redicine app to schedule their doses by setting specific days and times for each medication. Once configured, the device and the app collaborate to send timely reminders, ensuring patients stay on track with their treatment plans. “Our smart pill boxes use audio and visual alerts to remind patients to take their medication, record intake data, and share adherence insights with caregivers and health care providers,” explains Kush. The

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device connects to a cloud platform that analyzes data to track habits and offer personalized support. Dhaumil highlights the accessibility-focused approach. “We designed our pill boxes to be user-friendly, even for people less familiar with technology,” he says. “We also conducted educational initiatives to help patients and caregivers understand the role of adherence in better health outcomes.” Learnings from Nexus “The mentorship at Nexus helped us clarify our vision and refine our business model,” says Kush. The focus on operational excellence was a key takeaway for Dhaumil. “The mentors’ insights into supply chain management and scalability were invaluable as we expanded in India and prepared to enter the U.S. market,” he says. Raj, who is responsible for partnership strategies, praised the program’s emphasis on stakeholder relationships. “The exposure to global perspectives and strategies for building impactful partnerships has been instrumental in our growth,” he says. Redicine Medsol’s smart pill boxes have been widely embraced by health care providers and patients alike. “We’ve seen a 30 percent increase in medication adherence among users,” Kush says. He shares the story of a Type 2 diabetes patient who improved his adherence rate from 60 percent to over 90 percent, resulting in better condition management and fewer complications. Reflecting on the entrepreneurial journey, Kush urges aspiring health care innovators to focus on solving real-world problems with patient-centered designs. “In health care, persistence is crucial because results take time,” he emphasizes. Vision for the future The team aims to position Redicine Medsol as a comprehensive solution for chronic disease management. “We aim to integrate our technology with electronic health records and introduce artificial intelligence (AI)-driven alerts for proactive intervention,” says Kush. Expansion in the U.S. market and strengthening operations in India remain key priorities. The company is also developing AI-based adherence predictive tools and exploring digital therapeutics to offer holistic support for chronic disease patients.

The smart pill boxes use audio and visual alerts to remind patients to take their medication, record intake data, and share adherence insights with caregivers and health care providers.

Below / Krishna Thiruvengadam Rajagopal is the CEO and founder of dVerse Technologies.

From UV sterilizers to tactile tablets, Nexus alumnus dVerse Technologies is creating inclusive health tech products.

Courtesy James Dyson Award team

Innovations for the Greater Good BY ZAHOOR HUSSAIN BHAT

Krishna Thiruvengadam Rajagopal is an entrepreneur, tinkerer, designer, inventor and educator. He has always aspired to use the combination of design and engineering for the greater good. “Most of my projects align with social impact,” he says. Through his Chennai-based venture, dVerse Technologies, Rajagopal has created a range of unique health tech products, ranging from an artificial intelligence-based UV (ultraviolet) sterilizer for hospital elevators to a human-computer interface for coders with visual disabilities. Rajagopal is an alumnus of the Nexus Startup Hub, a partnership between the U.S. Embassy New Delhi and the Alliance for Commercialization and Innovation Research (ACIR). Nexus connects start-ups, innovators and investors, offering access to networks, training, mentors and funding. Excerpts from an interview with Rajagopal. What is the inspiration and vision behind dVerse Technologies? We started dVerse at the onset of the COVID-19

pandemic, remotely designing an artificial intelligence (AI)-based autonomous disinfection system for hospital elevators, which experience high traffic and are shared across floors. Our solution integrated ultraviolet (UV) disinfection technology, ensuring radiation is only activated when the elevator is empty, and the doors are closed. The motivation behind our efforts was to help people combat the pandemic. Why did you shift to creating technologies for people with visual disabilities? After early success with installations in hospitals, Chennai Metro Rail Limited and TIDEL Park in Chennai, we decided to pivot to our current product, CuriO, for two key reasons. First, we realized that to have a broader impact, we needed to create a product line capable of disinfecting entire buildings, from entry to exit. But, with our limited funding, scaling multiple hardware products was not feasible. Second, while our initial product, UVfy, addressed both COVID-19 and the ongoing challenge of hospital-acquired infections, we found ourselves caught up

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in the COVID-19 cycle. As the pandemic waned, so did customer interest, making it clear that we needed to refocus on a product with more sustained demand and impact.

Could you please tell us about your experience at the Nexus Startup Hub? The Nexus Startup Hub has been instrumental in shaping who we are today. As techies, we didn’t know the nitty-gritties of running an operational business. Nexus gave us that—especially in finance, a subject that was otherwise difficult to grasp. What are your plans for dVerse Technologies? While we are now focusing on affordable assistive technologies, we plan to scale up the impact to other segments as well, like the transport industry, food industry and the workplace. Some aircraft companies have shown interest in adopting our technology to make flying more inclusive. This could be done by installing refreshable tactile units beside the infotainment screens behind the seats to help visually impaired passengers fly independently.

Courtesy dVerse Technologies

Can you explain how your tactile tablet, CuriO, functions? CuriO’s key innovation is its high-resolution tactile graphics technology, which allows users with visual disabilities to touch and listen to digital graphics on a tablet connected to a computer. Unlike solutions like Alt-text, which describe images but don’t allow interaction, the CuriO tablet uses tactile pins to create interactive graphs, charts and maps, enabling users to explore content directly. For instance, a visually impaired sales manager can analyze a graph independently on the CuriO tablet, while visually impaired students can engage with complex science, technology, engineering, math (STEM) subjects that would otherwise be inaccessible. CuriO’s proprietary tactile technology makes it

more affordable—costing about one-third of competitors—but is also scalable for broader impact.

The CuriO tablet uses tactile pins to create interactive graphs, charts and maps, enabling users to explore content directly.

A U.S.-India collaboration develops a device to screen, diagnose and treat oral cancer.

Making Cancer Care Accessible BY KRITTIKA SHARMA

portable device for diagnosing and treating oral cancer was selected to receive the “Quantum Technologies and Artificial Intelligence (AI) for Transforming Lives” grant, an award supported by the governments of India and the United States. As part of this grant by the U.S.-India Science and Technology Endowment Fund (USISTEF), 11 AI projects and six quantum projects are receiving nearly $120,000 each, totaling more than $2 million.

obacco consumption is a leading cause of several types of cancer, heart diseases, and lung damage, especially when inhaled. In India, 48.9 percent of males between the ages of 35 and 49 are active tobacco users. Alarmingly, at least 8.5 percent of children between the ages of 13 and 15 years are also active tobacco users. Additionally, India has the largest number of oral cancer cases in the world. In October 2024, a project to commercialize a

Above / In India, 48.9 percent males aged between 35 and 49 are active tobacco users. India has the largest number of oral cancer cases in the world.

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Ease of use Celli and Dr. Gupta explain that health care professionals do not need extensive training to use the device. While cancer treatment itself can be complex, information about the size, location and other tumor details are relayed on to a shared database monitored by senior oncologists like Dr. Gupta. “Rural medical professionals, pharmacists or even dentists can use this device,” says Dr. Gupta. “All of it will be recorded, along with the images, and relayed centrally to doctors. We will intervene in case we find any issues with the patient’s tumor. Doctors like me The technology should be able to guide these peripheral health care According to Celli, his study on PDT started with workers and professionals to use the device properly. funding from the U.S. National InThey will be trained,” he says. stitutes of Health (NIH) and led to The device, says Dr. Gupta, is a clinical study in India. From 2017 currently in the trial phase. “We are The portable and to 2019, Celli and contributors from working to create the entire ecosysAligarh Muslim University tested tem so that we can start using it,” he low-cost device uses their technology on patients with explains. This ecosystem will include photodynamic therapy, early-stage oral cancer. The results screening for high-risk patients, esa special light-based were positive, paving the way to pecially in rural areas where access integrate the technology into an afto cancer care is limited and cases treatment, to identify fordable device for treatment. “The of oral cancer are often high. It will and kill cancer cells. goal of this [ joint] project is to take also involve diagnostics, treatment, clinically validated technology and follow-up and cessation of tobacco combine it with Dr. Gupta’s clinical use. expertise and build a commercial version that can be “While the instruments for screening and treatment disseminated to those who really need it,” he says. of oral cancer lesions were developed in the United PDT is a two-step process. “The patient takes a States, the tobacco cessation protocol was developed photosensitizing agent,” explains Celli, “which is a drug by our team in India,” he adds. molecule that accumulates in the tumor and makes it light sensitive. When you shine light at that site, you Going root-deep initiate photochemistry that kills cancer cells.” The tobacco cessation process, says Dr. Gupta, is The device is a small box with a fiber-optic cable key to reducing oral cancer-related deaths in India. that focuses the light on the tumor inside the patient’s “Motivation, behavioral therapy, body management mouth. “The optic cable is attached with a semi-cusand medication are all essential for successful tobactomized piece which shapes the light so that it reaches co cessation,” explains Dr. Gupta. “When a person is the patient’s cancer in the mouth,” explains Celli. asked to quit tobacco, the body undergoes withdrawThe health care professional administering the light al, which manifests as cravings. We consider all these treatment tracks the tumor on a smartphone-based factors—our protocol is designed to help patients quit imaging app, which captures the glowing cancerous tobacco, with or without medication, depending on cells. Additionally, the app helps guide the treatment. the needs of the patient.” When the tumor is exposed to the photosensitizing His advice for those who want to test themselves agent, it becomes fluorescent. The smartphone imagfor oral cancer? “Patients can carry out a self oral examing system captures this glow, helping doctors clearination. And if they find any lesions, they should go to ly see the tumor during treatment. This technology is a doctor immediately.” simple, effective and works specifically for cancers in the mouth. The oral cancer project is co-led by Dr. Pawan Gupta, a New Delhi-based surgical oncologist and founder of ICanCaRe; Jonathan Celli, professor of physics at the University of Massachusetts, Boston, and Rongguang Liang from The University of Arizona. The project includes an AI-enabled oral screening device, hardware for intraoral photodynamic therapy (PDT), and a tobacco cessation protocol. The technology helps screen and treat oral cancer through PDT, a special treatment that uses light to help kill cancer cells.

Nexus-trained Biosolve Innovations developed patented tech to purify water and soil.

Tackling Wastewater With Eco-Friendly Tech BY JASON CHIANG

Our efforts contribute to a healthier Earth by ensuring clean water, while using our biosurfactant to cleanse the soil promotes cleaner, more sustainable land. 14

kungfu01 / Shutterstock.com

Biosolve Innovations, a Nexus-trained start-up, focuses on providing effective wastewater treatment solutions for both domestic and industrial use. Founded by Mousumi Debnath, who drew on her background as a teacher and researcher, the start-up uses a patented bacteria mix that forms biofilms to remove micropollutants. The process not only cleans the water but also eliminates color and odor, making Biosolve a promising solution in wastewater management. “Biosolve’s core strengths lie in innovation and intellectual property. We focus on environmental issues, and our passion for creating a better planet drives our core mission as entrepreneurs,” says Debnath. “Our efforts contribute to a healthier Earth by ensuring clean water, while using our biosurfactant to cleanse the soil promotes cleaner, more sustainable land.” Excerpts from an interview with Debnath.

Could you please tell us about your background and how you became interested in entrepreneurship? I am an ardent researcher with postdoctoral experience in the United States, Germany and Australia, and a teacher by profession. Creating innovations that can save time and energy has been the prime motive behind my research, which is both product-oriented and process-oriented. Seeing the huge volume of colored water from the textile industries pumped directly out to the Amanishah Canal in Jaipur was unacceptable to me. It was even more disheartening to see that the same water was used for irrigation. Determined to find a solution for my community, I decided to innovate, leading to the birth of Biosolve Innovations Private Limited. The goal was to provide clean water to communities and

Courtesy Mousumi Debnath

Left / Mousumi Debnath (right) at the Inspiring Women of Rajasthan event. / Below and below left / Debnath’s startup Biosolve Innovations cleans and recycles domestic and industry wastewater using bacteria-based products that eat off pollutants.

industries, recycle the wastewater for industry, and reuse for irrigation. How does your wastewater treatment solution work? Using a modified moving bed biofilm reactor, we aim to clean, recycle and reuse the wastewater from different industries and the domestic sector. We use novel biological products from bacteria to create a fine mesh by developing microorganisms. This continuously eats off the pollutants. The system needs minimal maintenance cost after it’s set up. It is a safe process that requires very little space and energy consumption but, at the same time, assures the reduction of toxic compounds. Tell us about Biosolve Innovations’ major milestones.

We have successfully cleaned the wastewater from textile industries in Warangal, Sanganer, Bagru and Pune using our moving bed biofilm reactor technology. Additionally, the treated sewage water was sent back to the fields for irrigation. Please share some of your experiences during the Nexus program. Can you share any advice for people who are interested in building an environmental start-up? After graduating from an entrepreneurship program in Rajasthan, I was selected for the 13th cohort of the American Center New Delhi’s Nexus program. It was an exciting journey of sharing experiences and learning about everything related to the start-up journey. I treasure those days being a student of Nexus. I am indebted to all the Nexus mentors for all that I learned from the program. I feel entrepreneurship in the sustainability sector in India and the United States thrives on developing eco-friendly solutions. If the solution is robust and replicable, then success is inevitable. I would like to see many more new competitors in my domain. This can help rejuvenate our planet and help restore the air, water and soil. Courtesy Mousumi Debnath

SIVStockStudio / Shutterstock.com

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Jason Chiang is a freelance writer based in Silver Lake, Los Angeles.

Fulbright-Nehru Fellow Md. Haseen Akhtar has developed a low-cost, easy-to-deploy mobile health center designed for rural areas.

Mobile Solution for Health Care H

BY BURTON BOLLAG

Photographs courtesy Md. Haseen Akhtar

ealth care facilities in rural India are often underdeveloped in terms of health infrastructure. People have to travel long distances to reach health centers. This can lead to delayed treatment and the unchecked spread of communicable diseases. Md. Haseen Akhtar has developed what may be part of a solution. A Ph.D. candidate in the Department of Design of the Indian Institute of Technology Kanpur, he has developed a lightweight folding structure to house a mobile primary health center. The stable and easy-todeploy, tent-like structure is intended for use by small primary health teams visiting remote villages, thereby making it easier to bring basic care to rural inhabitants. The shelter has been designed for low-resource environments. It is easy to manufacture in simple sewing workshops and is low-cost. Akhtar developed a working, half-scale model of his structure while at the University of California (UC), Berkeley, where he spent the 2023-2024 academic year on a Fulbright-Nehru Doctoral Research Fellowship.

Above / Md. Haseen Akhtar constructed numerous small-scale models, experimenting with different designs, shapes and types of stitching for the mobile health center.

Versatile structure Akhtar says the structure could play a key role in the expansion of primary health services to rural populations. It would provide a clean, enclosed space where health workers could erect a folding table and some folding chairs. They would typically have with them a mini pharmacy and some basic equipment, like a stethoscope and a portable X-ray machine. “People travel far from their homes to reach primary health care facilities in the cities,” he says. “My aim is to have people have their first point of care in rural areas.” People in need of more intensive or specialized care could then be sent to larger health facilities. The shelters are intended to be carried by teams of

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Above / Md. Haseen Akhtar with a prototype of the mobile health center, inspired by origami (above right), the traditional Japanese art of paper folding.

four health professionals: a doctor, a nurse, a pharmacy technician and a receptionist or helper. They would travel by bicycle or foot to hard-to-reach areas. “Each day they would travel to a village, take 15 minutes to erect the structure, run an outpatient department for four to six hours, and then pack it up and come back to base,” says Akhtar. The structure could have widespread uses beyond mobile clinics, such as sheltering medical teams during disaster relief and providing public health services during mass gatherings like cultural or religious festivals. Designing innovation At UC Berkeley, Akhtar, alongside his Fulbright supervisor Mark Anderson, professor of architecture at the College of Environmental Design, spent his time at the Jacobs Institute for Design Innovation. There he explored the websites of American hiking tent manufacturers to see how they designed their lightweight shelters. He had already drawn inspiration from origami, the traditional Japanese art of paper folding, and spent countless hours folding paper into different shapes. He then fed those shapes into a computer to further test and modify, while he searched for the most lightweight, stable and easy-to-use design he could come up with. Akhtar was guided by the simple principle that deployment must be very fast, easily learned, just like opening an umbrella, and without the need for a manual. Through hours of brainstorming with his mentor Anderson, colleague Kirk Mendoza, and experts Cody Glen, Chris Parsell and Chris Myers at UC Berkeley, he learned to use the institute’s industrial sewing machines and constructed numerous small-scale models of different designs. He tested different shapes and even different types of stitching. When Akhtar was finally satisfied

that he had the best design, he built a half-scale model and set it up outside on windy, stormy days to test its stability. The shelter is in the shape of an eight-sided pyramid. At full scale, it will be approximately 10 feet square at its base and 11 feet off the ground at its highest point. It has four doors, each 7 feet high, and they are operated with zippers. The structure is held up by four lightweight, telescoping aluminum tubes and secured to the ground at four corners by strings attached to stakes pushed into the soil. It is covered by a skin of nylon-like material. The entire structure will weigh only about 3 kilograms. “I cannot imagine having done this if I had not been a Fulbright-Nehru Fellow at UC Berkeley,” says Akhtar. “It gave me the freedom and exposure to the experts and infrastructure I needed.” Just before leaving for California, he was awarded a BIRAC Biotechnology Ignition Grant of Rs. 50 lakh, which he plans to use to develop full-scale prototypes and make the shelter “market ready.” He is using the award money to create a private company for that purpose, under the name haseendesign. It will soon start testing prototypes in rural areas. Akhtar says his structure is sturdier than a typical American hiking tent. Yet, he says, “my work at Jacobs showed that when mass manufactured, it could be made very inexpensively, maybe for around $25 each.” It could also be used modularly by connecting several shelters together using the Velcro strips on their doors. “My end goal,” says Akhtar, “is to make something that is used on a massive scale in India and other countries.” Burton Bollag is a freelance journalist living in Washington, D.C.

The USAID-supported Pinky Promise app uses AI to provide affordable, private and quick gynecological care.

A Promise for Better Health Care

BY PAROMITA PAIN

inky Promise, a mobile application, is redefining reproductive health care for women in India. Supported by the U.S. Agency for International Development (USAID), this innovative platform bridges the gap in gynecological care, particularly in smaller cities by offering affordable, private and quick medical assistance. Since its launch, the app has helped over 150,000 women, by offering reliable and judgment-free health care.

Photographs courtesy Pinky Promise

Prioritizing women “Advancing gender equality and empowering women have always been at the core of our mission— whether through promoting economic opportunities, addressing gender-based violence, expanding access to reproductive health services, or ensuring women’s leadership in every sphere of life,” says Shikha Bansal, family planning adviser, USAID. Pinky Promise has received support from USAID’s Yash Entrepreneurs Program. Carried out by the Johns Hopkins University-supported Jhpiego, this program represents USAID’s dedication to fostering innovation and partnerships that improve

family planning and reproductive health outcomes. “By supporting bold, scalable business models with funding, technical assistance and mentorship, USAID is empowering a new generation of changemakers to deliver accessible and impactful solutions for young people in India,” says Bansal. The idea for Pinky Promise emerged during the COVID-19 pandemic when Divya Kamerkar, the CEO and co-founder, struggled to access quality gynecological care. Kamerkar, who was pregnant at the time, recalls, “It took me two weeks and multiple consultations to get a diagnosis. When I finally received one, I realized that we could have gotten a diagnosis in the first week if the doctor I was consulting had access to my medical history and the right data.” This experience revealed a critical gap in women’s health care, inspiring Kamerkar to address it. She felt that while many women’s health companies focus on community-building or addressing fragmented care experiences, hardly anyone was leveraging advanced technology or artificial intelligence (AI) to improve quality and outcomes. Left / Divya Kamerkar, CEO and co-founder of Pinky Promise.

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“Pinky promise” is an informal phrase for a symbolic gesture where two people link their little fingers together to make a promise, usually to show trust and commitment. Kamerkar named her app Pinky Promise as its name reflects its mission. “We have made a promise to women that we will provide high quality, private, judgment-free and affordable care. For us, it serves as a reminder that in our operations, technology and everything we do, we owe it to our customers to uphold our promise.” Leveraging technology Pinky Promise uses advanced AI and machine learning (ML) to enhance diagnostic accuracy and care delivery. Through a simple chat-based interface, women can consult gynecologists anonymously. These systems are designed to prioritize women’s privacy, ensuring that sensitive information is encrypted and securely managed. The app’s AI/ML algorithms, trained on over 250 women-specific medical protocols, assist doctors in diagnosing and treating patients more efficiently. The app’s AI acts as a triage system. It allows doctors to make quick, data-driven decisions, but every diagnosis and treatment plan is reviewed by a gynecologist before being shared with the patient. After rolling out a prototype in 2022, the final version launched in mid2023 following a year of refinement. Overcoming challenges and looking ahead One standout feature of Pinky Promise is its dedication to overcoming biases in health care AI. “We don’t use large language models (LLMs) for triaging or

Above and above right / Historically, women’s health has often been inadequately addressed in clinical research and medical data collection. Divya Kamerkar’s mobile app Pinky Promise aims to address the gap.

medical insights. Instead, we rely on traditional neural networks,” Kamerkar explains. “We also ensure that all medical information is verified by a doctor before it is sent to a patient.” Historically, women’s health has often been neglected or inadequately addressed in clinical research and medical data collection. This has created gaps in understanding the specific health needs and conditions affecting women, often leading to less effective or inclusive health care solutions. Pinky Promise addresses these long-standing disparities by curating gender-specific protocols, ensuring reliable and precise care. The app has gained popularity in smaller cities, where access to gynecological care is often limited. Users appreciate the app’s privacy, affordability and immediacy. Many also value the safe space it creates for discussing sensitive topics like periods, pregnancy and contraception. Kamerkar envisions expanding the platform beyond sexual and reproductive health to address all women’s health needs. “Pinky Promise addresses a global issue,” she says. “Across the world, women struggle to find gynecological care that is quick, affordable and dignified. Our goal is to extend our reach globally, beyond India.”

Paromita Pain is an associate professor of Global Media Studies at the University of Nevada, Reno.

Quad Fellow Asmita Sood combines computer science, biology and math to revolutionize diagnostics.

Innovating Medical Diagnostics BY STEVE FOX

eople in India who need medical treatment in the future may benefit from the work Asmita Sood is doing today. Sood, who is pursuing a master’s degree in biomedical data science at Stanford University in California, is a recipient of the prestigious Quad Fellowship, a scholarship program supported by the governments of Australia, India, Japan and the United States designed to foster ties among the next generation of scientists and technologists. While her undergraduate degree and internship are in computer science, Sood decided to focus on health care technology largely due to a difficult experience in her childhood. “When I was 11, I started having extreme stomachaches that would make me throw up continuously for days,” she recalls. “Nobody could figure out what was happening. I was given medicine for a stomach infection, but it didn’t help. This continued for a long time, and it got so bad that sometimes I couldn’t even get out of bed to take my exams,” she says. “I remember my mother reading my science textbook aloud so I could absorb the material by listening. Eight years later, in 2020, things got really bad, and I was taken to the emergency department. I was again given medicine for a stomach infection, but no one suggested any further tests. It was my mother

who said, ‘She needs to get an ultrasound done.’ ” An ultrasound revealed that Sood had 90 gallstones. “It was unbearable,” she says. “Because the infection had been going on for so long, it had spread to my pancreas, and the doctor said that it did not look good—they suspected it was cancer.” At that time, her hometown had only one PET (Positron emission tomography) scan machine available for doctors to examine her pancreas. PET scans produce detailed three-dimensional images of the inside of the body. However, due to the COVID-19 pandemic, Sood couldn’t access the local hospital for the test. “We had to go to another town for the scan,” she recalls. Fortunately, the scan showed that her condition could be managed with a gall bladder removal surgery and medications. This was a pivotal point where Sood decided that she didn’t want to concentrate specifically on software development but more on medical health care. “I wanted to do more, something where I could use my background in computer science to help health care professionals make better diagnostic decisions,” she says. Sood is currently working on pathology images and building a search and retrieval database. “The goal is that when a new patient comes in, their slide can be compared to previous patients and their slides and the diagnosis linked to them. This can help identify patterns,

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enabling more accurate diagnoses and better patient outcomes,” she says. “It gets complicated because processing whole slide images without tiling is a major challenge in computational biology, the size can be at a gigapixel level.” Sood also worked on improving non-invasive diagnostic techniques like magnetic resonance imaging (MRI) so that radiographers can analyze the results faster. One significant breakthrough involved training a computer program to analyze brain tumor MRI images. “We focused on this task to accurately locate and identify subregions within a tumor,” she explains, stressing that the computer model is intended to help radiographers, not replace them. Sood, who is combining computer science, biology and mathematics to make advanced health care more accessible, finds the Stanford environment extremely inspiring and collaborative. “I like how passionate everyone is about their research and that you can just meet anyone and talk to them about what they’re doing, and it’ll be something very interesting,” she says. “This is my first time in the United States, and I’m enjoying the environment here and how willing everyone is to talk about the wonderful things they’re working on.” Sood learned about the Quad Fellowship from a friend and decided to apply. “It was inspirational to see how the fellowship was bringing together people from research, from policy, and people from the industry, all with the common goal of using our knowledge for the public good, which is what I intend to do with my degree,” she says. Sood plans to pursue a Ph.D., with the ultimate goal of using her knowledge to improve health care in regions similar to the one where she grew up. “I do want to go back to India. My goal now is to just learn from the best here at Stanford in the company of so many people doing amazing work and research,” she says. “But I want to take the state-of-the-art technologies back to places where people don’t have access to them. I also want to work on personalized medicine where the solutions and the treatments are tailored to specific people.”

I want to take the state-of-the-art technologies back to places where people don’t have access to them.

Taylor Mickal / Courtesy IIE

Courtesy Asmita Sood

Below left / Asmita Sood is pursuing a master’s degree in biomedical data science at Stanford University in California.

Steve Fox is a freelance writer, former newspaper publisher and reporter based in Ventura, California.

Quad Fellow Roshni Shetty studies sex differences in irregular heartbeats to shape the future of personalized medicine.

Decoding the Human Heart

BY PAROMITA PAIN

ex differences play a pivotal role in the risk, causes and symptoms of heart diseases, particularly arrhythmias or irregular heartbeats. While the causes of arrhythmias vary, sex-specific variations in heart function are critical yet often overlooked factors. These disparities in cardiac risk and response inspired the research of Roshni Shetty, a Quad Fellow and Ph.D. student at the University of California Davis (UC Davis) specializing in biomedical engineering. The Quad Fellowship is a scholarship program supported by the governments of Australia, India, Japan and the United States designed to foster ties among the next generation of scientists and technologists. Path to cardiac research After graduating from IIT Madras in 2022, Shetty built a strong foundation in different areas of biomedical engineering, including cardiac electrophysiology— the study of the heart’s electrical system and rhythms to understand, diagnose and treat irregular heartbeats.

Through interdisciplinary projects on improving human health, she explored the intersection of biology and engineering, which fueled her passion for the field. A remote project with Dr. Leslie Tung at Johns Hopkins University using computational modeling to study cardiac stem cell behavior marked a turning point. “This research is crucial for applications in engineered cardiac tissues for repair, cardiotoxicity screening and disease modeling,” says Shetty. This project deepened her interest in the mechanisms regulating the heart’s electrical activity, with particular focus on sex differences. It was this fascination, combined with the mentorship and the interdisciplinary research environment at UC Davis, that led Shetty to pursue her Ph.D. under Dr. Eleonora Grandi, a leading expert in cardiac electrophysiology. “The university’s excellent research facilities and strong emphasis on cardiovascular research particularly drew my attention,” says Shetty. Shetty’s research focuses on why males and females

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also essays and letters of recommendation. To make her application stand out, Shetty focused on crafting essays that effectively communicated her passion for research and social impact, writing in simple terms accessible to both STEM and non-STEM reviewers. “I emphasized experiences where I positively impacted others through research, volunteering, extracurriculars and outreach,” she says. “Additionally, I requested my recommenders to highlight these aspects in their letters, ensuring alignment with the fellowship’s core values.” As her research progresses, Shetty envisions a future where sex-specific differences are no longer an afterthought in drug safety assessments but a cornerstone of personalized medicine. By developing predictive tools and advocating for inclusive research practices, she aims to bridge the gender gap in cardiac care, ultimately saving lives and improving outcomes for all. Balancing a demanding research schedule with personal well-being is important for Shetty. “I carefully plan my week to balance research, graduate work, hobbies and personal life,” she says. “Organizing tasks helps me prioritize and stay on top of everything.” For aspiring researchers, she advises finding a passion outside of work to stay motivated. “Open communication with mentors about expectations and workloads is also essential for managing graduate life effectively,” she says. “Don’t hesitate to seek support from friends, family, or campus resources when needed. Surrounding yourself with positive and encouraging people helps maintain focus and motivation.”

Left / Roshni Shetty is a Ph.D. student researching sex differences in cardiac electrophysiology. / Bottom right / As a 2024 Quad Fellow, Shetty (center) is part of a distinguished community of STEM professionals.

differ in susceptibility to irregular heartbeats. She says that women are more prone to drug-induced arrhythmias, while certain genetic arrhythmias are more common in males. Hormones like estrogen and testosterone affect heart cells and can change how the heart’s electrical signals work and maintain rhythm. Despite this knowledge, clinical and preclinical studies often neglect these differences. Many drugs are tested and prescribed without considering differences between males and females, increasing the risk of side effects and sudden cardiac death in females. Additionally, females remain underrepresented in clinical trials, perpetuating this oversight. Tools for personalized medicine To address these disparities, Shetty is developing a computational tool called a “cross-sex ECG translator.” This innovation uses male cardiac data to predict female responses to drugs, improving drug safety assessments tailored to each sex. While the underrepresentation of females in clinical studies is a well-known challenge, Shetty points to other critical gaps in cardiac research. “Preclinical studies often use male animal models and fail to account for physiological and hormonal differences,” she says. Another issue is the lack of sex-specific parameters in computational models. Many current algorithms are based on male data, limiting their applicability to females. This oversight underscores the need for inclusive research methodologies that prioritize sex differences at every stage of drug development.

Photographs courtesy Roshni Shetty

Driving change As a 2024 Quad Fellow, Shetty is part of a distinguished community of science, technology, engineering, math (STEM) professionals committed to addressing global challenges through innovation. The fellowship has inspired her to integrate science and policy for greater societal impact. “Interacting with peers, scientists and policymakers has deepened my understanding of how STEM can drive positive change,” she says. The Quad Fellowship application is evaluated holistically and considers not only academic excellence but

Paromita Pain is an associate professor of Global Media Studies at the University of Nevada, Reno.

Yummy pic / iStock / Getty Images

A Mental Health Buddy BY RANJITA BISWAS

Courtesy Wysa

Wysa, an AI-driven mental health app supported by USAID, helps underserved communities build resilience.

ccess to mental health resources and the well-being of communities is crucial to ensuring the UN Sustainable Development Goals are achieved by 2030. While a number of apps provide urban populations with access to licensed caregivers, mental health and emotional well-being services remain out of reach for many people in rural India. Wysa, an artificial intelligence (AI)-enabled tool supported by the U.S. Agency for International Development (USAID), is helping bridge the gap. “USAID/India is committed to building a resilient and supportive mental health framework across all our work. With a health partnership spanning decades, USAID collaborates with partners to strengthen referrals, reduce the mental health impact on other health outcomes, and integrate mental health into comprehensive primary health care, with technology as a key enabler,” says Moni Sagar, family health division chief at USAID/India. Wysa uses AI-enabled coaching through therapist-approved models, building skills to improve relationships, behaviors and actions. The app focuses on preventative well-being and early interventions by listening empathetically, offering users a safe space to explore their emotions. Jo Aggarwal, Wysa’s co-founder, says the platform is available round-the-clock, offers anonymity, and helps develop new mental resilience skills with 10 minutes of chat every day.

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Courtesy Wysa

Left / Wysa was launched globally on World Mental Health Day in 2016. About half of its users are women.

Mental health for grassroots communities Wysa’s parent company, Bengaluru-based Touchkin eServices Private Limited, was part of the 2023 cohort of the Yash Entrepreneurs Program, a USAID-supported initiative implemented by Jhpiego, a Johns Hopkins University affiliate. This incubator and accelerator program helps scale enterprises through intensive mentoring from technical and business experts, strategic partnerships, technical assistance support, and other benefits. Wysa was launched globally, including in India, on World Mental Health Day in 2016. Since then, more than six million people across 95 countries have used the “mental health buddy.” About half of its users are women. “Gender sensitivity is an important element in the Wysa program, given the added barriers faced by adolescent girls and women in many countries,” says Aggarwal. In India, with USAID and Jhpiego’s technical assistance, the tool is capable of addressing gender issues and mental well-being related to sexual and reproductive health. It has also been programmed to address issues faced by adolescent girls in underserved communities. In 2022, Wysa introduced Hindi to enhance accessibility. More than 1,800 users have engaged with the sexual reproductive health model in Hindi since it went live in September 2023. Similarly, Wysa plans to introduce conversations in Marathi soon.

mental health coach that helps users build resilience using their own language, “ensuring that the support is culturally relevant and easily accessible.” She says the app respects and protects user privacy, just as a therapist would. “We do not require a user to register,” explains Aggarwal, “and redact personal identifiers.” Sensitive data is encrypted using advanced standards, with strict access controls, multifactor authentication and regular audits. A wide range of experiences have informed Wysa’s development, with contributors ranging from blue-collar workers to rural women and youth with Type 1 diabetes. These experiences have helped Wysa address diverse mental health challenges and adapt to changing user trends for better reach. Aggarwal says they are exploring low-bandwidth and WhatsApp-based services, working on including more local languages, and leveraging partnerships with government platforms and mobile health clinics for a broader reach. “These lessons are being applied to redesign our tools and feedback systems for other regions, ensuring they are tailored to local needs and effectively integrated into existing health care frameworks,” says Aggarwal. “Our vision is to create a supportive environment where anyone can access mental health resources without stigma, making mental health care universally accessible.”

Creating a safe space Aggarwal says their vision is to provide a personal

Ranjita Biswas is a Kolkata-based journalist. She also translates fiction and writes short stories.

Photographs courtesy Anshul Khurana

eKure, a USAID-supported health tech platform, provides access to affordable care for low-income workers.

Expanding Health Access

BY NATASA MILAS

he National Sample Survey data on household consumption related to health expenditure showed that over 80 percent of Indians don’t have health expenditure coverage. According to the survey, medical expenses for hospitalization are substantial. On average, a rural household spends Rs. 16,676 annually, while an urban household spends Rs. 26,475. Samagra, an urban health project funded by U.S. Agency for International Development (USAID)/India, works on ensuring quality preventive, supportive and basic health care for the urban low-income population. Out-of-pocket expenses are one of the key barriers for this community in accessing health care, as insurance coverage is statistically low. Under USAID’s project, Population Services International and Entitled Solutions Private Limited have developed eKure, a technology-enabled, comprehen-

sive health platform with benefits like daily accident coverage, daily hospital cash benefits, teleconsultations, and annual health check-ups for contract workers and uninsured households. “As USAID’s Samagra project worked on scalable solutions to reduce out-of-pocket expenditures, the project also identified vulnerable sub-groups that could be efficiently reached,” says Anshul Khurana, co-founder of Entitled Solutions. They found that nearly 10 million workers in urban India, who work on short-term contractual low-income jobs, are vulnerable, need health benefits, and are “typically connected via the employer or platform ecosystem since they are hired by temporary agencies for temporary jobs and can be best reached through their employers,” he says. With this section of the workforce expected to reach around 23.5 million by 2029-30, the urgent need for

SPAN EDITION 1 / 2025 Left / Enrolment of construction workers in an insurance program through eKure, a USAID-supported health platform. / Below and below right / eKure extends health care services to contract and low-income workers through free health check-up camps.

affordable medical care is clear. Expanding health services What sets eKure apart is its ability to create tailored products designed specifically for contract and low-income workers. These products are integrated with employer platforms, with the costs often covered by the employers themselves. “The current offerings consist of a comprehensive subscription program that provides access to doctor consultations, prescribed diagnostics and pharmacy services,” says Anuradha Jain, senior adviser, Health System Strengthening, USAID/India. Additionally, there are flexi-micro and group health insurance plans available, which cover both outpatient and inpatient services. eKure also assesses eligibility and facilitates access for government health insurance programs such as the Pradhan Mantri Jan Arogya Yojana and the Employees State Insurance Corporation. “eKure has established a strong network of service providers and labs, including hyperlocal networks, to provide tailored and cost-effective products that cater to the specific requirements of employers and workers,” she adds.

Tapping into the tech ties eKure uses the employment ecosystem to create awareness via digital and onsite activities. It primarily uses WhatsApp for communication in multiple languages, alongside onsite activities and telephonic engagement. Through its partnerships with over 40 workforce platforms and associations, eKure has expanded its services to a wider population. “eKure primarily operates on a business-to-business-to-consumer model and collaborates with staffing platforms, as well as employers who manage a significant network of blue-collar workers,” says Neeta Rao, senior health adviser at USAID/India. “We have nearly 100,000 enrollments, resulting in a response rate of approximately 20 percent.” eKure serves as a comprehensive benefits platform that interfaces between health service providers and workers. “Health benefits in India, including insurance, teleconsultations and e-pharmacies, are now tech-enabled, and eKure has evolved as a comprehensive benefits platform,” she adds. By utilizing a primarily digital approach to the challenges of providing care, USAID’s eKure has been able to minimize operation expenses, thereby providing care to a large group at very competitive prices. In addition, its flexi-payment options allow users to make small payments over time, making it possible to achieve comprehensive coverage with minimal upfront costs.

Natasa Milas is a freelance writer based in New York City.

USAID-supported Swaasa uses AI-powered cough analysis for quick respiratory diagnosis through smartphones.

Transforming Respiratory Diagnostics BY CHARVI ARORA

agnostic tools became urgent. However, the Swaasa AI platform, which is intended for use by doctors and medical professionals, has broader applications, offering a versatile screening option for various respiratory conditions, including asthma, chronic obstructive pulmonary disease and tuberculosis. Traditional diagnostic methods often involve time-consuming procedures, specialized equipment and trained professionals, making access to care challenging. By enabling early detection, Swaasa can help

Courtesy USAID/India

magine falling sick, and instead of waiting in long hospital lines, you can get a preliminary diagnosis in seconds by simply coughing into a smartphone. This is a reality, thanks to Swaasa. This artificial intelligence (AI) tool analyzes cough sounds and symptoms to screen, diagnose and monitor respiratory conditions. Swaasa eliminates the need for on-site specialists for diagnosis and is user-friendly and affordable. The significance of Swaasa has grown since the COVID-19 pandemic, when the need for remote di-

Right / Swaasa eliminates the need for on-site specialists for diagnosis and is userfriendly and affordable.

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prevent disease progression, reduce mortality rates and improve overall respiratory health outcomes. Developed by Hyderabad-based Salcit Technologies, Swaasa has received support from USAID through the SAMRIDH Healthcare Blended Finance Facility. SAMRIDH supported the commercial validation of the Swaasa AI platform by implementing it in government health facilities in selected states. “Through its blended financing initiative, SAMRIDH, USAID/India fosters a health care ecosystem that allows innovations to access both market and capital toward addressing critical health system challenges,” says Neeta Rao, senior health lead at USAID/India. “Swaasa is a promising and affordable health care solution and has huge potential in the artificial intelligence and machine learning space for national and global benefit.” A cough away from diagnosis Swaasa uses AI and machine learning models to analyze the cough sounds along with other information like temperature, oxygen saturation and symptoms to assess the user’s lungs. The app aims to make pulmonary health care accessible and affordable, replacing the spirometry test that measures lung function. Data about symptoms and vitals and the recording of a cough audio clip are all done within the app. The audio clip is analyzed using proprietary algorithms. Within moments, Swaasa delivers a detailed assessment, identifying potential respiratory issues, for interpretation by a health care practitioner.

Swaasa’s availability in multiple languages and quick and accurate results make it an indispensable tool for doctors and beneficial for marginalized communities.

“Swaasa is an invaluable tool for triage and screening, surpassing traditional spirometry with its ease of use and diagnostic accuracy,” says Dr. Harshal, pulmonologist at the All India Institute of Medical Sciences (AIIMS), Ballabhgarh. “Its availability in multiple languages and quick and accurate results make it an indispensable tool for doctors and beneficial for marginalized communities.” Currently deployed in Andhra Pradesh, Bihar, Delhi, Odisha and Uttar Pradesh through private health service providers and nongovernmental organizations, Swaasa has grown from 5,000 scans a month in 2023 to over 10,000 scans a month in 2024. Transformative impact Swaasa has directly benefited over 15,000 patients by integrating cutting-edge technology into health systems. The increased usage suggests it could positively impact over 160,000 users within a year. Vasavya Mahila Mandali (VMM), a nonprofit organization, provides vital counseling and care for families affected by HIV in urban and rural villages in India. VMM staff members were trained by Salcit Technologies to use Swaasa for screening pulmonary tuberculosis. Out of the 25 high-risk HIV patients screened by VMM, Swaasa detected pulmonary tuberculosis in 11 patients. The platform challenges conventional methods, offering a new, cost-effective approach to disease detection. For instance, the referral rates for X-rays nearly tripled at the rural health center in Simhachalam, Andhra Pradesh, demonstrating Swaasa’s efficacy in bringing forth previously overlooked cases. “Swaasa has transformed respiratory assessments post-COVID. It simplifies the process, bridging the gap left by restricted physical examinations and distinguishing between upper and lower respiratory issues,” says Dr. Rani, a pulmonologist at a rural health center in Simhachalam. “Its accuracy is impressive, earning it a solid 5, on a scale of 1 to 5, for its game-changing impact on modern health care.” Salcit Technologies is now enhancing Swaasa’s capabilities by adding voice and inhalation/exhalation sound components to increase predictability and reliability. The plans for scale-up include partnerships with pharmaceutical companies and enterprise health care providers, as well as discussions with state governments for deployment under tuberculosis elimination programs.

NIH and NASA collaborate to develop and test biomedical technology on the ISS, scalable for use on Earth.

Bringing Health Tech From Space BY KRITTIKA SHARMA

ublic health drugs typically undergo decades of research and clinical trials to assess their efficacy in humans. Tissue chips are a type of biomedical device that can significantly shorten this timeline from years to months. Tissue chips, also called organs-on-chip (OOC), are engineered devices containing human cells that mimic physiological conditions. These chips, developed by the U.S. National Institutes of Health’s (NIH) National Center for Advancing Translational Sciences (NCATS), are also being sent to the International Space Station U.S. National Laboratory (ISS National Lab) to study the effects of a microgravity (nearly or zero-gravity) environment on the human body. In December 2005, the United States designated its part of the ISS as a National Laboratory, highlighting its importance for scientific research. This decision aimed to advance research missions of agencies like the NIH. National Aeronautics and Space Administration (NASA) astronauts have worked with NIH researchers to conduct experiments on the space station for more than a decade. The development and study of technologies like tissue chips have been made possible through collaboration between the two U.S. government agencies focused on health and space. Tissue chips in space The U.S. Congress established the NCATS in 2012 to address inefficiencies in translating basic scientific discoveries into diagnostics, treatments and cures. Dr.

Danilo Tagle, the director of the Office of Special Initiatives, started the tissue chips program. While approximately 10,000 diseases have been identified, only 5 percent have effective treatments. “The process of translating basic discoveries, such as identifying diseases, into diagnostics, treatments and cures has been very inefficient,” Tagle explains. The tissue chips technology, he says, has been developed to improve outcome predictions by emulating human physiological responses. “The chips are miniaturized and contain human-relevant cells and tissues,” he adds. The program has successfully developed various tissues and organs, like kidney, liver, blood-brain barrier, and muscle heart on a chip. These tissue chips have proven to capture human responses more accurately than traditional animal testing models. Over time, scientists began exploring the use of tissue chips in areas of research that are difficult to model, like aging, explains Tagle. “This is typically studied in animal models like rats, dogs and monkeys. However, it can take years, if not decades, to wait for the animals to age,” he explains. Tagle says his study revealed that astronauts experience accelerated aging when exposed to microgravity for a long period of time—months to no more than a year. This finding led to a collaboration between NIH and NASA. Since then, NCATS has launched nine missions with about 15 payloads, including tissue chips mimicking various conditions like cardiovascular, muscle bone joint, and lungs. The results have been promising, demonstrating that tissue chips can model aging processes quickly.

NASA / Nick Hague

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The program is now expanding to study interconnected organ systems using multi-organ chips, enhancing the understanding of complex biological interactions. Tagle explains that tissue chips allow researchers to study how human cells and tissues react in real-time, especially in unique environments like outer space. Traditionally, scientists would have to collect samples from astronauts and send them back to Earth for study. “With built-in sensors in the tissue chips, we can now actually study these reactions in real-time as they occur in space,” he explains.

Above / NASA astronaut Christina Koch works inside the Life Sciences Glovebox on the International Space Station with the Kidney Cells experiment to examine how kidney health is affected by microgravity and other factors of space travel.

NIH and NASA In September 2007, NASA signed a memorandum of understanding with NIH for the “development of biomedical research approaches and clinical technologies for use on Earth and in space and research in Earth

nasa.gov

NASA NIH

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Courtesy NASA

Translating basic discoveries into diagnostics, treatments and cures can take decades. The tissue chips technology, which emulates human physiological responses, helps speed up the process.

Courtesy NASA Johnson / Flickr

Above left / A view of the organs-on-chips as a platform for studying effects of microgravity on human physiology investigation taken aboard the International Space Station (ISS). / Left / The ISS and its unique environment enables research and technology development that might benefit human health on Earth.

and space-based facilities that could improve human health on Earth and in space.” This was the first such agreement between NASA and another agency to use the ISS as a National Laboratory. This agreement paved the way for the creation of the NIH BioMed ISS program. This program encouraged scientists to propose biomedical research that could use the ISS’ unique environment—like microgravity and radiation—to test new ideas that might benefit human health on Earth. “NIH funded the first three applications under this program in 2010 and a fourth in 2011,” says Dr. Jonelle Drugan, deputy chief of the Scientific Planning, Policy, and Analysis branch at NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Astronauts on the ISS conducted experiments on three

of the funded grants: Gravitational Regulation of Osteoblast Genomics and Metabolism, Osteocytes and Mechano-Transduction, and Suppression of the Immune Response in Spaceflight and Aging. The osteocytes and mechano-transduction study, developed by Dr. Paola Divieti Pajevic of Massachusetts General Hospital, studied the cellular and molecular mechanisms that allow bone to respond to stresses, like gravity. The goal was to develop therapies that could mitigate bone loss in individuals with limited physical activity due to illness or injury. In 2021, Dr. Pajevic published findings indicating that microgravity on board the ISS altered gene expression of osteocytes, the major mechanical sensing cells of bone. The results also showed that some commonly used ground-based simulated microgravity devices do not accurately replicate the conditions experienced in space. These findings have significant implications not only for the spaceflight program but also for understanding and treating bone loss diseases caused by reduced mechanical loading, such as those resulting from immobilization.

The USAID-supported SAMRIDH program boosts women-led health enterprises with financing, mentoring and access.

Investing Through a Gender Lens BY BURTON BOLLAG

esearch indicates that women entrepreneurs frequently encounter unique challenges compared to their male counterparts. Women often have limited access to mentorship and may face greater obstacles in securing funding to start or grow their businesses. An article published by the World Economic Forum says that according to the International Finance Corporation, the private sector arm of the World Bank, women-led businesses in India face an unmet credit

gap of more than $11.4 billion and female entrepreneurs received only 5.2 percent of the outstanding credit granted to enterprises by Indian public sector banks. To give women health care entrepreneurs a boost, the United States Agency for International Development (USAID) has extended a financing and mentoring program initially launched during the COVID-19 pandemic. Known as the Sustainable Access to Markets and

Courtesy USAID/India

Left / SAMRIDH has helped develop a drone facility to deliver health care to remote areas, taking blood or other samples back to a laboratory for testing and bringing medicines to patients.

Above / At the American Center New Delhi

Photographs courtesy USAID/India

SAMRIDH solutions have reduced out-of-pocket health care expenses for underserved populations by offering affordable services in remote areas.

Top, above and far right / SAMRIDH empowers women-led enterprises with financing and support, leveraging their insights to address health care gaps and create sustainable solutions.

Resources for Innovative Delivery of Healthcare (SAMRIDH), the program offers blended financing, technical assistance, business advice, and support for market access to advance high-impact health care solutions. “As the COVID-19 pandemic began, urgent and high-impact health care solutions were desperately

needed. In response, USAID and our partners sought to leverage the expertise and innovation of India’s dynamic private sector to scale and sustain responsive health care solutions,” says Neeta Rao, senior health lead, Health Office, USAID/India. “With vast experience in innovative financing in India, USAID collaborated with the Indian government, development partners, financial institutions, health care businesses, incubators and academic institutions to provide commercial capital to proven market-based health solutions, which otherwise struggle to scale, due to lack of access to capital and access to market. Thus, the SAMRIDH initiative was born to support health care solutions that strive to be commercially viable while being focused on social returns.” “SAMRIDH was initially created to address the COVID-19 challenge. But as COVID-19 became less of a crisis, we realized we could expand the program to address broader health care needs. SAMRIDH solutions have reduced out-of-pocket health care expenses for underserved populations by offering affordable, high-quality services and ensuring they’re available in remote areas,” says Himanshu Sikka, senior director at IPE Global, an Indian development consulting firm that is running SAMRIDH with funding from USAID. Toolkit for gender balance The Gender Lens Investing Toolkit allows the program to evaluate funding applicants based on their

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leadership by women or focus on meeting women’s needs. The approach also prioritizes partnering with business incubators and organizations that support women entrepreneurs and can help identify good candidates for funding. Under the new approach, the number of women-led or -focused enterprises supported by SAMRIDH has nearly doubled—from 16 percent of all supported health care entities in 2021 to 31 percent today. The amount of funding to these enterprises increased from 8 percent of all SAMRIDH portfolio support to 18 percent today. The goal of this push to support women-led enterprises extends beyond fairness. Program organizers believed that the low level of female involvement was a missed opportunity to improve health care services for underserved populations. “Women’s roles as primary health care decision-makers in families and communities give them unique insights into health care gaps and needs, especially in underserved areas,” says Vinaina Suri, a spokesperson for SAMRIDH. “Women health care entrepreneurs often develop solutions that address lastmile delivery challenges, improve health care accessibility, and create sustainable community-level impact through their deep understanding of local contexts and needs.” Suhani Mohan, co-founder and CEO of Saral Designs, is an example of this. “I was working with an investment bank when I first learned about the deplorable state of menstrual hygiene in India. Low-income women were using cloth rags, sand and husk to manage their periods,” she says. She launched Saral Designs, which provides high-quality and affordable feminine hygiene products, along with a range of machines to make hygiene products. During the COVID-19 pandemic, with support from SAMRIDH, Mohan’s social enterprise devised a way to adapt its existing machines to manufacture three-ply surgical masks using a decentralized machine technology.

interest subsidies, and subsequently helps raise equity investments. The program has provided early-stage funding to develop several low-cost, portable diagnostic and treatment devices for use in remote or rural areas. These include a manual defibrillator that doesn’t need to be charged with electricity, a pocket-sized electrocardiograph (ECG) machine to monitor heart function costing only about $100, and a low-cost pediatric CPAP (continuous positive airway pressure) device to help premature babies breathe. It has also supported the development of new artificial intelligence (AI) screening tools, like software to scan X-rays for various lung diseases and a mobile phone app that analyses coughing to detect different types of respiratory disorders. The program has helped develop the use of drones to deliver health care in hilly rural areas, taking blood or other samples back to a laboratory for testing and bringing medicines to patients in remote areas. Since its founding in early 2020, SAMRIDH has provided support to more than 90 health care enterprises, often start-ups, led by both men and women. In many cases, they first receive funding in the form of grants to expand and scale their already tested product or service in tier 2 and 3 cities and rural areas along with bespoke blended finance structures facilitated by the program to expand their operations. As they scale their operations, the program supports them in raising equity investments, expanding the operations across public and private sectors. Burton Bollag is a freelance journalist living in Washington, D.C.

Success stories SAMRIDH uses blended finance—a combination of public, private and philanthropic funds—to support market-based initiatives. It draws on a pool of $370 million, of which $35 million is in the form of grants to health care enterprises; the rest helps the enterprises borrow money through loan guarantees or

A USAID-backed portal provides at-risk HIV communities easy access to medications, counseling and referrals.

Taking HIV Care Online BY JASON CHIANG

Photographs courtesy Safe Zindagi

t-risk HIV communities reluctant to access in-person services are often unaware of online resources, where they have the advantage of anonymity. Safe Zindagi, an online portal funded by the U.S. Agency for International Development (USAID) and the U.S. President’s Emergency Plan For AIDS Relief (PEPFAR), provides HIV care and services to hard-to-

reach populations in India. The platform is implemented through Project ACCELERATE, in partnership with India’s National AIDS Control Organization. Safe Zindagi has a team of trained sexual health managers to answer questions in person and remotely, offering counseling and linking users with doctors and health centers. The platform is active in 23 cities across

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India and headquartered in New Delhi. Safe spaces Dia, a transgender woman, has been a sexual health manager at Safe Zindagi for over two years. She used social media to share her struggles and connect with the transgender community. “I am now able to share my own stories, personal experiences and struggles through social media, which has also led to the realization that there are many who struggle like me,” she says. “I have used the Safe Zindagi platform to educate people regarding safe sex practices, risks of unprotected sex, and to create a support space for those who are struggling.” Safe online platforms are especially crucial for trans women to share their stories, she says. “If we are unable to locate safe spaces, then it stifles our creativity, freedom, and the very human nature to talk, engage and share.”

Above / A sexual health manager explains the HIV self-testing process to a client. / Left / Safe Zindagi, an online platform, helps users make informed choices and access HIV services.

Easy access Arjun (name changed), a 25-year-old transgender man, is a friend of one of the sexual health managers at Safe Zindagi who helped him access the site and place an order for an HIV self-testing kit. For him, accessing Safe Zindagi’s resources was easier than going to a clinic or a lab. After getting tested, Arjun went through the Safe Zindagi social media handles and found testimonials on HIV services. “The short experience-sharing videos were very interactive. In a way, they answer your queries on testing and the procedures afterward,” he says. Community challenges Bobby (name changed), a chef and a transgender woman, wanted to know more about HIV and sexually-transmitted infections. She used the Safe Zindagi portal to book an HIV self-testing kit and scheduled an interaction with a virtual counselor. Bobby has been hesitant about exploring other online platforms or facilities. “The LGBTQIA+ community’s challenges are not the same as what others face,” she explains. “This needs to be resolved and addressed with sensitivity, which requires accurate knowledge about our community.” Preventative measures Tulsi (name changed) is a 30-year-old transgender sex worker, who accessed the Safe Zindagi portal for the first time to order HIV testing. This was also when she was introduced to HIV self-testing kits. After her results came back negative, her sexual health manager introduced her to Safe Zindagi’s PrEP (pre-exposure prophylaxis) manager. “My counselor told me about the option of PrEP to prevent HIV and asked me to use it in addition to condoms,” she explains. “I needed more information about this and was promptly linked to Safe Zindagi’s PrEP manager,” she recollects. Safe Zindagi provides PrEP to eligible candidates at subsidized rates. This makes the medication affordable for users like Tulsi, who says she is happy with the platform and has referred five of her friends to Safe Zindagi. “Availability of services like Safe Zindagi can increase awareness about these options to the mainstream community,” she says. Jason Chiang is a freelance writer based in Silver Lake, Los Angeles.

One teen’s journey to self-discovery through an avatar-based mobile phone app.

Gaming for Growth COURTESY USAID

and shame around discussing sexual and reproductive health, which only increases information gaps on those topics. However, the widespread use of mobile phones among Indian youth presents an opportunity for girls to bypass gatekeepers and directly access the information and products they need online. Developed by women-owned small business Howard Delafield International with support from USAID, the game is available for free on Google Play and has been downloaded more than 500,000 times. Until she downloaded the app, Sonia says it was

Photographs by Soumi Das for USAID

n the bustling streets of New Delhi, Sonia navigates the vibrant colors and sounds of urban life on her way to meet her friends for chai. They are gathering to catch up and show each other their progress in a mobile game called Go Nisha Go. Go Nisha Go is not just a fun game that teenage girls in India and Nepal like to play on their cell phones— it’s also been a game changer for them to learn about sexual and reproductive health, issues often considered taboo. Social norms in India perpetuate a culture of silence

Above / Sonia is inspiring others to break the silence surrounding sexual and reproductive health through an innovative mobile app called Go Nisha Go. / Above right / The USAID-supported mobile game explores important topics like menstruation and menstrual products, and consent and contraceptives. It also includes in-game linkages to products and services, and a chat bot where girls can ask questions.

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difficult for her to learn about these topics. “At first, I didn’t know much about sexual and reproductive health, because we were not taught a lot about it in school and there is no space in the family to talk about it,” Sonia says. India has one of the highest global rates of early marriage, with 23 percent of marriages involving a girl under 18—a practice that often results in early childbearing and poor sexual and reproductive health. Once married, girls are more likely to experience early pregnancy and dangerous complications during pregnancy and childbirth, as well as domestic violence and sexually transmitted infections like HIV. Societal pressures can drive adolescents into early marriage. Go Nisha Go explores important topics like menstruation and menstrual products, and consent and contraceptives. It also includes in-game linkages to products and services, and a chat bot where girls can ask questions. With Nisha as their avatar, game players can practice making decisions in realistic scenarios that can have broad implications for their relationships and career planning. Through interactive gameplay in relatable storylines and informative resources, Go Nisha Go

Through interactive gameplay in relatable storylines and informative resources, Go Nisha Go acts as a catalyst for change.

acts as a catalyst for change. Sonia found sanctuary in the game, where she could explore topics surrounding sexual and reproductive health at her own pace and convenience in privacy. Go Nisha Go gave Sonia the confidence to engage in important conversations with her parents. When she completes her undergraduate degree, she plans to pursue her dream of a graduate degree in psychology. Sonia now uses what she has learned to educate her friends, encouraging them to play the game, too. Wanting to have more of an impact, Sonia served as one of five peer educators in New Delhi to help users deep-dive into the game’s content with facilitated discussions in the summer of 2023. “As a youth leader for this game, I am happy and confident about making people more aware about the topic,” Sonia says. Sonia hopes that Go Nisha Go continues to empower youth as they explore the maze of adolescence, learn to embrace their uniqueness, and continue on their journeys of self-discovery. “The game becomes a good tool for us to get and spread knowledge about sexual and reproductive health,” Sonia says. “Whichever girl or boy has played it can speak more confidently about their health and dreams.” Through her advocacy in encouraging others to play the game, Sonia is not only shaping her own future, but also inspiring others to break the silence surrounding sexual and reproductive health. With Go Nisha Go at her side, Sonia is helping to empower the next generation of informed Indian teens and girls.

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