Research

Giovanni Traverso of Brigham and Women’s Hospital and MIT, Joins Denver Frederick

The following is a conversation between Dr. Giovanni Traverso of Brigham and Women’s Hospital and MIT, and Denver Frederick, Host of The Business of Giving on AM 970 The Answer in New York City.

prof497Denver: Only about 50% of people take medication as prescribed. Some folks on long-term medication, well, they eventually just give up and stop taking it. This non-adherence could cost up to $100 billion a year in the US alone, so this is quite a problem. But with us right now is someone working on the solution. He is Dr. Giovanni Traverso from Brigham and Women’s Hospital and MIT in Boston. Good evening, Doctor!

Giovanni: Good evening! Thank you so much for having me on the show.

One of the things that we recognize, and others have recognized this, is that making it easier for a patient to take their medication really increases the likelihood that someone is going to take their medicine.

Denver: So, tell us about your research to address this problem.

Giovanni: Absolutely. As you highlighted, non-adherence is an incredible problem affecting over 50% of the population and translating into significant cost to the health care system and access actually about $100 billion per year here in the US alone. Aside from the cost are the significant morbidity and mortality that are associated by the simple fact that folks just don’t take their medication. One of the things that we recognize, and others have recognized this, is that making it easier for a patient to take their medication really increases the likelihood that someone is going to take their medicine. So let me give you an example. If a doc prescribes a medication that you have to take four times a day versus taking that same medication once a day, people are more likely to take it once a day than four times a day just because it’s hard to remember to take it four times a day.

Denver: It makes a lot of sense.

Giovanni: Exactly. And actually there are some data out there also supporting that if you extend that a little further, that the likelihood of taking the medication also continues to increase. And so what I’m referring to is going from, for example, a medication that is dosed once a day to once a week and even once a month. There are some medications where you can do that, there’s only a limited number that exists in those formulations. And so, what we set out to do is to try and develop a system that allowed patients to take their medication more infrequently.

Let me just take a step back and tell you sort of a little bit about where we started this work. Several years ago, a team from the Gates Foundation came to visit us in the lab and then subsequently circled back to us with a challenge. They said, “You know, it would be great if we had systems that allowed us to give our patients, for example, in Sub-Saharan Africa, really resource-constrained settings, their full course of treatment in a single-administration event.”

Denver: Like for things like malaria, I would imagine.

Giovanni: Exactly. And you have to sort of put yourself in that situation. And really what you want to make sure is that folks on the ground in these really sort of limited setting have the ability to get the full treatment and the docs and other health care professionals there on the ground will ensure that the patients are dosing themselves correctly just to avoid any complications or antibiotic resistance, et cetera. And so that, working with the Gates Foundation, we actually set out to address this. And so what we did was develop a capsule that can stay in your stomach for a prolonged period of time, and by “prolonged,” I mean a week, two weeks, and perhaps even longer. When you consider a regular capsule, you take a regular capsule, you take it, and just as food, when you eat your food, that would go through your body in about a day.

Denver: Right through the pillories and out it goes.

Giovanni: Exactly. And so similarly, a capsule, typically when you go the pharmacy and you get an extended-release capsule. An extended-release capsule is for 24 hours and that’s really limited by a couple of factors, but one of those is just that our GI tract — our stomach, small intestines and large intestines – they’re actually thoroughly effective at transiting materials through them. And so what we set out to do is really to explore different ways of sort of slowing that down and then allowing essentially a system to really deliver a drug over prolonged period of time.

And so, the way that we did that was by developing a capsule that looks much like a star. The capsule itself looks like any other capsule, but when the shell dissolves in the stomach, out pops out a star that is able to stay in the stomach without causing any obstruction or any symptoms but that little star, the arms of the star, so the spokes of the star, are made of a polymer which is impregnated or loaded with a drug. What happens is then that drug can slowly come out over whatever time frame it is that one needs to receive that medication over.

Denver: So if I get this right, you are warehousing the medicine in the stomach?

Giovanni: That’s exactly right. In order to prevent that star system to essentially be expelled out of the stomach, there’s a couple of things that we had to work out in the lab. One of them was “what’s the best size?” What we know is that the exit of the stomach is about 2 centimeters, so we knew that a star had to be over 2 centimeters when in the stomach. And then the other thing that really is really important is that the stomach is actually a really strong organ and that it helps digest food and it really compresses material in the stomach, so we had to develop some materials to withstand those compressive forces. And then what we built into this system are segment that are capable of dissolving either in the intestine in case it passes inadvertently out of the stomach so that it breaks up and doesn’t cause an obstruction or that can break up over time. And so you have a star that you can control how long it will live or reside in the stomach.

We really want to bring this technology to the patients, and as part of that effort, we actually started a company in 2015 called Lyndra that is really focusing on bringing these technologies to patients and really building out all of the safety parameters and all of the data that’s required by the FDA in order to safely dose human.

Denver: Now, I know that you have so far managed a two-week diffusion but were working on increasing it to a month. How is that going?

Giovanni: It’s going really well. We’ve actually managed to actually keep these stars without any side effects in our pre-clinical models for over a month. And so, I think we’re well on our way. I think it will require more development. We really want to bring this technology to the patients, and as part of that effort, we actually started a company in 2015 called Lyndra that is really focusing on bringing these technologies to patients and really building out all of the safety parameters and all of the data that’s required by the FDA in order to safely dose human.

Denver: That’s fantastic. And I would imagine actually the dosage that people are going to get is going to be even more even than the spikes we get when we take that daily pill or that multi-day pill. Would that be correct?

Giovanni: That’s absolutely right. Now, that’s a great point. Because you have the system in your stomach slowly releasing, it’s exactly as you pointed out. It gives you a much more even dose, constant dose, and so therefore, actually, in some situations, for example, you may need less drugs because you’re able to provide this continuous, steady dose as opposed to the peaks and valleys that you might face when you’re dosing a regular medication. And then I think the other piece to that is that because it’s there for prolonged period of time, any effect that sometimes are seen with food are really significantly removed because it’s there all the time. It’s delivering slowly irrespective of the food and that really, as you highlighted, really provides a much smoother level of drug in the body.

Denver: We mentioned malaria before. Give us a few other things that this might be useful for.

Giovanni: Absolutely. So we’ve been working on HIV and some other neglected tropical diseases. There are some parasitic infections that affect a lot of people, for example in Sub-Saharan Africa. And so a lot of our focus in the lab has been with the Gates Foundation on working on diseases affecting Sub-Saharan Africa and Southeast Asia, for example. But HIV is another big area that we’ve been focusing on and parasitic diseases also. Lyndra is looking at a whole host of different things including psychiatric illness, problems with addiction. So really, I think, there’s a very broad of conditions that can benefit from this system.

Denver: It’s truly a brilliant platform and I know you don’t have a crystal ball predicting what the FDA is going to do, but how soon do you think this might get to market and people on our listening audience might be able to take a pill like this?

Giovanni: That’s a great question. So we’re starting the first in human trials this year and 2017, so as far as being on the market, likely in about three to five years.

Denver: That’s fantastic. Well, this is very exciting and important research with some real practical benefits to just countless people out there. Thanks so much, Doctor, for taking the time to share it with us tonight.

Giovanni: No, thank you so much, Denver, for your interest in really sharing it with your audience.

Denver: I’ll be back with more of The Business of Giving right after this.


The Business of Giving can be heard every Sunday evening between 6:00 p.m. and 7:00 p.m. Eastern on AM 970 The Answer in New York and on iHeartRadio. You can follow us @bizofgive on Twitter and at facebook.com/business of giving.

Doug Powell, Designer at IBM, Joins Denver Frederick

The following is a conversation between Doug Powell, Distinguished Designer at IBM, and Denver Frederick, Host of The Business of Giving on AM 970 The Answer in New York City.

dap_headshot02_cropDenver: I am at the Measured Summit and I’m now speaking with Doug Powell, Distinguished Designer at IBM Design. Good evening, Doug.

Doug: It’s great to be with you. Thanks, Denver.

Denver: IBM embarked on a complete redesign of its company back in 2013, which is an incredibly ambitious program. You’re one of those lead designers. So, tell us, what inspired it and what are you doing?

Doug: Well, it’s really about connecting with the people who use IBM technology and really understanding who they are, what their needs are, and finding ways to design and develop tools and technology that really meet those needs in a very human way.

The users of our technology traditionally and historically have been deeply technical people – engineers and developers. And what we found in the last decade or so is that more and more of our users are less and less technical, so think about nurses and teachers and data scientists and small business owners. That requires us to think about the tools we’re building in a different way. Designers happen to have the skills to really address problems with a user and human focus, so that’s really what inspired the design-driven reinvention of IBM, as you said. It was about four or five years ago that the program was launched.

Denver: And I guess users today, they want something delightful and intuitive and fun and mobile.

Doug: Yes. And it has to be available to them anytime, anywhere, in their pocket, in their purse, in their backpack. The tolerance for a bad user experience has evaporated, whether it’s in personal technology or in the technology we use for our work, which is IBM’s focus, of course. That line between work and life has completely blurred at this point. The bar for a great user experience is incredibly high right now and we need to be reaching that bar and even setting that bar in the experiences we’re building.

Denver: And at IBM, Doug, you had about 100 or 200 designers or about 350,000 or 400,000-person organization. That has expanded dramatically.

Doug: Right. We’ve hired now more than 1,200 formally trained designers into IBM. We now have more than 1,500 in the company making IBM the largest employer of designers in the world, which is kind of a surprising little piece of trivia for many people. But it’s exciting. It’s really cool.

Denver: Tell us a little bit about the impact the design has had in the business world. Can you please give us an example or two of that?

Doug: Well, you go back now almost exactly 10 years to the release or the introduction of iPhone in early 2007. And that was a pivot point. That was really the moment that everything as we look back on this era is going to be before iPhone and after iPhone. And it really demonstrated that design and user experience is a business driver and it is increasingly the single way that businesses can distinguish themselves. Everything else has been commoditized. You can’t find an edge anymore in supply chain or manufacturing or materials or even advertising and media. It really comes down to the kind of experience, the quality of the experience that you can deliver.

Denver: What has the impact of design been in the social sector and particularly in health care and in education?

Doug: I think healthcare is a place where, quite frankly as we all know, os a pretty lousy user experience. We all are required at different points in our life to engage with the healthcare system, and I don’t know anybody who really looks forward to that experience. So that means that there is an opportunity. That’s an opportunity space for designers to make a difference and we’re just seeing so much cool stuff.

We’re going to see at the Measured Summit just some great examples of designers making a difference in health care, from the patient experience level of doctors and caregivers interacting with patients in different way up to the systems level, and at IBM that’s where we play, at the systems level. Our Watson Health business is just doing incredible work in making sense of just unthinkable amounts of medical data that is out there and packaging that data in a way that is consumable for clinicians who are making diagnosis so that they can have access to far more relevant data than they ever have before.

Denver: I think it was Thomas Watson who said, “Good design is good business.”

Doug: Indeed. In fact, that’s interesting that you point that out because we just discovered a memo that Watson Jr. had written to his executive leadership and it was dated December 20, 1966, which means that a few weeks back, we celebrated the 50th anniversary of “Good design is good business.” And so that’s pretty cool. It’s cool, as a designer, in the year 2017 to be able to reach back a half century into a great heritage of design and really be inspired by that.

Denver: Well, what you’re doing is pretty cool as well. Thanks very much, Doug Powell, Distinguished Designer at IBM, for being on The Business of Giving this evening.

Doug: It’s my pleasure. Thank you.


The Business of Giving can be heard every Sunday evening between 6:00 p.m. and 7:00 p.m. Eastern on AM 970 The Answer in New York and on iHeartRadio. You can follow us @bizofgive on Twitter and at facebook.com/business of giving.

Jacob Harold, President and CEO of GuideStar, Joins Denver Frederick

GuideStar is the largest platform of information about data for nonprofits.  In this segment, Jacob Harold, President and CEO of GuideStar, talks about how both individual donors and nonprofit executives leverage the data that GuideStar curates.  He also discusses the danger of “short-termism”– of thinking everything happens on a quarterly basis. He explains that if you’re trying to build a great company, it takes years or decades… and the same is true for social change.

The following is conversation between Jacob Harold, President and CEO of GuideStar, and Denver Frederick, host of The Business of Giving, on AM 970 The Answer in New York City.


135d0bbDenver: It is a bit ironic that at a time when we have more information and data than at any other time in human history, our ability to predict the future and to make sound decisions has never been less. And one reason for that may be because not enough people are thinking about how to make this data accessible, meaningful, and truly useful. That is why the nonprofit sector is so fortunate to have someone like Jacob Harold, the President and CEO of GuideStar…who just happens to be with us now. Good evening, Jacob, and welcome to The Business of Giving.

Jacob: I’m thrilled to be here, Denver.

Denver: Some listeners may never have heard of GuideStar. For those who have, they may be thinking: “Oh, Yeah, Yeah. The 990 tax form people.” So, let’s start by having you tell us what GuideStar is, and what you do.

Jacob: You bet!  GuideStar is the largest platform of information about data for nonprofits. And let’s just start by saying:  Why do we even care about having data about nonprofits?  And for me, it’s to address what I call “the elephant in the philanthropic room,” which is simply that some nonprofits are better than others.  Some are able to squeeze more good out of the dollars that they spend. It’s not necessarily that those that are not as effective are bad people, but they haven’t figured out the most effective way to do good in the world.

So the challenge that donors face and that nonprofit executives face…and researchers and government officials… is trying to find excellence in the field, to learn from it… to make sure it gets the resources it needs. And so GuideStar’s mission is to help in that process: to provide the kind of information so that the “stakeholders of social change”–the people who have a stake in the work of the nonprofit sector–are able to make good decisions with their time, and with their money,  and with their attention, with their passion. So, we provide data. And historically that’s mostly been, as you said, from the IRS Form 990, the tax form that most nonprofits are required to file. But we realize that that’s a very powerful foundation of data, but none of us would tell our own story through our 1040. And  we need to supplement that with other kinds of information to tell a richer story about nonprofits. And so that’s what we’re really trying to do at GuideStar right now.  And we’re having some success; we have about 7 million people each year who use GuideStar.


I had a chance to work for a whole set of different environmental organizations: Green Corps, Greenpeace, Rainforest Action Network. And I got to know dozens of others. And it became very clear to me in my early 20s that some of these organizations were simply far more effective. And it led me to a question: ‘Well, okay, how are we going to tackle a great challenge like climate change if we’re not sending money to where it can be most effective?’


 

Denver: That’s right. And you really get into the inner workings of all this data and how the whole philanthropic system works. Where did that come from? What kind of background did you have that instilled this into your DNA?

Jacob: In some ways, it came from the dining room table at the house I grew up in. Both of my parents worked for small community-based nonprofits. My mom worked at an AIDS hospice. My dad worked for Catholic Social Services, providing services to the poorest of the poor in our community. And so over the dining room table, I would hear about the struggles faced by those people who are devoting their lives to try and make the world better.  And these were my parents!

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Seeking “One Brave Idea” to End Heart Disease: Nancy Brown and The American Heart Association

Heart disease is the #1 killer in this country, but 80% of it is preventable, according to Nancy Brown, CEO of the American Heart Association. In this segment from The Business of Giving, Ms. Brown spells out the different programs of AHA devised to reduce death from heart disease and to improve the cardiovascular health of all Americans.

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Nancy Brown, Chief Executive Officer of The American Heart Association

Heart disease is the #1 killer in this country, but 80% of it is preventable, according to Nancy Brown, CEO of the American Heart Association. In this segment from The Business of Giving, Ms. Brown spells out the different programs of AHA devised to reduce death from heart disease and to improve the cardiovascular health of all Americans.

She also discusses how mission-aligned businesses of AHA are generating 9-figure revenues for the organization, and how they and their partners are using crowdsourcing to find “One Brave Idea” to find a cure for coronary disease. Finally, she shares the keys to alignment, passion and camaraderie in a national charity.
The following is a conversation between Nancy Brown, Chief Executive Officer of the American Heart Association and Denver Frederick, host of The Business of Giving on AM 970 The Answer in New York City. It has been edited for clarity.

Denver: More than one in three American adults suffers from cardiovascular disease. To provide a little context: more women will die from heart disease this year than from all the cancers combined. So, Americans are fortunate that the person charged with leading the oldest and largest volunteer organization dedicated to fighting heart disease and stroke, has created a culture of innovation. In so doing, she has forged some extraordinary partnerships and is increasing the amount of resources available to help better the lives of all Americans. That leader is Nancy Brown, Chief Executive Officer of The American Heart Association, and it is my pleasure to welcome her to The Business of Giving. Good evening, Nancy, and thanks for being with us this evening.

Nancy: Good evening, Denver. Thank you so much for the opportunity.

Denver: So, tell us about the American Heart Association, a little about your history, and more about the mission and objectives of the organization.

Nancy: Absolutely! I’d be delighted to. As you’ve mentioned, the American Heart Association is actually the world’s oldest and largest voluntary health organization dedicated to fighting cardiovascular diseases and stroke. We’ve been in existence since 1924. At the foundation of the American Heart Association’s work is the scientific enterprise of the AHA–coupled with our grassroots presence in communities throughout America–and our presence in 70 international locations. In these,  we dedicate our resources to help make the world a better place for people, and to prevent heart disease and stroke. We are guided by the organization’s 2020 strategic impact goal: which is to improve the cardiovascular health of all Americans by 20% by the year 2020, while reducing deaths from heart disease and stroke by 20% during that same timeframe. So this decade-long goal really is the goal that is the guidepost for the work of the organization.

Denver: Let me ask you a bit about heart attacks. I went around to a couple of my buddies this week, and I said, “Do you know what a heart attack is exactly? How does it differ from cardiac arrest?”  I have to tell you, Nancy, the answers were a little fuzzy; they were a bit uncertain. So give us an abbreviated heart disease 101 course if you would.

Nancy: Sure! I’d be pleased to. So, heart disease is, as you said, the country’s and the world’s number one killer. Heart disease is 80% preventable!  What happens when a person has a heart attack, is that the arteries or vessels leading to the heart muscle generally become blocked. They become blocked from atherosclerosis– which happens as we age, and also happens because of a hardening of arteries in individuals who have high blood pressure. When the arteries narrow, or when the arteries are blocked due to atherosclerosis, the heart muscle is deprived of oxygen, therein causing the heart, in some cases, to have a heart attack. There is another kind of heart attack called a  “sudden cardiac arrest,” which is actually not a heart attack at all.  That is a misnomer. A sudden cardiac arrest happens when the electrical functions of the heart malfunction, and a person’s heart suddenly stops.

Denver: Completely.

Nancy: And that person can be revived generally through CPR or through a defibrillator, if one is available, or if people are trained in CPR. We can come back and talk about the role the American Heart Association has played in that over time. The important thing– if you’re experiencing symptoms of a heart attack or symptoms of a stroke–is to call 911 and get emergency care immediately! (more…)

Kate Roberts of Maverick Collective and the Women-Centric Model of Philanthropy

“Money doesn’t solve problems. People do!” says Kate Roberts, co-founder of the Maverick Collective, an organization that aims to redefine what it means to be a philanthropist.

 

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Kate Roberts, Co-Founder of Maverick Collective

In this interview from The Business of Giving, Ms. Roberts explains how Maverick Collective members invest a minimum of $1 million over three years to pilot an innovative solution for girls and women in the developing world. The organization, co-chaired by Melinda Gates and Crown Princess Mette-Marit of Norway, is an initiative of Population Services International (PSI).

The following is a conversation between Kate Roberts, Co-Founder of The Maverick Collective and Denver Frederick, host of The Business of Giving, on AM 970 The Answer in New York City. This interview has been slightly edited for clarity.

Denver: With the constant barrage of messages, tweets, ads, Facebook posts and the rest, it is extremely difficult for any new initiative to break through and capture people’s attention. But then along comes The Maverick Collective, which has quickly become a hot topic in the world of philanthropy….. and beyond. So it’s a great pleasure to have with us this evening its co-founder, Kate Roberts. Good evening, Kate, and welcome to The Business of Giving.

Kate: Good evening! It’s great to be here.

Denver: The Maverick Collective, which is still quite young, has really captured many people’s imagination. What is it?  And where did the spark of this idea come from?

Kate: The spark of it came from being so impressed with watching philanthropists, such as Melinda Gates, who serves as our co-chair. Coming to the realization that she’s leaving so many of her own resources on the table — and having the smarts, as well as money, to create social change. So, personally, I was really inspired by her journey and the great work that she was doing at the foundation. She then started to mobilize billions of dollars for the issue of family planning. So, that really led us to believe that there is an incredible platform for other like-minded, bold women who really do want to use their skills, their resources and their voice to create change…. rather than just writing a check. Go beyond the check…really get involved and amplify your impact as a philanthropist. And then, of course, the sustainable development goals were announced–very aggressive goals.

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Mark Tercek and His Views On True Philanthropy and Nature Protection

Mark Tercek talks about the Nature Conservancy’s collaborative, science-grounded approach to land, water, and climate issues — embedded in the nonprofit’s DNA when it was founded 65 years ago to purchase and protect the Mianus River Gorge in upstate New York.

 

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Mark Tercek, President and CEO of TNC

This interview has been edited for clarity.

The following is a conversation between Mark Tercek, President and CEO of The Nature Conservancy and Denver Frederick, host of The Business of Giving on AM970 The Answer in New York City. Mark here raises interesting insights about how our differences in approaches, science and data, collaboration, and even criticisms, among other things, can work for getting things done for the benefit of people and nature. Below is the full transcript of the interview:

Denver Frederick:    In a political season where each side appears to be more resolute and certain about the rightness of their cause, finding common ground seems to be more elusive than ever. So, it’s of particular interest that an environmental group has broken through in search of pragmatic solutions that work for all parties involved to protect the environment.  That group is The Nature Conservancy, and it’s a pleasure for me to welcome to the show their President and CEO, Mark Tercek.  Good evening, Mark. Thanks for being with us.

Mark Tercek: It’s a pleasure to be here.

Denver: Tell us about TNC, a bit about its history and the organization’s mission.

Mark:    TNC was born about 65 years ago here in New York. The Mianus Gorge is near the border of New York and Connecticut. Sixty-five years ago, some local scientists decided they wanted to protect the Mianus Gorge for science-based reasons. They were practical individuals. They said:  “What would be the best way to assure it would really endure?”  After considering a variety of options, they said, “Let’s just buy it.” They took out mortgages on their homes. They bought it,  and they were right. Sixty-five years later, the Mianus Gorge, now an independent preserve, is thriving. And that has been the spirit of TNC ever since –practical people driven by science, wanting to get things done in a way that will really stick. That’s a formula that really allowed us to grow a lot. People found it appealing, so we grew state by state across the US.

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Charities with Higher Overhead Costs Are More Effective

Caroline Fiennes, Founder and Director of Giving Evidence, discusses using rigorous research to improve nonprofit effectiveness, and dispels a common myth regarding the correlation of overhead costs and charity effectiveness.  In this segment, Fiennes (a trained physicist) explains why nonprofits “can’t be afraid of the math.”

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