My eyes were opened.
When I met a doctor in Malawi
who is responsible for 250,000 people.
Patients were walking up to a 100 miles
to get to that hospital.
During rainy season,
there were three or four families
sharing every bed in that pediatric ward.
People were being systematically excluded from care.
What I mean by that is that the system simply
was not reaching those who were
furthest away and poorest.
My eyes were open and the burden was overwhelming.
Then I met community health workers.
I listened to them, I shadowed them
and like many before me, they changed my perspective.
These are people who are doing everything in their power
to provide care for their neighbors.
They're from the communities that they serve.
They're welcomed into homes and into lives
and they're there for patients
in the most trying moments.
Clearly, I had to rethink who a health worker was
and how we supported them.
And if they're health workers,
what should the tools look like by their side?
And what should the system look like?
This designed with them and around them.
We created Medic Mobile as a nonprofit technology company
and we committed to building world-class software
for health workers in the hardest to reach communities.
Today, we work with inspiring partners
all over the world.
We support 20,000 health workers
as they provide care for 11 million people.
Every day, this network is finding
and caring for 3,500 sick children in their homes.
Every day, they're helping 200 women and their families
deliver safely at a health facility with skilled care.
And this network is global and it's growing.
Now, we're following a community health worker
in rural Nepal, as she does a home visit
for a family, with a woman who's pregnant in her community.
These health workers have shown us
that it is possible for systems to reach everyone.
They've shown us time and time again,
that they can deliver high quality care
and services door to door.
If only we do our jobs.
And that means making sure that
they earn a living wage,
that they have the essential medicines that they need.
They have continuous training and supervision,
and they have technology that's designed with them
and for them.
Medic mobile expects to play our part.
In the next year, we'll expand to serve
15,000 additional health workers.
Within five years,
our goal is that the software is supporting
200,000 health workers, as they provide care,
at least a hundred million people.
That scale-up is happening in the context
where general trends for maternal mortality
and child mortality are promising.
We have multiple country models we can point to,
but the truth is that political will
funding for delivery and new ideas are still critical.
In too many communities, one out of 10 children
will not survive until the age of five.
They will die before they turn five.
That is normal.
That status quo is unacceptable and unjust.
And in order for the pace of progress to pick up,
humans and machines have to work together.
This is already happening.
Smartphones and smart software is guiding health workers
to the right families at the right time
and then helping them provide the right care.
Managers can see a stream of information
and visualizations to see what's happening in these homes
and provide support for the right health workers.
New diagnostics and home-based testing
is decentralizing care and meeting people where they are.
And it's up to us to ask and answer the question,
what should this look like in the future?
What if the software in the hands of these women
could predict which child in their community
is most likely to be sick
or which family is most likely
to miss their immunization visit?
What if the software could build across millions
of cases experienced to guide them
on the course of action.
And what if as we need to roll out a new vaccine
or we have new treatments to provide
the software, could onboard them to that new responsibility.
When we think about humans and machines
as a team, we're freed up to focus on strengths
rather than shortcomings.
For humans, we might design around our abilities
to empathize and comfort.
To recruit and to motivate.
To act with courage and moral imagination.
And we might ask machines for help with all of the math,
complex logic and learning across billions of data points.
And if we take that approach,
I think we'll stop the conversation about machines
replacing humans in the workforce.
And instead we'll be designing systems
that can reach everyone.
We'll be designing systems that create millions of jobs
because these systems are being redesigned.
And we're rethinking who a health worker is.
I expect these systems to operate
within the resource budget for our one earth.
And I expect that this human machine team
is the only way we'll meet ambitious goals
for health equity locally, nationally, and globally.
We believe it's important, what we build, why we build it,
how we build it and who contributes.
We must stand by those who are marginalized
and often ignored and put technology to work for them.
We must design with deep respect for our own humanity
and actively bring humanity into the technology.
And we must put these people first.
We must live up to the daily ambition,
the hope and the grit of the people in the heroes
on the front lines. Thank you.
_ Thanks Josh,
So this is actually a question
I've been wanting to ask you for a while.
Um, months ago, I wrote Josh an email
and asked him a rather broad question.
I'm sorry for such a big question
about the shifts underway in global health
that he thought we should be focusing on.
Um and he wrote a very helpful email,
seven different bullet points
and at the bottom, you said,
technology needs to accelerate
and enable these shifts, not hold them back.
And I've been wanting to ask,
and our audience might like to know
what do you mean by that?
So that's that answer was really about technology
creating space for the shifts
that we've known had to happen for decades
to people-centered care, to proactive care.
These shifts that systems have been wanting to make.
And from my view, technology was holding us back.
I'm going to jump ahead and say also,
we're at a point now that technologists
need to think about the future,
where we're co-creating with the people that we serve.
And we have to come to terms with the fact
that when we're building something that helps someone,
as soon as we make that statement,
we're into distribution ethics
and questions of distributive justice.
We're talking about moral philosophy.
We're talking about
libertarianism and egalitarianism and utilitarianism,
and I want to jump right into those conversations
because that's a, those are questions
about the world we're going to create.
And just to add onto that,
how we build these things really matters.
I'm that's my next question, so.
Great, I'm really concerned
about black boxes for algorithms
and prison systems, we don't understand.
Parole systems, we don't understand.
Global health can not be,
the next thing we don't understand.
In the system shaping millions of people,
have to be clear and open and the best that can be.
So how we build these things matters.
I wanted to ask you one more question,
which I think a lot of people in this room,
if they work in some of the same market
the Medic Mobile is working in,
they feel that, um, you know,
the emergence of AI is not really relevant
to the context in which they work.
You're based in San Francisco,
but you work all over the world
and you see that connection
and you're acting on it now.
So any advice for how people can navigate these shifts?
That's a great question.
I'd have two pieces of advice.
The first is for people who live and work alongside
those who should benefit from the technology,
just own the challenges
and own your understanding of the daily lived experiences.
Focus on that.
Tell the whole world over time,
technologists will find you and we'll find teams.
The second thing that needs to happen
is we need more philanthropy and weird capital
that's allocated to let the smartest technologies
and smartest technologists focus on these types of problems.
Until we can't hope and wish
that the types of products that are built
will apply because it's too important
to hope and just wish.
Thank you, Josh.
Thanks