Innovate or die

BMJ 2013; 346 doi: (Published 27 March 2013) Cite this as: BMJ 2013;346:f1699
  1. Paul Corrigan, adjunct professor,
  2. Christopher Exeter, senior fellow,
  3. Richard Smith, adjunct professor
  1. 1Imperial College Institute of Global Health Innovation, London SW7 2AZ, UK
  1. Correspondence to: R Smith richardswsmith{at}

Health systems must innovate to survive the pandemic of non-communicable disease but many innovations do not spread easily. Paul Corrigan, Christopher Exeter, and Richard Smith examine why this is so and how to help them spread

The pandemic of non-communicable disease (NCD) affecting low and middle income countries is well recognised.1 2 In high income countries multiple chronic conditions already account for the lion’s share of expenses.3 4 Health systems are threatened by the escalating costs of NCD and must innovate to keep their systems functioning and deliver improved care. We discuss the drivers and diffusion mechanisms needed to promote the spread of innovations using seven novel approaches to reducing the burden of NCD.

Examples of innovations to counter NCD

In preparing the report from which this article is derived we compiled over 200 innovations aimed at reducing the burden of NCD and categorised them under a new taxonomy (table).5 Box 1 describes how we devised the taxonomy and collected the innovations.

View this table:

Box 1: Identification and classification of innovations

The innovations used as case studies for the report Countering Non Communicable Disease through Innovation were collected using a variety of methods.5 These included a survey of members of the report’s working group; case studies forwarded to the authors; and primary research undertaken by the authors.

We identified about 200 case studies and selected 12 for inclusion in the final report. The selection was not based on any classification of ranking but to ensure an adequate representation from across the taxonomy of innovations (table).

The taxonomy, devised by a subgroup of the report’s working group, classifies interventions to tackle NCD by the principal ways they can be achieved (technology, medical devices, patients, civil society, organisational, etc) and by the underlying risk factors for NCD (biological, behavioural, social).

From our database we selected seven innovations (box …

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