GOViral

GOViral develops digital healthcare solutions to break the cycle of Hepatitis B transmission from mother to child in the Philippines. 

GOViral’s mission is to help eradicate Mother-To-Child Transmission (MTCT) of Hepatitis B Virus (HBV) by 2030 (UN 2030 Agenda). Globally, 257 million people are infected with HBV, which can progress to severe liver disease and death. Unlike declining infectious diseases such as HIV and tuberculosis, viral hepatitis is rising: deaths increased by 50% since 1990. Hepatitis B can remain asymptomatic for many years, which is why 91% of infected individuals are unaware of their status, yet they can spread the virus.

The Philippines is one of the countries most hard-hit by HBV infection, affecting 17% of the population, with rural low-income areas most at-risk. MTCT causes 80% of new infections. The main drivers of MTCT transmission include: the stigma and discrimination faced by people infected or affected with HBV, the lack of sufficient, culturally-appropriate education, and the prompt availability of treatments, including vaccines, in rural areas. MTCT is preventable through a combination of testing, treatment (antiretrovirals – ARVs) and vaccination, which could break the cycle of HBV transmission in one generation.

As this is an infrastructure issue, it demands an infrastructure-oriented solution. Our solution is a two-tiered approach based on best practices for HBV management, developed in consultation with experts, healthcare workers, and our target population, women of childbearing age in rural Filipino communities. We created a digital healthcare platform with user-friendly chatbot interface that seamlessly integrates into the local healthcare system.

Our solution strengthens existing data infrastructure through a combination of tools from machine learning firmly ensconced within a friendly user experience design framework that facilitates intervention at two key points in the user journey: a) educating & screening women leading to timely vaccination of newborns, and b) health data curation + supply chain management of tests/ARVs/vaccines. Our user-friendly chatbot interface provides culturally appropriate, evidence-based knowledge transfer for behaviour change. Secondary benefits include linking users with support networks and a focus on discrimination reduction. Additionally, health data collected will serve as database to guide national HBV management strategies.

Our solution is unique: integrating within the local context, recognising existing realities. Local healthcare workers carry authority and trust in the community and are our key allies to introduce women to our chatbot. Embedding our digital solution into their networks, we bridge the critical gap preventing expectant mothers from accessing healthcare. Our solution will change the world of the 3.3 million undiagnosed women currently living in the Philippines that will transfer the virus to their babies if they remain untreated. By focussing on maternal health, we safeguard not only the mother’s health, but also the health of her baby, and by extension her older children. HBV leads to poor lifetime health outcomes and places strains on an already burdened society and economy. Importantly, our solution is scalable. HBV bears many parallels to other infectious diseases. Additionally, the Philippines is just one of several countries struggling to address the HBV health crisis. Implementing GOViral in the Philippines prepares us to ultimately GOGlobal and eradicate similar infectious diseases across the globe.

Filipino health data is stored locally (offline) – statistics and best practices are not shared efficiently between regions. Our infrastructure seamlessly integrates into existing systems, digitizing & connecting them. Real-time HBV and pregnancy status is crucial for timely supply of ARVs & vaccines to rural areas. Our chatbot interface considers local technology penetration by using Facebook Messenger, the main Filipino communication channel, accessible without requiring internet data. Thus, we reach women in their homes, through existing channels. Our intervention is unique: besides newborn vaccination efforts, the health burden of HBV infection in Filipino women has remained unaddressed so far.

Our chatbot uses machine-learning for tailored user experience. What sets it apart from other data curation systems or educational apps is that we integrate into existing community practices rather than moving users to new platforms. Thus, our technology enhances the integral structure of the Filipino Barangay (community). Interviews with community stakeholders indicate that women already use chatbots for information and entertainment purposes, which facilitates user uptake. Additionally, digitization of existing healthcare records and practices has significant value in benchmarking social health indicators for research & health strategy development purposes.

Our immediate goals for GOViral are forming strategic partnerships in the Philippines to prototype our platform in rural areas to educate and activate screening & treatment practices. The digital infrastructure connecting different government and municipal health offices will be finalized, which allows solid data feedback into the machine learning backend for meaningful interactions between the chatbot and expectant mothers. We will finalize ongoing research in our pilot Barangay on literacy, technological penetration, and vaccination/disease status to further tailor our solution to maximize impact in the region. Finally, we campaign for legislation to improve national HBV care through a senate/congress bill.

GOViral targets the Philippines because of the high disease burden and our existing connections within the local health ecosystem. Once fully developed, our platform technology can be tailored to other communicable diseases (hepatitis subtypes, HIV, other sexually transmitted infections; we validated our concept with leading international AIDS/HIV experts). Moreover, the digital healthcare model can be implemented in other countries facing issues with healthcare access due to similar geographic, social, and economic factors as in the Philippines. For example, Taiwan decreased HBV carrier rates by 85% in 20 years through a vaccination programme: our integrated approach can accelerate such impact.

We engage Barangay Health Workers (BHW) as our community champions to introduce users to the chatbot. It has both written and spoken text language processing to consider local literacy rates. It was developed with BHW and target users for culturally appropriate engagement. It responds to user-initiated conversations, but can also initiate engagement and provide notifications (vaccination scheduling etc.). Facebook Messenger is locally available without data charge and a core platform in women's daily routines: Filipino’s spend an average of 4h/day on Facebook. Machine learning will continuously enhance user experience as we pilot, prototype, and expand to new areas.

The Municipality of Bagumbayan in the Southern Philippines is our pilot area: home to over 60,000 Filipinos (19 Barangays), exemplary of low-income rural Filipino communities. Statistically, ~10,000 people are expected to be HBV+. We set up strategic partnerships with the Municipal Mayor, Municipal Health Officers, Barangay officials and BHWs, and local Field Health Surveillance Information System. The local Youth Organisation is currently conducting surveys among 18-30 y/o to gather data on health & vaccination status, literacy, and needs. We are digitizing and analyzing their current offline healthcare data to enable sharing of best practices and identifying actionable goals.

Next 12 months: platform refinement in our pilot municipality (60K inhabitants). We prototype our chatbot by maximizing user engagement and improvement through associated machine learning. We identify best practices with experts and map local needs to feed into construction of the digital infrastructure in real-time. We will establish the current baseline to define impact targets and performance indicators, such as %user engagement, %increase in awareness indicators, %uptake of screening/medication/vaccination, and ultimately %decrease HBV+ status and associated QOL measures. After completion of the pilot (year 1) we expand to neighbouring Barangays and ultimately throughout the Philippines (103M inhabitants).

Our co-founders are rising young leaders in their fields, all relevant to GOViral (public health, medical science, engineering, pharmaceutical industry). Ryan founded a social enterprise in the Philippines that upskills disabled people to enable their full participation in economic society. His network extends through all stakeholders touched by our solution, local to national. Leila founded an NGO that educates young people to reduce the incidence of HIV, STIs, unwanted pregnancies and sexual violence. To date, her organisation has reached over 18,000 youth and she has expertise in SRH programming, monitoring and evaluation. Our team versatility brings skills/networks/resources to scale rapidly.

The early stage development of our initiative will be financed through external sources (grants, VC for social enterprises). These are used for product development (data platform + chatbot tech) and digitization of health records for benchmarking purposes. At this stage, partnerships with NGOs and local universities (e.g. Mapúa Institute of Technology) allows us to tap into funding for the research component, where we collect health data while researchers interpret and model data. Once the technology infrastructure is in place, allowing the exchange of information across various local health offices, we set up a number of potential revenue streams: 1. Licencing of chatbot and data infrastructure technology; 2. Fee-for-service to the government through provision of infrastructure platform; 3. Provision of data-for-fee to different operators (companies, NGOs, policy makers); 4. Aiding distribution of pharmaceuticals (ARVs, vaccines) to currently undiagnosed/untreated communities: partnerships with pharma companies (e.g. Gilead Sciences, Merck & Co.) have already been implemented in similar settings; 5. Patient/Health Insurance co-pay, where feasible, since many developing countries do not reimburse the cost of all medicines.

The MIT SOLVE challenge embodies everything our initiative’s philosophy stands for: creating real-life value through tackling global issues with transformative solutions. Presently, our value is a well-kept secret within our inner circle of benefactors and advisors. Our participation in Solve will help refine our strategy to reconcile profitability and sustainability and provide support in navigating the complex economic ecosystem of social innovation by working collaboratively with organizations and policy shapers. MIT Solve will provide us with a platform and exposure to launch new strategic partnerships, and the funding to hire a research assistant and encoders to accelerate our growth.

Barrier 1: Our founders are separated geographically. Our co-founder on the ground has an indispensable network, but he needs local support to scale up (operations manager, ad hoc researchers, encoders, community builders) and implement the GOVIRAL solution. 2: Health data transfer & storage needs to be handled responsibly considering privacy protection & legislation (note that the Western approach & legislation concerning privacy is fundamentally different in SE Asia). 3: Community uptake is crucial. Thus, local integration & support, partnerships are our main focus throughout. 4: We need to develop a sustainable business model to ensure long-term viability (not charity).