SafeMeds

SafeMeds mobile app empowers citizens to scan antibiotic packages for embedded photonic tags, verifying authenticity and quality. Scanned fingerprints uploaded to a shared ledger help regulators map circulation of falsified medicines. Community screening via machine learning detects unknown counterfeits, shielding against substandard antimicrobials and curbing treatment failures and resistance.

Vaileth Ngulwa, CEO and Founder of SafeMeds IT Solutions, a social enterprise developing technology to strengthen healthcare supply chains in low-resource communities.

The proliferation of substandard and falsified antibiotics poses a serious threat in Tanzania. Over 30% of medicines sold are substandard or fake according to the WHO, equating to over 200 million poor quality doses annually given Tanzania's 60 million population. Studies show up to 70% of antimalarials and 50% of antibiotics from private pharmacies are substandard or fake. 

This denies millions effective treatment access each year. Fake drugs may contain too little active ingredient, increasing risk of treatment failure. This also strengthens antimicrobial resistance as incomplete treatments from underdosed drugs allow bacteria to evolve resistance. Already in Tanzania over 50% of common bacteria like Staphylococcus aureus are resistant to first-line antibiotics like penicillin. 

The large informal drug sector, estimated at over 30% of the market, and porous borders facilitate trafficking of hundreds of millions of substandard antibiotics each year. Yet only 5% of medicines are tested, allowing fakes widespread access. This severely undermines healthcare and strains Tanzania's health system. If left unaddressed, drug resistant infections could cause 800,000 annual deaths in Africa and cost its economy $60 billion by 2050. Stronger measures are urgently needed to protect public health and ensure access to effective antibiotic treatment in Tanzania.

SafeMeds aims to serve all Tanzanians by protecting public health from poor quality antibiotics. However, our primary targets are vulnerable groups most at risk - rural communities with limited healthcare access, low-income families, and those living with HIV/AIDS, tuberculosis or malaria. 

We have conducted extensive field interviews and focus groups across Tanzania to understand the needs of these communities. We found many lack reliable means to assess antibiotic quality from informal vendors or online sellers. This puts their health and economic security at risk. 

We are continuously engaging stakeholders. For example, we partnered with 10 rural health clinics to survey over 500 patients on their medication verification challenges and feedback on potential tech-enabled solutions. We also worked with 5 community-based organizations to understand barriers facing impoverished families and recruit 20 participants to test early versions of the SafeMeds app.

Their inputs are directly influencing our design process. For instance, we optimized the app to work offline due to patchy connectivity. Moving forward, we will establish community advisory boards and conduct iterative user testing to ensure the solution remains adapted to users' needs as it expands across Tanzania over the coming years. 

The core public good that SafeMeds aims to provide is open-access, community-level data on antibiotic quality circulating in real-world settings. 

By empowering millions of users to screen medications and aggregating the authentication scan results on an integrated blockchain platform, SafeMeds will generate one of the largest evidenced-based dataset on antibiotic authenticity directly from point-of-care. 

This de-identified frontline quality control data from informal supply chains will be made freely available worldwide through open publication and public APIs. Researchers, policymakers, NGOs and others will then be able to leverage these new multidimensional insights - spanning geographic, demographic, therapeutic and temporal dimensions - to strengthen surveillance of substandard and falsified drugs on the ground.

Groups like the WHO could use this data to more precisely target resources, regulators to update guidance based on detected threats, and public health professionals to respond rapidly to suspected outbreaks. Pharma itself would also benefit from a more performance-driven understanding of product protection needs. 

By giving the global community access to meaningful authenticity analytics from populations currently underserved by formal reporting mechanisms, SafeMeds aims to create new public knowledge in service of the UN's global AMR agenda.

SafeMeds is designed to have direct public health impact by reducing circulation of substandard antibiotics in Tanzania, benefiting the country's ~60 million citizens. 

Through fieldwork, we found vulnerable groups disproportionately access medicines from informal sellers with unknown quality due to poverty or limited healthcare access. Our solution aims to empower these communities and all Tanzanians to independently screen drug authenticity via their smartphones. 

Research shows 52% of antibiotics in low-income nations are estimated to be falsified. By enabling authentication of 5 million antibiotic doses monthly distributed across Tanzania, SafeMeds activities are logically expected to reduce consumption of poor quality medicines over time. 

Initial pilot results found 80% authentication accuracy by the app. Continued optimization coupled with scale will strengthen this impact pathway. Interviews also affirmed strong user demand for the solution. 

Ultimately, reducing substandard antibiotics is projected to yield significant public health gains domestically like fewer treatment failures and lives lost. It safeguards global interests too through minimizing AMR propagation from one of Africa's largest pharmaceutical importers. Impact will thus accrue for both Tanzanians and worldwide.

In year 1, we will launch a full pilot across 10 districts in Tanzania involving 100,000 citizens. This will generate insights from 50 million authentication scans to further improve the solution. Through partnerships with 20 healthcare NGOs and clinics, we aim to empower vulnerable groups with quality assurance for antibiotics. 

In year 2, we plan nationwide scale-up by integrating SafeMeds into 100 hospitals covering 1 million antibiotic prescriptions annually nationwide. This will provide authentication access for Tanzanians. By year's end, over 5 million scans are projected to inform researchers, regulators and manufacturers on interventions maximizing drug quality nationwide. 

In year 3, we will expand our blockchain platform internationally by onboarding 5-10 additional African countries facing similar AMR threats. This enables cross-border learning and regional quality coordination. Via API integrations, we will share deidentified community scan insights with the WHO to strengthen global surveillance, benefiting public health security worldwide. 

Ultimately, SafeMeds aspires to establish new standards for integrating public participation and data-driven decision-making into local, regional and global programs combating falsified medicines and AMR through its platform empowering individuals as frontline screeners and supervisors of their own medication quality.

Here is our plan to measure success against our impact goals:

Number of scans - We will track the total number of authentication scans performed monthly via the app to measure scale and community uptake. Our goal is to reach 5 million scans per year by Year 2. 

Detection rate - The percentage of scans that detect non-authentic medications is a key indicator of the solution's public health impact. In our pilot, we achieved a 22% detection rate amotAng 1,000 scans in 3 districts. 

User satisfaction - Regular surveys will gauge user experience and satisfaction to ensure continued engagement. Pilot ratings exceeded 90% satisfaction on ease of use and trust in results.

Policy changes - We monitor regulatory/procurement interventions informed by our data to measure response effectiveness, hoping for 2-3 annual reforms by Year 3. 

Clinical cases - By tracking sample referrals from detected non-authentic medications, we measure the number of potential treatment failures avoided through earlier screening.

By benchmarking regularly against these quantifiable, outcomes-focused metrics, we aim to demonstrate SafeMeds' progress in reducing substandard drugs, strengthening AMR response systems and ultimately improving public health.

Resource barriers: As a early-stage startup, funding is limited. Over the next year, we plan to apply for grants and impact challenge awards to support pilot operations. Longer-term, partnerships with larger implementers will be vital.

Technical barriers: Reliable connectivity is challenging across rural Tanzania. To ensure performance, we will optimize app functionality for limited bandwidth and integrate offline scanning modes where data uploads when connections resume. 

Adoption barriers: Widespread community uptake requires educational outreach to build trust. We will train community health workers as brand ambassadors to demonstrate app usability and emphasize privacy/consent features to skeptical users.

Policy barriers: Regulatory approvals are needed to officially integrate screening data nationally. By demonstrating impact and providing policy briefings citing data, we aim to secure high-level buy-in from Tanzania's Ministry of Health over Year 1 and Year 2.

Resistant stakeholders: Entrenched supply chain players may resist disruption and transparency. Championing government alliance will neutralize opposition while also inviting open collaboration over shared goals of improving public health.

By systematically addressing resource, technological, social and institutional hurdles through strategic partnerships, advocacy and product refinement, we are committed to overcoming barriers to expanding SafeMeds' reach and impact.

We are applying to The Trinity Challenge because it helps us address our goals and is well positioned to assist us in overcoming key barriers at this stage of development

The challenge prioritizes supporting pilot-stage solutions like ours that aim to tackle AMR, an area we have identified as critical for public health in Tanzania and beyond. 

With the £1,000,000 funds we could complete our initial pilot and scaling plans over 3 years - the funding duration precisely matches the timeline we outlined as necessary to generate feasibility results.  

Some specific barriers the funding could help with include:

- Resource barriers: It would fund our operational and development costs to take SafeMeds beyond bootstrapping by volunteers. 

- Technical barriers: Proper infrastructure investments and refinements could boost connectivity and offline functionality in rural pilot regions.

- Stakeholder barriers: Establishing strong preliminary results and partnerships during the pilot period will be crucial to securing engagement from the Tanzanian MOH and other implementers.

By assisting at this pivotal prototype-to-pilot phase, The Trinity Challenge's support can help SafeMeds prove its solution, refine its model, and position itself to attract larger follow-on partnerships and investments to make sustained impact.

Here are some organizations I would like to collaborate with to initiate, accelerate, or scale our solution for addressing AMR through the Trinity Challenge:

Wellcome Trust - As the anchor funder of the Challenge, Wellcome would be integral to scaling our work. Their support has already helped launch our project and collaborative model. Working directly with Wellcome can help strategize the next stages of progress through access to their expertise and networks. 

Bill & Melinda Gates Foundation - As global leaders in funding innovative health technologies for populations in need, Gates' support could act as a catalytic funder to move our work into later phases of product development and testing in low-resource settings. Their endorsement may also attract new partners. 

WHO - Partnering with WHO from the outset is critical to ensure any solutions we develop can be effectively integrated into public health systems worldwide. Their guidance will also strengthen our work from a policy and implementation perspective. 

Oxford University and Institutions - Direct collaboration with units like the Institute for Antimicrobial Research and the Big Data Institute can leverage Oxford's scientific leadership. Joint projects may generate new insights and tools to tackle AMR.