Aivi: AI-enabled Decision Support for Medical Equipment Procurement in LMICs

VIA Global Health is aligned with the MIT Solve Challenge principle that every person has the right to access the full range of quality health services they need, when and where they’re needed and that technology innovation can play a critical role, when developed and deployed responsibly and equitably. With more than half the globe's population without adequate access to healthcare (World Health Organization 2023), progress to reduce preventable deaths and morbidities is stalling.  

 Among other global health access challenges, there are many failure points in the global supply chain for medical products reaching LMICs. Customers confront challenges in budget constraints, technological advances, clinical appropriateness, compatibility and integration with existing infrastructure, regulatory compliance, service and maintenance, and training requirements. These challenges are amplified in LMIC environments where there are limited resources, more vulnerabilities to supply chain disruptions, and weak distribution and supply chain channels. These pose limitations on and risks to relationships between vendors (sellers) and buyers, creating information asymmetry and inequity in access between those with purchasing power and those without.

 A related challenge is access to trustworthy content and product information for informed purchase decision-making. Hundreds of millions of dollars are invested each year by the global health community for research and development of innovative and life-saving medical products, content, toolkits, and guidelines, many of which are static, buried in websites, or not easily “discoverable” to prospective buyers and users. In addition, LMIC customers who have product queries are often ignored by manufacturers. Collectively, these barriers in equitable access to critical product information, relevant content, and reliable channels to purchase life-saving medical products, especially for customers with less purchasing power, highlight the need for solutions that enable better decision support, and trustworthy distribution channels.

These barriers to equitable and reliable procurement have the downstream effect of preventing many underserved healthcare facilities and communities from accessing life-saving and affordable medical equipment and supplies that can enable quality health care.  They also prevent life-saving medical products from scaling or finding sustainable pathways in market adoption, when many potential customers are not aware of, and cannot purchase such products. VIA Global Health is confident that innovative technology and responsible AI can help close the access and equity gaps, which is why we have created Aivi, an AI-enabled chatbot to facilitate access to product information, procurement decision support, and training resources.

Several years ago, VIA Global Health developed "Buyers Guides" on our website, which have proven to be highly visited and with strong user engagement. However, it is difficult to keep the content current and interactive, which is where the value of AI can be realized. Our solution is an AI-enabled chatbot, (Aivi), which we are developing as a procurement decision-support tool for customers of medical equipment and supplies in LMICs, facilitating more equitable access to information and distribution channels for medical products. Our goal with Aivi started as an internal tool for the VIA team, but the prototype has demonstrated that the ability of the AI tool to source information of different types improves the customer journey by reducing the time and effort required by our sales team, while producing important content for informed purchasing. In our development of Aivi, we also plan to train it to source "globally reliable" information from sources such as World Health Organization, UNICEF, PATH, regulatory bodies, to enhance accessibility and utilization of these resources.

VIA believes that Aivi will address the information asymmetry and equitable access gap that currently characterizes the supply chain in LMICs, and provide an interactive decision support and product training tool for end users and customers who may not otherwise have access to such information, or be participants in donor-funded programs, which have challenges in scalability and sustainability. 

Customers and end users will discover Aivi through a variety of ways, through VIA Global Health, through our manufacturer/supplier partners, and through other global health stakeholders who can link to the resource. Taking the Non-pneumatic Anti-shock Garment (NASG) for management of postpartum hemorrhage (PPH) as an example, Aivi greets them with a friendly and welcoming prompt, such as "Welcome to VIA Global Health, I see you are interested in the NASG, can I answer any questions for you?"  In addition to answering specific product questions, or regulatory questions based on inputs from the user,  Aivi can also offer the training portal with content from the manufacturers (e.g., videos on use, cleaning, etc), and facilitate access to other relevant resources related to PPH management in LMICs.    Lastly, in cases where VIA Global Health sells the product, a user may have an immediate ability to inquire about purchasing, but VIA will not limit Aivi only to products on our platform, and to the extent the information is available and the channels are accessible, Aivi will identify those.

Key Features of Aivi will include:

• AI-enabled guidance for content, product information, and resources
• Personalized training journeys based on inputs from the users
• Free global access for end users in LMICs
• Adapted content for short topics, allowing for both personalized training as well as a resource library for browsing and queries
• Data to manufacturers on their content and training effectiveness
• User engagement data for other partners and stakeholders

Aivi leverages AI to increase equitable access to the information and solutions that are otherwise underserved by the existing weaknesses of the global supply chain.

VIA Global Health, and by extension, Aivi, serve small and medium size enterprise distributors (SMEs) and local NGOs in LMICs, by providing a channel for them to learn about and purchase medical products. VIA serves as a platform, facilitating the financial transactions and managing the logistics between those customers and the manufacturers and suppliers of those products. These customers are “smaller players” representing the highly fragmented markets that characterize LMIC supply chains, but they are also essential players in equipping the health care delivery ecosystem in LMICs.  

These customers are currently underserved in several ways.  First, they do not necessarily have the purchasing power to “capture the attention” of manufacturers and suppliers, nor negotiate pricing discounts and minimum order quantities.  As a result, they do not have a way to learn about, or purchase products at the volumes they realistically need.  Second, many manufacturers do not want to or cannot make a business case for navigating these fragmented segments, particularly when it requires selling low volumes into LMICs that are otherwise not a market priority.  Third, these smaller customers are often outside of donor-funded programs or donor-subsidized procurement platforms, and therefore do not have an alternative way to compete or serve their communities by delivering essential equipment and supplies to enable quality healthcare.  Fourth, and perhaps most relevant to Aivi, these customers do not necessarily know to learn more about products or have sufficient information to determine which product might be most relevant for them and their downstream customers, end users, and beneficiaries.  There is rarely a “one size fits all” product that meets all LMIC contexts and clinical environments, which is why VIA is committed to developing Aivi in a way that is interactive and supportive to these users by facilitating information about products, product categories, and providing decision support guidance.

Aivi will also serve manufacturers and innovators, and the global health community at large by extending the reach of product information, awareness, relevant training, and other decision support resources and toolkits that are often undiscoverable if one doesn’t know exactly what to search for.  Business and philanthropic resources are also finite, which limits innovative product manufacturers from scaling beyond target geographies, and poses risks to sustainability beyond the life of programmatic activities and in-person trainings.  Our commitment to global access to Aivi, essentially extends the reach of innovators and manufacturers, and leverages the resources of the global health philanthropic and donor community by providing an interactive channel for information and, as relevant, purchasing, for the fragments of LMIC markets who otherwise are on the outside, looking in.

Aivi becomes a "direct to consumer" tool that can provide customized and relevant information for the population of customers and end users of medical equipment and supplies, who otherwise face barriers to access, language barriers, and purchasing power that prevent them from serving their communities with essential medical equipment and supplies.

VIA has transformed global distribution of medical equipment and has been recognized by the BMGF, USAID, UNICEF/WHO and the hundreds of customers in 93 countries (6 continents) that have received products that otherwise would not have been available to them, positively impacting over 7 million lives with the 41,000+ products we have delivered. With support from the Bill and Melinda Gates Foundation, VIA developed Buyers Guides for key maternal and newborn health categories, those pages have generated high traffic on our website, and include content, comparison tables, and resources for additional reading for customers and page visitors. Recognizing the value in providing decision support and resources for those who engage with VIA Global Health, Aivi will be paradigm shift as a more dynamic global good, leveraging AI to bring broader access to critical information for more users and beneficiaries.

As an organization, VIA Global Health fills a gap in global medical equipment and supplies procurement in LMICs by providing an equitable channel for information, procurement, and delivery. VIA addresses market failures by serving those who do not have a channel to learn about products, or the purchasing power to compete in the global market, or who are excluded from larger humanitarian and philanthropic procurement channels.  VIA also is a channel for manufacturers and innovators to deliver their products to market segments that they might not otherwise reach or be able to serve given limited resources and geographic or business priorities. 

In this role, VIA has unique visibility into “the market” as we have proximity to our customers, and real-time data about customer engagement with product pages, resources, demand, and product preferences.  Aivi aligns with our commitment to be both market-oriented, and consumer-friendly, and provide a sustainable complement to other efforts to improve the global health supply chain.

 With our global headquarters and operational functions based in Nairobi, Kenya, our team has personal interactions every day with prospective customers and users of medical equipment and supply, providing us with insights and perspectives that might otherwise get lost in the macro level activities of large procurement programs and donor-funded channels, which have inherent limitations in engaging the private sector and smaller market segments.  VIA also has our digital platform and global engagement, which provides data and visibility into other user and customer behavior.  On a practical level, this proximity will enable us to co-develop and evaluate Aivi with immediate user input from representative communities in LMICs.  These different levels of “proximity” are the driving force behind our commitment to create impactful solutions that are meaningful to the underserved markets and leverage other investments and resources that are impactful but often underutilized or slow to scale.  

Aivi is a basic prototype for some limited internal use cases, but a concept for the more broad vision described in this proposal. 

Aivi is a very basic prototype that has been developed for internal purposes only, and for conceptual idea testing for the use cases described in this proposal.  For example, we have started to train Aivi to source information from VIA's own existing content (product information, training, videos, etc) to support our sales team in their interactions and responsiveness to customers.   In further exploration of AI capabilities, and considering the gaps and opportunities in the global supply chain, we have identified the additional functionalities and features for Aivi, but do not have the resources to actually develop those to their full capabilities, and wish to approach this with caution and optimism, and appropriate stakeholder engagement, all of which take time and resources.  

VIA learned about Solve because we had previous interactions with a Solve team, and learned about this particular challenge.  We feel that the intersection of appropriate technology and global health challenges is an exciting opportunity for innovative solutions, and this challenge aligns closely with VIA's ongoing commitment to innovate solutions in equitable access to medical equipment and supplies for LMIC customers.

While AI has limitations and must be approached with healthy skepticism, VIA also feels that is presents enormous capabilities to close the equity and sustainability gaps that prevent life-saving products from reaching the populations who most need them.  Information and access asymmetry are some of the biggest barriers to scale and uptake, and VIA's digital platform, services, and human engagement are all focused on reducing those points of friction.  However, to do so in a way that is scalable and sustainable will require leveraging technology in a responsible and compassionate way.

The specific interest in AI solutions is what most attracted us to this Solve challenge, as we feel like support to accelerate the development of Aivi, as well as the potential for some technical assistance (non-monetary support) can help us develop Aivi in a way that is responsible, ethical, and cost and time efficient, and ensure our commitment to global access without any conflicts or commercial pressures.

Aivi is innovative in that it is focused on sourcing and providing information from a variety of sources to help inform purchases of medical equipment and supplies and will be dynamic and interactive so that resources are more discoverable and accessible to end users in LMICs who would not otherwise know what to search for, or get responsiveness from manufacturers, or who have questions about different product choices.   

There are two specific ways that Aivi is differentiated from existing “resources” and is an innovative solution for common challenges in procurement in LMICs.  First, the intent is not to prescribe specific products to users, but to provide information that helps them understand the options, relate those options to their clinical context, and identify channels for purchasing, either with VIA or other procurement channels, and to do so based on “engagement” with the user, or customer through Aivi’s interactive features.  The status quo requires a user to know what to search for, and then navigate to or through multiple websites, and yet still not have sufficient product details or an identified procurement channel to make a purchase.   The second way in which Aivi is innovative, is that “she” can also facilitate content and training materials for users of products, which enables a more scalable and sustainable pathway for product uptake and appropriate use, than the alternative in-person trainings with are highly resource intensive and challenging to scale.

In this way, Aivi can also catalyze more visibility and access to other products, materials, resources, and content that manufacturers, innovators, in which the global health research and philanthropic community have invested hundreds of millions of dollars.   The AI functionality of Aivi will also enable these investments to have a more dynamic and interactive “outlet” than being buried in a website or quickly obsolete as new evidence is generated, new products emerge, and new decision-support resources are developed.

Our innovation is an AI-enabled chatbot, Aivi, which we intend to enhance as a procurement decision-support tool for customers of medical equipment and supplies in LMICs, facilitating more equitable access to information and products. Our goal with Aivi started as an internal tool for the VIA team, but the prototype has demonstrated that the ability of the AI tool to source information of different types improves the customer journey by reducing the time and effort required by our sales team while producing important content for informed purchasing. In our development of Aivi, we are also training it to source “globally reliable” information from sources such as World Health Organization, UNICEF, PATH, regulatory bodies, to enhance accessibility and utilization of these resources. 

Theory of Change: VIA has been operating for over 5 years specifically serving SME distributors and local NGOs in LMICs, and our experience shows that (1) there are no “one size fits all” solutions given the variability of clinical environments and resources; (2) information about products and new innovations is not widely accessible to many prospective buyers because manufacturers are unresponsive and resources are hard to find; (3) LMIC buyers confront more risks and barriers to procure products, particularly if they do not have purchasing power and are outside donor-subsidized procurement channels. As a result, hundreds of millions of people do not have access to the appropriate and affordable medical products they need and the enormous investments into resources and solutions are not utilized. VIA believes that Aivi will address the information asymmetry and equitable access gap that currently characterizes the supply chain in LMICs, by facilitating, in an interactive and personalized way, content and information that the user either asks for, or that Aivi is trained to provide. Currently, those types of resources are dispersed and a user has to know how to navigate and search. Users can customize their own learning or training journey by interacting with Aivi who can point them to product information, training videos, comparison charts, WHO guidelines and toolkits, and ultimately a way to purchase the products.  

We are requesting funds from Solve partners to advance Aivi from its current prototype phase, into a more robust proof of concept with ethical engagement of VIA customers and global health stakeholders.

VIA Global Health’s impact goals with Aivi are concentrated around the principles of equitable access to medical products that enable quality care, particularly for underserved markets and communities in LMICs.   Although this principle primarily relates to Sustainable Development Goal 3, we believe that “democratizing” information and “Facilitating the scale and sustainability of critical product information and training” also reduces inequalities and information asymmetry that contributes to poor health outcomes. 

More specifically our outcome goals and indicators are:

1)     To deliver health product information to users and customers in LMICs to support their appropriate use of medical supplies in their communities.  Indicator: user engagement and satisfaction with Aivi content

2)     To leverage Aivi to facilitate informed procurement of medical equipment.  Indicator: increase in transactions on VIA Platform with products in our catalogue, and increase in other procurement channels as shared by partners

3)     To increase visibility of and access to other resources from manufacturers and iNGOs and global health community.  Indicator: increase in number of participating partners contributing to and linking to Aivi

4)     To continue measuring impact of products sold using VIA Global Health’s impact scoring and manufacturer’s data.  Indicator:  continued distribution to SME and local NGO customers across LMICs.  This is an existing VIA Indicator but we will be able to measure if users of Aivi continue on to purchase products through VIA, which will drive our impact scores.

Although Aivi is not a direct to beneficiary solution, in that it is not a clinical tool or AI guided healthcare delivery, VIA strongly believes that effective and quality healthcare is not possible if there is not access to affordable and appropriate equipment and supplies.  Weaknesses in the supply chain, which is where Aivi’s innovative position sits, may be indirect but we see it and the other VIA Global Health services as being enabling factors to strengthen equitable access and more reliable distribution channels.

Aivi is the intersection of AI, medical product innovation, novel training approaches through video shorts and feedback tools, and research and development of medical products and their appropriate use in LMICs.   AI is the driving technology powering Aivi, but the task is to bring more essential product information and decision support tools, many of which have developed in static or other dynamic forms, into user accessible content and relevance, regardless of where users may live or what access they otherwise have to other global health programs and training.   

Purchasing medical products can be daunting even in higher resource settings, but imagine for users who are trying to learn about, or purchase a medical product for their clinical setting, trying to determine which one is best, when much of the information is not available or accessible to them, and when people don’t pick up the phone or answer emails because the users are not making the minimum order quantity.  This is where the information asymmetry and gross inequities in the supply chain prevent underserved communities from accessing the tools they need for quality healthcare.    Much of the content and tools and even products exist, but learning about them, feeling confident in the purchasing of them, and then developing the competency to safely use them is not easy to find, or is concentrated in very resource intensive “programs” that a single practitioner in rural Zimbabwe or Ecuador is not a participant.  The backbone of Aivi will be VIA Global Health, which is an eCommerce Platform with an enormous amount of user and site visitor data, product catalogs, and services to facilitate global transactions between buyers and sellers. 

VIA Global Health is comprised of 12 FTE and 3 part-time staff.

Specific to Aivi, we will have 1 FTE and 2 part-time staff and likely 1-2 contractors (AI and software developers)

VIA Global Health has existed and grown since 2018; we have been working on Aivi as a prototype and concept for 6 months as a way to bring our own content and resources to a more user-friendly format to support our own sales team and customer journey. 

VIA had intended to establish global headquarters in Nairobi, Kenya in 2020, but due to the Covid pandemic and lack of much interpersonal engagement and travel, we worked virtually as a team until 2022, when we finally were able to establish our headquarters in Nairobi.  

In our team, 9 of the 12 full time employees are based in Nairobi, or South Africa, and we have made a commitment to have all new hires be based in and reflective of the markets we serve.  This has become particularly relevant in our sales and marketing team, because VIA still has a sales force that is personal and relationship based, focusing on sub-Saharan Africa, to complement our digital eCommerce platform which serves customers and markets in other LMICs.  

As a small start-up, we are committed to equitable environments because there are constant changes and requirements to be agile and lean with our limited resources, and the problem solving culture at VIA is very inclusive and "flat" in terms of identifying and solving challenges.

We have our own DEI statement, Equal Opportunity Statement, and policy at VIA win the employee handbook and onboarding activities. 

VIA Global Health is an impact-oriented for-profit enterprise dedicated to serving LMICs with a distribution channel that provides more equitable access to information and product procurement.

We collect revenue in the form of a "service fee" (almost like a sales commission) from the manufacturers, so we do not charge or mark up anything to the end users in these markets.   This service fee/commission model essentially pays for us to manage the transactions (financial) and logistics on behalf of both parties, which manufacturers or innovators might not otherwise pursue or restrict themselves to only a few geographies.  This fee also supports our marketing efforts on behalf of the manufacturers.  

VIA also pursues grant and philanthropic capital to accelerate and support our impact related initiatives, which align with our business objectives but the resources are not always sufficient to rapidly develop tools and solutions that we feel are important value propositions for our customers and these markets.  We have received funding from Bill and Melinda Gates Foundation, USAID, and Merck for Mothers to develop Buyers Guides, financing options, and support to African manufacturers at a level and pace we would not otherwise be able to afford to do.    For that reason, we are seeking support from Solve Challenge partners who share principle that responsible AI and innovation can be used to address otherwise intractable problems.

VIA's financial sustainability plan is primarily as a self-sustaining business, in which we sell products to customers in LMICs and collect sales revenue and sales commissions (service fees) from manufacturers of products in our catalog.  In this way, VIA is a very market-oriented business, in which the voice of customers drives our product sales and catalog, and in which our services are designed to meet their unique needs.  This gives us unique visibility into the true "voice of the customer" through which we can distinguish need from demand, understand user and customer preferences within and across product categories, and fulfill products that they actually want and will pay for, not what others tell them they need to buy.

VIA is also in the process of a Series A funding round to more rapidly accelerate and support our growth in east Africa and eventually west Africa and southern Africa.

Lastly, we do pursue grant and philanthropic capital (Bill and Melinda Gates Foundation, USAID, Merck for Mothers) to support projects that align with our business objectives and support stronger distribution and equitable access in these otherwise fragmented markets.  This type of funding, like the Solve challenges, is typically project based but enables us to prioritize solutions that meet the needs of our customers. 

Evidence that we have been successful is in our Year over Year growth in sales revenue, which has enabled us to grow a sales and marketing team.  We had 10x revenue in Kenya alone in 2023 relative to 2022.  We also are working on our second round of support from Bill and Melinda Gates Foundation, reflecting their interest in VIA's unique model and value proposition in addressing distribution channels in LMICs.