February 12, 2014 |

Target the “poorest of poor?”

Many global health organizations strive to target the “poorest of the poor” with health services and technology innovations. But this may be a mistake.
Smiling woman in a yellow sari holds a cup of water to her lips as she poses by a water container and filter.
It may be better to market global health products initially to people who have some means. Here, a woman in India poses with her home water filter. Photo: PATH/Gabe Bienczycki.

Are the “poorest of the poor” always the right market to target with global health innovations? Joel Segrè, an independent strategy consultant focused on product development and distribution challenges in global health, took on that question during a recent panel discussion organized by our Drug Development Program. Here’s an excerpt, first published on the Drug Development blog.

Q: There seems to be a tension between targeting the “poorest of the poor” and other market segments. Who should be our first target users for global health innovations?

Portrait of Joel Segre.
Joel Segrè argues that marketing to the poorest market segment may not always be the best course.

A: Many global health organizations strive to target the “poorest of the poor” with various health services and technological innovations. If we are truly working to improve the lives of the maximum number of people, this “poorest of the poor” approach may be a mistake for two reasons.

The first has to do with cost-effectiveness. For most health innovations, it will almost always be more cost-effective to address the needs of urban poor or those who live within a reasonable walking distance of care—and these people have real needs that we can address immediately.

The second reason to question the “poorest of the poor” approach has to do with diffusion of innovation. Technological innovations that really take off almost never start by serving the most downtrodden users. Instead, innovation and uptake often begins with users who are easier to reach and present a market opportunity. Then, over years, the innovation finds its way to all economic strata.

Often private-sector providers find a profitable way to extend reach beyond what anyone thought possible. Mobile phones are the classic example. Let us innovate with a long-term view to serving all people, but a short-term view to addressing the needs that can be met most cost-effectively.

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