Healthcare perspectives from The Economist Intelligence Unit
Building a sustainable future: balancing growth, net-zero goals and public health
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UAE recognises the need to act on climate change fast
By organising global events such as COP28, the UAE aspires to demonstrate its commitment to climate action and bolster its global influence. The nation has been stepping up its climate actions over the years, starting with it being the first nation among Gulf Co-operation Council (GCC) countries to ratify the Paris Agreement in 2016.1 Then in 2022, it announced its Net Zero by 2050 strategy, the first such initiative in the region. The introduction of “The COP28 UAE Declaration on Climate on Health” further underscored the UAE’s substantial efforts towards climate-change mitigation and sustainability, and the crucial connection between climate change and health.
The impacts of climate change in the UAE affect well-being
By integrating climate considerations into public-health practices, the UAE's health system can enhance its resilience to climate-change impacts and better prepare for any associated health risks. The impacts of climate change in the UAE and the Middle East are becoming increasingly evident. As a result of climate change, the region is experiencing extreme weather in the form of more prolonged droughts, increasing frequencies of hotspells, extreme precipitation and compound effects on water resources, which will affect agricultural production and water availability. Furthermore, projections indicate a decrease in winter precipitation, leading to dryness and desertification in the Middle East. Recent studies suggest a significant decline in precipitation and an increase in temperatures, exacerbating the water-shortage crisis in the Middle East's semi-arid and arid climate.2 All of this will affect public health and therefore people’s well-being.
Focusing on capacity and infrastructure
The UAE is taking steps to address climate-related health challenges. This will mean a focus on existing building blocks. We will need to build resilient health-care systems by focusing on upgrading our health-care infrastructure, capacity and preparedness. Identifying and addressing the UAE’s top health priorities, such as cardiovascular diseases, cancer and childhood obesity, will also be an essential part of strengthening health systems in order to mitigate and manage the health impacts of climate change.
And we must not forget about research, as much is still unknown. We need to prioritise research on climate-change-related health issues to inform evidence-based interventions, which will provide valuable insights for effective policy formulation. Moreover, leveraging information and communication technologies (ICT) can enhance the UAE's health-system response to climate change. The health system can improve preparedness and response to climate-related health challenges by using telemedicine, remote sensing and data analytics. These advancements can strengthen health-care delivery, increase adaptive capacity and promote resilience in the face of climate-change impacts.3
By focusing on all these priorities, health systems can enhance their capacity to respond to the health impacts of climate change, promote public-health resilience and contribute to sustainable development in the region.4
Health is not alone—calling out to other sectors
As climate change is a collective challenge which requires cross-sectoral collaborative efforts, health actors need to lean on other sectors to manage this system challenge. By integrating climate considerations into urban planning, cities can develop green spaces, pedestrian-friendly infrastructure and efficient public-transportation systems, which will improve air quality and well-being.5 The UAE is also diversifying its energy mix and reducing its dependence on traditional fossil fuels. Initiatives such as solar-power plants and user-owned solar-power generators are being implemented in selected UAE cities to introduce renewable energy. Research has also highlighted the potential of biofuels sourced from mangroves, underscoring the UAE's commitment to renewable energy.6 Furthermore, sustainable-agriculture practices can bolster food security and minimise the environmental impact of food production, thereby positively influencing public health. Practices such as conservation-agriculture techniques and integrated pest-management techniques are critical for ensuring food security and promoting environmental sustainability. Furthermore, embracing alternative proteins and food tech interventions offers a promising avenue to bolster food security. These innovations can diversify food sources, reduce reliance on traditional livestock and farming, and mitigate the environmental impact of food production. The UAE has also been exploring the use of ICT for smart and sustainable agriculture, to enhance productivity while minimising environmental impact.7
Engagement will be key
While these initiatives are needed, we must also improve multi-sector collaboration, public education and engagement in climate advocacy. Many stakeholders will be needed, but universities and educational institutions, as custodians of knowledge, can help facilitate students and faculty to engage and act on climate change.
A good example of multi-stakeholder engagement is the UAE Climate Change Research Network, which was created in January 2021 by the Ministry of Climate Change and Environment. It is dedicated to improving climate resilience in all sectors, which includes new research, addressing adaptive capabilities and improving public awareness of the implications of climate change. Currently, the network consists of five clusters: Climate Change and Public Health (which I lead), Climate Data and Modelling, Climate Change and Infrastructure, Climate Change and Terrestrial, Marine and Freshwater Ecosystems, and Climate Change and Food and Water Security.8 This network also actively contributes to the UAE's global climate-action initiatives.
Demonstrating regional leadership, the UAE is actively identifying and implementing effective strategies to enhance its health and broader systems in response to climate change. While acknowledging the imperative for acceleratered action, the UAE remains committed to driving positive change swiftly and decisively.
1 UAE Ministry of Climate Change and Environment. The United Arab Emirates’ First Long-Term Strategy (LTS) Demonstrating Commitment to Net Zero by 2050. 2023. Available at: https://unfccc.int/sites/default/files/resource/UAE_LTLEDS.pdf
2 Chandran, A., Basha, G. and Ouarda, T.B.M.J. (2015). Influence of climate oscillations on temperature and precipitation over the United Arab Emirates. International Journal of Climatology, 36(1), 225-235. https://doi.org/10.1002/joc.4339
3 Alkhaldi, M., Moonesar, I.A., Issa, S.T. et al. (2023). Analysis of the United Arab emirates' contribution to the sustainable development goals with a focus on global health and climate change. International Journal of Health Governance, 28(4), 357-367. https://doi.org/10.1108/ijhg-04-2023-0040
4 Gan, C.C.R., Banwell, N., Pascual, R.S., Chu, C. and Wang, Y.W. (2019). Hospital climate actions and assessment tools: a scoping review protocol. BMJ Open, 9(12), e032561. https://doi.org/10.1136/bmjopen-2019-032561
5 Amrousi, M., Paleologos, E., Caratelli, P. and Elhakeem, M. (2018). Are garden cities in the desert sustainable? International Review for Spatial Planning and Sustainable Development, 6A(1), 79-94. https://doi.org/10.14246/irspsd.6a.1_79)
6 Merheb, M., Matar, R., Marton, J.M., Youssef, K.A., Hodeify, R. and Shafiq, N. (2018). Alternative energy in the UAE: the potential of biofuels sourced from Ras Al Khaimah mangroves. Al Qasimi Foundation. https://doi.org/10.18502/aqf.0091
7 Bilali, H.E., Bottalico, F. and Palmisano, G.O. (2020). Information and communication technologies for smart and sustainable agriculture. 30th Scientific-Experts Conference of Agriculture and Food Industry, 321-334. https://doi.org/10.1007/978-3-030-40049-1_41
8 https://www.moccae.gov.ae/en/climate-change-research-network-about.aspx

The longevity equation: climate resilience for health in the Middle East
Climate change is one of the most complex threats to the health of our people and our planet. The Middle East is among the geographic areas most vulnerable to rising temperatures, air pollution, food and water insecurity and adverse weather events. Without considerable mitigation and adaptation efforts, the health and longevity of current and future generations will be severely impacted.
COP28 will be the first to feature a “Health Day”, evidence of the growing realisation that the climate crisis is also a health crisis and an opportunity for the region to play a leading role in driving international co-operation on climate mitigation and public health.
The longevity equation: climate resilience for health in the Middle East is an Economic Impact report supported by PureHealth. Our report explores the consequences of the climate crisis for the health and wellbeing of populations in the Middle East and aims to stimulate discussion on the urgency for accelerated climate action in the region and the priorities for governments, health systems and all sectors.
We have identified a number of common priorities under three key pillars: knowledge empowerment, climate-smart health systems and multisector action. These can help guide regional stakeholders in mitigating and adapting to the impacts of climate change while also supporting the health and longevity of the region’s populations.
Knowledge empowerment:
Build awareness, education and accountability of the climate risk factors and their potential impact on human health across all stakeholder groups and levels of society
Improve surveillance, data collection and monitoring of the region’s climate change risk factors and their direct and indirect impact on human health
Support ongoing research to quantify the health impacts of climate change to raise the alarm and build an investment case for climate mitigation and adaptation efforts
Climate-smart health systems:
Develop national health adaptation plans (NAPs) that consider the unique country dynamics and health systems across the region
Strengthen the capacity of health systems to prevent, prepare and respond to climate change through robust surveillance and early warning systems and a trained workforce
Adopt initiatives to reduce emissions and unnecessary waste from regional health systems and hold suppliers accountable for their climate commitments
Multisector action:
Integrate health into national climate mitigation and adaptation strategies and support cross-sectoral collaboration and accountability
Consider the co-benefits of public health action and environmental sustainability in current and future urban development
Expand the scope of climate mitigation and adaptation beyond national borders through regional data sharing, resource sharing and collaboration
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Positioning health at the forefront of climate negotiations
In December 2023, 49 health ministers and over 60 ministers from other ministries gathered in Dubai for the first inter-ministerial meeting on climate and health held at the annual United Nations climate change conference, COP. While long overdue, the adoption of a dedicated health day at COP28 was not a surprise, as the health impacts of climate change have never been as visible as they are today.
Much of the political discourse on climate change is around emissions, finance and technology, yet the impacts of climate change affect the health of everyone. This is evident in the global impact felt in 2023, the hottest year on record, during which increased death and disability from extreme temperatures were recorded across almost all regions.1 Last Summer, wildfires in Canada and Hawaii underscored the severity of climate-related events, leading to smoke-covered cities in North America and significant casualties in Hawaii. As I write, wildfires in Chile, exacerbated by the current heatwave, have already caused more than 100 deaths. Globally, flooding and superstorms are increasing the risk of disease outbreaks, while climate change-driven drought, impacting food production, exacerbates hunger and famine. In the Middle East, rising exposure to dust storms and water stress are growing concerns, highlighting the urgent need for climate action.
Health at COP28: a small step in the right direction
COP28 achieved notable health successes, including the Declaration on Climate and Health, advancements in the Global Goal on Adaptation (GGA), and consensus on establishing a Loss and Damage Fund to provide compensation for climate-vulnerable countries.
The Declaration on Climate and Health, formulated with input from governments in the months leading up to COP28, has garnered signatures from 149 countries to date. This widespread support signals acknowledgment of the crucial link between climate change and health, and the urgent need for action, along with emphasising the importance of preparing and strengthening health systems. The declaration also recognises that many sectors determine health. Clean air, water, sanitation, and access to nutritious food, play pivotal roles in safeguarding people's health.
Established under the Paris Agreement, the GGA aims to establish collective commitments and funding for national adaptation needs. Agreed upon for the first time at COP28, it includes language addressing the necessity to strengthen health systems, especially in vulnerable regions. Though the wording requires further strengthening with measurable targets, indicators, and clear accountability, and badly needs to be underpinned by appropriate levels of funding, this represents a positive step forward.
Countries that contribute the least to driving climate change are often those experiencing the worst impacts, but lack the time and resources to adapt and protect themselves. In some cases, the climate impacts are so extreme that adaptation isn't feasible. Developing nations have long called for funding to respond to the impacts from climate change that they haven’t been able to adapt to, and at COP28, we finally saw the operationalisation of the Loss and Damage Fund. While a crucial step in compensating vulnerable nations, the current pledge of US$700 million from wealthy nations only covers 0.2% of the projected annual need of US$400 billion.2
These measures signal recognition among countries of the link between climate change and health, and their readiness for action, however the negotiated outcomes from COP28 fall far short of the urgency and ambition required for effective climate response. Notably, fossil fuels were explicitly mentioned for the first time, with a commitment to transition away from them in the energy sector. However, it is far from a firm commitment to a full and just phase-out of fossil fuels, containing language that leaves loopholes and potential room for expanding oil and gas use.3
Maintaining momentum beyond COP28
A louder health voice in climate policy As the damaging impacts of climate change on health become increasingly evident, involving the health community in climate negotiations, and placing health at the heart of decision-making, is vital.
Approaching climate change through a health lens results in distinct policy decisions that directly benefit the health and wellbeing of people, locally and in the near term. Among the best examples is cutting air pollution and fossil fuel use. Even if technologies like carbon capture and storage could help control greenhouse gas emissions (this has not yet been demonstrated), they don't mitigate the harmful air pollution impacts of fossil fuel use. Air pollution currently kills around 7m people a year, and 99% of people on the planet breathe air that exceeds the World Health Organisation’s air quality guidelines.4 Eliminating fossil fuel use would both mitigate climate change and make a substantial difference to the impacts of air pollution. Similarly, transitioning to electric vehicles, alone, reduces greenhouse gas emissions but falls short of the extensive health benefits associated with active transport. Safe bikeways, sidewalks, and walking to public transportation, offer opportunities for physical activity and contribute to substantial health gains, as well as influencing mental and social well-being.
Despite record health-sector participation at COP28, with around 1,900 health professionals present, the fossil fuel sector had over 2,400 representatives.5 To ensure the health voice prevails, a well-organised and informed health community is essential. Integrating climate change into health training and advocating for health ministries to actively participate in shaping national commitments and policies that address climate change is crucial. We look forward to seeing an even greater, and increasingly well-informed, health presence at future COPs.
Investment in health systems Strengthening our health systems is imperative to respond to the challenges of a changing climate. All health professionals need necessary training, and hospitals and clinics require proper infrastructure for effective response to weather events.
Historically, public health relied on past weather patterns for planning interventions and requirements. We're now in a time when the past is not an indicator of what's happening in the future. Adapting to future changes necessitates a shift from traditional approaches. Public health systems need real-time data and modelling, and early warning systems to let them know what is coming, whether a heat wave, a storm or period of poor air quality, so they can then take action that protects people as well as possible.
We also need to acknowledge the scale of the challenge we are facing. We're currently on a trajectory towards a world that would see nearly 3°C of global warming over the pre-industrial era.6
All the disasters and health impacts we're seeing are at 1.5°C or less. We cannot adapt to a 3°C world. Strengthening health systems alone won't suffice; addressing emissions in energy, transportation, and food systems is essential to protect public health.
A necessary equitable pursuit Many people in the world lack access to basic primary healthcare. Healthier populations are more resilient to climate threats, which means we must invest in universal health coverage worldwide.
Solutions like renewable energy, solar power and wind power, can improve healthcare in remote or low-income areas. Solar power, for instance, provides an independent energy source for hospitals and clinics without a formal grid, enhancing healthcare accessibility.
For low-income and developing countries, scalable solutions are crucial. Wealthy nations, especially those contributing significantly to the climate crisis, have a responsibility to support vulnerable nations. While this is a moral imperative and necessary to ensure global health equity, it is also in every nation’s self-interest. The climate crisis transcends borders, and affects all of us. We must all step up and make a united global effort to ensure the well-being, and indeed survival, of us all.
References
1 United Nations. Hottest July ever signals ‘era of global boiling has arrived’ says UN chief. July 2023. Available from https://news.un.org/en/story/2023/07/1139162.2 Green Central Banking. ECB warns climate laggard banks of penalty escalation. December 2023. Available from https://greencentralbanking.com/2023/12/13/ecb-warns-climate-laggard-banks-of-penalty-escalation/3 Wise, Jacqui. COP28 decision to “transition away” from fossil fuels is hailed as milestone but loopholes are decried. BMJ 2023;383:p2941.4 WHO. Billions of people still breathe unhealthy air: new WHO data. April 2022. Available from https://www.who.int/news/item/04-04-2022-billions-of-people-still-breathe-unhealthy-air-new-who-data5 NPR. A record number of fossil fuel representatives are at this year's COP28 climate talks. December 2023. Available from https://www.wamc.org/2023-12-07/a-record-number-of-fossil-fuel-representatives-are-at-this-years-cop28-climate-talks6 SEI, Climate Analytics, E3G, IISD, and UNEP. (2023). The Production Gap: Phasing down or phasing up? Top fossil fuel producers plan even more extraction despite climate promises. Stockholm Environment Institute, Climate Analytics, E3G, International Institute for Sustainable Development and United Nations Environment Programme. https://doi.org/10.51414/sei2023.050
A guest blog from Jeni Miller, executive director, Global Climate and Health Alliance
Visit The longevity equation: climate resilience for health in the Middle East to learn more
The views and opinions expressed in this article are those of the authors and do not necessarily reflect the views of Economist Impact or any other member of The Economist Group. The Economist Group cannot accept any responsibility or liability for reliance by any person on this article or any of the information, opinions or conclusions set out in the article.
Mitigating the ongoing and future health, economic and organisational consequences associated with covid-19
Despite the end of the declared public health emergency, the lingering effects of covid-19 still impacts people’s health, work and productivity. The current winter season introduces the risk of a “tripledemic” — the simultaneous occurrence of flu, covid-19 and respiratory syncytial virus (RSV) —, also making it more prevalent. At the same time, the prolonged effects of “long covid” winders the life of millions. In light of that, businesses must remain vigilant about the risks associated to covid-19.
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Accelerating urban intelligence: People, business and the cities of tomorro...
About the research
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Respondents to the citizen survey were evenly balanced by age (roughly one-third in each of the 18-38, 39-54 and 55 years and older age groups) and gender. A majority (56%) had household incomes above the median level in their city, with 44% below it. Respondents to the business survey were mainly senior executives (65% at C-suite or director level) working in a range of different functions. They work in large, midsize and small firms in over a dozen industries. See the report appendix for full survey results and demographics.
Additional insights were obtained from indepth interviews with city officials, smart-city experts at NGOs and other institutions, and business executives. We would like to thank the following individuals for their time and insights.
Pascual Berrone, academic co-director, Cities in Motion, and professor, strategic management, IESE Business School (Barcelona) Lawrence Boya, director, Smart City Programme, city of Johannesburg Amanda Daflos, chief innovation officer, city of Los Angeles Linda Gerull, chief information officer, city of San Francisco Praveen Pardeshi, municipal commissioner, Brihanmumbai Municipal Corporation (Mumbai) • Brian Roberts, policy analyst, city of San Francisco Sameer Sharma, global general manager, Internet of Things (IoT), Intel • Marius Sylvestersen, programme director, Copenhagen Solutions Lab Tan Kok Yam, deputy secretary of the Smart Nation and Digital Government, Prime Minister’s Office, SingaporeThe report was written by Denis McCauley and edited by Michael Gold.

Talent for innovation
Talent for innovation: Getting noticed in a global market incorporates case studies of the 34 companies selected as Technology Pioneers in biotechnology/health, energy/environmental technology, and information technology.
Leonardo Da Vinci unquestionably had it in the 15th century; so did Thomas Edison in the 19th century. But today, "talent for innovation" means something rather different. Innovation is no longer the work of one individual toiling in a workshop. In today's globalised, interconnected world, innovation is the work of teams, often based in particular innovation hotspots, and often collaborating with partners, suppliers and customers both nearby and in other countries.
Innovation has become a global activity as it has become easier for ideas and talented people to move from one country to another. This has both quickened the pace of technological development and presented many new opportunities, as creative individuals have become increasingly prized and there has been greater recognition of new sources of talent, beyond the traditional innovation hotspots of the developed world.
The result is a global exchange of ideas, and a global market for innovation talent. Along with growth in international trade and foreign direct investment, the mobility of talent is one of the hallmarks of modern globalisation. Talented innovators are regarded by companies, universities and governments as a vital resource, as precious as oil or water. They are sought after for the simple reason that innovation in products and services is generally agreed to be a large component, if not the largest component, in driving economic growth. It should be noted that "innovation" in this context does not simply mean the development of new, cutting-edge technologies by researchers.
It also includes the creative ways in which other people then refine, repackage and combine those technologies and bring them to market. Indeed, in his recent book, "The Venturesome Economy", Amar Bhidé, professor of business at Columbia University, argues that such "orchestration" of innovation can actually be more important in driving economic activity than pure research. "In a world where breakthrough ideas easily cross national borders, the origin of ideas is inconsequential," he writes. Ideas cross borders not just in the form of research papers, e-mails and web pages, but also inside the heads of talented people. This movement of talent is not simply driven by financial incentives. Individuals may also be motivated by a desire for greater academic freedom, better access to research facilities and funding, or the opportunity to work with key researchers in a particular field.
Countries that can attract talented individuals can benefit from more rapid economic growth, closer collaboration with the countries where those individuals originated, and the likelihood that immigrant entrepreneurs will set up new companies and create jobs. Mobility of talent helps to link companies to sources of foreign innovation and research expertise, to the benefit of both. Workers who emigrate to another country may bring valuable knowledge of their home markets with them, which can subsequently help companies in the destination country to enter those markets more easily. Analysis of scientific journals suggests that international co-authorship is increasing, and there is some evidence thatcollaborative work has a greater impact than work carried out in one country. Skilled individuals also act as repositories of knowledge, training the next generation and passing on their accumulated wisdom.
But the picture is complicated by a number of concerns. In developed countries which have historically depended to a large extent on foreign talent (such as the United States), there is anxiety that it is becoming increasingly difficult to attract talent as new opportunities arise elsewhere. Compared with the situation a decade ago, Indian software engineers, for example, may be more inclined to set up a company in India, rather than moving to America to work for a software company there. In developed countries that have not historically relied on foreign talent (such as Germany), meanwhile, the ageing of the population as the birth rate falls and life expectancy increases means there is a need to widen the supply of talent, as skilled workers leave the workforce and young people show less interest than they used to in technical subjects. And in developing countries, where there is a huge supply of new talent (hundreds of thousands of engineers graduate from Indian and Chinese universities every year), the worry is that these graduates have a broad technical grounding but may lack the specialised skills demanded by particular industries.
Other shifts are also under way. The increasing sophistication of emerging economies (notably India and China) is overturning the old model of "create in the West, customise for the East". Indian and Chinese companies are now globally competitive in many industries. And although the mobility of talent is increasing, workers who move to another country are less likely to stay for the long-term, and are more likely to return to their country of origin. The number of Chinese students studying abroad increased from 125,000 in 2002 to 134,000 in 2006, for example, but the proportion who stayed in the country where they studied after graduating fell from 85% to 69% over the same period, according to figures from the OECD (see page 10).
What is clear is that the emergence of a global market for talent means gifted innovators are more likely to be able to succeed, and new and unexpected opportunities are being exploited, as this year's Technology Pioneers demonstrate. They highlight three important aspects of the global market for talent: the benefits of mobility, the significant role of diasporas, and the importance of network effects in catalysing innovation.
Brain drain, or gain?
Perhaps the most familiar aspect of the debate about flows of talent is the widely expressed concern about the "brain drain" from countries that supply talented workers. If a country educates workers at the taxpayers' expense, does it not have a claim on their talent? There are also worries that the loss of skilled workers can hamper institutional development and drive up the cost of technical services. But such concerns must be weighed against the benefits of greater mobility.
There are not always opportunities for skilled individuals in their country of birth. The prospect of emigration can encourage the development of skills by individuals who may not in fact decide to emigrate. Workers who emigrate may send remittances back to their families at home, which can be a significant source of income and can help to alleviate poverty. And skilled workers may return to their home countries after a period working abroad, further stimulating knowledge transfer and improving the prospects for domestic growth, since they will maintain contacts with researchers overseas. As a result, argues a recent report from the OECD, it makes more sense to talk of a complex process of "brain circulation" rather than a one-way "brain drain". The movement of talent is not simply a zero-sum gain in which sending countries lose, and receiving countries benefit. Greater availability and mobility of talent opens up new possibilities and can benefit everyone.
Consider, for example, BioMedica Diagnostics of Windsor, Nova Scotia. The company makes medical diagnostic systems, some of them battery-operated, that can be used to provide health care in remote regions to people who would otherwise lack access to it. It was founded by Abdullah Kirumira, a Ugandan biochemist who moved to Canada in 1990 and became a professor at Acadia University. There he developed a rapid test for HIV in conjunction with one of his students, Hermes Chan (a native of Hong Kong who had moved to Canada to study). According to the United States Centers for Disease Control, around one-third of people tested for HIV do not return to get the result when it takes days or weeks to determine. Dr Kirumira and Dr Chan developed a new test that provides the result in three minutes, so that a diagnosis can be made on the spot. Dr Kirumira is a prolific inventor who went on to found several companies, and has been described as "the pioneer of Nova Scotia's biotechnology sector".
Today BioMedica makes a range of diagnostic products that are portable, affordable and robust, making them ideally suited for use in developing countries. They allow people to be rapidly screened for a range of conditions, including HIV, hepatitis, malaria, rubella, typhoid and cholera. The firm's customers include the World Health Organisation. Providing such tests to patients in the developing world is a personal mission of Dr Kirumira's, but it also makes sound business sense: the market for invitro diagnostics in the developing world is growing by over 25% a year, the company notes, compared with growth of only 5% a year in developed nations.
Moving to Canada gave Dr Kirumira research opportunities and access to venture funding that were not available in Uganda. His innovations now provide an affordable way for hospitals in his native continent of Africa to perform vital tests. A similar example is provided by mPedigree, a start-up that has developed a mobile-phone-based system that allows people to verify the authenticity of medicines. Counterfeit drugs are widespread in the developing world: they are estimated to account for 10-25% of all drugs sold, and over 80% in some countries. The World Health Organisation estimates that a fake vaccine for meningitis, distributed in Niger in 1995, killed over 2,500 people. mPedigree was established by Bright Simons, a Ghanaian social entrepreneur, in conjunction with Ashifi Gogo, a fellow Ghanaian. The two were more than just acquaintances having met at Secondary School. There are many high-tech authentication systems available in the developed world for drug packaging, involving radio-frequency identification (RFID) chips, DNA tags, and so forth.
The mPedigree system developed my Mr Gogo, an engineering student, is much cheaper and simpler and only requires the use of a mobile phone — an item that is now spreading more quickly in Africa than in any other region of the world. Once the drugs have been purchased, a panel on the label is scratched off to reveal a special code. The patient then sends this code, by text message, to a particular number. The code is looked up in a database and a message is sent back specifying whether the drugs are genuine. The system is free to use because the drug companies cover the cost of the text messages. It was launched in Ghana in 2007, and mPedigree's founders hope to extend it to all 48 sub-Saharan African countries within a decade, and to other parts of in the developing world.
The effort is being supported by Ghana's Food and Drug Board, and by local telecoms operators and drug manufacturers. Mr Gogo has now been admitted into a special progamme at Dartmouth College in the United States that develops entrepreneurial skills, in addition to technical skills, in engineers. Like Dr Kirumira, he is benefiting from opportunities that did not exist in his home country, and his country is benefiting too. This case of mPedigree shows that it is wrong to assume that the movement of talent is one-way (from poor to rich countries) and permanent. As it has become easier to travel and communications technology has improved, skilled workers have become more likely to spend brief spells in other countries that provide opportunities, rather than emigrating permanently.
And many entrepreneurs and innovators shuttle between two or more places — between Tel Aviv and Silicon Valley, for example, or Silicon Valley and Hsinchu in Taiwan — in a pattern of "circular" migration, in which it is no longer meaningful to distinguish between "sending" and "receiving" countries.
The benefits of a diaspora
Migration (whether temporary, permanent or circular) to a foreign country can be facilitated by the existence of a diaspora, since it can be easier to adjust to a new culture when you are surrounded by compatriots who have already done so. Some observers worry that diasporas make migration too easy, in the sense that they may encourage a larger number of talented individuals to leave their home country than would otherwise be the case, to the detriment of that country.
But as with the broader debate about migration, this turns out to be only part of the story. Diasporas can have a powerful positive effect in promoting innovation and benefiting the home country. Large American technology firms, for example, have set up research centres in India in part because they have been impressed by the calibre of the migrant Indian engineers they have employed in America. Diasporas also provide a channel for knowledge and skills to pass back to the home country.
James Nakagawa, a Canadian of Japanese origin and the founder of Mobile Healthcare, is a case in point. A third-generation immigrant, he grew up in Canada but decided in 1994 to move to Japan, where he worked for a number of technology firms and set up his own financial-services consultancy. In 2000 he had the idea that led him to found Mobile Healthcare, when a friend was diagnosed with diabetes and lamented that he found it difficult to determine which foods to eat, and which to avoid.
The rapid spread of advanced mobile phones in Japan, a world leader in mobile telecoms, prompted Mr Nakagawa to devise Lifewatcher, Mobile Healthcare's main product. It is a "disease selfmanagement system" used in conjunction with a doctor, based around a secure online database that can be accessed via a mobile phone. Patients record what medicines they are taking and what food they are eating, taking a picture of each meal. A database of common foodstuffs, including menu items from restaurants and fast-food chains, helps users work out what they can safely eat. Patients can also call up their medical records to follow the progress of key health indicators, such as blood sugar, blood pressure, cholesterol levels and calorie intake.
All of this information can also be accessed online by the patient's doctor or nutritionist. The system allows people with diabetes or obesity (both of which are rapidly becoming more prevalent in Japan and elsewhere) to take an active role in managing their conditions. Mr Nakagawa did three months of research in the United States and Canada while developing Lifewatcher, which was created with support from Apple (which helped with hardware and software), the Japanese Red Cross and Japan's Ministry of Health and Welfare (which provided full access to its nutritional database).
Japanese patients who are enrolled in the system have 70% of the cost covered by their health insurance. Mr Nakagawa is now working to introduce Lifewatcher in the United States and Canada, where obesity and diabetes are also becoming more widespread — along advanced mobile phones of the kind once only found in Japan. Mr Nakagawa's ability to move freely between Japanese and North American cultures, combining the telecoms expertise of the former with the entrepreneurial approach of the latter, has resulted in a system that can benefit both.
The story of Calvin Chin, the Chinese-American founder of Qifang, is similar. Mr Chin was born and educated in America, and worked in the financial services and technology industries for several years before moving to China. Expatriate Chinese who return to the country, enticed by opportunities in its fast-growing economy, are known as "returning turtles". Qifang is a "peer to peer" (P2P) lending site that enables students to borrow money to finance their education from other users of the site. P2P lending has been pioneered in other countries by sites such as Zopa and Prosper in other countries.
Such sites require would-be borrowers to provide a range of personal details about themselves to reassure lenders, and perform credit checks on them. Borrowers pay above-market rates, which is what attracts lenders. Qifang adds several twists to this formula. It is concentrating solely on student loans, which means that regulators are more likely to look favourably on the company's unusual business model. It allows payments to be made directly to educational institutions, to make sure the money goes to the right place. Qifang also requires borrowers to give their parents' names when taking out a loan, which increases the social pressure on them not to default, since that would cause the family to lose face.
Mr Chin has thus tuned an existing business model to take account of the cultural and regulatory environment in China, where P2P lending could be particularly attractive, given the relatively undeveloped state of China's financial-services market. In a sense, Qifang is just an updated, online version of the community group-lending schemes that are commonly used to finance education in China. The company's motto is that "everyone should be able to get an education, no matter their financial means".
Just as Mr Chin is trying to use knowledge acquired in the developed world to help people in his mother country of China, Sachin Duggal hopes his company, Nivio, will do something similar for people in India. Mr Duggal was born in Britain and is of Indian extraction. He worked in financial services, including a stint as a technologist at Deutsche Bank, before setting up Nivio, which essentially provides a PC desktop, personalised with a user's software and documents, that can be accessed from any web browser.
This approach makes it possible to centralise the management of PCs in a large company, and is already popular in the business world. But Mr Duggal hopes that it will also make computing more accessible to people who find the prospect of owning and managing their own PCs (and dealing with spam and viruses) too daunting, or simply cannot afford a PC at all. Nivio's software was developed in India, where Mr Duggal teamed up with Iqbal Gandham, the founder of Net4India, one of India's first internet service providers. Mr Duggal believes that the "virtual webtop" model could have great potential in extending access to computers to rural parts of India, and thus spreading the opportunities associated with the country's high-tech boom. A survey of the bosses of Indian software firms clearly shows how diasporas can promote innovation.
It found that those bosses who had lived abroad and returned to India made far more use of diaspora links upon their return than entrepreneurs who had never lived abroad, which gave them access to capital and skills in other countries. Diasporas can, in other words, help to ensure that "brain drain" does indeed turn into "brain gain", provided the government of the country in question puts appropriate policies in place to facilitate the movement of people, technology and capital.
Making the connection
Multinational companies can also play an important role in providing new opportunities for talented individuals, and facilitating the transfer of skills. In recent years many technology companies have set up large operations in India, for example, in order to benefit from the availability of talented engineers and the services provided by local companies. Is this simply exploitation of low-paid workers by Western companies?
The example of JiGrahak Mobility Solutions, a start-up based in Bangalore, illustrates why it is not. The company was founded by Sourabh Jain, an engineering graduate from the Delhi Institute of Technology. After completing his studies he went to work for the Indian research arm of Lucent Technologies, an American telecoms-equipment firm. This gave him a solid grounding in mobile-phone technology, which subsequently enabled him to set up JiGrahak, a company that provides a mobile-commerce service called Ngpay.
In India, where many people first experience the internet on a mobile phone, rather than a PC, and where mobile phones are far more widespread than PCs, there is much potential for phone-based shopping and payment services. Ngpay lets users buy tickets, pay bills and transfer money using their handsets. Such is its popularity that with months of its launch in 2008, Ngpay accounted for 4% of ticket sales at Fame, an Indian cinema chain.
The role of large companies in nurturing talented individuals, who then leave to set up their own companies, is widely understood in Silicon Valley. Start-ups are often founded by alumni from Sun, HP, Oracle and other big names. Rather than worrying that they could be raising their own future competitors, large companies understand that the resulting dynamic, innovative environment benefits everyone, as large firms spawn, compete with and acquire smaller ones.
As large firms establish outposts in developing countries, such catalysis of innovation is becoming more widespread. Companies with large numbers of employees and former employees spread around the world can function rather like a corporate diaspora, in short, providing another form of network along which skills and technology can diffuse. The network that has had the greatest impact on spreading ideas, promoting innovation and allowing potential partners to find out about each other's research is, of course, the internet. As access to the internet becomes more widespread, it can allow developing countries to link up more closely with developed countries, as the rise of India's software industry illustrates. But it can also promote links between developing countries.
The Cows to Kilowatts Partnership, based in Nigeria, provides an unusual example. It was founded by Joseph Adelagan, a Nigerian engineer, who was concerned about the impact on local rivers of effluent from the Bodija Market abattoir in Ibadan. As well as the polluting the water supply of several nearby villages, the effluent carried animal diseases that could be passed to humans. Dr Adelagan proposed setting up an effluent-treatment plant.
He discovered, however, that although treating the effluent would reduce water pollution, the process would produce carbon-dioxide and methane emissions that contribute to climate change. So he began to look for ways to capture these gases and make use of them. Researching the subject online, he found that a research institution in Thailand, the Centre for Waste Utilisation and Management at King Mongkut University of Technology Thonburi, had developed anaerobic reactors that could transform agro-industrial waste into biogas. He made contact with the Thai researchers, and together they developed a version of the technology
suitable for use in Nigeria that turns the abattoir waste into clean household cooking gas and organic fertiliser, thus reducing the need for expensive chemical fertiliser. The same approach could be applied across Africa, Dr Adelagan believes. The Cows to Kilowatts project illustrates the global nature of modern innovation, facilitated by the free movement of both ideas and people. Thanks to the internet, people in one part of the world can easily make contact with people trying to solve similar problems elsewhere.
Lessons learned
What policies should governments adopt in order to develop and attract innovation talent, encourage its movement and benefit from its circulation? At the most basic level, investment in education is vital. Perhaps surprisingly, however, Amar Bhidé of Columbia University suggests that promoting innovation does not mean pushing as many students as possible into technical subjects.
Although researchers and technologists provide the raw material for innovation, he points out, a crucial role in orchestrating innovation is also played by entrepreneurs who may not have a technical background. So it is important to promote a mixture of skills. A strong education system also has the potential to attract skilled foreign students, academics and researchers, and gives foreign companies an incentive to establish nearby research and development operations.
Many countries already offer research grants, scholarships and tax benefits to attract talented immigrants. In many cases immigration procedures are "fast tracked" for individuals working in science and technology. But there is still scope to remove barriers to the mobility of talent. Mobility of skilled workers increasingly involves short stays, rather than permanent moves, but this is not yet widely reflected in immigration policy. Removing barriers to short-term stays can increase "brain circulation" and promote diaspora links.
Another problem for many skilled workers is that their qualifications are not always recognised in other countries. Greater harmonisation of standards for qualifications is one way to tackle this problem; some countries also have formal systems to evaluate foreign qualifications and determine their local equivalents. Countries must also provide an open and flexible business environment to ensure that promising innovations can be brought to market. If market access or financial backing are not available, after all, today's global-trotting innovators increasingly have the option of going elsewhere.
The most important point is that the global competition for talent is not a zero-sum game in which some countries win, and others lose. As the Technology Pioneers described here demonstrate, the nature of innovation, and the global movement of talent and ideas, is far more complicated that the simplistic notion of a "talent war" between developed and developing nations would suggest. Innovation is a global activity, and granting the greatest possible freedom to innovators can help to ensure that the ideas they generate will benefit the greatest possible number of people.

Integrated Transformation: How rising customer expectations are turning com...
Modern customers have it good. Spoilt for choice and convenience, today’s empowered consumers have come to expect more from the businesses they interact with. This doesn’t just apply to their wanting a quality product at a fair price, but also tailored goods, swift and effective customer service across different channels, and a connected experience across their online shopping and in-store experience, with easy access to information they need when they want it.
Meeting these expectations is a significant challenge for organisations. For many, it requires restructuring long-standing operating models, re-engineering business processes and adopting a fundamental shift in mindset to put customer experience at the heart of business decision- making. Download our report to learn more.
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Accelerating urban intelligence: People, business and the cities of tomorrow is an Economist Intelligence Unit report, sponsored by Nutanix. It explores expectations of citizens and businesses for smart-city development in some of the world’s major urban centres. The analysis is based on two parallel surveys conducted in 19 cities: one of 6,746 residents and another of 969 business executives. The cities included are Amsterdam, Copenhagen, Dubai, Frankfurt, Hong Kong, Johannesburg, London, Los Angeles, Mumbai, New York, Paris, Riyadh, San Francisco, São Paulo, Singapore, Stockholm, Sydney, Tokyo and Zurich.
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Pascual Berrone, academic co-director, Cities in Motion, and professor, strategic management, IESE Business School (Barcelona) Lawrence Boya, director, Smart City Programme, city of Johannesburg Amanda Daflos, chief innovation officer, city of Los Angeles Linda Gerull, chief information officer, city of San Francisco Praveen Pardeshi, municipal commissioner, Brihanmumbai Municipal Corporation (Mumbai) • Brian Roberts, policy analyst, city of San Francisco Sameer Sharma, global general manager, Internet of Things (IoT), Intel • Marius Sylvestersen, programme director, Copenhagen Solutions Lab Tan Kok Yam, deputy secretary of the Smart Nation and Digital Government, Prime Minister’s Office, SingaporeThe report was written by Denis McCauley and edited by Michael Gold.

Talent for innovation
Talent for innovation: Getting noticed in a global market incorporates case studies of the 34 companies selected as Technology Pioneers in biotechnology/health, energy/environmental technology, and information technology.
Leonardo Da Vinci unquestionably had it in the 15th century; so did Thomas Edison in the 19th century. But today, "talent for innovation" means something rather different. Innovation is no longer the work of one individual toiling in a workshop. In today's globalised, interconnected world, innovation is the work of teams, often based in particular innovation hotspots, and often collaborating with partners, suppliers and customers both nearby and in other countries.
Innovation has become a global activity as it has become easier for ideas and talented people to move from one country to another. This has both quickened the pace of technological development and presented many new opportunities, as creative individuals have become increasingly prized and there has been greater recognition of new sources of talent, beyond the traditional innovation hotspots of the developed world.
The result is a global exchange of ideas, and a global market for innovation talent. Along with growth in international trade and foreign direct investment, the mobility of talent is one of the hallmarks of modern globalisation. Talented innovators are regarded by companies, universities and governments as a vital resource, as precious as oil or water. They are sought after for the simple reason that innovation in products and services is generally agreed to be a large component, if not the largest component, in driving economic growth. It should be noted that "innovation" in this context does not simply mean the development of new, cutting-edge technologies by researchers.
It also includes the creative ways in which other people then refine, repackage and combine those technologies and bring them to market. Indeed, in his recent book, "The Venturesome Economy", Amar Bhidé, professor of business at Columbia University, argues that such "orchestration" of innovation can actually be more important in driving economic activity than pure research. "In a world where breakthrough ideas easily cross national borders, the origin of ideas is inconsequential," he writes. Ideas cross borders not just in the form of research papers, e-mails and web pages, but also inside the heads of talented people. This movement of talent is not simply driven by financial incentives. Individuals may also be motivated by a desire for greater academic freedom, better access to research facilities and funding, or the opportunity to work with key researchers in a particular field.
Countries that can attract talented individuals can benefit from more rapid economic growth, closer collaboration with the countries where those individuals originated, and the likelihood that immigrant entrepreneurs will set up new companies and create jobs. Mobility of talent helps to link companies to sources of foreign innovation and research expertise, to the benefit of both. Workers who emigrate to another country may bring valuable knowledge of their home markets with them, which can subsequently help companies in the destination country to enter those markets more easily. Analysis of scientific journals suggests that international co-authorship is increasing, and there is some evidence thatcollaborative work has a greater impact than work carried out in one country. Skilled individuals also act as repositories of knowledge, training the next generation and passing on their accumulated wisdom.
But the picture is complicated by a number of concerns. In developed countries which have historically depended to a large extent on foreign talent (such as the United States), there is anxiety that it is becoming increasingly difficult to attract talent as new opportunities arise elsewhere. Compared with the situation a decade ago, Indian software engineers, for example, may be more inclined to set up a company in India, rather than moving to America to work for a software company there. In developed countries that have not historically relied on foreign talent (such as Germany), meanwhile, the ageing of the population as the birth rate falls and life expectancy increases means there is a need to widen the supply of talent, as skilled workers leave the workforce and young people show less interest than they used to in technical subjects. And in developing countries, where there is a huge supply of new talent (hundreds of thousands of engineers graduate from Indian and Chinese universities every year), the worry is that these graduates have a broad technical grounding but may lack the specialised skills demanded by particular industries.
Other shifts are also under way. The increasing sophistication of emerging economies (notably India and China) is overturning the old model of "create in the West, customise for the East". Indian and Chinese companies are now globally competitive in many industries. And although the mobility of talent is increasing, workers who move to another country are less likely to stay for the long-term, and are more likely to return to their country of origin. The number of Chinese students studying abroad increased from 125,000 in 2002 to 134,000 in 2006, for example, but the proportion who stayed in the country where they studied after graduating fell from 85% to 69% over the same period, according to figures from the OECD (see page 10).
What is clear is that the emergence of a global market for talent means gifted innovators are more likely to be able to succeed, and new and unexpected opportunities are being exploited, as this year's Technology Pioneers demonstrate. They highlight three important aspects of the global market for talent: the benefits of mobility, the significant role of diasporas, and the importance of network effects in catalysing innovation.
Brain drain, or gain?
Perhaps the most familiar aspect of the debate about flows of talent is the widely expressed concern about the "brain drain" from countries that supply talented workers. If a country educates workers at the taxpayers' expense, does it not have a claim on their talent? There are also worries that the loss of skilled workers can hamper institutional development and drive up the cost of technical services. But such concerns must be weighed against the benefits of greater mobility.
There are not always opportunities for skilled individuals in their country of birth. The prospect of emigration can encourage the development of skills by individuals who may not in fact decide to emigrate. Workers who emigrate may send remittances back to their families at home, which can be a significant source of income and can help to alleviate poverty. And skilled workers may return to their home countries after a period working abroad, further stimulating knowledge transfer and improving the prospects for domestic growth, since they will maintain contacts with researchers overseas. As a result, argues a recent report from the OECD, it makes more sense to talk of a complex process of "brain circulation" rather than a one-way "brain drain". The movement of talent is not simply a zero-sum gain in which sending countries lose, and receiving countries benefit. Greater availability and mobility of talent opens up new possibilities and can benefit everyone.
Consider, for example, BioMedica Diagnostics of Windsor, Nova Scotia. The company makes medical diagnostic systems, some of them battery-operated, that can be used to provide health care in remote regions to people who would otherwise lack access to it. It was founded by Abdullah Kirumira, a Ugandan biochemist who moved to Canada in 1990 and became a professor at Acadia University. There he developed a rapid test for HIV in conjunction with one of his students, Hermes Chan (a native of Hong Kong who had moved to Canada to study). According to the United States Centers for Disease Control, around one-third of people tested for HIV do not return to get the result when it takes days or weeks to determine. Dr Kirumira and Dr Chan developed a new test that provides the result in three minutes, so that a diagnosis can be made on the spot. Dr Kirumira is a prolific inventor who went on to found several companies, and has been described as "the pioneer of Nova Scotia's biotechnology sector".
Today BioMedica makes a range of diagnostic products that are portable, affordable and robust, making them ideally suited for use in developing countries. They allow people to be rapidly screened for a range of conditions, including HIV, hepatitis, malaria, rubella, typhoid and cholera. The firm's customers include the World Health Organisation. Providing such tests to patients in the developing world is a personal mission of Dr Kirumira's, but it also makes sound business sense: the market for invitro diagnostics in the developing world is growing by over 25% a year, the company notes, compared with growth of only 5% a year in developed nations.
Moving to Canada gave Dr Kirumira research opportunities and access to venture funding that were not available in Uganda. His innovations now provide an affordable way for hospitals in his native continent of Africa to perform vital tests. A similar example is provided by mPedigree, a start-up that has developed a mobile-phone-based system that allows people to verify the authenticity of medicines. Counterfeit drugs are widespread in the developing world: they are estimated to account for 10-25% of all drugs sold, and over 80% in some countries. The World Health Organisation estimates that a fake vaccine for meningitis, distributed in Niger in 1995, killed over 2,500 people. mPedigree was established by Bright Simons, a Ghanaian social entrepreneur, in conjunction with Ashifi Gogo, a fellow Ghanaian. The two were more than just acquaintances having met at Secondary School. There are many high-tech authentication systems available in the developed world for drug packaging, involving radio-frequency identification (RFID) chips, DNA tags, and so forth.
The mPedigree system developed my Mr Gogo, an engineering student, is much cheaper and simpler and only requires the use of a mobile phone — an item that is now spreading more quickly in Africa than in any other region of the world. Once the drugs have been purchased, a panel on the label is scratched off to reveal a special code. The patient then sends this code, by text message, to a particular number. The code is looked up in a database and a message is sent back specifying whether the drugs are genuine. The system is free to use because the drug companies cover the cost of the text messages. It was launched in Ghana in 2007, and mPedigree's founders hope to extend it to all 48 sub-Saharan African countries within a decade, and to other parts of in the developing world.
The effort is being supported by Ghana's Food and Drug Board, and by local telecoms operators and drug manufacturers. Mr Gogo has now been admitted into a special progamme at Dartmouth College in the United States that develops entrepreneurial skills, in addition to technical skills, in engineers. Like Dr Kirumira, he is benefiting from opportunities that did not exist in his home country, and his country is benefiting too. This case of mPedigree shows that it is wrong to assume that the movement of talent is one-way (from poor to rich countries) and permanent. As it has become easier to travel and communications technology has improved, skilled workers have become more likely to spend brief spells in other countries that provide opportunities, rather than emigrating permanently.
And many entrepreneurs and innovators shuttle between two or more places — between Tel Aviv and Silicon Valley, for example, or Silicon Valley and Hsinchu in Taiwan — in a pattern of "circular" migration, in which it is no longer meaningful to distinguish between "sending" and "receiving" countries.
The benefits of a diaspora
Migration (whether temporary, permanent or circular) to a foreign country can be facilitated by the existence of a diaspora, since it can be easier to adjust to a new culture when you are surrounded by compatriots who have already done so. Some observers worry that diasporas make migration too easy, in the sense that they may encourage a larger number of talented individuals to leave their home country than would otherwise be the case, to the detriment of that country.
But as with the broader debate about migration, this turns out to be only part of the story. Diasporas can have a powerful positive effect in promoting innovation and benefiting the home country. Large American technology firms, for example, have set up research centres in India in part because they have been impressed by the calibre of the migrant Indian engineers they have employed in America. Diasporas also provide a channel for knowledge and skills to pass back to the home country.
James Nakagawa, a Canadian of Japanese origin and the founder of Mobile Healthcare, is a case in point. A third-generation immigrant, he grew up in Canada but decided in 1994 to move to Japan, where he worked for a number of technology firms and set up his own financial-services consultancy. In 2000 he had the idea that led him to found Mobile Healthcare, when a friend was diagnosed with diabetes and lamented that he found it difficult to determine which foods to eat, and which to avoid.
The rapid spread of advanced mobile phones in Japan, a world leader in mobile telecoms, prompted Mr Nakagawa to devise Lifewatcher, Mobile Healthcare's main product. It is a "disease selfmanagement system" used in conjunction with a doctor, based around a secure online database that can be accessed via a mobile phone. Patients record what medicines they are taking and what food they are eating, taking a picture of each meal. A database of common foodstuffs, including menu items from restaurants and fast-food chains, helps users work out what they can safely eat. Patients can also call up their medical records to follow the progress of key health indicators, such as blood sugar, blood pressure, cholesterol levels and calorie intake.
All of this information can also be accessed online by the patient's doctor or nutritionist. The system allows people with diabetes or obesity (both of which are rapidly becoming more prevalent in Japan and elsewhere) to take an active role in managing their conditions. Mr Nakagawa did three months of research in the United States and Canada while developing Lifewatcher, which was created with support from Apple (which helped with hardware and software), the Japanese Red Cross and Japan's Ministry of Health and Welfare (which provided full access to its nutritional database).
Japanese patients who are enrolled in the system have 70% of the cost covered by their health insurance. Mr Nakagawa is now working to introduce Lifewatcher in the United States and Canada, where obesity and diabetes are also becoming more widespread — along advanced mobile phones of the kind once only found in Japan. Mr Nakagawa's ability to move freely between Japanese and North American cultures, combining the telecoms expertise of the former with the entrepreneurial approach of the latter, has resulted in a system that can benefit both.
The story of Calvin Chin, the Chinese-American founder of Qifang, is similar. Mr Chin was born and educated in America, and worked in the financial services and technology industries for several years before moving to China. Expatriate Chinese who return to the country, enticed by opportunities in its fast-growing economy, are known as "returning turtles". Qifang is a "peer to peer" (P2P) lending site that enables students to borrow money to finance their education from other users of the site. P2P lending has been pioneered in other countries by sites such as Zopa and Prosper in other countries.
Such sites require would-be borrowers to provide a range of personal details about themselves to reassure lenders, and perform credit checks on them. Borrowers pay above-market rates, which is what attracts lenders. Qifang adds several twists to this formula. It is concentrating solely on student loans, which means that regulators are more likely to look favourably on the company's unusual business model. It allows payments to be made directly to educational institutions, to make sure the money goes to the right place. Qifang also requires borrowers to give their parents' names when taking out a loan, which increases the social pressure on them not to default, since that would cause the family to lose face.
Mr Chin has thus tuned an existing business model to take account of the cultural and regulatory environment in China, where P2P lending could be particularly attractive, given the relatively undeveloped state of China's financial-services market. In a sense, Qifang is just an updated, online version of the community group-lending schemes that are commonly used to finance education in China. The company's motto is that "everyone should be able to get an education, no matter their financial means".
Just as Mr Chin is trying to use knowledge acquired in the developed world to help people in his mother country of China, Sachin Duggal hopes his company, Nivio, will do something similar for people in India. Mr Duggal was born in Britain and is of Indian extraction. He worked in financial services, including a stint as a technologist at Deutsche Bank, before setting up Nivio, which essentially provides a PC desktop, personalised with a user's software and documents, that can be accessed from any web browser.
This approach makes it possible to centralise the management of PCs in a large company, and is already popular in the business world. But Mr Duggal hopes that it will also make computing more accessible to people who find the prospect of owning and managing their own PCs (and dealing with spam and viruses) too daunting, or simply cannot afford a PC at all. Nivio's software was developed in India, where Mr Duggal teamed up with Iqbal Gandham, the founder of Net4India, one of India's first internet service providers. Mr Duggal believes that the "virtual webtop" model could have great potential in extending access to computers to rural parts of India, and thus spreading the opportunities associated with the country's high-tech boom. A survey of the bosses of Indian software firms clearly shows how diasporas can promote innovation.
It found that those bosses who had lived abroad and returned to India made far more use of diaspora links upon their return than entrepreneurs who had never lived abroad, which gave them access to capital and skills in other countries. Diasporas can, in other words, help to ensure that "brain drain" does indeed turn into "brain gain", provided the government of the country in question puts appropriate policies in place to facilitate the movement of people, technology and capital.
Making the connection
Multinational companies can also play an important role in providing new opportunities for talented individuals, and facilitating the transfer of skills. In recent years many technology companies have set up large operations in India, for example, in order to benefit from the availability of talented engineers and the services provided by local companies. Is this simply exploitation of low-paid workers by Western companies?
The example of JiGrahak Mobility Solutions, a start-up based in Bangalore, illustrates why it is not. The company was founded by Sourabh Jain, an engineering graduate from the Delhi Institute of Technology. After completing his studies he went to work for the Indian research arm of Lucent Technologies, an American telecoms-equipment firm. This gave him a solid grounding in mobile-phone technology, which subsequently enabled him to set up JiGrahak, a company that provides a mobile-commerce service called Ngpay.
In India, where many people first experience the internet on a mobile phone, rather than a PC, and where mobile phones are far more widespread than PCs, there is much potential for phone-based shopping and payment services. Ngpay lets users buy tickets, pay bills and transfer money using their handsets. Such is its popularity that with months of its launch in 2008, Ngpay accounted for 4% of ticket sales at Fame, an Indian cinema chain.
The role of large companies in nurturing talented individuals, who then leave to set up their own companies, is widely understood in Silicon Valley. Start-ups are often founded by alumni from Sun, HP, Oracle and other big names. Rather than worrying that they could be raising their own future competitors, large companies understand that the resulting dynamic, innovative environment benefits everyone, as large firms spawn, compete with and acquire smaller ones.
As large firms establish outposts in developing countries, such catalysis of innovation is becoming more widespread. Companies with large numbers of employees and former employees spread around the world can function rather like a corporate diaspora, in short, providing another form of network along which skills and technology can diffuse. The network that has had the greatest impact on spreading ideas, promoting innovation and allowing potential partners to find out about each other's research is, of course, the internet. As access to the internet becomes more widespread, it can allow developing countries to link up more closely with developed countries, as the rise of India's software industry illustrates. But it can also promote links between developing countries.
The Cows to Kilowatts Partnership, based in Nigeria, provides an unusual example. It was founded by Joseph Adelagan, a Nigerian engineer, who was concerned about the impact on local rivers of effluent from the Bodija Market abattoir in Ibadan. As well as the polluting the water supply of several nearby villages, the effluent carried animal diseases that could be passed to humans. Dr Adelagan proposed setting up an effluent-treatment plant.
He discovered, however, that although treating the effluent would reduce water pollution, the process would produce carbon-dioxide and methane emissions that contribute to climate change. So he began to look for ways to capture these gases and make use of them. Researching the subject online, he found that a research institution in Thailand, the Centre for Waste Utilisation and Management at King Mongkut University of Technology Thonburi, had developed anaerobic reactors that could transform agro-industrial waste into biogas. He made contact with the Thai researchers, and together they developed a version of the technology
suitable for use in Nigeria that turns the abattoir waste into clean household cooking gas and organic fertiliser, thus reducing the need for expensive chemical fertiliser. The same approach could be applied across Africa, Dr Adelagan believes. The Cows to Kilowatts project illustrates the global nature of modern innovation, facilitated by the free movement of both ideas and people. Thanks to the internet, people in one part of the world can easily make contact with people trying to solve similar problems elsewhere.
Lessons learned
What policies should governments adopt in order to develop and attract innovation talent, encourage its movement and benefit from its circulation? At the most basic level, investment in education is vital. Perhaps surprisingly, however, Amar Bhidé of Columbia University suggests that promoting innovation does not mean pushing as many students as possible into technical subjects.
Although researchers and technologists provide the raw material for innovation, he points out, a crucial role in orchestrating innovation is also played by entrepreneurs who may not have a technical background. So it is important to promote a mixture of skills. A strong education system also has the potential to attract skilled foreign students, academics and researchers, and gives foreign companies an incentive to establish nearby research and development operations.
Many countries already offer research grants, scholarships and tax benefits to attract talented immigrants. In many cases immigration procedures are "fast tracked" for individuals working in science and technology. But there is still scope to remove barriers to the mobility of talent. Mobility of skilled workers increasingly involves short stays, rather than permanent moves, but this is not yet widely reflected in immigration policy. Removing barriers to short-term stays can increase "brain circulation" and promote diaspora links.
Another problem for many skilled workers is that their qualifications are not always recognised in other countries. Greater harmonisation of standards for qualifications is one way to tackle this problem; some countries also have formal systems to evaluate foreign qualifications and determine their local equivalents. Countries must also provide an open and flexible business environment to ensure that promising innovations can be brought to market. If market access or financial backing are not available, after all, today's global-trotting innovators increasingly have the option of going elsewhere.
The most important point is that the global competition for talent is not a zero-sum game in which some countries win, and others lose. As the Technology Pioneers described here demonstrate, the nature of innovation, and the global movement of talent and ideas, is far more complicated that the simplistic notion of a "talent war" between developed and developing nations would suggest. Innovation is a global activity, and granting the greatest possible freedom to innovators can help to ensure that the ideas they generate will benefit the greatest possible number of people.

Integrated Transformation: How rising customer expectations are turning com...
Modern customers have it good. Spoilt for choice and convenience, today’s empowered consumers have come to expect more from the businesses they interact with. This doesn’t just apply to their wanting a quality product at a fair price, but also tailored goods, swift and effective customer service across different channels, and a connected experience across their online shopping and in-store experience, with easy access to information they need when they want it.
Meeting these expectations is a significant challenge for organisations. For many, it requires restructuring long-standing operating models, re-engineering business processes and adopting a fundamental shift in mindset to put customer experience at the heart of business decision- making. Download our report to learn more.
Podcast | Vaccine development: A race to the finish line
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The world must devise a globally fair covid-19 vaccine allocation system
Vaccination is our best hope for stopping the coronavirus pandemic in its tracks. But producing safe, effective and globally accessible vaccines within the next 12 to 18 months is not only a scientific challenge: new levels of collaboration and investment across industry and government will be essential.
This pandemic is the biggest public health threat that humankind has faced in a century. It is wreaking havoc on societies and economies and it is an acid test for public-private partnerships. We need to move fast to unleash the funding required to develop vaccines.
Delivering covid-19 vaccines for the world—at record speed—will take a collective effort. We must combine the resources and expertise of academia and the private sector with the ability only governments have to mobilise the political will and amass the large sums of money that will be required.
No therapies to prevent or treat covid-19 are available, but research is advancing at a breakneck pace. The private and public sectors must now collaborate to ensure the best and fairest use of new products—wherever they come from—when they arrive.
In the case of vaccines, this means pursuing multiple approaches across both established and new technologies rather than trying to pick one or two “winners” prematurely since many candidate vaccines will inevitably fall by the wayside.
Given the threat posed by covid-19 we must regard vaccines as a global good: a shared resource that is deployed for the good of all irrespective of a country’s ability to pay. Given the global threat posed by covid-19 and the universal, simultaneous need for a vaccine, the world must devise a globally fair allocation system to ensure that healthcare workers and the most vulnerable segments of the world’s population get priority access.
Today, exceptional science is being done around the world. Researchers have been working around the clock to produce vaccine candidates ever since the genome of the new virus was sequenced in January 2020. The good news is this has yielded a flood of more than 90 promising candidates. Now this effort must be buttressed by large-scale public-sector assistance to optimise clinical trial procedures and scale-up manufacturing capacity—something that involves risky upfront investments before any product is approved.
The Oslo-based Coalition for Epidemic Preparedness Innovations (CEPI) provides a platform to deliver just this kind of private-public co-operation. The coalition was initially set up in 2017 after West Africa’s deadly Ebola epidemic to accelerate work on vaccines against emerging infectious diseases.
CEPI—a partnership of governments, industry and philanthropies—has a clear roadmap to accelerate covid-19 vaccine development at an estimated cost of US$2bn over the next 12-18 months. Financial support from the UK, Germany, Norway, Denmark and Finland has brought in around US$660m. Closing the remaining financing gap is imperative if we are to stay on track.
Vaccine development is complex and expensive. Rates of attrition are high. We need multiple candidates to ensure that we can produce safe and effective vaccines. My organisation estimates that a large part of the US$2bn will be needed by the middle of this year to develop eight vaccine candidates through initial phase 1 testing, prepare for phase 2/3 trials and to invest in manufacturing processes for up to six candidates.
Assuming one or more of these candidates succeeds, there will then be a huge global demand requiring unparalleled efforts to harness manufacturing capacity and distribution networks.
Last month, G20 leaders pledged to support the global effort against covid-19, including contributing to this vital vaccine work. The message could not be clearer: now is the time for governments and industry to join forces to fight back against this deadly disease.

Covid-19 population tracker: deaths from covid-19 and the ones we must not...
There has been a morbid fascination with the number of deaths associated with covid-19 and the extent to which countries are mishandling the crisis. But we are also facing a data crisis which distorts proper analysis of either.
Scientists are tinkering with models on the expected number of deaths based on incomplete data as not all countries apply the same covid-19 testing rules and not all deaths are accurately recorded. At the same time countries are still deliberating about who they should test, be it asymptomatic cases, only those with symptoms, those presenting to healthcare systems or healthcare workers.
Officials in the US have cast doubt on the numbers being reported by China, and not all countries have the resources to follow the WHO’s “test, test, test” advice. This is particularly true for economies with under-developed healthcare systems such as India, Africa and Latin America.
So with that cautionary note, we have tried to work with the data at hand—incomplete as it is—to map the number of confirmed cases of covid-19 against deaths per 100,000 population over time. While the absolute numbers of deaths are important to note because each loss of life is painful to loved ones, we should also look at death rates across populations to better understand the virus and to keep abreast of potentially effective containment measures. In developing countries cause of death information is often hard to obtain, mostly because systems for recording these details are inadequate or non-existent.
The bubbles represent absolute deaths in an individual country. You can eliminate regions from the timeline to see, for example, how Europe is faring against North America, or zoom in on the trajectory for an individual country. As of April 20th, death rates appear to be highest in Europe with Belgium reaching around 50 deaths per 100,000 population.
While people are still focused on covid-19 deaths, be prepared for a new type of death associated with covid-19 over time. These are deaths and morbidity that will arise as healthcare systems direct more and more resources to covid-19 and less and less to common diseases such as stroke and cancer. For developing countries, the common diseases affected will be tuberculosis, malaria and AIDS.
These “excess” deaths may also arise as people become more fearful of overloading healthcare systems or worried about catching the virus if they attend healthcare facilities including hospitals. There are also the deaths of older people living in residential care facilities or dying at home that are not being properly accounted for. If you have cancer and your treatment is delayed, that is a life and death situation for your overall prognosis. The same applies if treatment is delayed following the first signs of stroke. Patients living with chronic health conditions will see a significant change in the level of service and care received during this crisis, and the damage caused may take years to repair.
So while scientists study the data around covid-19, expect new data to emerge on how other diseases have been affected by this pandemic.