Strategic Pioneering in the Global Health Business

An April 2018 report by the US Researcher,  Business Insider Intelligence, states: “Digital health will take off in emerging markets, leapfrogging developed markets”

Mobile stethoscope

The idea of leapfrogging is linked to East Africa’s experience with mobile money and mobile telephony generally, where East Africans have moved from not having either bank accounts nor telephone lines, to conducting the majority of daily payment transactions using mobile phones. This innovation came about because of a confluence of different factors: 1. The extensive penetration of mobile phone usage, 2. The limited penetration of bank accounts, and 3. The increasing need to trade efficiently over distance.

The conditions for mobile health solutions in an East African country like Uganda, where I am based, are based on similar factors: 1. High mobile phone penetration once again,  2. Less legacy infrastructure in health compared to more developed countries, and 3. Greater urgency for health solutions in more remote locations,  which continue to experience a high although reducing disease burden.

The confluence of factors is often a driver of this kind of disruptive innovation. It gives businesses in Uganda an opportunity to become strategic pioneers in the global health business.  In the chapter on “Strategic Pioneering” in my book,  I refer to this idea of a confluence of factors as “Creative Juxtaposition”


“I believe what is happening is a phenomenon I call Creative Juxtaposition.  It’s the idea that entities with apparently very different or even opposite polarities come together to bring creative and often positive results.  Knowledge that comes from different sources, possibly referring to different subjects, combines to form great ideas – a breakthrough in new knowledge, a great strategy or even a new sense of victory.  So much great new positive creative stuff seems to come to us in this way.

My favourite  example of this comes from the world of mathematics – the heartland of formal risk theory. It is Pythgoras’ theorem: ‘ The square on the hypothenuse is equal to the sum of the squares on the other two sides’.  It was the basis of much mathematical geometry, extended into other trigonometry, and thence into a wide range of practical science applications: wave theory in electrical engineering, or Newtonian physics as applied to mechanical and structural engineering.

Pythagorus was a Greek philosopher and mathematician, who lived around 500 BC. We speculate that he learned about triangles and right angles in Egypt, where perfect right angles would have been important, for example, in the construction of the pyramids.  It would have been impossible to have constructed them without perfectly right-angled corner stones, as the resulting structure would not have been based on a perfect square as we witness today.  He would have learned in particular that something like a papyrus reed folded into 12 exact segments, could then be folded into a triangle of sides length 3 notches, 4 notches and 5 notches, and that this would form a perfect right-angle.

Quite separately, he learned of arithmetic from Phoenicia, in which he would have learned about the properties of numbers multiplied by themselves, squares.  And the curious idea that the squares of three sequential whole numbers, 3 , 4 and 5 are related by the equation: 3 squared added to 4 squared are equal in quantity to 5 squared.  He would have recalled his lessons on papyrus and pyramid construction, and noted that the numbers representing the sides of his right angled triangle could actually be related arithmetically.  Who was it that then, I wonder, who asked: “I wonder if you would find the same numerical relationship of side dimensions in all triangles with right angles”. And through this process of combining different disciplines of knowledge,  amazing new knowledge with wide reaching usefulness is born. We have the process of Creative Juxtaposition.

I see this idea of Creative Juxtaposition at the heart of all sorts of different forms of creativity.  The atoms of hydrogen gas and oxygen gas combine to form the most unlikely and miraculous of molecules, the water molecule.  Animals of different genders combine to create new life.  Animal and plant combine in pollenisation to create new plant life and food for animals.  There’s Gilbert & Sullivan, Morecambe & Wise, Flanders & Swan,  Marks & Spencer, Procter & Gamble. In Chinese tradtion, there is the idea in Yin and Yang, that contrasting concepts,  light and dark, sunny and shady, sun and moon, combine to create a whole picture.  This book explores a number of yin and yangs that combine to create something bigger than the sum of its parts:   risk and strategy, tiger and elephant, danger and opportunity.”