Category: Business/Economics Page 1 of 8

This Entrepreneur Is Changing the Way We Repair the Human Body

On January 28, 2025

In Biology, Biomedical Engineering, Business/Economics, Data, Engineering, Genetics/Genomics, Global Health

A long time ago in a galaxy far, far away… Or should I say, January 23 at the Rubenstein Arts Center…? That is where biomedical engineer Nina Tandon showed us the almost magical, yet extremely precise, science of EpiBone–where personalized bones and cartilage are grown from stem cells.

But first, it would be completely inappropriate of me to discuss Tandon’s revolutionary work without first sharing her stories from her childhood and adolescent years; that was one of the many aspects I admired about her talk–how much love Tandon shared for those who helped spark her passion for science.

First, there was her grandmother, Dadi Ma, who at a young age wanted to study math, but unfortunately, due to the time she grew up in, was pushed away from any STEM-related field. Tandon helped complete her Dadi Ma’s dreams to pursue a STEM education. And there were the late nights in the research library with her mother; Tandon told us how she would often use her class as a group to “test how people’s memories worked, and test our (Tandon’s) classmate’s depth perception.” Then, Tandon met Dr. Maria Musarella, who helped identify her brother’s retinitis pigmentosa. And while no cure for it at the time, Dr. Musareli told Tandon how there was a team at MIT working on it–to which Tandon thought, “Maybe I’ll join that team one day.”

Little did young Nina Tandon know just what she would do one day.

After going to school for electrical engineering, Tandon found herself working at a Bell Labs spin-off, where she learned one of the most important lessons of her life: One’s choice of job should always be “content secondary, people primary.” However, because of the new suburban area she found herself in post-9/11, Tandon felt isolated. But within this time of solace, she was able to connect the similarities between genes and data: “The axon conduction in a nerve–that’s a lot like those same equations that govern the transatlantic cable… cell membranes are 20 times higher capacitance than the best capacitors that we could build with our human hands.”

Through these observations, Tandon was able to conclude that “our bodies are the most exquisite technology we have ever been familiarized with.”

Photo credit: London College of Osteopathy

So she decided to apply to the team at MIT that Dr. Musarella had told her about years before, in which she was accepted and then joined. It was a full circle moment; Tandon was seeing herself living the dreams of the girl who would conduct experiments on her elementary school class. It should have been perfect, right?

“And I had made a mistake… I made a mistake.” She had not chosen people first and content secondary. However, as Tandon noted many times throughout her talk, it is her failures that showed her what it was she needed to do in order to succeed.

I found this aspect of the talk truly inspiring. Usually, when an extremely accomplished person talks to an eager room, they spend most of their time highlighting what they have done correctly. But here Tandon was, taking her time telling us all of the ways in which she had failed. And how those were the moments that led to her largest lessons learned. Although I can’t speak for everyone in that room, as a college student myself, there was a comfort in seeing such a successful, powerful, and kind woman telling us that we will fail… And showing us that that is the beauty in success.

So, to make an extremely long story short, Tandon then proceeded to join Robert Langer’s lab at MIT for five years, studying “how electrical signals could coax stem cells into becoming tissue,” work in a management consulting job at McKinsey & Company to learn more about entrepreneurship, and then attend Columbia for her EMBA and PhD (at the same time!). Phew, that’s a lot.

In 2014, Tandon co-founded EpiBone, in which she and her team began working in a candy factory-converted lab in Harlem. By starting with CT scans, EpiBone can make a “perfect puzzle piece-shaped biome material scaffold and a perfect puzzle piece bioreactor.” In other words, “an environment that simulated the natural conditions for tissue development.” Within two to four weeks, Tandon and her team can grow any cartilage, bone, and joints needed throughout the body.

Since starting her company, EpiBone has been able to grow jaw bones for six patients, which “fit perfectly and were integrated within four to six months.” This is just the beginning. EpiBone’s technology could change how we view medicine and treatment–giving patients a promise of more active lives instead of just a prescription of pain medicines.

However, as much of a miracle as this is, Tandon had to move her business’s location because of the restraining process of clinical trials within the United States, where the limited funding cannot match the necessary costs of clinical trials. Now in Abu Dhabi, Tandon has found a home for her and her family to live happily while also being in a place where she feels like EpiBone is finally starting to see a future where it can be implemented into medicine and used in patients.

Ending her talk, Tandon noted how she has learned to count her blessings, even in times when she felt like her work was not being appreciated for what it was. “It’s a shortcut for me because I’ve studied biology to be grateful… Oh my god, my heart just beat five times–that’s like a million miracles.”

Tandon has shown us that true success is not viewed from the top of the mountain, looking down at all that you have climbed, but instead, learning to appreciate and find joy in the trek to the top. I thank her, on behalf of all of the people at Duke and all who she will help in the future, for her revolutionary work in science and her honest words of inspiration.

By Sarah Pusser Class of 2028

From Immune Responses to Private Equity, New Series Offers “Research On Tap”

By Crystal Han

On October 28, 2024

In Biology, Business/Economics, Entrepreneurship, Global Health, Immunology

On every third Thursday of the month, Devil’s Krafthouse is host to Research on Tap: a series that gives Duke researchers, from undergraduates to postdoctoral fellows, the opportunity to present their work in a casual setting. It may seem odd for the procedures of academia to make their way into a space for socialization and entertainment, but this situation allows individuals to practice speaking publicly to a general audience under a short time limit–good conditions for developing their “research elevator pitch.” These were the pitches on October 17:

*As it’s name suggests, Cv is a bacterium violet in color. Photo courtesy of Dr. Edward Miao and Dr. Carissa Harvest.*

Jacqueline Trujillo, a Ph.D. student in the Department of Molecular Genetics and Microbiology, who is part of Dr. Edward Miao’s lab, presented her research on immune cell response to the bacterium Chromobacterium violaceum (Cv). Being an environmental pathogen, Cv usually resides in the soil of tropical and subtropical areas. While disease in humans is rare, the mortality rate is high in immunocompromised individuals.

“The Miao Lab was initially studying pyroptosis, a form of cell death that occurs during infection, when they discovered Cv-induced granulomas,” Trujillo said. Granulomas are specialized structures that are formed to contain and eradicate pathogens, but they can range in the arrangement and type of cells they consist of; one induced by tuberculosis infection, for example, would include adaptive immune cells like T and B cells. However, when the pathogen inducing them is Cv, only innate immune cells are present: neutrophils in the inner cluster and inflammatory macrophages in the outer cluster. When Cv is detected, neutrophils are the first to flock to the site of infection in a “toxic swarm.” The neutrophils themselves are typically able to effectively kill microbes even before granuloma formation. “These are one of the most toxic defending cell types in the immune system,” Trujillo said.

Despite this, the lab observed something unusual: these neutrophils failed to kill off the Cv bacteria, which continued to replicate despite the swarm. The lab ultimately saw Cv eliminated by the innate granulomas within about 21 days, but the ability to survive the neutrophils is what Trujillo now aims to understand. Such a feat from an environmental bacterium comes as a surprise, being “something more characteristic of the causative agent [Yersinia] of the bubonic plague,” Trujillo said. A comparison between the proteins CopH and YopH, virulence effectors in Cv and Yersinia respectively, reveals lots of similarities between the two. Trujillo hypothesizes that CopH is part of the secret to how Cv disarms the immune system’s defenses.

The role of virulence effectors is generally “aid[ing] in survival, invasion, and suppressing immune responses.” Through needle-like structures, bacteria inject these proteins into a host cell. A cell responds to this in two main ways. It dies–initiating pyroptosis to prevent the pathogen from replicating inside the cell. Second, it signals for help by making chemical messengers called inflammatory cytokines. Investigating the first response is what led the Miao Lab to Cv-induced granulomas.

Now, the lab is interested in understanding the regulatory signals that form the granuloma–and the role that inflammatory cytokines might play, if any. In addition to testing her hypothesis on CopH, Trujillo intends to determine if neutrophils respond to Cv’s initial survival by producing the cytokine IL-18, thus recruiting immune cells to the infection site. This would help the Miao Lab confirm their idea that the neutrophils’ failure to clear Cv is what prompts the process of granuloma formation.

With much still unknown in the area of granuloma biology, Cv provides an “excellent model for studying immune cell biology and characterizing bacterial virulence effectors,” Trujillo said.

Though it happens that many Research On Tap speakers are in the sciences, the program isn’t discipline-specific. Our second researcher of the evening, Sungil Kim, studies a far different field from Jacqueline.

As a Ph.D. student in Finance at the Fuqua School of Business, Kim is looking at the effects of a growing trend in recent years: private equity (PE) firms acquiring healthcare companies. His focus is on what’s known as the “buy-and-build”, as this business strategy is often used by such firms entering the healthcare sector. The scenario typically looks like this: a private equity firm first acquires a large existing company, called the platform company or “first deal.” They’ll then acquire several smaller companies, or “add-on deals,” in order to expand the platform company’s operations.

Since private equity firms buy businesses with the eventual goal of selling them at a profit, their primary focus is increasing efficiency to reduce costs. On one hand, these buyouts might be seen as beneficial for languishing businesses in need of operation enhancements. But within the healthcare sector, many worry the resultant cost-cutting will lead to declining standards of care for patients.

Kim set out to investigate if operational improvements are sustainable across multiple acquisitions within the buy-and-build framework. The simple answer? No.

Kim confirmed that, on average, private equity firms improve the operational performance of hospitals without hurting quality, “a finding that agrees with some of the previous literature.” Yet, one only needs to take a closer look into the sequence of deals to uncover a different, more complicated story.

To arrive at his answer, Kim considered three main factors–operational efficiency, profitability and quality–in both the platform company and add-on companies. Platforms, or first acquisitions, did see success in performance, but this came with what appears to be a trade-off, as the first two factors increased while quality went down. As in, quality of healthcare. From one of Kim’s graphs, it was apparent that occurrences of four of the six health outcomes measured, including mortality and remission of heart failure, increased in such first deal situations.

Meanwhile, results for the add-ons changed little before and after the buyout, meaning that the initial success from the platform didn’t carry over to later acquisitions, even as reduced costs did. A potential reason for this inability to replicate success, Kim explained, is that these cost savings may come from reducing the number of patients and services, instead of truly improving the efficiency of operations.

In contrast to academic journals that display research that’s been in the works for years, Research on Tap brings us closer to working papers in their ongoing, exploratory stages. While it’s difficult to draw wider conclusions from Kim’s findings just yet, and important to remember the specific first deal context of this study, research like his helps us further understand the issues facing improvement of our healthcare system and where private equity plays a role.

If you’re interested in learning something new and free Krafthouse bites, swing by and attend a session–the next one occurs on November 21, 2024 at 5 p.m. The program welcomes prospective speakers to place themselves on the waitlist for a spot.

Soldier to Philanthropist: Abraham George’s Lasting Legacy at Shanti Bhavan

By Noor Nazir

On January 31, 2024

In Business/Economics, Entrepreneurship, Lecture

From his time in the Indian military to his journey to the NYU Stern School of Business to making his mark in India through his social work, Abraham George seems to be, and indeed is, a jack of all trades. He is the founder and principal of Shanti Bhavan, a school for students born into India’s lowest socioeconomic class.

“The last 29 years since I founded Shanti Bhavan, it has been the most rewarding and satisfying part of my life – I’ve done a lot of stuff, but nothing compares to what I’ve done with this,” George said. “The satisfaction comes from the fact that the children we have worked with are able to acquire jobs in Amazon and study in schools like Duke – one of them is here!” His words were infused with unmistakable passion. The crowd cheered the former student. We experienced a collective shiver down our spines; the fruit of George’s work was right in front of us – undeniable and beautiful.

The story of his life’s work was made into a Netflix documentary called “Daughters of Destiny.” Created and produced by Vanessa Roh, it featured the lives of students at the boarding school George founded. During his talk, we saw an ABC news segment called “Shanti Bhavan: haven of peace”.

After hearing the inspirations and motivations behind the creation of this boarding school, the designation of it being a ‘haven of peace’ is irrefutable.

George didn’t start in philanthropy. As an 18-year-old he found himself in the Indian military; he was posted near Tibet (in the Salem pass) where his job was to establish gun positions in case China invaded the country, India. In subzero temperatures, he lived through it for eleven months. During his time there, he read a quote ‘there is nothing right about war, it is about who is left’.

And so, George began asking himself questions: Why was he ready to take people’s lives? What was he truly doing with his life? And what would life be like in service of others?

He embarked on a newfound journey: to create a safe space where religion, caste or class does not matter. Today, Shanti Bhavan serves as a school for all – where students are not called ‘students’ but rather ‘children’.

A crucial question still stands: does the success of Shanti Bhavan prove the effectiveness of all charitable projects? When asked, George was quick to point out the fact that without money, there is no success. Consequently, his first goal was to earn, and second was to fund. Perhaps then all charitable causes could be effective if one has funding? It’s difficult to have a concrete answer, but it goes without saying that if it is true, George’s work serves as evidence.

George moved on from the life of a solider, to pursue education in the hopes of reaching a place where he could benefit others. “Think of a world only a heart can build and never ask why” – a memorable quote from a true benevolent force, akin to angelic presence.

Liam Frumkin and AHAV: Improving Lives Through Simple Snacks

By Emily Zou

On December 13, 2023

In Behavior/Psychology, Business/Economics, Entrepreneurship, Students

We’re all familiar with the quintessential elementary school bake sale: hand-drawn posters, homemade treats, and shockingly high price tags, all in the name of charity. However, for Duke sophomore Liam Frumkin, his Few Quad bake sale resulted in a potential Shark Tank Product.

Liam Frumkin, Trinity '26 — Liam Frumkin, Trinity ’26

Frumkin is a 20 year old economics major who recently got back from a gap year developing AHAV, a snack company specializing in healthy treats. AHAV, which means “to love” in Hebrew, has a mission statement “To Improve Lives Through Simple Snacks and Simple Ingredients!” Through selling healthy cookie dough bites and donating a portion of the proceeds to the National Eating Disorders Association (NEDA) and No Kid Hungry, Frumkin has been able to turn his bake sale into an amazing entrepreneurial venture.

Frumkin’s story started seven years ago when he began to develop an eating disorder. Throughout his freshman and sophomore years of high school, Frumkin remembers losing unhealthy amounts of weight through constant exercise and eating very little. At grocery stores, he was overwhelmed by ingredient lists and nutritional contents of the snacks lining the aisles.

His eating disorder came to its peak during his junior year, when he was hospitalized and began professional treatment for his eating disorder. Throughout treatment, Frumkin began to cook more in order to create snacks that both satisfied his cravings, and felt comfortable and safe to eat. At first, he says, Frumkin was doing this “just for [him]self”.

When Frumkin arrived at Duke in August of 2021, he continued cooking in his dorm kitchens. Intrigued, his dorm-mates and friends would stop by to inquire and try Frumkin’s creations. Frumkin said he received stellar feedback about the nutritional value and deliciousness of his treats (I can confirm, having tried AHAV chocolate chip cookie dough bites, that they are, in fact, delicious). Because of his obsession with Shark Tank (I’m sure we can all relate), Frumkin began looking into how to capitalize on his passion of creating nutritional snacks.

Liam and his very first batch of cookie dough bites.

And so, Frumkin began to hold bake sales in front of Few Quad on West Campus, selling ziploc bags of his homemade treats. Within a couple of months, he had made thousands of dollars, far surpassing my elementary school bake sales. When the Duke Administration caught wind of Frumkin’s bake sales, they informed him that the sale of foods without a license were illegal and encouraged him to find a professional kitchen.

Frumkin agreed with Duke and began searching for a professional kitchen, eventually finding a Duke alumnus who had started their own food business through an accelerator program called Union Kitchen. Union Kitchen accepts eight people a year and in exchange for 10% equity, allows access to kitchens, resources, and connections.

Frumkin applied to the program with zero expectations, not even telling his parents about his plans. However, after receiving the good news, his parents were nothing but supportive.

Liam and his parents in the AHAV kitchen.

With nothing but a few suitcases and ziploc bags of cookie dough bites, Frumkin began his semester off, moved to Washington D.C., and started work on AHAV.

Pretty soon, a gap semester turned into a gap year, and Frumkin launched AHAV on January 1, 2023. At the time of the launch, Frumkin had already partnered with local retail stores to sell AHAV products in-store. When I talked with Frumkin, he expressed immense appreciation for Union Kitchen’s connections and their help getting his company off the ground.

Liam and the first bag of AHAV ever produced.

Frumkin turned to TikTok and Instagram to share his own journey with his eating disorder and to market AHAV, receiving resounding support from his followers, who resonated with both Frumkin’s story and AHAV’s mission. AHAV has more than 120,000 followers across various social media platforms and a team of six full-time employees based out of Washington D.C.

From applying for Shark Tank, to grocery stores like Trader Joe’s and Whole Foods, AHAV clearly has a bright future. AHAV has also donated over 120,000 meals to kids in need and helped over 6,000 kids get treatment for their eating disorders. Frumkin’s philanthropy has really lived up to AHAV’s meaning of “to love” and the heart-based logo.

During his time-off, Frumkin found himself struggling with loneliness, having no consistent interactions with students his own age. Since he’s been back, Frumkin says he’s still searching for that perfect work-life-school balance. Despite this, he still says it is hands-down the smartest decision he’s ever made, which he largely credits to Duke’s support. During his time-off, Frumkin said Time Away From Duke was extremely supportive and accommodating. Since being back on campus, he’s reached out to the Innovation & Entrepreneurship Office and connected with fellow Duke students who are eager to help with video editing, marketing, etc. Frumkin also found support from Duke’s extensive alumni network, which he met through the pre-orientation group Project Edge, as well as the Duke in Silicon Valley program.

Frumkin says that as a freshman, he still continued to struggle with disordered eating. He frequently met with a nutritionist from Duke Student Health, who he says was very helpful, specifically around his obsession with nutrients and ingredients. Frumkin stressed that students with eating disorders can fight their battles together. He says one of the most rewarding parts of starting AHAV has been sharing his journey and helping other people realize that they’re not alone.

By Emily Zou, Class of 2027

Capital, Canaries, or Catalysts: Insurance Industry’s Role in Climate

By Samera Eusufzai

On December 1, 2023

In Animals, Business/Economics, Climate/Global Change, Environment/Sustainability

*Mining foreman R. Thornburg shows a small cage with a canary used for testing carbon monoxide gas in 1928. Credit: George McCaa, U.S. Bureau of Mines*

Throughout the 19th and 20th centuries, canaries were used in coal mines to assess the risk of toxic gasses. If the birds became ill or passed away, their fate served as a warning for miners to vacate the premises.

Similarly to how a canary detects unseen risks, the insurance industry is responsible for matching assets to liabilities based upon risks, according to Francis Bouchard, the managing director for climate at the insurance company Marsh McLennan. Bouchard spoke at Duke University on November 10 to discuss the insurance sector’s responsibility to tackle risks as a result of climate change.

During a one-year residency that begins in January, Bouchard will explore ways in which the insurance sector can incentivize and support advances in management of climate risks by helping Duke to build new research partnerships and networks with the insurance and other affected sectors.

Historically, the insurance industry has served as a catalyst to influence safety regulations for the welfare of citizens, as opposed to a canary that withers under risks. Take, for instance, the World Columbian Exposition in Chicago in 1893. It was the first time in history “anyone would deploy electricity on a large level,” Bouchard said. Therefore, an insurance company sent an engineer to examine the security of the electricity and determine the hazards for attendees. Consequently, the brightest minds of this sector banded together to create the Underwriters Laboratories, which is now the largest testing laboratory in the United States.

But more recently, the insurance sector has not acted as a catalyst in its role to address climate risk. Several policies and systems “distort the purity of the risk signals insurance companies send.” Firstly, its inability to combat systemic level risks as they are providing individual incentives. The industry is highly effective in “handling individual risk and incentivizing immediate actions to address an immediate risk,” Bouchard said, but this method cannot translate on a systemic level.

Secondly, the insurance sector provides a “temporal mismatch” as they sell 12 months of risk, but the lasting impacts of climate change will not occur within a year. Therefore, their “ability to capture in a 12 month policy, decades worth of climate change risk is impossible.”

Thirdly, the regulations for insurance differ between states. In most states, the insurance commissioner dictates the price of insurance based upon the company’s risk assessment because when “risk goes up, price of risk also goes up.” When citizens cannot afford insurance, commissioners are more likely to side with the experts of the insurance companies as opposed to their disadvantaged constituents.

Finally, their climate model is not advanced enough to estimate how specific cities will change within a few decades due to climate change. Therefore, it cannot entirely predict its risks either.

You can watch Bouchard’s talk, with slides, on YouTube

The insurance industry has been successful in its asset-liability matching “in committing some of its capital to advancing climate technology or green technology.” However, this sector receives “publicity around insurance companies withdrawing capital from wildfire or climate exposed jurisdiction.”

This system is explained by the TCFD Filing, which was created by the Bank of International Settlements to discover insurance companies exposure to climate transition issues, physical risks from climate change, and their strategy to aid clients. Essentially, most insurance companies are not “concerned about physical risks” as they would simply reprice their 12-month insurance policy if there is a heightened threat to physical risk. According to Bouchard, the “insurance industry has already signaled through its TCFD filings precisely what their strategy is: ‘we’re gonna play this game as long as we can and then we’re going to withdraw.’” Therefore, an insurance company would continue to increase their cost until a person can no longer afford its price or actually endures physical damage to which they would cease providing insurance. “These last resort-type mechanisms are when the government steps in,” Bouchard said. He even estimates that the government will control 30% of this $1 trillion industry ($2 trillion globally) within ten years. This is dangerous as the government is already enduring fiscal dilemmas and will not be equipped to manage the complexity of the sector.

Bouchard, with 30 years of experience in this industry, said he “truly, truly believes in the social role that the industry plays. I’m petrified that we’re not going to be there to help society cope with climate with the technical knowledge we have, the expertise we have, the mechanisms we have, and the money.” If the sector continues upon this path, they will dissolve under the risks, similarly to a canary in a mine.

Francis Bouchard’s work in combating climate battles with insurance is of the utmost necessity. Continued global warming will force citizens to rely on this industry for aid against climate disasters. The most recent Conference of Parties, created by the United Nations for climate change discussions, recognized the insurance industry as a “key finance player in climate transition alongside private industry and government because the world is recognizing that we have a key part to play.”

By Samera Eusufzai, Class of 2026

How to be a Global Inventor

By Olivia Ares

On November 29, 2023

In Biomedical Engineering, Business/Economics, Climate/Global Change, Engineering, Entrepreneurship, Faculty, Global Health

Gadgets, devices, doo-dads, oh my! The Duke Global Health Institute (DGHI) recently hosted three of its members to lead a panel on creating medical devices for low- and middle-income countries. The event was called “Global Medical Device Innovation: Three Models for Creation and Commercialization.”

Each sought to decrease costs and increase scalability for medical procedures. In short, they are expert inventors who are doing good in the world.

*Two of the most prominent inventors of our era. Image courtesy of Disney.*

We’ll go step-by-step in a moment, but to start you on your journey to being just like our panelists, here’s a short glossary:

Standard-of-care: a public health term for the way things are usually done.

IRB: institutional review board, a group of people, usually based in universities, that protect human subjects in research studies.

Screening: when doctors look at signs your body might show to determine
whether you need to be tested for certain conditions.

Supply-chain: the movement of materials your product goes through before, during, and after manufacturing. It is a general term for a group of different suppliers, factories, vendors, advertisers, researchers, and others that work separately.

Regulatory pathways: supply-chain for government approvals and other paperwork you need to have before introducing your product to the public.

Step 1: Meet your Mentors

Walter Lee is Chief of Staff of the Department of Head and Neck Surgery & Communication Sciences, Co-Director of the Head and Neck Program, and an affiliate faculty member at the Duke Global Health Institute. He presented ENlyT (pronounced like en-light), a newfangled nasopharyngoscope – a camera that goes down your nose and down your throat to screen for cancer. He wants to expand with partners in Vietnam and Singapore.

Marlee Kreiger helped found the Center for Global Women’s Health Technologies at Duke in 2007. Since then, she has led the Center in many interdisciplinary and international ventures. In fact, the Center for Global Women’s Health Technologies spans both the Pratt School of Engineering and the Trinity College of Arts and Sciences. She presented on the Callascope, a pocket-sized colposcope – a camera device for cervical cancer screening.

Julias Mugaga will soon be a visiting scholar at Duke – until then, he heads Design Cube at Makerere University in Uganda. He presented his KeyScope, a plug-and-play surgical camera with 0.3% of the cost of standard-of-care cameras.

Step 2: Name your Audience

DGHI has “global” in the name, so it is no surprise that these presenters serve communities around the world. Perhaps something that inventors like Dr. Doofenshmirtz often get wrong is that new innovation should come at the benefit of underserved communities, not at the cost of them. For Lee, that focus would be in his collaborations in Vietnam; for Mugaga it was his community in Uganda; and for Kreiger, it was the many studies conducted in Zambia, Tanzania, Kenya, Costa Rica, Honduras, and India.

Each of the presenters could agree that the main strategy is simple: find partners. Community members on the ground. Organizations that can benefit from your presence.

*Another prominent–albeit villainous–inventor, Dr. Doofenshmirtz. Image courtesy of Disney.*

Another notable aspect of your audience will be the certification you vie for. Depending on your location, you may need different permissions to distribute your product, or even begin on the journey to secure funding from certain sources.

In the United States, the most relevant regulatory pathway is FDA clearance, which is notably less restrictive than the CE mark distributed in the European Union. Both certifications are accepted in other countries, but many of the inventors on the panel opted to secure a CE mark to potentially appeal to a wider variety of governments around the world.

ISO is an international organization that is also necessary for certification, particularly if you are looking to test a medical product. No reason to be dragged down by the paperwork, though! When asked about securing Ugandan product certification, Mugaga declared, “This is one of the most exciting journeys I have taken.” His path to clearance was even more wrought with uncertainty – without steady sources of material in the Ugandan economy, it is harder to earn FDA or CE approval, two of the most widely-acknowledged certifications in the world.

Step 3: Test

Now that you have permission, you can start changing lives. Many participants in our panelists’ studies were patients in community health clinics across the globe. Their partners in these clinics also had the opportunity to save tens to hundreds of thousands of dollars in equipment. While it seems like a no-brainer, there are ethical concerns that need to be addressed first. For that, you need to fill out…. You guessed it: more paperwork. IRB approval is usually granted by educational institutions (as you should recall from my handy glossary), and is crucial to secure before any testing with humans is started. In fact, the government (and most private investors) won’t even give you a second glance if you ask them for money without IRB approval.

One big hurdle many of the panelists noted was a distrust of the technology and institution it came from – a foreign entity testing their products on you does not always invoke fear, but it certainly does not always promote trust. Kreiger noted that the work of their community health partners does the heavy lifting on that front; not only are they known community pillars, but they have authority to promote health technology through their existing relationships. If you run into trouble identifying partners in your inventorship journey–never fear. Lee has a message for you: “Ask around. At Duke, there’s always an expert around who’s willing to lend you their time.”

Step 4: Distribute

Now that you are an expert, your invention works, and you’re saving lives, you can attempt to cement your design as standard-of-care. This may look different depending on where in the world you want to distribute, but the next step is to contract a large-scale manufacturer. Your materials have been sourced by now (FDA says they better be) — so finding someone to put them together at an industrial scale should be easy! Your cost may fluctuate at this scale with the increased labor costs, but bulk production and distribution altogether should provide you, your institution, and your clients the best possible chance at changing the world.

Lee did not receive NIH funding until his fourth attempt at applying. Kreiger did not settle on the first manufacturer contracted. Mugaga is still in the process of securing a CE mark. And yet, all of them are success stories. You can see the ENlyT saving lives in hospitals in Vietnam; you can track the reallocation of $18,000 in savings from purchasing a Calloscope; and if you’re lucky, you’ll catch Mulgaga on campus next year as a visiting scholar at Duke!

Post by Olivia Ares, Class of 2025

Blue is The New Color of Sustainable Investing

By Guest Post

On October 5, 2023

In Business/Economics, Climate/Global Change, Oceans

The green bond market’s remarkable success, currently valued at over US $500 billion[i], shows how bond finance is an effective way to raise substantial capital for climate-related investments. Following on this success, blue bonds are emerging as the newest trend in sustainability investing and they’re poised to make waves.

Introduced in 2008, green bonds commit to using the funds they raise exclusively for environmentally friendly projects, assets, or business activities[ii]. Since then, the green bond market has seen explosive growth and helped to shape investor attitudes toward sustainable investing.

The blue bond market — blue as in oceans — is where green bonds were 15 years ago[iii]. Blue bonds are a relatively new type of sustainability designed to finance the conservation and sustainable management of ocean and coastal resources[iv].

The Republic of Seychelles issued the first blue bond in 2018, with funds dedicated to expanding Marine Protected Areas (MPAs) and improving fisheries governance[v]. To date, only 25 other blue bonds have been issued[vi]. Although in its infancy in comparison to green bonds, the blue bond market is poised to follow a similar trajectory as governments, companies, and investors begin to realize the importance of the blue economy and the relationship between climate change and our oceans[vii].

The Ocean’s Big Role

The ocean covers 70% of the Earth’s surface, comprises 97% of all water on earth, and contains 99% of all living space on the planet[viii]. It plays a vital role in absorbing carbon dioxide and producing the oxygen we breathe, it is a significant component of the global economy, and a key element in fighting climate change. However, governments and organizations around the world continue to abuse the ocean rather than protect it. But with over three billion people reliant on a healthy ocean for their livelihoods, and more than 350 million ocean-related jobs, continued exploitation of our oceans will have catastrophic consequences[ix].

Commitments without Capital

The past few years have seen numerous commitments to restoring and protecting the long-term health our oceans. The United Nations declared 2021-2030 as “The Ocean Decade” and the 30×30 campaign pledges to protect at least 30% of the ocean by 2030[x]. Despite these commitments, the ocean remains chronically underfunded. Sustainable Development Goal (SDG) 14 “Life Under Water” receives the least amount of long-term funding of any of the SDGs. Recent reports suggest that $175 billion per year is needed to achieve SDG 14 by 2030; and yet, between 2015 and 2019, just below USD $10 billion was invested.[xi]

Source: https://icg.citi.com/icghome/what-we-think/citigps/insights/sustainable-ocean-economy

Not only does this gap prevent any meaningful progress, the cost of inaction is devastating. Failing to invest in our oceans could result in a total bill of USD $200 billion to $1 trillion a year by 2100 in loss of land, people relocation, and coastal protection[xii]. To put it simply, we cannot afford to underinvest in our oceans.

Mobilizing Capital Through Blue Bonds

Current ocean funding comes primarily through public and philanthropic sources, which are essential, however incredibly insufficient. Enabling the increased use of private finance is critical to achieving ocean conservation goals, and the use of blue bonds can play an essential role.

Bonds are a debt instrument that facilitates an interaction between a borrower and an investor. The investor provides capital to the borrower, and the borrower is required to pay back that capital within a certain period. In the case of blue bonds, the borrower is also required to use the capital to create positive impact on the marine environment. Such an arrangement enables the borrower to access significant amounts of capital upfront and provides the investor with a predictable income stream. This relationship is of particular use within the climate landscape. Green and blue bonds effectively unlock additional sources of capital for climate-related investments and enable private investors to participate in markets that would otherwise be considered too risky.

Source: https://enviroaccounting.com/green-bonds-and-pay-for-performance/

Successful Green Bonds as a Blueprint

To enable the rapid and responsible scaling of the blue bond market, we can leverage existing frameworks from green bonds as models. The green bond market has seen numerous innovative bond structures that support investment in traditionally underserved markets and align financial incentives with sustainability-focused outcomes. Three of these innovative bond issuances are outlined below and offer unique opportunities to apply similar structures to the blue bond market.

Blue is the New Green: A deep dive into three green bond structures and how they can turn blue

The Wildlife Conservation Bond

In 2022, The World Bank and Global Environment Facility issued a first-of-its-kind Wildlife Conservation Bond (WCB) which channels investment into conservation outcomes. This five-year $150 million bond contributes to protecting and increasing black rhino populations in two protected areas in South Africa[xiii]. The WCB is a great example of an innovative green bond that unlocked new financing streams for biodiversity protection and conservation initiatives.

Using the Wildlife Conservation Bond as a model, we can replicate this template across new geographies and species and transform how conservation is funded. Investors in the WCB do not receive coupon payments. Instead, the issuer makes conservation investment payments to help fund rhino conservation initiatives. In a similar manner, blue bonds can be created that enable coupon payments to be channeled to protect critical marine species.

Uruguay’s Sustainability-Linked Bond

In 2022, Uruguay issued a USD $1.5 billion sustainability-linked bond which includes a pricing feature designed to reward progress made on emissions-reduction targets. Coupon payments received by investors would decrease if the Uruguay government met pre-determined emissions targets, but if targets were missed there was a required increase in payment[xiv]. This arrangement aligned financial and environmental incentives and offered a signal to borrowers that more affordable finance is available in return for performing – or exceeding – sustainability strategies[xv].

Similar financing structures could be applied across a range of sustainability goals within the ocean landscape. Rather than reward progress on emissions reductions, blue bonds could be structured to offer favorable financing for biodiversity, establishing marine protected areas (MPA ) reducing plastic pollution, or fisheries management.

The Forests Bond

The Forests Bond was issued by the International Finance Corporation in 2016 to help unlock private finance for reducing deforestation. Investors in the USD $152 million Forests Bond could choose to receive coupons in the form of verified carbon credits, rather than cash payments[xvi]. This arrangement helped to boost demand for carbon credits and demonstrated investor interest in sustainability-focused investments.

The Forests Bond model can be repeated to support conservation of blue carbon ecosystems such as mangroves, salt marshes, and seagrasses. Blue carbon ecosystems sequester two to four times the amount of carbon of terrestrial forests, however, it is estimated that these ecosystems are being destroyed at four times the rate of tropical forests[xvii]. Designing a bond to act as a catalyst for the blue carbon market could offer the critical incentives needed to protect these essential environments.

Building the Blue Bond Wave

In all three of the above cases, investor demand for the green bond far exceeded initial expectations or the planned bond offering. This indicates that there is high investor interest for innovative bond models that provide both positive financial and climate returns. The main challenge is then providing investors with enough attractive opportunities to participate. With just 25 blue bonds issued to date, the blue bond market is nascent. Establishing a robust blue bond market requires transparency, standardization, and accountability. Clear Key Performance Indicators (KPIs) must be developed to demonstrate the tangible benefits of blue bond investments in terms of ocean conservation and sustainable resource management. Additionally, collaboration between governments, financial institutions, and environmental organizations is essential to create a supportive ecosystem that encourages blue bond issuance. Ultimately, the future of the blue bond market hinges on aligning financial incentives with environmental objectives, fostering innovation, and building a robust infrastructure that inspires trust and commitment from a diverse set of stakeholders[xviii].

Guest Post by Mackenzie Audino, 2024 Masters candidate in business administration and environmental management. This project was completed as part of the ClimateCap Fellowship, a program of the ClimateCap Initiative led by Duke University’s Fuqua School of Business and supported by the Hearst Foundations.

[i] https://www.sciencedirect.com/science/article/pii/S0308597X22002664#bib26

[ii] https://www.oecd.org/environment/cc/Green%20bonds%20PP%20%5Bf3%5D%20%5Blr%5D.pdf

[iii] https://unglobalcompact.org/take-action/ocean/communication/blue-bonds-accelerating-sustainable-ocean-business

[iv] https://www.undp.org/indonesia/blog/indonesia-launches-worlds-first-publicly-offered-sovereign-blue-bond-undps-support

[v] https://www.worldbank.org/en/news/press-release/2018/10/29/seychelles-launches-worlds-first-sovereign-blue-bond

[vi] https://www.mdpi.com/1911-8074/16/3/184

[vii] https://www.wellington.com/en-gb/intermediary/insights/blue-bonds-marine-ecosystem

[viii] https://oceanliteracy.unesco.org/our-blue-planet/

[ix] https://www2.deloitte.com/content/dam/Deloitte/uk/Documents/risk/ocean-financing.pdf

[x] https://marine-conservation.org/30×30/

[xi] https://www.weforum.org/whitepapers/sdg14-financing-landscape-scan-tracking-funds-to-realize-sustainable-outcomes-for-the-ocean/

[xii] https://www.nature.com/articles/s41467-021-23168-y

[xiii] https://www.worldbank.org/en/news/press-release/2022/03/23/wildlife-conservation-bond-boosts-south-africa-s-efforts-to-protect-black-rhinos-and-support-local-communities

[xiv] https://www.reuters.com/markets/rates-bonds/bank-floats-10-bln-brazilian-bond-plan-halt-amazon-deforestation-2022-12-19/

[xv] https://www.ifre.com/story/3661444/latin-america-bond-uruguays-us15bn-sustainability-linked-bond-wh65f7xrlp

[xvi] https://www.conservation.org/docs/default-source/peru/forests-bond_factsheet.pdf?Status=Master&sfvrsn=867eadb8_3

[xvii] https://siwi.org/latest/what-are-we-getting-wrong-about-blue-carbon/

[xviii] OpenAI. “The future of the blue bond market and what needs to happen to increase the amount of capital that is invested.” ChatGPT, 2023, [https://chat.openai.com/c/ba58a2d7-1129-465c-9fa5-f4815f08aa91]. Accessed [September 27, 2023]

My Face Belongs to The Hive (and Yours Does Too)

By Victoria Wilson

On October 4, 2023

In Artificial Intelligence, Business/Economics, Computers/Technology, Policy, Responsible Conduct

Imagine having an app that could identify almost anyone using only a photograph of their face. For example, you could take a photograph of a stranger in a dimly lit restaurant and know within seconds who they are.

This technology exists, and Kashmir Hill has reported on several companies that offer these services.

An investigative journalist with the New York Times, Hill visited Duke Law Sept. 27 to talk about her new book, Your Face Belongs To Us.

The book is about a company that developed powerful facial recognition technology based on images harnessed from our social media profiles. To learn more about Clearview AI, the unlikely duo who were behind it, and how they sold it to law enforcement, I highly recommend reading this book.

Hill demonstrated for me a facial recognition app that provides subscribers with up to 25 face searches a day. She offered to let me see how well it worked.

*Screen shot of the search app with Hill’s quick photo of me.*

She snapped a quick photo of my face in dim lighting. Within seconds (3.07 to be exact), several photos of my face appeared on her phone.

The first result (top left) is unsurprising. It’s the headshot I use for the articles I write on the Duke Research Blog. The second result (top right) is a photo of me at my alma mater in 2017, where I presented at a research conference. The school published an article about the event, and I remember the photographer coming around to take photos. I was able to easily figure out exactly where on the internet both results had been pulled from.

The third result (second row, left) unsettled me. I had never seen this photo before.

*A photo of me sitting between friends. Their faces have been blurred out.*

After a quick search of the watermark on the photo (which has been blurred for safety), I discovered that the photograph was from an event I attended several years ago. Apparently, the venue had used the image for marketing on their website. Using these facial recognition results, I was able to easily find out the exact location of the event, its date, and who I had gone with.

What is Facial Recognition Technology?

Researchers have been trying for decades to produce a technology that could accurately identify human faces. The invention of neural network artificial intelligence has made it possible for computer algorithms to do this with increasing accuracy and speed. However, this technology requires large sets of data, in this case, hundreds of thousands of examples of human faces, to work.

Just think about how many photos of you exist online. There are the photos that you have taken and shared or that your friends and family have taken of you. Then there are photos that you’re unaware that you’re in – perhaps you walked by as someone snapped a picture and accidentally ended up in the frame. I don’t consider myself a heavy user of social media, but I am sure there are thousands of pictures of my face out there. I’ve uploaded and classified hundreds of photos of myself across platforms like Facebook, Instagram, LinkedIn, and even Venmo.

The developers behind Clearview AI recognized the potential in all these publicly accessible photographs and compiled them to create a massive training dataset for their facial recognition AI. They did this by scraping the social media profiles of hundreds of thousands of people. In fact, they got something like 2.1 million images of faces from Venmo and Tinder (a dating app) alone.

Why does this matter?

Clearly, there are major privacy concerns for this kind of technology. Clearview AI was marketed as being only available to law enforcement. In her book, Hill gives several examples of why this is problematic. People have been wrongfully accused, arrested, detained, and even jailed for the crime of looking (to this technology) like someone else.

We also know that AI has problems with bias. Facial recognition technology was first developed by mostly white, mostly male researchers, using photographs of mostly white, mostly male faces. The result of this has had a lasting effect. Marginalized communities targeted by policing are at increased risk, leading many to call for limits on the use of facial recognition by police.

It’s not just government agencies who have access to facial recognition. Other companies have developed off-the-shelf products that anyone can buy, like the app Hill demonstrated to me. This technology is now available to anyone willing to pay for a subscription. My own facial recognition results show how easy it is to find out a lot about a person (like their location, acquaintances, and more) using these apps. It’s easy to imagine how this could be dangerous.

There remain reasons to be optimistic about the future of privacy, however. Hill closed her talk by reminding everyone that with every technological breakthrough, there is opportunity for ethical advancement reflected by public policy. With facial recognition, policy makers have previously relied on private companies to make socially responsible decisions. As we face the results of a few radical actors using the technology maliciously, we can (and should) respond by developing legal restraints that safeguard our privacy.

On this front, Europe is leading by example. It’s likely that the actions of Clearview AI are already illegal in Europe, and they are expanding privacy rights with the European Commission’s (EC) proposed Artificial Intelligence (AI) regulation. These rules include requirements for technology developers to certify the quality of their processes, rather than algorithm performance, which would mitigate some of these harms. This regulation aims to take a technology-neutral approach and stratifies facial recognition technology by it’s potential for risk to people’s safety, livelihoods, and rights.

Post by Victoria Wilson, MA Bioethics and Science Policy, 2023

Helping People and Wildlife Coexist in Ways That Benefit Both, Using Math

By Robin Smith

On July 13, 2023

In Animals, Business/Economics, Climate/Global Change, Mathematics, Students

Duke team wins top prize in mathematical modeling contest

Safari-goers watch a pride of lions in the Maasai Mara, a famous game reserve in Kenya. Credit: Ray in Manila, CC BY 2.0 via Wikimedia Commons

Of all the math competitions for college students, the annual Mathematical Contest in Modeling (MCM) is one of the biggest. And this year, Duke’s team took home a coveted top prize.

Undergraduates Erik Novak, ’24, Nicolas Salazar, ’23, and Enzo Moraes Mescall, ’24, represented the Blue Devils at this year’s contest, a grueling 4-day event where teams of undergraduates use their mathematical modeling skills to solve a real-world problem. The results are finally in, and the Duke team was chosen as one of the top 22 outstanding winners out of more than 11,200 teams worldwide.

Their task: to analyze some of the challenges facing a nature reserve in Kenya known as the Maasai Mara. This region is named for the local Maasai people, a tribe of semi-nomadic people who make a living by herding cattle. It’s also teeming with wildlife. Each year, more than a million wildebeests, zebras and gazelles travel in a loop from neighboring Tanzania into Kenya’s Maasai Mara Reserve and back, following the seasonal rains in search of fresh grass to eat.

Some 300,000 safari-goers also flock to the area to witness the massive migration, making it a major player in Kenya’s billion-dollar tourism industry. But protecting and managing the land for the benefit of both wildlife and people is a delicate balancing act.

The reserve relies on tourism revenue to protect the animals that live there. If tourism slumps — due to political unrest in Kenya, or the COVID-19 pandemic — desperate communities living around the park resort to poaching to get by, threatening the very wildlife that tourism depends on.

Poachers aren’t the only problem: wild animals such as lions, leopards and elephants sometimes venture into human settlements in search of food. Conservationists must strike a balance between protecting these animals and managing the dangers they pose by raiding crops or killing valuable domestic livestock.

Tourism is a mixed blessing, too. While safari-goers bring money into the region, they can also disturb the animals and pollute the Mara River, and off-road drivers can erode the soil with their jeeps.

The mission facing the Duke team was to identify ways to mitigate such conflicts between wildlife and people.

From left: Teammates Erik Novak, ’24, Nicolas Salazar, ’23, and Enzo Moraes Mescall ’24 finished in the top 0.1% in the 2023 Mathematical Contest in Modeling.

This year’s contest ran over a single weekend in February. Camped out on the third floor of Perkins library, the team of three worked 12 hours a day, fueled by a steady supply of Red Bull and poke bowls. During that time, they built a model, came up with budget and policy recommendations, and wrote a 25-page report for the Kenyan Tourism and Wildlife Committee, all in less than 96 hours.

They built a mathematical model consisting of a system of six ordinary differential equations. According to the model’s predictions, they said, it should theoretically be possible to increase the reserve’s animal populations by about 25%, reduce environmental degradation by 20%, nearly eliminate retaliatory lion killings, and cut poaching rates in half — all while increasing the average yearly flow of tourists by 7.5%.

Participating in a smaller-but-similar contest last fall, the Triangle Competition in Mathematical Modeling, helped them prepare. “It’s kind of like a practice for the MCM,” Salazar said.

“They did not win that contest, but they took everything they learned and look what they did with it. I’m very proud,” said assistant professor of mathematics and biology Veronica Ciocanel, who coached the team and co-organized the Triangle competition.

In addition to finishing in the top 0.1% of competitors, the Duke team got three additional awards for their performance; the Mathematical Association of America (MAA) award, the Society for Industrial and Applied Mathematics (SIAM) prize, and an International COMAP Scholarship Award of $10,000.

The problems in these contests tend to be much more open-ended than typical coursework. “We didn’t know what the solution was supposed to be or what tools to use,” Novak said.

Modeling, computation and coding skills are certainly important, Ciocanel said. “But really what matters more is practice, teamwork, and communicating their results in a written report. Students who have a solid course background don’t need to do anything else to prepare, they just need to be creative about using what they know from the courses they already took.”

“Use what you have and work well together,” Ciocanel said. “That I think is the most important thing.”

Is The World In Crisis?

By Skylar Hughes

On April 6, 2023

In Behavior/Psychology, Business/Economics, Climate/Global Change, Environment/Sustainability, Global Health

According to a recent NPR/Ipsos poll, nearly 70% of Americans believe that U.S. democracy is “in crisis and at risk of failing.” Two out of every three respondents also agree that U.S. democracy is “more at risk” now than it was a year ago.

These fears are not unfounded. For the past three years, the United Nations Human Development Report has issued increasingly grave warnings for the state of the world. The warnings focus specifically on the Anthropocene, rising inequality, and growing polarization, conveying themes of both uncertainty and hope.

*Pictured above: The 2022 Human Development Report*.

On March 22nd, the director of the United Nations Human Development Report Office, Dr. Pedro Conceição, discussed his perspective at Duke University. The fireside chat was hosted by the Duke Center for International Development and the South-North Scholars, and was moderated by Dr. Anirudh Krishna.

“People should be able to live their lives at their full potential,” Dr. Conceição began. “When you look at the world and see how people are living their lives compared to how they should be living their lives, you get the need for human development.”

First introduced in 1990, the Human Development Report focuses on improving the quality of human life, rather than just the economy in which human beings live. The report emphasizes three pillars: people, opportunity, and choice. “Living life to your full potential is essentially about human freedom,” Dr. Conceição said. It is these freedoms that are at risk as the conditions in the Human Development Report worsen.

**Credit:** 2021/22 United Nations Human Development Report.

“We need to dig more deeply into why we aren’t taking action,” Conceição maintains. He explains that current efforts to spark change are too factual. Governments and corporations are focused too heavily on raising awareness and should pivot to trying to take tangible steps.

Political division is also a major source of stagnation, as those who lie on either side of the spectrum tend to be more insecure in their views of the future. Because of these obstacles, it requires a “more complex and unusual way of trying to understand these problems.”

The report has citizens from around the world concerned about potential declines in the quality of well-being. But Dr. Conceição asserts that the reports are meant to communicate hope.

“It’s precisely because we are having this level of uncertainty that this becomes even more relevant,” he said. In fact, it is this uncertainty that the report will build off of for future publications. The literature will dig deeper into novel areas of uncertainty, to figure out the best way forward.

*An analysis of the current global uncertainties. Credit: 2021/22 United Nations Human Development Report*.

Dr. Conceição urges students to invest in the United Nations and its initiatives, as it is crucial in creating a better outlook on the future. As Abraham Lincoln once expressed, “The most reliable way to predict the future is to create it.”

Want to get involved with the United Nations? Click here!