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Collaborative development of open source-appropriate technologies: a way to reduce the global access gap?
  1. Roberto Aufieri,
  2. Simonetta Picone,
  3. Piermichele Paolillo
  1. Division of Neonatology and Neonatal Intensive Care, Casilino General Hospital, Roma, Italy
  1. Correspondence to Roberto Aufieri, Policlinico Casilino, Via Casilina, 1049, Roma 00169, Italy; r.aufieri{at}

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Healthcare systems in low- and middle-income countries (LMIC), due to scarcity of economic resources, often lack appropriate health technologies necessary for the prevention, diagnosis and treatment of many curable diseases.1 WHO acknowledges that most of the current global health targets and goals would be impossible to achieve without an increase in access to essential medical devices,2 hence promotes the development and local production of appropriate devices.3 Nonetheless, despite the increasing interest and efforts, prices of devices, as well as prices of patents for local producers, continue to not be appropriate for many LMIC. Research, development and production of biomedical devices are mostly performed by companies in high-income countries for high-income markets, and it has been estimated that only 13% of manufacturers are located in LMIC.2 Consequences are that high prices, along with inefficient local production and distribution, among other factors, contribute to set back commercialisation and availability of final products in low-resource settings. This problem has been recently highlighted and defined as the last mile translation.4

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  • Contributors RA conceived the work, performed the literature research, wrote the first draft of the manuscript and revised subsequent and final drafts. SP, PP conceived the work and revised subsequent and final drafts.

  • RA, SP, PP: read and approved the final manuscript. RA, SP, PP are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.