The people behind healthcare innovation: Interview with Luan Vo, President of Friends for International Tuberculosis Relief (FIT)

As part of my work, I have the privilege to speak with many inspiring innovators. Although the business community usually focuses on companies, pitches, and valuations — and less on the innovator — I thought it would be interesting to learn a bit more about the people behind healthcare innovation. In this series, I’m sharing some of my conversations with innovators in a condensed format to gain insights into their experience, their opinions, and their learnings.

This latest conversation is with Luan Vo, President of Friends for International TB Relief (FIT), who is working towards ending tuberculosis during our lifetime.

Tobias: What’s your story, how did you become an innovator in healthcare?

Luan: Tuberculosis was not always my passion or even an area I would have considered for innovation. It has affected humans for tens of thousands of years, killed billions of people throughout this time and to this day remains the deadliest infectious disease on the planet. As they say, it’s a problem that’s been chewed up and spat out. On the other hand, I had never heard about it, because nobody actually talks about tuberculosis in Germany and the US (the places I was raised). But still, why tuberculosis and not climate change, social justice, gender equality or world peace?

The answer was my cousin Tam, born around the same time, in the same place, to the same family. The difference was that I had the privilege of growing up with food and shelter, education and safety, hope and love. Tam wasn’t so lucky. He was a neglected child in a broken home, got mixed up with the wrong crowd, contracted HIV and died far too young. No one knows the exact cause, but as they say „live with HIV, die of tuberculosis“. This is when I realized how fortunate I was. Had I been born 1 year later to my uncle’s family, it could have been Tam telling my story. That’s why I felt I needed to do something differently; find a way to innovate in this forsaken space. As I started to engage with the topic, I quickly realized that the biggest issue with tuberculosis is actually financing: finding ways to improve its „attractiveness“ for commercial investment and moving away from the traditional model of donor funding and charitable contributions. In tuberculosis and development in general, we often confound need with demand. We believe that just because we NEED to end tuberculosis as a public health emergency in the name of social justice and global welfare, there will be someone willing to pay for it. This is sadly not the case, which is why tuberculosis remains a global health issue.

Instead, commercial investment requires innovation to drive BOTH better health outcomes AND generate demand, which results in tangible returns on this investment. As such, we have worked with pharmaceutical companies, diagnostics manufacturers, digital health and AI companies to identify these "sweet spots" of improved health outcomes and returns on investment. Tuberculosis has suffered from the lack of commercial interest and financing for decades. At FIT, we want to rewrite this narrative and turn tuberculosis into a niche, but attractive space for innovation and investment: We are always open to explore improvements in tuberculosis with innovators.

Tobias: Where do you see tuberculosis care moving to in the next ten years in healthcare?

Luan: Over the next 10 years, I expect tuberculosis care to undergo significant changes driven by technological, clinical and health system innovations. First, I expect that technological innovations such as tongue swab-based diagnostics, ultra-portable radiography, AI-based cough monitors and digital stethoscopes will reach a level of product maturity and commercialization, where they can be used for self-testing or at the primary care and community level without the need for extensive training, infrastructure or investment. More importantly, this decentralization and individualization of care has the potential to fuel consumer demand and tap into market-based financing mechanisms, which can address the aforementioned funding challenges faced in our space.

On the clinical side, another evolution of tuberculosis care I hope to see over the next decade is the increased recognition of tuberculosis infection, which affects up to 2 billion people in the world, as a risk factor that warrants broad societal intervention. In my view, we could treat TB a bit more like hypertension, which I don’t really see as a disease in itself, but it is treated as one due to its inherent negative long-term consequences in terms of cardiovascular disease. Moreover, tuberculosis infection is already treated in high-resource, low-incidence countries and thus this should be made the standard of care globally as well, in my opinion.

In terms of system innovations, I hope we can reposition tuberculosis care as the perfect synergy to other health issues. If you get a health check for cardiovascular disease, diabetes, cancer or chronic lung disease, then integrate a low-cost tuberculosis screen. If governments seek to enhance global health security and airborne pathogen surveillance, consider strengthening existing tuberculosis care systems today to enhance pandemic preparedness, prevention and response for tomorrow. If the goal is universal health coverage, tuberculosis diagnosis, treatment and prevention have to be included on all essential medicines, diagnostics and health services lists.

Tobias: If you could design a digital-first health system for a country from scratch, what would it look like?

Luan: A digital-first health system requires a digital-first societal structure including (unique) personal identification, personal digital health records, monetary and financial systems, etc. A digital-first health system further requires interoperability across sectors and providers.

As such, designing a digital-first health system from scratch would require the digital transformation of many of the basic recording and surveillance systems first. Once these are in place, connectivity through concepts such as „internet of things“ for tools and services will be needed to ensure linkage and real-time updates to personal health records.

In the case of tuberculosis, there is extensive evidence that the patient pathway is often convoluted, arduous and expensive. A digital-first TB care system would ensure the ability to track and refer people to appropriate screening, diagnosis and care. 

Tobias: In your opinion, what would be meaningful near-term steps towards a digital-first health system?

Luan: In my setting, the country of Vietnam is moving towards having a national electronic ID system. The completion of this initiative could be a useful near-term step towards a digital-first health system. The establishment of a secure centralized system for personal medical records accessible by individuals on their personal devices could be the next step. The digitization and digital reporting of medical services that is linked to individual records could be another prerequisite of a digital-first health system. 

Tobias: What do you know now that you wish you had known when you were starting out as an innovator?

Luan: Innovation and entrepreneurship are akin to risk-taking and thus require a high degree of risk appetite and resilience to (and security from) uncertainty. This is particularly the case in sectors such as tuberculosis and healthcare, where the potential returns are not really commensurate with the risk and investments (time, financial, relationships) needed to succeed.

If I had known this beforehand, I might have more carefully prepared for the endeavor to restart my professional life in this fashion, whether that is by building up a greater financial cushion, seeking more collaborators or managing personal commitments to family and friends.

About Luan Vo

Luan is President of Friends for International TB Relief and supports Vietnam’s National Tuberculosis Control Program to implement and generate evidence for active case finding, private sector engagement, social protection, diagnostics and prevention. He co-led the 2015-2020 Tuberculosis Program Review and is on Vietnam’s national technical advisory group for the Global Fund’s country coordinating mechanism.

Outside of FIT, Luan is Treasurer of The International Union Against Tuberculosis and Lung Disease, and member of the Stop TB Partnership (STBP) Board's Innovation Constituency, the World Health Organization (WHO) Civil Society Task Force on TB and the WHO-STBP's Public-Private-Mix Core Group.

Luan is a doctoral candidate with Karolinska Institutet. He holds a master’s degree in public health from the London School of Hygiene and Tropical Medicine and a bachelor’s degree in bioengineering and mathematics from the University of Pennsylvania. 

For more information, see Luan Vo and Friends for International TB Relief (FIT).