Introducción
Pilar Mateo Herrero breaks the link between poverty and disease through a community-based approach that creates sustained change in communities and living environments in developing countries. Accelerated by a new painting technology that effectively eradicates diseases like Chagas, dengue fever, and malaria, Pilar combines methodologies and local development efforts to improve health, economic development, and community mobilization.
La idea nueva
Pilar is dramatically improving life conditions and life expectancy rates and restoring hope in severely disenfranchised communities in developing countries. She is shifting the response mechanisms for the most destructive diseases spread by insects. Instead of narrowly focusing her efforts on costly reactions to these deadly diseases (i.e. expensive medicines, vaccines, or fumigation), Pilar has an inclusive intervention methodology to help sustain healthy communities. Her strategy expands beyond mere treatment to focus broadly on eradicating the insects, or the vector, and also effectively involves the community in this process, to build their own future.
Pilar’s innovation is partly based on a microencapsulation technology she created that can be applied to paint and potentially other materials. By microencapsulating the ingredients that eliminate adult insects and arachnoids and stop growth hormones in these insects, her paint forms a protecting seal against the diseases they carry. This paint, called Inesfly, protects against Chagas, the sleeping disease, malaria, dengue fever, and other vector-borne diseases. The paint is applicable to nearly any kind of building, such as homes, stables, apartment buildings, and sewage conducts. Pilar has already proven the effectiveness of Inesfly to eliminate vinchucas (Chagas-carrying insects) from communities in Bolivia. Inesfly is also undergoing certification by the World Health Organization (WHO), which will endorse its effectiveness against the Trypanosoma Cruzy and is also in the last phase of control of the Aedes Anopheles (that transmits malaria). In México the product has been very successful in controlling the Aedes Aegyptien that controls dengue.
Beyond simply removing the carriers of deadly diseases, Pilar is using her methodology as a platform to empower local communities to take control of their own problems. She begins by involving all levels—both within the communities and local organizations—in the process of preparing homes for painting and then the painting. The paint, when used as a tool in her community-building program, serves to raise awareness of the need to keep certain hygienic habits that will avoid a future return of the causes of the disease. Also, as communities organize around improving their housing, Pilar has found an ideal space to encourage people, particularly women, to work together to achieve citizenship in areas that had been previously thought impossible—including equality in rights, basic education, and freedom of speech. The results of this process include the local founding of the Indigenous Women of the World Movement (MOMIM), an organization that empowers indigenous women, as well as increases the impact of other organizations.
Additionally, in 2010 Pilar founded, with the support of the Praxis Pharmaceutical Group, a new foundation called Science and Knowledge in Action (the acronym in Spanish is CyCA), with the objective of supporting health projects to tackle endemic diseases in third world countries.
El problema
More than half of the world’s population is exposed to endemic diseases spread by different kinds of insects or arthropods. In Latin America alone, an estimated 25 million people are infected with Chagas disease, while another one hundred million are susceptible. Chagas disease kills 45,000 people annually. There are fifty million annual dengue infections worldwide. Around 300 million people live with malaria that kills around one million people every year. The damage caused by these endemic diseases is worsened by the prevalence of poverty in many parts of the world. Environments, such as precarious housing and infrastructure or unhygienic and damp living spaces, are particularly conducive for the dissemination and transmission of disease. In particular, weak infrastructure, including cracks in adobe walls of houses, offers the perfect environment for insects to grow. Hygienic habits are critical for controlling the outbreak and recurrence of disease.
Traditional solutions to control these kinds of endemic diseases often involve the use of insecticides, whether through directly fumigating houses or impregnating sleeping nets and clothes with chemicals. This traditional approach fails for three reasons: (i) the life span of insecticides is very limited. Periodic fumigations are recommended every four months, but this practice raises costs well above what most impoverished families can afford. Thus, families usually fumigate once a year, which is ineffective in terms of long-term control and eradication. In turn, expectations unmet by an unsatisfactory result reinforce a lack of trust in insecticides (ii) even when fumigation practice is timely and correct, affecting insects in an advanced development stage through insecticide use allows new breeds of insects to develop resistance to the killing components. This then requires continuous development of new compounds and a dependency on the product (iii) traditional insecticides can be toxic, especially for children and older populations, causing respiratory problems. Where nets are in fact available, a new problem arises when trying to manage the residues that usually contaminate rivers and water streams.
Partial approaches to the problem have also resulted in limited material solutions. Fumigation practices are not usually combined with the necessary complementary actions to build and sustain certain enabling basic conditions: The training of the community, organization of the community to adopt more sustainable measures, and developing long-term approaches and solutions to maintain good results. Building community self-esteem, pride, and hope are key elements to keep the community working toward results.
La estrategia
Pilar has developed a very sound strategy that combines her scientific breakthroughs and commitment to community betterment. Pilar is currently working on receiving official validation of the effectiveness of Inesfly products by international authorities such as the WHO, while involving different players ranging from local communities to regional governments in the field.
Infesfly, Pilar’s paint, is based on a technology that micro-encapsulates a special component that inhibits the growth of the insect larvae, resulting in the elimination of the disease. Unlike insecticides, Inesfly is not toxic when applied to buildings and other materials or structures in the home and it lasts much longer without the need for reapplication. Because of its chemical makeup, it is effective for up to four years. Though commercially registered for commercial use in a number of countries, Pilar is working with WHO experts to validate the technology and receive official international recognition of the paint’s effectiveness for combating Chagas, malaria, and dengue fever. Official recognition is very important as competitors have tried to copy the technology, but have not passed similar scientific testing.
Pilar has developed an implementation methodology that goes well beyond the application of the paint to different building structures. From the very beginning, the whole community is involved in the diagnosis process. The first stage is an assessment of the state of infection in the houses and surrounding environments. Once the community, with support from local experts, has determined the situation, they organize themselves to paint, repair, or rebuild the houses. The community then works together to paint the houses using Inesfly paint. The whole process is structured to empower the community in a way that achieves more than merely improved building infrastructure, but also works on developing economic opportunities, cultural initiatives, and educational activities.
Pilar’s methodology is also structured to simultaneously build and foster the self-esteem of the community. First, it starts with cleaning the houses’ surroundings, organizing waste management, and developing a sense of dignity relating to the most immediate living conditions of the families. As the perception of Chagas or other diseases shifts from inevitable to avoidable, health and hope play a very central role in the community’s attitude toward what they can or cannot do, and what they can expect for their future. In fact, Pilar takes advantage of these organizational moments to launch different local development projects. With a new life prospect, free of chronic diseases, people in general and women in particular, start to dream about what they want for themselves and their families. Pilar creates space and provides tools—such as the “box of dreams”—for these projects to emerge. Examples of successful initiatives include professional training schools, a local radio station managed by women and an endless number of business microenterprises. This has been particularly true in the Bolivian Chaco region where Pilar has invested most of her personal field work time.
In this process Pilar has helped strengthen different local communities like MOMIM and has involved many partners (i.e. international development agencies, regional governments, and local citizen organizations) to fund or implement these projects, involving new actors from Spain to get involved in functional development projects at a local level.
In order for the technology to reach communities most affected by these diseases, generally in rural areas with low economic levels, Pilar leverages the commercial interests in the paint by creating a scaled pricing model. Since the product is effective against any vector-carried disease, private companies and international organizations purchase it at retail price, covering production costs and making it commercially viable for production. This enables the paint to be sold to lesser able organizations, communities, and governments at or below production price. Pilar’s method is also becoming quickly available at an international level, as a reliable and inexpensive way to eliminate a number of diseases. In addition to making it cheaper, and to secure both new developments of the technology and its implementation to use for other diseases, Pilar has created the Science and Knowledge in Action Foundation. The foundation has two branches. The first continuously develops medical solutions focused on contexts of extreme poverty and the second implements projects, spreads the model, and reaches out to new countries and communities. Profits from the solutions created through R&D are reinvested in developing projects through Knowledge in Action.
Inesfly has been applied to 300,000 houses in Bolivian Chaco alone. Pilar’s full approach—including the community organizing, public health education, and the actual paint application—was applied to these homes. According to impact evaluation, because the inhabitants were treated and the vinchucas were no longer infected with the disease, this multi-pronged intervention enables the cohabitation of vinchucas and humans. Pilar’s methodology is currently being tested in Bolivia, Brazil, and Mexico. In Benin, Ghana and the Ivory Coast, experimentation focuses on targeting malaria. Pilar expects WHO validation process to be completed sometime between 2013 and 2014 which will allow for the scaling of Inesfly to many more countries. Currently, she is also working on a proposal for implementation in Ghana and Cameroon, combining three particular action points: Prevention and eradication with Inesfly, medical treatment, and training on waste management. This project would open a new model of application that builds on previous experiences.
La persona
A chemist by training, Pilar was struck when she witnessed a news report documenting the forced closing of a local hospital due to a cockroach infestation. Out of this reaction evolved her second career: Pilar completed a Ph.D. in microencapsulation technology, which she applied to paint, which was also her family’s business. She is committed to balancing purely scientific research with the actual application of this knowledge in the field. Through her work with the microencapsulation in paint, Pilar has become fixated with the application of knowledge into action; a concept that has inspired her long-term career and most recently, the creation of the Science and Knowledge in Action Foundation.
Since Pilar developed microencapsulation technology and tested its implementation in the field, she has spent long periods living with remote and impoverished indigenous communities in Bolivia, where she learned firsthand the needs of these communities. Pilar also realized the inefficiencies of traditional international development aid. Her relationship with the local communities is such that she is officially recognized as a member of the indigenous community in the Chaco, one of the poorest regions in Latin America.
Before dedicating her time and efforts toward developing Inesfly, Pilar worked in Israel on a joint venture with Jordan. Although the organization eventually closed, she derived a wide range of learnings from the experience. Pilar has also held high level positions in La Comunidad Valenciana (Spanish Regional Government), which is in charge of developing the international cooperation and regional aid agency.
Pilar is working with experts of various countries in Africa, Bolivia, and Mexico who are testing the effectiveness of the paint for different diseases in addition to Chagas. Although the scientific community around this issue is growing, Pilar plays a distinguished role in it due to her work with Inesfly, which has since been widely published in international peer-reviewed journals.