By Meg Wirth, co-founder of Maternova
Let’s start with a young mom. Just a regular young mother in a place like Ecuador or Guatemala, Mali or Kenya—but a woman whose family farms and who lives far away from a health clinic. Let’s say this woman knows she’s pregnant but is worried that she has HIV. She’s afraid to get tested for HIV because, frankly, there’s more fear and uncertainty ahead. Even if the facility had the antiretroviral drugs to prevent maternal to child transmission of HIV to her baby (PMTCT), she could not afford to get to and from the clinic. Even if she takes home a bottle of antiretroviral medicine a number of factors limit its efficacy. What’s a mother to do?
And what could a biomedical engineering team at Duke University do that might change her life? It seems like a problem that should be left to policymakers, doctors, activists and politicians—not a likely puzzle for engineers. Well, the DHT lab invented the Pratt Pouch, a novel drug delivery mechanism designed for mothers like the one who in the above scenario.

(Photo credit: Fundacion VIHDA)
Part do-it-yourself kit for pharmacists, and part in-hospital manufacturing, the Pratt Pouch allows local pharmacists to carefully dose out antiretroviral medicines into foilized pouches that can be kept in the home for up to a year. The pharmacists are trained to carefully fill each pouch and then to heat-seal the pouches so that the contents of the pouch are kept from light, air, and moisture. Furthermore, the pouch includes an accurate dose of the medicines, one for each day.
Each layer of the pouch has a different purpose and contribution to the design. The most important is the layer that touches the drug. This is the key to preserving the drug that will save the baby from HIV transmission. In fact, the hospital pharmacy in Ecuador, and the team of medical providers, and the love and skill of the mothers have saved approximately 1,000 babies from HIV over the last several years.
So now the community health worker can tell our young mom that she is empowered to prevent the transmission of HIV to her baby. The mom takes home a pre-dosed set of Pratt Pouches with visual instructions to remind her how to administer. She can store the pouches in her home, so that even when she gives birth at home, she can provide the life-saving drugs within 24 to 48 hours of birth, and she can do so with pride and dignity. The delivery system has been tested in multiple countries around the world, and women find it easy to use—and they use it effectively. Simply tear open the top of the pouch and squeeze the medication into the baby’s mouth. Here’s what it looks being administered in Ecuador:

(Photo credit: Fundacion VIHDA)
This is how innovation can change the odds for women and newborns. And the Pratt Pouch demonstrates how innovation can extend the reach of PMTCT into the hardest to reach areas. Now, help us spread the word that the Pratt Pouch empowers women to prevent transmission of HIV to babies.
Meg Wirth is the co-founder of Maternova Inc., a company that accelerates access to life-saving global health technologies through a pioneering ecommerce platform. She was also co-author of the UN Millennium Project’s final report on child and maternal health. Email or tweet for more information.