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  • Published: 1 January 2018
  • ISBN: 9781609947897
  • Imprint: Berrett-Koehler
  • Format: Hardback
  • Pages: 240
  • RRP: $65.00

Pharmacy on a Bicycle

Innovative Solutions for Global Health and Poverty



Every four minutes, over 50 children under the age of five die. In the same four minutes, 2 mothers lose their lives in childbirth. Every year, malaria kills nearly 1.2 million people, despite the fact that it can be prevented with a mosquito net and treated for less than $1.50.

Sadly, this list goes on and on. Millions are dying from diseases that we can easily and inexpensively prevent, diagnose, and treat. Why? Because even though we know exactly what people need, we just can’t get it to them. They are dying not because we can’t solve a medical problem but because we can’t solve a logistics problem.

In this profoundly important book, Eric G. Bing and Marc J. Epstein lay out a solution: a new kind of bottom-up health care that is delivered at the source. We need microclinics, micropharmacies, and microentrepreneurs located in the remote, hard-to-reach communities they serve. By building a new model that “scales down” to train and incentivize all kinds of health-care providers in their own villages and towns, we can create an army of on-site professionals who can prevent tragedy at a fraction of the cost of top-down bureaucratic programs.

Bing and Epstein have seen the model work, and they provide example after example of the extraordinary results it has achieved in Africa, Asia, and Latin America. This is a book about taking health care the last mile—sometimes literally—to prevent widespread, unnecessary, and easily avoided death and suffering. Pharmacy on a Bicycle shows how the same forces of innovation and entrepreneurship that work in first-world business cultures can be unleashed to save the lives of millions.

  • Published: 1 January 2018
  • ISBN: 9781609947897
  • Imprint: Berrett-Koehler
  • Format: Hardback
  • Pages: 240
  • RRP: $65.00

Praise for Pharmacy on a Bicycle

“In this compelling, practical, and very human book, Bing and Epstein offer real-life solutions to ending millions of preventable deaths around the world. By integrating tools from public health, medicine, and business, they have created an approach—IMPACTS—that has potential for saving millions of lives, not only in low- and middle-income countries, but in resource-poor, hard-to-reach settings within wealthier nations.” —Helene D. Gayle, MD, MPH, President and CEO, CARE USA “Powerful medicine for a world that is ailing from growing health disparities and a must-read for anyone providing care for—or caring about—the world’s most vulnerable people. Short on abstraction and long on practical solutions, this is an inspiring call to action that awakens the entrepreneur in all of us.” —Julie Gerberding, MD, MPH, President, Merck Vaccines, and former Director, Centers for Disease Control and Prevention “This is what needs to be done in order to save lives! The creativity and originality of this book provide the impetus to bridge the final mile in global health. Bing and Epstein exemplify cost-effective and successful innovative solutions—a must-have for all working in global health.” —Christine Kaseba-Sata, obstetrician and gynecologist and First Lady of the Republic of Zambia Pharmacy on a Bicycle demonstrates how, even in the most dire circumstances, entrepreneurs can develop cost-effective, sustainable, innovative solutions that have the potential for replication and scale. Not only are the examples inspiring and instructive, but the IMPACTS framework has applications that extend well beyond global health.” —Professor J. Gregory Dees, cofounder, Center for the Advancement of Social Entrepreneurship, Duke University “This book provides workable answers for applying tested entrepreneurial techniques to the unique challenges of the very poor. Among the fertile minds of its readers, it will inspire new solutions from many successful examples. This book will save lives!” —Marc J. Shapiro, Chair of the Board of Trustees, Baylor College of Medicine, and former Vice Chair, JPMorgan Chase & Co. “By engaging emerging leaders with diverse skills and backgrounds, Bing and Epstein recognize how we can solve the problems we face in global health now. They demonstrate how partnership is fundamental to improving health access for all—an essential read for tomorrow’s leaders in global health!” —Barbara Bush, CEO and cofounder, Global Health Corps “So many of the solutions to the world’s most tragic health-care problems are simple and inexpensive—if we can get them to the people who need them most. Bing and Epstein show how that can be done by unleashing the entrepreneurial spirit of the world’s poor.” —Sir Fazle Hasan Abed, KCMG, founder and Chairperson, BRAC “Bing and Epstein show how people from around the world are creating successful innovative, ‘outside the box’ solutions to take health services the last mile. Stakeholders across the public, private, and nonprofit sectors will find the lessons shared in this book highly useful.” —Dr. Agnes Binagwaho, Minister of Health, Republic of Rwanda “Bing and Epstein tackle the most important problem vexing global development: how do we spread what we know works to places and people who need it? This book offers powerful frameworks and examples that spark practical insights into what it will take to truly solve many of our most challenging problems.” —Jeff Bradach, cofounder and Managing Partner, The Bridgespan Group “Drs. Bing and Epstein remind us that many of the deaths and much of the disease among mothers and children can be halted through simple and low-cost solutions. They combine their medical knowledge with cutting-edge business school methodologies to identify and summarize the opportunity for innovative solutions to combat disease and poverty. It’s a must-read for people who care deeply about the world’s poorest people.” —Peter Hotez, MD, PhD, Dean, National School of Tropical Medicine, Baylor College of Medicine, and President, Sabin Vaccine Institute “If you ever wondered why easily preventable and curable diseases cripple human potential across the developing world, this book has answers. Bing and Epstein are on a mission to make sure that access to basic health care is never a barrier for anyone to reach his or her full potential. This book will leave you with the hope that seemingly insurmountable development challenges can be transformed into solvable problems when creative partnerships are formed across sectors and mutual accountability is established.” —Ambassador Sally Cowal, Senior Vice President and Chief Liaison Officer, PSI Pharmacy on a Bicycle is about saving lives—simply, effectively, and inexpensively. Through their focus on innovative and entrepreneurial solutions, Bing and Epstein show how to take health care the last mile—to a place that’s accessible, in a way that’s acceptable, and at a cost that’s affordable. Chock full of successful examples of ways this is already happening, it will leave you inspired and filled with hope!” —Rich Stearns, President, World Vision USA “While so much of the focus on health is a debate about the science, Pharmacy on a Bicycle is a timely reminder that simple, cost-effective solutions exist and can be scaled to provide access to quality care. A practical guide to successful program delivery—showing how millions of lives can be saved globally.” —Paul Bernstein, CEO, Pershing Square Foundation “This is the first book I know of that goes beyond inspiring stories of social entrepreneurs to provide a comprehensive and practical guide to the entrepreneurial process itself. Every policy maker and aspiring social entrepreneur will benefit from the practical steps to successful entrepreneurship articulated in this book.” —Kirk O. Hanson, University Professor and Executive Director, Markkula Center for Applied Ethics, Santa Clara University “We firmly believe that the world can dissociate health care from affluence. Change in policies is all we need to turn this dream into reality. Pharmacy on a Bicycle has many valuable propositions to make it happen.” —Dr. Devi Shetty, Chairman, Narayana Hrudayalaya Group of Hospitals, Bangalore, India “Bing and Epstein have written an eminently readable and absorbing book that will be essential for any organization interested in empowering underserved populations to improve their health and well-being. Bravo!” —Stanley S. Litow, Vice President of Corporate Citizenship and Corporate Affairs, IBM, and President, IBM International Foundation