Pharmacy on a Bicycle
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More About This Title Pharmacy on a Bicycle


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.


Eric G. Bing, MD, PhD, MBA, is a Harvard-educated physician who has created and managed innovative health programs throughout Africa, the Caribbean, and Latin America for over two decades. He is a senior fellow and the director for global health at the George W. Bush Institute and professor of global health at Southern Methodist University in Dallas, Texas.


Chapter 1--Millions are Dying Unnecessarily
Chapter 2--Using Innovative Solutions to Solve Global Challenges
Chapter 3--Let's Tackle These Diseases First
Chapter 4--Solutions for Prevention, Diagnosis, and Treatment
Chapter 5--Products and Services Already Exist
Chapter 6--WHy Haven't These Solutions Been Taken to Scale
Chapter 7--The Low-Hanging Fruit and Easy Solutions
Chapter 8--A Bit More Challenging, but Solutions Are at Hand
Chapter 9--We Can Solve this Problem, but Some Time and Effort Are Needed
Chapter 10--Getting More Bang for the Buck
Chapter 11--Overcoming the Barriers


“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