A PATH to more equitable health - via AI project leadership
 Today’s post is about the People - and of course, the Project - portions of People, Planet, Profits, and Projects. My attention was drawn by this article: https://www.npr.org/2026/07/23/g-s1-134929/this-ai-tool-promises-a-second-sight-of-eyes-to-clinicians-did-patients-benefit which looked at a project in Kenya to determine whether an AI ‘medical consultant’ made a difference in diagnosis and treatment. I expanded my search to look for other initiatives in medically-underserved areas of the world. The article starts with a dramatic story (side note: this is how I coach my students to begin a presentation if appropriate). A 4-month-old boy comes into the clinic with a fever and a stuffy nose. (Medic) Vyonne Njeri thinks it's just a cold. Then a yellow box pops up on her computer telling her to check his heart — because his heart rate is elevated. Njeri is a registered clinical officer in Nairobi, Kenya; she sees patients on her own like a nurse practitioner. When she listens with a stethoscope she hears a whoosh — a sign that the infant could have a congenital heart defect. "That's something I would have missed on any other day," Njeri says of the visit a few months ago. "That child would have just gone home." She credits an AI tool that double checks her work for helping her.
Broader Study PATH is evaluating LLM-assisted clinical support not only in Kenya but also in Nigeria and Rwanda. Its work explicitly addresses the limited evidence available concerning the safety, appropriateness, and effectiveness of these tools in African primary healthcare. A pilot project like the one in Kenya proves that a technology can operate. A program of coordinated trials such as PATH is initiating, is needed to establish whether it can create sustainable value. The Threats My research showed that unfortunately, there are areas in which AI can be a negative in terms of underserved populations in two ways. 1. Performance inequality: the tool works less accurately for certain populations. 2. Access inequality: the communities that could benefit most receive the technology last—or not at all. These are repairable problems solved by reducing bias and providing better, more representative data to AI systems and assuring that there is equity in deploying AI systems worldwide – both initiatives in which (in my opinion) project leaders should play key roles. Additional research and cases: Autonomous AI for diabetic-eye screening “Autonomous artificial intelligence for diabetic eye disease increases access and health equity in underserved populations” The study specifically examined how autonomous AI screening for diabetic eye disease could increase access and improve equity in underserved populations. This supports an important sustainability principle: The value of AI may be greatest not where doctors are plentiful, but where expertise is scarce, distant, or unaffordable. Source: Autonomous artificial intelligence for diabetic eye disease increases access and health equity in underserved populations AI and unexplained pain disparities Researchers used deep learning to analyze knee X-rays and better account for pain experienced by underserved patients. Conventional radiographic measures did not fully explain the greater pain reported by some disadvantaged populations; the AI-derived measure accounted for more of that disparity. This example broadens the story beyond access. AI may also challenge clinical measures that have historically failed to represent certain patients’ lived experiences. That provides a powerful “People” question: What if the problem is not that patients’ symptoms are inexplicable, but that the measurement system was never designed to see them? Source: An algorithmic approach to reducing unexplained pain disparities in underserved populations | Nature Medicine Multi-disease screening through an eye scan A recently reported AI system analyzes retinal images to screen for conditions including diabetes, hypertension, high cholesterol, osteoporosis, gout, and thyroid disease. Because it requires a relatively basic fundus camera, researchers see potential applications in primary-care offices, pharmacies, mobile clinics, and remote communities. This is a good example of healthcare infrastructure being redesigned around accessible technology. Source: AI analyses of eye scans can detect diseases like diabetes, osteoporosis and thyroid disease in seconds From a project perspective, the innovation is not merely the algorithm. It only comes to life with project leadership, which includes:
PATH (originally Program for Appropriate Technology in Health) is a global nonprofit public-health organization, started in 1977 that works to make healthcare more accessible, particularly in low-resource and underserved communities. It operates in more than 70 countries and partners with governments, healthcare providers, researchers, businesses, and community organizations. Its work includes:
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The Flip-Side of Biomimicry
 A few weeks ago I wrote about the pomelo — how its thick, air-pocketed rind has inspired engineers designing better crash-protection and packaging, simply by copying what evolution already perfected. That's biomimicry: nature solves the problem, we study the solution. This piece is about the other side of that coin. Instead of mimicking what nature already does well, we're now trying to engineer our way around problems nature is increasingly struggling to absorb on its own — pulling carbon back out of the air and ocean we put it into in the first place. It's a useful contrast, because the two approaches reveal very different things about cost, value, and who's actually paying for the difference. The inspiration for this post comes from an episode of How We Survive, which is a spinoff podcast of Marketplace, called Carbon Burial at Sea: A Promising Climate Solution - or Another Engineering Experiment? Carbon Burial at Sea: A Promising Climate Solution—or Another Engineering Experiment? Marketplace's How We Survive explores one of the more ambitious ideas in climate mitigation: capturing carbon dioxide and storing it in the ocean or deep underground before it can contribute to global warming. The episode follows two different approaches.
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A citrus fruit schools us on material science and project leadership (Part 2 of 2)
 In Part 1, I discussed the characteristics of the pomelo and how scientists and engineers and others in project teams are using biomimicry to allow human-made materials to behave in this shock-absorbing manner. As a reminder- here's a bit of a summary of Part 1: The real story isn't the pomelo itself. It's the idea that nature has spent millions of years conducting R&D, and project leaders, engineers, and innovators can learn from those solutions. The Pomelo as Nature's Safety Engineer A pomelo fruit can fall 30 feet from a tree and survive with its interior intact. Development engineers look at this capability and ask (as they do any time biomimicry is applied), "How did nature solve a problem we've been trying to solve for decades?" The answer isn't a hard shell. It's a sophisticated, layered structure that:
From Ideation to Operations: The Project Management Angle This is a textbook example of how innovation moves through a technology maturation pipeline:  As you can see, multiple functions of organizations – and across organizations – are working together for a common objective. Notice a pattern here? This is where project leaders need to shine. One Application: Football* Helmets Modern football helmets already incorporate foam layers, but helmet designers face a difficult challenge:
Instead of a uniform foam, the pomelo (as you saw in part one of this post) takes advantage of:
The goal isn't necessarily a stronger helmet – it’s a helmet that behaves more like a pomelo peel. Beyond Football The implications extend well beyond football – hockey, cycling, military, youth sports, vehicle safety – the list is significant. Biomimicry Instead of starting from scratch, biomimicry asks: "What has nature already figured out?" Nature's solutions are frequently:
Millions of years of evolutionary pressure produced an elegant impact-management system without steel, electronics, batteries, or AI. This effort, however, as we’ve seen above, needs project leadership. The value chain here goes something like… ·Botanists studied a fruit. ·Materials scientists studied its structure. ·Engineers modeled it. ·The Navy funded applications. ·Sports equipment designers and users will ultimately benefit, potentially reducing injuries and saving lives. That's delivering value. Closing Thought and Summary The pomelo reminds us that innovation does not always begin in a lab – sometimes it begins in a tree. The project leader’s job is to notice, translate, test, and deliver value throughout that change. Learn More
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A citrus fruit schools us on material science and project leadership (Part 1 of 2)
| A recent video ‘short’ from Boston University, which features dropping a citrus fruit – a pomelo – from the roof of a university building – caught my attention. This video focuses on the possible connection between the pomelo and better phone cases, but keep in mind that the implications are much bigger (literally and figuratively) than phone cases. Click on the picture or the link for the short video.  Click here for video. Since it caught my interests as a good example of applying biomimicry in design, I followed some of the research, and I am glad I did – on top of the biomimicry here, it has some good lessons on project leadership. The way I am approaching this blog post is to break it into to two parts. The first focuses on the science. Since this is about biomimicry, and since I fell into the rabbit-hole while trying to understand this myself, I thought I would share the ‘bio’ part first, and then go into the ‘mimicry’ and leadership piece with that well in hand. I know…this is going to seem a bit science-geeky, but I promise that this will connect to the intersection of project leadership and sustainability, and if you don’t want the science piece, you can wait for part 2 which should be available in a week or two. So let’s cut to the chase – literally, by looking at a cross-section of a pomelo:  The albedo – the piece involved in the biomimicry - is effectively a natural, porous foam. Its parenchyma cells have intercellular air spaces that help dissipate energy when a fruit falls, protecting the internal pulp and seeds. The parenchyma refers to the soft, living plant tissues that make up this layer Researchers at Boston University and Texas A&M University and beyond have studied this for several years. Their work focused on the pomelo peel's unique gradient porosity—small pores near the outside, larger pores in the middle, and finer pores again near the fruit. They developed finite-element models and Voronoi-based foam structures that replicated this architecture. Their simulations showed improved energy dissipation and impact resistance compared with conventional uniform foams. Wait a second, you say. What’s this about Voronoi-based foam structures? What’s that about? I couldn’t help myself, I had to follow that rabbit-hole as well. Voronoi structures are patterns that naturally divide space into many adjoining regions, each centered around a particular point. They were first described mathematically by the Russian mathematician Georgy Voronoi, but similar structures are found throughout nature.It’s not an actual Voronoi structure but a giraffe’s coat pattern gives you the basic idea. Whether in biological tissues, mineral formations, animal markings, or cellular materials, Voronoi-like patterns often emerge when space is filled efficiently and neighboring regions grow until they meet. The function of a Voronoi structure is to organize space into distinct territories with minimal gaps and overlaps. In biological systems, these structures can help explain how cells pack together, occupy available space efficiently, or distribute forces. That last part – about distributing forces – is key here.Shock absorption is precisely about that! To bring this back to the pomelo, I used a simple example of five PMI Exam test centers first, and then expanded that to 2,000 sites so you can see the similarity to the pomelo’s albedo.  Now let's expand that by a couple of orders of magnitude...  OK, so now that you know what a Voronoi structure is… let’s continue with how this very real fruit exhibiting Voronoi structures is telling us. Researchers have noted potential applications including:
So what is biomimicry? In project management terms, it's leveraging nature's ultimate continuous-improvement program—a process refined through millions of years of iterative experimentation, adaptation, and learning (we could call that evolution). Nature has been running Agile sprints long before humans coined the term, testing countless prototypes, discarding what doesn't work, and scaling what does. I will pick up on the project leadership and sustainability piece of this in Part 2. |
Black Tape Over the Engine Light
 I’m going to combine three things in this post, and it is going to end up getting a bit political, but I think for a good project leadership lesson. The three things:
A story broke this week on CNN that stopped me in my tracks. Here’s the teaser for the story. In the North Atlantic Ocean, south of Greenland and Iceland, a large patch of water is doing something very strange. While the rest of the ocean heats up, it’s been getting colder. A new study says it has the answer to this mystery — and it’s an ominous sign the world is hurtling toward one of the most alarming climate tipping points. There is an image of the 'cold blog' below - with and without the black tape. Turns out that scientists have been puzzling for years over a mysterious "cold blob" in the North Atlantic — a patch of ocean south of Greenland that has been cooling while the rest of the world's oceans warm. A new study, just published in Geophysical Research Letters, has now confirmed what many suspected: it's a fingerprint of a weakening AMOC — the Atlantic Meridional Overturning Circulation — the vast ocean conveyor belt that moves warm water from the tropics northward and keeps the Northern Hemisphere's climate in balance. Why should project managers care? Because an AMOC shutdown would mean accelerated sea level rise on the U.S. East Coast, a deep freeze across Europe, and prolonged droughts from disrupted monsoons in Africa. Planetary-scale consequences. And, it’s another indicator of why this is called ‘climate change’ and not ‘global warming’. Here’s the real point: we only know this threat exists because of decades of painstaking ocean temperature monitoring. Now here's the part that should make every project leader wince. We are actively dismantling the systems that told us this and can tell us about such threats in the future. And I think you can begin to see the connection to black tape over the engine light. More on that later. The Trump administration had already cut nearly $100 million from NOAA's research arm — described internally by the administration as a "down payment" on plans to eliminate the office entirely. On May 21 of this year, the National Science Foundation (NSF) has announced the decommissioning of the Ocean Observatories Initiative, a network of 900 deep-sea instruments tracking ocean temperature, salinity, and chemistry across the Atlantic and Pacific. One researcher called it "the end of a federal commitment to basic scientific research that has served this nation well for 70 years." Now let's put on our Project Leadership hats. In project (or program, or portfolio) risk management, we distinguish between (1) informed risk acceptance — where a team deliberately decides a threat's probability or impact (or the combination) is tolerable — and (2) what I'd call risk acceptance by ignorance. The first (1) – informed acceptance of risk - is a legitimate strategy, and a good one, because it lets us focus on the threats that have a high combination of probability and impact. The second (2) is just blindness - due to being overly focused on the budget of the moment – or even thinking of that particular threat as a hoax. In any case, it certainly doesn't make the threat - in this case, a big one - go away. The cold blob is a textbook early warning signal. It's exactly the kind of trigger you build into a risk register — a leading indicator that something larger and more serious may be developing. The AMOC story only exists because instruments were in the water, collecting data, year after year, long before anyone knew what they were looking for. Remove those instruments, and the next warning signal goes undetected. You don't retire the risk. You just lose your only chance at a timely response. If we think of the Earth — its climate, oceans, ecosystems, and inhabitants — as a long-running program (the ultimate long-running program!), then NOAA's monitoring network is its status reporting system. Its dashboard. And no project leader, facing budget pressure, or scared of a threat, or thinking the threat may be a hoax, starts by unplugging the dashboard or covering up the nasty bits by turning off sensors or covering them with black tape. You might reduce scope. You might defer features. But you protect and keep scanning the sensors of your project or program - because without them, you're not managing the project anymore. You're just hoping. People, Planet, and Profit all suffer here. People lose warning systems for hurricanes and floods. The Planet loses its ability to detect accelerating changes before they become irreversible. And Profits — fisheries, insurance, coastal real estate, agriculture — all depend on the data these systems provide. The cold blob is a gift, in a way. It's nature handing us an early warning signal, right on schedule, exactly as our monitoring systems were designed to catch it. It’s a “Check Engine” light. And that brings us to Boston (Cambridge, actually) and a beloved show called Car Talk (which unfortunately has gone silent after many years). Learn about the history of The Car Talk Guys here. It’s worth a side trip.  Fans of this late, great NPR show Car Talk will remember that Click and Clack (wacky but brilliant brothers Tom and Ray Magliozzi, MIT graduates and car repair shop owners, pictured above) had a running joke about the "check engine" light. Callers would describe their dashboard warning lights and wonder what to do about it. The brothers' tongue-in-cheek solution? Black tape. Just cover it up. They even sold their own branded Car Talk Black Tape — the ultimate solution to any dashboard warning light, guaranteed to make the problem invisible. It's funny because it's absurd. Everyone knows that putting tape over the check engine light doesn't fix the engine. The threat is still there. You've just made yourself blissfully unaware of it. And yet… Defunding NOAA's ocean monitoring network is black tape at planetary scale. The AMOC doesn't care about our budget process. It doesn’t care whether we think climate change is real. The cold blob doesn't disappear because we stopped measuring it. We've just taped over our check engine light. I hope we peel it off soon.  |
