I’m just returning from the Global Forum for Health Research meeting in Havana, Cuba. The theme of this year’s meeting was “Innovating for the Health of All.” As a veteran of the biotechnology industry I thought I knew something about innovation. After all, innovation has been the engine behind the emergence of biotechnology worldwide from a cottage industry in the late 1970s to a vital force for improving health care and building national wealth. But I encountered a new and puzzling use of the term innovation, in the form of “social innovation” to address global health needs.

To understand social innovation in the context of global health, I spoke with Rakgadi Mohlahlane, a senior researcher at the University of Pretoria in South Africa, whose focus is HIV medical education in Africa. She described one of the problems that she is passionate about addressing: how can one design programs for HIV therapy for residents of remote African villages? In South Africa, it is estimated that 5.2 million individuals are living with HIV among a population of 27 million people. The country has one of the world’s largest HIV treatment programs with about 5 million people taking antiretroviral (ARV) therapy, but it primarily reaches urban residents and has not penetrated into more remote, isolated settings.

Why does this problem require “social innovation?” Providing ARVs isn’t just a matter of sending pills along with instructions for use. First, the knowledge that someone is HIV-positive is profoundly transforming for the individual, for their family, and for their community contacts. And while testing is an essential first step in controlling the epidemic, it’s a step approached fearfully and is often avoided by individuals who may be HIV-positive. Infection is still a cause for social opprobrium, which is perhaps even more intense in small communities where it is difficult to find the refuge of anonymity. Second, there is an intense need for culturally appropriate medical education—on the value of knowing one’s HIV status, on the complex management of this disease, and on the appropriate precautions for both HIV-positive and HIV-negative individuals. Third, implementation plans have to take into account the dearth of medical professionals who can provide oversight of patients to stay on chronic therapies or make adjustments to regimens. ARVs can have serious side effects; regimens can be complicated; and poor compliance can result in the development of drug resistance. How do you effectively support a patient in an isolated village of 600 people who must take a chronic therapy for the rest of his or her life?

Think of the challenge of developing an HIV testing and treatment program for a rural and scientifically unsophisticated community in Africa. And then multiply by the tens of neglected diseases and hundreds of different community, religious, and social contexts around the globe. And that’s how I came to understand the need for social innovation in the context of global health.

David Cook is the Vice President of Business Development at BIO Ventures for Global Health.