What kind of effort might have the greatest leverage in changing people’s health, especially in the developing world where resources are often limited? For decades, this question has been at the heart of debates on how to improve health around the world.

Efforts to answer these questions have resulted in two broad areas of inquiry. First, how best can we set up our health systems, and second, how best can we use resources to finance health systems. But is there a different way to think about how best to leverage our efforts and resources in changing people’s health?

A few weeks ago I had an opportunity to engage with friends at Vital Strategies in Singapore to ponder upon these issues. There I made a case about how we use “scientific knowledge” may offer an alternate way of exploring this question. Specifically, for organizations like Vital Strategies that aim to maximize the impact of their work in improving public health and healthcare delivery around the world, understanding scientific knowledge as a point of leverage to maximize the impact of their work could be insightful. This could also inform where resources and programmatic priorities should lie to maximize impact.

The ecosystem of scientific knowledge production and use runs on a spectrum. At one end of that spectrum is the production of scientific knowledge itself. This part is often understood as the basic research leading to scientific discovery or invention. For example the discovery of the fact that germs cause disease. At the other end of the spectrum is the use of that knowledge to benefit mankind — the use of antimicrobials to treat an infection. In the middle is the important task of translating the basic scientific discovery into a product or a service to benefit mankind.

The sequence of events that lead to the creation of antimicrobials is illustrative. In 1882, building on incremental scientific advances made by Louis Pasteur and others, Robert Koch discovered the Tubercle bacilli as the cause of Tuberculosis. This discovery resulted in Koch’s postulates — the boundary conditions under which a germ may be implicated as the cause of a disease. Based on this scientific knowledge, a German physician named Paul Ehrlich, conjured up an idea that it may be possible to create a specific microbial agent against the germs that cause diseases.

In 1910 — for the first time in human history — Ehrlich created Salvarsan, an antimicrobial agent that was astonishingly better at treating Syphilis than existing therapies. The treatment of Syphilis, a disease that was rampant at the time, was quite unsuccessful until then, and not for the want of trying. Salvarsan, a product that resulted from the scientific knowledge that resulted from our centuries long quest in trying to understand the cause of diseases, was successful in treating a disease considered the bane of human civilizations.

Soon after, Salvarsan was distributed to people around the world; millions of people benefited, and it also led to the creation of several antimicrobial agents including Penicillin that we use even to this day.

This begs the question, which was the most important leg of the work that resulted in people being able to be treated from antimicrobial infections? Was it Pasteur and Koch’s initial scientific discovery, Ehrlich’s translating that scientific knowledge into a successful product Salvarsan, or the distribution and use of Salvarsan around the world?

A case — and a successful one — may be made that, for the amount of time, effort and resources that went into each of these three legs of activities, the middle portion of translating scientific knowledge was the one that resulted in the greatest relative impact for the effort. So for organizations and individuals that are intent on making the greatest impact for the limited time, effort and resources that they can bring to the table, translation of scientific knowledge and discovery into successful products and programs may be the best activity they can engage in.

There are other reasons why the translation of scientific knowledge into products, programs, or even policies may be the most impactful activity. There has been a breathtaking expansion of the scientific knowledge base in health sciences, however many people in resource limited settings have been unable to benefit from these scientific advances because the technical know-how and the effort required to translate these bits of knowledge into usable programs, services or products does not exist in many communities.

For example, the knowledge that tobacco taxes are the most effective way of reducing cigarette smoking has been known for quite some time now. However the use of this knowledge to improve tobacco policies has been suboptimal in many countries. In Nepal alone, harmonizing tobacco control policies according to the latest available scientific evidence could substantially reduce tobacco consumption and save tens of thousands of lives per year. The translation of this bit of scientific knowledge into effective policy is one of the most effective ways in improving population health.

Doing translational work is not without its challenges though. There are conditions that have to align before being able to do this kind of work. The first is to find oneself in a bridging role between where the knowledge is created, and where the knowledge could be useful. It means having a ring side view of several intellectual and implementation domains that may expand from basic sciences, epidemiology and public health, clinical medicine, public policy, economics and business to the social sciences. It also means being able to bridge geographies, cultures and disparate professional environments.

Recent technical advances mostly in communications, artificial intelligence, genomics, and structural biology in general are poised to result in a Cambrian explosion of novel scientific knowledge and ideas. The opportunity to impact human health by translating these ideas into successful products and services to benefit all of mankind is tantalizing. Individuals and organizations that are situated to do such translational work should grasp this opportunity, because therein lies the opportunity to make the greatest impact on human health for the amount of effort expended.