In the recent past, waterborne and foodborne diseases such as cholera and typhoid fever were among the leading causes of death across the globe. For example, in 1900, typhoid fever accounted for nearly 2% of deaths in the US (35,000 deaths) (Census, 1900). Fortunately, advancements in water and food sanitation practices have significantly reduced the spread and damage of these infections in many countries, especially high-income countries (Vanderslott, et al. 2023; CDC, 1999).
However, amid these improvements, a persistent public health challenge remains: respiratory infections. Ranging from the seasonal flu to the common cold and the unprecedented challenge of COVID-19, these diseases often spread indoors via air and respiratory droplets. Even in years without a major outbreak, respiratory infections account for over 4% of deaths in high-income countries (400,000 deaths per year) (IHME, 2024). Although measures such as ventilation, filtration, and vaccines have aided in reducing indoor respiratory disease transmission, there is still considerable room for improvement. One innovative solution, germicidal ultraviolet light (“GUV”), holds promise in further combating respiratory infections. Policymakers and philanthropists should consider using market shaping instruments to incentivize research and development (“R&D”) and, potentially, scale-up of GUV technology given the potentially large social benefits.
Germicidal ultraviolet light (GUV)
Germicidal ultraviolet (GUV) light, a subset of ultraviolet (UV) light can inactivate bacteria and viruses (Sliney, 2021). Historically, GUV’s applications have been limited to uses where humans are not directly exposed (Reed, 2010). However, researchers have also explored using different wavelengths within the GUV spectrum for indoor air disinfection that directly exposes humans and, therefore, has more protective potential. Interest in this application increased during and after the COVID-19 pandemic. Nevertheless, before the technology can scale, critical questions about safety and efficacy need to be answered and costs need to come down substantially.
Market failures
The presence of two market failures suggests that there may not be sufficient commercial incentives for firms to quickly research and develop this technology:
- Positive externalities – The societal benefits of enhanced indoor air quality extend beyond individual buyers. In addition to reducing the likelihood of infection for the buyer, indoor air quality interventions, such as GUV, reduce transmission throughout society, broadly. This societal benefit constitutes a positive externality.
- Public good – Research into the safety of, efficacy of, and cost reduction opportunities for GUV represents a public good. This potentially poses funding challenges. Patents incentivize some research into these areas but bring concerns that intellectual property will keep costs high and, thus, adoption low. On the other hand, certain aspects of GUV technology may not be eligible for patents. While the absence of patent protection prevents firms from monopoly pricing, it may also lead firms to abstain from financing essential research endeavors. Insofar as firms do invest in research, they may keep information as trade secrets given the potential to use it later for future business decisions or consulting offerings.
The opportunity for market shaping
These market failures may reduce private investment in the R&D necessary to make this product commercially viable. A combination of push (e.g., grants) and pull (e.g., prizes) funding can bridge this incentive gap.
While researchers have made significant progress, further push funding is needed to conduct additional safety and efficacy studies in both laboratories and real-world settings. Key questions concerning skin safety, eye safety, and ozone production still need to be studied further (Gorlitz, 2023). Additionally, it’s important to better understand the relationship between GUV adoption and disease transmission (as opposed to the relationship between GUV adoption and pathogen inactivation) (IFP, 2022).
The relationship between society-level adoption of GUV technology and disease transmission may be nonlinear. For example, there may be increasing returns to adoption, indicating that higher adoption rates could yield disproportionately greater reductions in disease transmission. A better understanding of this relationship is essential for gauging the value of GUV usage and determining optimal adoption thresholds.
If GUV proves safe and effective, policymakers and philanthropists can use pull funding to incentivize additional R&D necessary to bring affordable products to market at scale. Funders could use their understanding of the relationship between adoption and disease transmission to tailor funding strategies. For example, perhaps, greater incentives could be offered if optimal society-level adoption rates were hit.
Multiple pull funding strategies should be explored, but advance market commitments (“AMC”) may be a promising tool for incentivizing the development and scale-up of GUV technology. An AMC entails a commitment to subsidize a product meeting specific criteria. In the context of GUV, an AMC could hinge on the technology receiving certain regulatory approvals and/or meeting critical price and scale thresholds. Furthermore, one nice feature of AMCs – which tie payments to uptake – is that they incentivize the development of products desirable to buyers, such as fixtures that are easy to install.
Given that customers like cruise operators and office buildings stand to derive some private benefit from GUV installations, they may have an interest in hosting research and financially supporting push and pull funding. Nevertheless, policymakers and philanthropists should consider providing significant funding for these studies and units, given the potentially large social benefits.
Conclusion
While sanitation measures have curtailed the prevalence of waterborne and foodborne infections, respiratory infections persist as a formidable health challenge. GUV technology presents a promising tool to address this challenge. Funders can use a combination of push and pull funding to determine the safety and efficacy of GUV and, if deemed safe and effective, ensure widespread adoption of these technologies.
1Day Sooner, a leader in this space, is exploring these issues as part of their ongoing work and Phase II of our Innovation Challenge. The team is led by Gavriel Kleinwaks, Indoor Air Quality Lead, and advised by Dr. Richard Bruns, Senior Scholar at the Johns Hopkins Center for Health Security.
Want to get in touch with MSA about our work in this area? Please reach out to [email protected].
Learn more
1Day Sooner – Air Safety to Combat Global Catastrophic Biorisk
David Brenner – TED Talk: A new weapon in the fight against superbugs
Blatchley, et al. – Far UV-C radiation: An emerging tool for pandemic control
Vox – Ultraviolet light can kill almost all the viruses in a room. Why isn’t it everywhere?
