What is RIH

Responsible Innovation in Health (RIH) builds on the field of Responsible Research and Innovation (RRI), which promotes the involvement of societal actors in scientific and technological development processes through inclusive participatory approaches. The aim is to develop “ethically acceptable, socially desirable and sustainable” solutions to major societal challenges (von Schomberg, 2013). Innovation stakeholders operate in the private, public or non-governmental sectors and are involved at different stages of innovation: financing, design, production, regulation, diffusion, reimbursement, etc. These stakeholders possess complementary skills and pursue objectives that sometimes conflict with each other. Deliberation is therefore central to RIH.

The RIH conceptual framework is comprised of 9 attributes that should be considered when designing innovations, throughout their lifecycle and in the light of the context where users are located. These attributes highlight the processes by which an innovation is developed, its characteristics as well as the organisation that develops it and makes it available to users (Silva et al. 2018).

The nine RIH attributes in brief

Health relevance	Importance of the health needs addressed within the overall burden of disease, considering the causes of death, injury and disability and risk factors in the users’ region.
Ethical, legal & social issues (ELSIs)	Means by which the innovation’s negative impacts on the moral and sociocultural well-being of individuals and groups and the legal issues it raises can be mitigated.
Health inequalities	Extent to which avoidable health status differences across individuals and groups associated with one’s socioeconomic status, social position, and capabilities is reduced.
Inclusiveness	Degree of stakeholder engagement in the design, development and pilot stages of an innovation using an accountable method.
Responsiveness	Ability to provide dynamic solutions to existing and emerging challenges in health systems (e.g., demographic or epidemiologic shifts, service delivery or governance gaps).
Level & intensity of care	Labour intensity optimization by mobilizing the most decentralized unit in the health system to provide the service when it is possible to do so effectively and safely.
Frugality	Provision of greater value to more people using fewer resources through a focus on: affordability; core functionalities and ease of use; and optimized performance.
Business model	Propensity to provide value to society: social, not-for-profit, or environmental mission; patent-free innovation; redistributive price scheme; employees with particular needs, etc.
Eco-responsibility	Reduction of negative environmental impacts along the innovation’s lifecycle stages: raw material sourcing; manufacturing; distribution; use; and disposal.

What RIH is not

RIH considers responsibility in the processes and decisions of organisations that develop and bring innovations to market, including their suppliers and distributors. These organisations must comply with environmental regulations, adopt proper governance frameworks and respect human and labor rights. Corporate Social Responsibility is necessary for RIH, but it is not sufficient. The 9 RIH attributes rather draw attention to the way health innovations foster equity and sustainability in health systems.

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