🔍 I speak with Rubayat Khan, a systems thinker, entrepreneur, and now investor at the Endless Foundation, where he is helping reimagine how global health innovation is funded and delivered.

We unpack what it means to move beyond vertical health solutions, how to prioritize innovation in an era of shrinking aid budgets, and how large language models (LLMs) might be the missing piece in unlocking integrated, people-centered care especially in low-resource settings. We also talk about the challenges, risks, pitfalls and how to think about the right counterfactuals for the context when we evaluate LLMs in healthcare.

Rubayat brings the rare perspective of someone who has been a patient, builder, and funder, and who now advocates for rethinking everything from clinic hours to global incentive structures.

🔑 In this episode:

• Why governments are not always best placed to design people-centered care : an example of this was the fact that government run clinical in villages in rural Bangladesh were only open 10am till 2pm. And so nobody would access them as people are working on the fields or caring for their family. 
• Four priority areas Endless Foundation is focusing on
• How LLMs could shift access, quality, and cost curve if implemented thoughtfully
• Why self-care is the blind spot we can no longer afford to ignore
• The dangers of "digital colonialism" and what needs to change in global AI governance
• What funders can do differently to support impact beyond rhetoric

🗣️ Key Quotes

“Most of what we call healthcare happens outside clinics. If we ignore that, we miss the biggest opportunity for real impact.”

To paraphrase Rubayat:
"A consultation with a doctor in Bangladesh averages 48 seconds. There should be little surprise that people (including Rubayat's parents!) find value and better quality information with a LLM than they would in their own contexts. 

So much valuable insight for people who are building, or wrestling how to invest or fund the right interventions for last mile impact in LMICs. 

🎧 Listen if you’re:

• A global health funder or innovator rethinking priorities post development cuts
• A builder working on AI in healthcare
• A policymaker exploring people-centered design
• An innovator aiming to solve real problems in underserved settings

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About Rubayat

Reubayat's Substack: https://rubayatkhan.substack.com/

Rubayat Khan is a health entrepreneur and technologist from Bangladesh and currently Director of Health Programs at Endless Network, a US family foundation. Prior to Endless, Rubayat co-founded mPower Social Enterprises and Jeeon, which have both pioneered innovative models for delivering healthcare and other essential services to last-mile populations across 15 countries, currently reaching over 120 million people. Rubayat is a passionate advocate for bottom-up and user-centered thinking in global health, and has written extensively in leading global publications like the Guardian, SSIR and Frontiers in Public Health. He is an Acumen and Aspen New Voices Fellow, and is currently based in Baltimore with his wife and two children.

• (00:00) - Introduction
• (08:33) - Navigating the Challenges of Healthcare in Bangladesh
• (10:46) - Transitioning from Ground-Level Solutions to System-Level Thinking
• (18:07) - Identifying Key Challenges in Global Health Systems
• (23:20) - Seizing Opportunities Amidst Crisis in Global Health
• (29:30) - Leveraging AI and Technology for Healthcare Transformation
• (37:49) - AI vs Human Decision-Making in Healthcare
• (41:26) - Evaluating AI in Healthcare Contexts
• (44:07) - AI's Potential in Low-Resource Settings
• (46:47) - Concerns About Digital Colonialism and Data Ownership
• (51:05) - The Need for Coordinated Leadership in Healthcare
• (54:26) - Finding the Right Problems to Solve