Good design solves problems.
Great design solves problems that matter: public health

Video

Why should designers and tech people focus on hard problems?

A 25 min video explaining why we want to see more designers and tech people tackling urgent global issues (and why this is so challenging).

We were asked to present about Hard Problems at the wonderful Leading Design conference in London in November 2025. It’s a gathering of design leaders from around the world, from Chief Design Officers at big companies like Vinted to leads at large public sector technology teams like the UK’s Government Digital Service.

Thank you to the team at Clearleft, who organize Leading Design, for the invitation.

The talk

This talk was given by myself, with my co-founder Mahima Chandak coming in over video from Bangalore, India.

My career spans back to the late 1990s — including the sale of my startup, Milk to Google and a subsequent tenure at Google Ventures (where I co-authored the book Sprint) and worked with many startups. I left that world to work in global public health for the last 8 years and I drew on that experience to explain why I think more designers should follow a similar path.

While I don’t think corporate tech jobs entirely “poison” individual talent, I argued that business models inevitably dictate and compromise the desire to optimize for what’s best for the world at most organizations. We often hear corporate slogans that, on the surface, sound meaningful but ultimately the real goal is sell ads, sign-up more paying users, or ink business deals.

“The best minds of my generation are thinking about how to make people click ads. That sucks.”

Jeff Hammerbacher

Is corporate work the only option?

There is a fundamental misalignment between many designers’ professional aspirations and market realities. I recently visited the Royal College of Art graduate presentations, where service design students in their Masters program presented sophisticated projects for inspiring problems like the diabetes care pathway and support systems for victims of sexual assault. Almost none of these ambitious students will be working on those problems in a few years’ time — economics routinely funnel top-tier young designers into corporate roles.

Mahima echoed this frustration, noting that while human-centered design programs in India train students to tackle community health crises and childhood malnutrition, the market offers virtually no employment for such roles upon graduation. This structural disconnect, I argued, explains a widespread “malaise” and historic burnout within the design community, as highly compensated tech workers increasingly realize their labor yields little societal value compared to lower-paid professions like nursing or teaching.

Invoking the Japanese philosophical framework of Ikigai, I asserted that while many contemporary designers successfully align what they love, what they’re skilled at, and what pays well, they fundamentally neglect what the world actually needs.

I emphasized my personal ethos by referencing a tattoo on my wrist: “Don’t make anything unless it’s necessary, but if it’s necessary don’t hesitate to make it beautiful.”

“Don’t make anything unless it’s necessary, but if it’s necessary don’t hesitate to make it beautiful.”

Shaker design philosophy

Examples from the field

To demonstrate the viability of design-for-good, I shared my last eight years leading Simple, an open-source electronic medical record built alongside former CDC Director Dr. Tom Frieden. Deployed in Bangladesh, India, Ethiopia, and Sri Lanka, where primary care clinicians will manage up to 120 patients a day at a pace of one patient every two minutes, the app was designed to record data in under 13 seconds, successfully returning the clinician’s focus back to the patient and driving critical feedback loops into the health system that actually create systemic improvement in patient outcomes. If you want to learn more about Simple, this case study in BMJ (the British Medical Journal) is helpful.

Mahima introduced a second case study: a mobile-based screening application for oral cancer in rural India. The disease claims five Indian lives every day due to the widespread cultural practice of chewing betel nut, a potent carcinogen. To bridge the gap where rural patients have zero access to oncology specialists, Mahima’s team designed an intuitive app that enables frontline healthcare workers — many unfamiliar with smartphones — to capture oral cavity photos for automated AI risk assessment and immediate clinical referral.

Mahima also outlined an ongoing climate preparedness initiative with a regional disaster management unit to combat dangerous heatwaves across India. While affluent citizens rely on air-conditioned offices, outdoor laborers like farmers face skyrocketing rates of heatstroke, rage, and suicide. The project relies on behavior and information design to share information with vulnerable communities, allowing them to dynamically alter their daily routines.

Hard problems are hard

I explicitly cautioned the audience against technological hubris, citing historical missteps like the “One Laptop per Child” program as examples of arrogant developers expecting hardware to solve deeply rooted poverty. I strongly suggested reading the excellent book Geek Heresy by Kentaro Toyama that gives excellent caution and guidance on how to create technology and design that might actually accomplish your goals on hard challenges. Complex humanitarian problems cannot be fixed simply by throwing isolated technologies at them; they require an understanding of economics, local politics, partnerships, and long-term, iterative solutions developed with local stakeholders.

I didn’t minimize the real financial trade-offs required to engage in this work — most organizations working for the public good will never be able to compete on salary directly with the Googles of the world.

Furthermore, because the practitioners operating in global public health humbly keep their heads down rather than chasing viral engagement on LinkedIn or TikTok, these career paths remain largely invisible to the broader design community. This is an issue we would like to see changed.

It’s possible to change the culture of design

In a final call to action, I urged the design community to establish a unified professional ethos, explicitly comparing the moment to the American legal revolution of the late 1960s, when a generation of Ivy League lawyers left corporate firms to join “Nader’s Raiders” and successfully pass landmark safety and environmental laws.

I hope we can change the culture of tech and design to value people who have dedicated many years on gnarly problems like climate change, public health, and good government. Just because we currently don’t value these things enough, doesn’t mean it needs to stay that way. We, as a community, could choose different values.

I closed by introducing Hard Problems. We hope you join us on this journey.