As a global health care company, we have a responsibility to help increase access to medicines, vaccines and quality health care worldwide.
We are committed to discovering smart, sustainable ways to expand access, especially in parts of the world where there are limited or no health care infrastructure and resources. Given the immensity of this challenge, we believe we can make the strongest contribution by working in partnership with others—governments, donors, patient organizations, health care professionals, nongovernmental organizations, academic institutions, multilateral organizations and the private sector.
We focus on select areas of global health need and relevance to our company, namely, noncommunicable diseases (NCDs) or chronic conditions in four areas: cancer, diabetes, hepatitis C, and HIV/AIDS. Our program investments in these areas focus on innovative interventions with evidence of effectiveness in improving health care quality and reducing disparities in access and health outcomes among underserved populations who are particularly burdened by these diseases.
African Comprehensive HIV/AIDS Partnerships (ACHAP)
In 2000, together with our company’s Foundation and the Bill & Melinda Gates Foundation, we established the African Comprehensive HIV/AIDS Partnerships to support Botswana’s national HIV/AIDS strategy for preventing new HIV infections and reducing morbidity and mortality associated with HIV/AIDS. Our funding of ACHAP concluded in 2014.
China-MSD HIV/AIDS Partnership (C-MAP)
This partnership between our company’s Foundation and China’s Ministry of Health is focused on strengthening integrated HIV treatment capacity in Sichuan Province’s Liangshan Prefecture, Chongqing Municipality and Fujian Province. C-MAP aims to improve the quality of HIV/AIDS management and treatment services as well as to expand overall treatment coverage.
HIV Care Collaborative
To help improve HIV care in the U.S., our company’s Foundation established the HIV Care Collaborative for Underserved Populations in the U.S. This initiative was established to support the efforts of local health departments in Atlanta, Georgia; Houston, Texas; and Philadelphia, Pennsylvania to connect more people living with HIV to the care and treatment they need to stay healthy. This initiative concluded at the end of 2015.
Population Services International (PSI)—HCV Prevention and Capacity-Building Program in Vietnam
With a three-year (2013–2015), $650,000 grant from our company, PSI implemented a program in Vietnam to strengthen capacity in hepatitis C (HCV) prevention across multiple health care sectors. This program helped to improve access to HCV-prevention information and education among at-risk populations to help motivate the adoption of HCV-preventive behaviors. Through advocacy and capacity-building efforts, this program also helped to raise awareness and build support for the expansion and integration of HCV-prevention services into national public health programming. Over the course of the three-year project, PSI reached more than 27,740 at-risk individuals with HCV-prevention education and information through a series of outreach events and face-to-face communications.
During 2014, PSI initiated the development of an HCV provider training curriculum in collaboration with the National Hospital of Tropical Disease (NHTD) to serve as the national curriculum for HCV training. This training curriculum was approved in 2015 by Vietnam’s ministry of health. At the outset of the project, PSI also collaborated with the NHTD to design and implement an HCV Prevention Master Training program. Following this training, master trainers trained HIV service providers from project provinces (Thai Nguyen, HCMC, and Nghe An) on how to integrate HCV prevention counseling and referral for diagnosis and treatment into their routine HIV services delivery. Over the course of the project, 52 HCV master trainers and 562 HIV service providers received training.
Over the course of the three-year project, PSI reached more than 27,740 at-risk individuals with HCV-prevention education and information.
PSI also implemented various community events designed to attract and engage members of at-risk communities by offering free haircuts or free motorbike washing while individuals received HCV prevention counseling. Data collected before and after the haircut-day events revealed a substantial increase in the percentage of participants who perceived themselves to be at risk of HCV, from 14 percent prior to attending a haircut-day event to 100 percent after-participation in a haircut-day event. These events reached more than 3,770 individuals at risk of HCV.
Alliance to Advance Patient-Centered Cancer Care
With funding from our company’s Foundation, the Alliance is seeking to increase timely access to patient-centered care and reduce disparities in cancer care, especially for vulnerable and underserved populations in the United States. Learn more.
Alliance to Reduce Disparities in Diabetes
With funding from our company’s Foundation, Alliance program partners worked to decrease disparities in diabetes outcomes and improve the quality of health care for underserved adults living with or at risk for diabetes in five communities in the United States: Camden, New Jersey; Chicago, Illinois; Dallas, Texas; Memphis, Tennessee; and Wind River Reservation, Wyoming. Learn more.
American Cancer Society – Patient Navigation Program
With a four-year (2015–2018), $1.58 million grant from our company’s Foundation, the American Cancer Society (ACS) is implementing a comprehensive Patient Navigation Program in the United States to enhance care coordination, promote patient activation and increase access to high-quality cancer care in three communities where substantial health care disparities exist. The program sites that the ACS has selected to participate in the community-based program include the Queens Hospital Center in Queens, New York; the Phoenix Cancer Center/Maricopa Integrated Health System in Phoenix, Arizona; and the University of New Mexico Cancer Center in Albuquerque, New Mexico.
This program aims to:
- Support patients in overcoming barriers to diagnostic services and timely initiation of treatment
- Empower patients with the information and skills to more actively engage in their health care, treatment planning and shared decision-making
- Support the navigation of treatment decisions, completion of treatment and follow-up care
The ACS plans a robust evaluation of the program and dissemination of its results to advance best practices in patient navigation.
Bridging the Gap: Reducing Disparities in Diabetes Care
With funding from our company’s Foundation, Bridging the Gap aims to improve access to high-quality diabetes care and reduce health disparities among vulnerable and underserved populations with type 2 diabetes in the United States. Learn More
Camden Coalition of Healthcare Providers – ACO Capacity Building
Through a two-year (2015–2016) grant, our Foundation is supporting the Camden Coalition of Healthcare Providers (CCHP) in its efforts to transform the delivery of primary care as a Medicaid Accountable Care Organization (ACO) in Camden, New Jersey. CCHP is working to bolster four key components of an effective, well-functioning ACO:
- Data: Expanding the scale and functionality of the citywide Health Information Exchange
- Clinical Redesign: Improving the quality and delivery of primary care through more efficient office work flow, performance score cards, and quality metrics
- Care Coordination: Implementing team-based care management and coordination for patients who are “high utilizers” of the health care system
- Community Engagement: Engaging community stakeholders through advocacy and outreach to build widespread support for the CCHP ACO
Preliminary results from these efforts are anticipated later in 2016.
Project ECHO® in India and Vietnam
Our company’s Foundation recently launched a new partnership with the Extension for Community Healthcare Outcomes (ECHO) Institute™ at the University of New Mexico Health Sciences Center through a $7 million, five-year (2017-2021) grant to support the expansion of Project ECHO in underserved communities in India and Vietnam. Through this partnership, we aim to improve access to specialty care for complex, chronic conditions such as: hepatitis C, HIV, tuberculosis, and non-communicable diseases, including diabetes and mental health conditions.
Project ECHO is a telementoring model that links multidisciplinary expert specialists with primary care providers through “virtual clinics” (teleECHO™ clinics) where the specialists mentor and share their knowledge through case-based learning, thereby enabling primary care providers to develop the ability to treat patients with complex conditions within their own communities. Read the full press release.
YMCA’s Diabetes Prevention Program
With a three-year (2016–2018), $2 million grant from our company’s Foundation, the YMCA will expand its Diabetes Prevention Program in 60 communities across five U.S. states: Illinois, Kentucky, New Jersey, Pennsylvania, and Texas. The YMCA’s Diabetes Prevention Program (YMCA’s-DPP) is an evidence-based chronic disease prevention program that aims to improve the health of participants with prediabetes through modest weight loss achieved by healthy eating and physical activity. It is also part of the National Diabetes Prevention Program led by the U.S. Centers for Disease Control and Prevention. Read the full press release.
We recognize that strengthening health systems and building health workforce capacity are important to improving access to quality health care and helping to address underlying barriers to health. Our investments in capacity-building are consistent with our corporate responsibility approach. Where feasible and appropriate, we seek to align our program investments with the health priorities of a country’s ministry of health (MoH) to help ensure program sustainability.
African Programme for Onchocerciasis Control (APOC)
The African Programme for Onchocerciasis Control (APOC) was established in 1995 by the World Health Organization (WHO) to carry out a sustainable strategy to control onchocerciasis (river blindness) in Africa using MECTIZAN® (ivermectin), our company’s broad-spectrum antiparasitic medication that treats river blindness. Starting in 2008, we committed $25 million over eight years to the World Bank in support of APOC’s continued development of country-led river-blindness efforts. In 2014, the APOC partnership supported treatment for an estimated 100 million people. In the coming years this number is expected to increase as the WHO and other partners pursue a strategy to eliminate onchocerciasis transmission using MECTIZAN, signaling a shift from a control strategy to an elimination strategy that will require broader treatment coverage.
Starting in 2008, we committed $25 million to the World Bank in support of APOC’s river-blindness efforts.
Recent years have seen wider efforts to integrate neglected tropical disease (NTD) programs, and resources such as the WHO NTD Roadmap and the London Declaration on NTDs—to which our company is a signatory—are helping to inform that process.
Learn more about the MECTIZAN Donation Program.
The Management and Leadership Academy of the BroadReach Institute for Training and Education (BRITE)
With a $4 million commitment from our company’s Foundation, the BroadReach Institute for Training and Education (BRITE) implemented its Management and Leadership Academy (MLA) program in Zambia. The program teaches critical management and leadership skills to health care professionals in order to build and strengthen the capacity of their local health systems. This program helped equip health care workers with the knowledge and skills to lead, own and, ultimately, transform the delivery of health care in their own countries.
BRITE worked with Abt Associates in implementing this MLA program and received additional support under the USAID-funded Zambia Integrated Systems Strengthening Program (ZISSP). BRITE and ZISSP worked in close partnership with the ministry of health and the National Institute of Public Administration (NIPA)1 in Zambia to support the ministry’s ongoing efforts to develop management and leadership capacity at different levels of the health system. The MLA program has been endorsed by the MoH as an important component of the government’s capacity-building efforts and is accredited by NIPA.
Through the MLA program, BRITE and its partners conducted training for health care professionals in all 10 provinces across 27 target districts of Zambia. Between 2011-2014, BRITE trained 767 health care professionals in MLA.
During 2015, BRITE conducted a survey of 90 MLA alumni. Their responses confirmed that the MLA training was relevant, helped improve the workplace climate in health facilities, helped strengthen the delivery of health services, and provided opportunities for career advancement. BRITE also focused on helping ensure MLA program sustainability by training 91 MLA master trainers within Zambia’s ministry of health in 2015. The master trainers enable the government to provide MLA training to more trainers, to increase the number of trainees, and to enhance its overall capacity to improve health services delivery. In 2016, BRITE will continue to advance long-term sustainability efforts by working to integrate MLA into the regular curriculum of the University of Zambia School of Medicine and NIPA’s general course offerings. Foundation funding for MLA concluded in 2015.
EngenderHealth—Mobile Outreach Program
With a three-year (2012–2014) grant from our company’s Foundation, EngenderHealth worked to build the capacity of health workers and implement mobile outreach services to increase the availability and accessibility of effective family-planning and reproductive health services among underserved, rural populations in Ethiopia. The program spanned 19 remote districts in three regions of Ethiopia: Amhara; Oromia; and the Southern Nations, Nationalities and People’s Region (SNNP).
In each region, EngenderHealth worked in close collaboration with ministry of health (MoH) partners to strengthen the capacity of health program managers and service providers. These capacity-building efforts facilitated the introduction and sustainability of high-quality family-planning services through regular outreach at decentralized health facilities that otherwise could not offer these services. EngenderHealth also worked with selected community-based organizations in each of the three regions to conduct training for community-level health providers and volunteer “health agents.” The training equipped community health providers and volunteers to be able to provide information and counseling on effective family planning through peer-group discussions.
The project used a “public-to-public” mentorship model whereby trained family-planning providers from higher-level health facilities provided services at lower-level sites that lacked the staff, infrastructure and supplies needed to provide services on a routine basis. This approach helped strengthen the district health system by training and orienting service providers and community volunteers as well as supporting the gradual transfer of skills and capacity between public health facilities to ensure the sustainability of the interventions.
Overall, the project built up the capacity of 23 host sites (four hospitals and 19 health centers) and 72 peripheral health centers to initiate and sustain regular mobile outreach services across the three regions. To date, 78 qualified family-planning providers from the 23 host facilities have received training and regular on-the-job clinical coaching and supportive supervision. Additionally, 152 service providers from mobile outreach facilities have received training to strengthen their counseling skills as well as their provision of family-planning services. An additional 592 health extension workers (community-level providers) received training on effective family-planning methods, counseling skills, referrals and client follow-up. The Mobile Outreach Program provided family-planning services to more than 31,000 clients and disseminated information to more than 251,000 married women of reproductive age and married men residing in some of the most remote districts in Ethiopia.
EngenderHealth completed an end-of-project evaluation and disseminated the results and lessons learned during three in-country workshops (one per region), including 178 participants from the Regional Health Bureau and Zonal Health Departments, and District Health officials and mobile outreach facility managers and providers, among others.
From the outset, the project considered the sustainability of the intervention by design and progressively provided capacity-building and technical support tailored to promote a smooth transition of the program to the MoH. By the end of the project, all implementing districts had prepared final sustainability plans for implementation, which affirmed the full transition of the Mobile Outreach Program to the government and ensured sustainability of the training and medical supplies.
Possible-Digital Supply Chain Management Program
With a one-year grant from our company, Possible is implementing an integrated digital model for pharmaceutical and consumable supply chain management within Nepal’s public health care infrastructure. The program plans to implement and refine an electronic stocking system that can be replicated throughout Nepal’s public health care system. This model aims to integrate with Nepal’s first electronic medical record (EMR) system and serve as a replicable model for Nepal’s health care system in order to expand reliable and consistent access to high-quality pharmaceuticals and consumables.
The project was first launched in 2015 through key investments in physical storage capacity at Bayalpata Hospital in Achham District, along with the launch and refinement of a digital OpenERP supply chain management platform for pharmaceuticals and consumables. In the first quarter of 2016, the system expanded to Charikot Hospital in Dolakha District (the area severely impacted by the May 2015 earthquake in Nepal).
Possible launched OpenERP at Bayalpata Hospital in September 2015. Since the launch of OpenERP, Possible has been able to more effectively manage its inventory of pharmaceuticals and consumables, leading to improvements in the average stock-out rate for all medicines and reduced costs in the pharmaceutical supply chain. Possible is now better able to predict stock needs and procure pharmaceuticals weeks in advance to maintain the needed supply. It is also better able to track and predict usage to further refine the pharmaceutical supplies that it receives from the government of Nepal. Additionally, since OpenERP links directly to the EMR, it allows Possible to track and manage its full supply chain, providing essential data that can be used to inform quality of care.
Save the Children Federation, Inc.—Frontline Health Workers Program
With a $5 million grant over six years (2011–2016) from our company’s Foundation, Save the Children is implementing frontline health worker training programs in Pakistan and Nepal. When properly trained and supported, community health workers, midwives and health assistants can help reduce the rates of maternal and infant mortality caused by preventable and treatable diseases, such as pneumonia, malaria and diarrhea, and from complications of pregnancy and birth.
In Pakistan, the project reached seven remote and underserved districts (Shangla, Battagram, Haripur, Malakand, Swabi, Buner and Charsadda) of the Khyber Pakhtunkhwa (KPK) Province to increase access to high quality, lifesaving maternal, newborn and child health services. The program also supported the National Maternal, Newborn and Child Health program of Pakistan’s ministry of health. To date, 3,796 frontline health workers have received training in Essential Newborn Care.
In addition, 2,911 Lady Health Workers (LHWs) and 40 Lady Health Trainers have completed their training on Community Case Management (CCM) of pneumonia, diarrhea and malaria. In the Battagram District, Save the Children, in collaboration with Pakistan’s department of education, completed the planning and implementation of the Accelerated Education Program, which helps women reach an eighth-grade education level so that they can be eligible for training as Lady Health Workers. Sixteen Accelerated Education Program centers (covering grades 6 to 8) have been established. Sixty LHW candidates (who have already passed grade eight) began the 15-month training program in 2014. Among this first cohort of trainees, 16 trainee LHWs were selected to join the national LHW program in 2015. Additionally, another 35 female candidates were selected in 2015 to participate in the Community Midwives Training Program. Save the Children program operations in Pakistan concluded in August 2015.
In Pakistan, the frontline health worker programs reached seven remote and underserved districts to increase access to high quality, lifesaving maternal, newborn and child health services.
In Nepal, the program focused on increasing the quality and coverage of maternal, newborn and child health services by training frontline health workers in two districts (Baitadi and Bajura) of the Far-Western Region. The project also focused on strengthening national-level activities to improve the quality of pre-service frontline health worker training in maternal, newborn and child health services at Nepal’s health institutes. To date, 944 frontline health workers, traditional healers, Female Community Health Volunteers (FCHVs) and other stakeholders have been trained for the Community-Based Newborn Care (CBNC) Program in the Bajura District.
During 2015, Save the Children completed pre-service training of approximately 60 nursing focal teachers. Training focused on skills and knowledge regarding essential newborn care. Save the Children also has worked closely with Nepal’s child health division of the department of health services to help ensure a smooth transition of the Community-Based Integrated Management of Newborn and Childhood Illness (BC-IMNCI) Program to the government of Nepal in Baitadi and Bajura Districts. Save the Children plans to expand the CB-IMNCI Program in two new regions (Dang and Kailali) of Nepal during 2016.
AmeriCares—Health Workforce Safety
In 2014, we donated $25,000 and 5,400 doses of RECOMBIVAX® HB to AmeriCares to help protect health workers and medical students in Tanzania’s Lake Zone against hepatitis B infection. The goals of the program include increasing hepatitis B coverage to 90 percent among health workers and students; collaborating with the ministry of health and social welfare in its objective to increase hepatitis B vaccination coverage among high-risk health workers nationally; and documenting program outcomes including workplace satisfaction; effective infection prevention and control protocols; effective reporting of needle-stick injuries (and a decline in numbers); and best practices in waste segregation. As of December 2015, a total of 1,652 staff and medical students were vaccinated, along with a percentage of new hires throughout the program implementation, which ran from January through June 2015. Some of the lessons learned were that hepatitis B vaccination was more successful (better turnout and and a higher attendance at follow ups) where sensitization campaigns on the need for vaccination were held prior to actual vaccination, and screening prior to vaccination followed by individual counseling for those who were hepatitis B–positive was very helpful in avoiding false expectations and reducing wastage of vaccines. The program builds upon the successes of the Health Workforce Safety Program conducted from 2009 through 2012 by AmeriCares (also with support from our company) at the Bugando Medical Centre in Tanzania.
1NIPA is the national academic institution whose mandate is to build capacity in the Zambian civil service.