Gordon Perkin, He Jiyi, and Peggy Morrow

Cofounder Gordon Perkin (left) and first full-time employee Peggy Morrow (right) with He Jiyi, director of the Tianjin Condom Factory in China, circa 1982.

An organization grows from big ideas and humble roots to improve health around the world

At a time when “population control” was the catchphrase of global reproductive health, three researchers in family planning were more interested in getting control into women’s hands and letting them make their own decisions about contraception.

Those three researchers—Gordon Duncan, Rich Mahoney, and Gordon Perkin—formed a nonprofit organization in the mid-1970s that would bridge public health agencies and private industry to make sure couples around the world had access to condoms, birth control pills, intrauterine devices, and other modern forms of pregnancy prevention.

The organization would succeed at these early goals in contraceptive technology and expand its focus to include an array of health technologies, developing a reputation for excellence and collaboration, for partnering with the private sector, and for smart, effective solutions to global health problems.

From orange shag carpeting in a cramped, converted apartment to a product development shop, high-tech laboratory, and offices in countries around the world—this is the story of the birth of PATH.

Need met opportunity

More than 30 years ago, Duncan, Mahoney, and Perkin saw an urgent need and prime opportunity for ensuring that newly developed contraceptives such as intrauterine devices and oral contraceptives, as well as condoms, reached people who needed them, especially those in developing countries. In China, for example, decades of isolation due to the Cultural Revolution left the country’s reproductive health technology lagging behind Western manufacturing and pharmaceutical methods.

Perkin recalls visiting a condom factory in China where, around a large table piled with condoms, older women rolled the prophylactics over air hoses, inflated them slightly, and held them close to their cheeks to feel for any leakage. “That’s the way they tested condoms when we arrived,” he says.

At the time, several US and European entities were researching and developing contraceptive technologies, but no one was taking them from the private-sector pipeline and bringing them into developing-country health programs.

“It was like the third person in the relay race was missing,” says Perkin, recalling the void in reproductive health that he and the other founders aimed to fill. Field staff were working with communities on the ground and researchers were developing new products, but a gap existed, he explains. “There was no one in that middle position to take new methods and pass them on to people in developing countries for introduction and use.”

Duncan, Mahoney, and Perkin—already acquaintances through their domestic and international contraceptive work—were asked to collaborate on a feasibility study commissioned by the United Nations Population Fund (UNFPA) to explore a new entity to fill this void for the developing world. When no existing organizations were interested in taking it on, the founders opted to start a new one.

They set up shop in Seattle with support from the Battelle Institute’s Population Study Center, where Duncan served as associate director.

Modest roots, overwhelming potential

With $92,000 in seed money from the Ford Foundation and a donated office carpeted in orange shag, the organization that would become PATH was born.

Initially called the Program for the Introduction and Adaptation of Contraceptive Technology, or PIACT, the organization drew on the extensive experience each of its founders had in international family planning. Duncan, a PhD and reproductive health expert, had a background in contraceptive research. Mahoney, also a PhD, supported contraceptive development for the Ford Foundation in New York. And Perkin, a medical doctor, worked with the Ford Foundation’s human reproduction programs in Latin America. Duncan became PIACT’s first executive director.

A counterbalance to family planning organizations

In Seattle, PIACT quickly became a counterbalance to the East Coast’s heavy presence of family planning organizations. It was one of the few organizations, if not the only one, linking contraceptive developers, contraceptive users, and contraceptive makers, and its mission strongly resonated with donors, Mahoney recalls.

The organization proved unique in its approach of pairing public and private entities to achieve health solutions. “I think we could say that PATH originated the concept of public-private partnerships, long before it became cachet,” says Michael Free, one of PATH’s earliest employees and now its vice president and senior advisor for technologies. “Right from the very beginning, we were engaged in public-private collaborations of one sort or another, and that’s been a feature of the organization all its life.”

Similarly, an international board of directors has been a longtime facet of the organization. From the very beginning, PIACT formed a board of directors made up mostly of people from the countries where PIACT was working. Board members helped staff address sensitivities in various cultures and effectively serve the needs of developing countries. “It really was key to our success,” Duncan says.

Improving contraception in China

In 1979, PIACT hired its first full-time employee, Peggy Morrow, and launched its first large-scale international project—assisting China with modernizing its contraceptive factories and boosting production to keep up with the country’s burgeoning population.

As the Chinese government made reforms to curb population growth, PATH’s expertise helped the country transform its contraceptive operations into medical technology and pharmaceutical manufacturers that met international standards. The endeavor turned into 15 years of work that dramatically changed the contraceptive landscape of China, gave millions of couples the tools to control and improve their health, and paved the way for future PATH projects to enhance lives in China.

A global presence, a growing mission

At the same time that PIACT was starting work in China, the organization was also launching projects elsewhere in Asia, which had an overwhelming need for access to contraception. In 1979, Mahoney moved to the Philippines to start a PIACT office in Manila and, later, in Indonesia and Thailand.

After a few years of operating under the name PIACT, the organization’s founders realized that the public health needs in developing countries—and PIACT’s skills—reached far beyond just contraception.

“It was quite apparent that we needed to work in a broader landscape,” says Perkin, “and what we were doing in contraceptive technology also made sense in (the broader context of) health technology.” To reflect its new direction, the organization in 1980 changed its name to PATH—Program for Appropriate Technology in Health. (As of 2014, we are known simply as PATH.)

A lasting impact

Three decades after its inception, PATH’s modest origins have given way to a headquarters with a state-of-the-art laboratory and product development shop in Seattle’s emerging center for global health, the South Lake Union neighborhood. PATH now employs hundreds of people around the globe, and our work reaches more than 70 countries and touches on every major global health issue.

We still have a strong foundation in health technologies tailored to low-resource settings, but our scope has expanded to include helping governments strengthen public health systems and helping individuals protect themselves and their families against disease.

PATH continues to stay true to the core values established in those early years. We are still guided by an international board of directors, and we continue to collaborate with public and private partners for effective outcomes. Numerous PATH publications—including the reproductive health newsletter Outlook, started in 1983—share updated information and research with global health colleagues. And PATH staff, representing diverse competencies, serve as professional advisors to myriad entities worldwide—from ministries of health and the World Health Organization to the biotechnology industry and local, on-the-ground organizations working to improve the health of citizens in their communities.

“Our work has allowed us to go into women’s homes,” Duncan says, “and while there meet their children, their parents, their aunts, and their uncles and really get to know them, sharing the problems, joys, aspirations, and the beauty of the family unit.”

Says PATH president and CEO Steve Davis, “Over 30-plus years, the landscape of global health and development has expanded, bringing with it new partners, new tools, and new opportunities to scale up the impact of our work. But at its core, our job remains the same: find and bring forward the innovative solutions that change families’ lives for the better.”

At PATH, we’re continuing to work toward a world where health is within reach for everyone.

Photo: PATH.