Message to grads: innovate for good

Portrait of Steve Davis.

Steve Davis. Photo: Auston James.

Last Saturday, PATH President and CEO Steve Davis delivered the commencement address to the 2013 graduating class of City University of Seattle. Davis challenged the graduates to use innovation and creativity to change people’s lives for the better, and he shared stories of different types of innovation he’s seen in his career. Below is an excerpt from his speech.

Every day, I think about—some might say even obsess on—how to use innovation and creativity to change our world. I try to avoid the trap that creative genius and innovation is only relevant to artists, or inventors, or technology stars. I have come to deeply appreciate that there is an enormous opportunity—in fact, an enormous need—for finding, deploying, exploiting, and even demanding innovation and creativity in every walk of life, in every type of work, and in tackling every kind of issue.

A few weeks ago, I went to South Africa for my work as the leader of PATH. I was visiting a health clinic in a township where poverty is rampant. More than 200 babies are born at the clinic each month. But too many women are dying in childbirth because they don’t have access to the services and tools they need for good health.

The head nurse of this clinic was this incredible lady—weathered, funny, determined. She’s doing heroic work in a very difficult environment, making sure she and her staff can save as many lives as possible.

Three women holding babies on their laps.

Mothers and their children at a South African health clinic. Photo: PATH/Wendy Stone.

Simple innovation saves lives

As we toured the clinic, she showed me the government-issued log books where she manually fills in information on each patient. I noticed that she had drawn a number of vertical lines in the book to create extra columns.

So I asked her what these were, and she said that she needed to collect more information on each patient in order to determine better treatments. She needed to look at the trends and data differently in order to save more women’s lives. So she figured out a simple, on-the-spot way of changing the process.

Now that’s innovation that really matters. Continue reading »

In the news: pig spill, poo wars

It must have been a tough choice for New York Times op-ed contributors Charles J. Vorosmarty and Claudia Pahl-Wostil: Lead off with the dead pig spill in China’s Huangpu River, the 8 million plastic discs covered with sewage in Massachusetts’ Merrimack, or the annual 16-ton load of ashes from cremated bodies in the Ganges? And if that’s not enough to grab your attention, read on for the really shocking part: “Exposure to unsafe drinking water and inadequate sanitation results in 3.4 million deaths, mostly poor children, each year from diarrhea, yet this fact never makes the news.”

Delivering water from disaster

The New York Times, June 10, 2013

If one incident best highlights the perilous state of the world’s fresh waters, it’s the “pig spill” in China last March. After the slaughter and illegal dumping of a diseased herd, the authorities in Shanghai went fishing for 16,000 bloated carcasses in the Huangpu River, which flows through the city. Hardly the thing you wish to hear about if you use the Huangpu for drinking water.

Read the article.

Child stands in front of a row of toilet stalls.

A row of toilets in Kenya. Photo: PATH/Jesse Schubert.

Cape Town ‘poo wars’: 180 protesters arrested in South Africa

GlobalPost, June 11, 2013

At least 180 people were arrested on Monday, some carrying bags of human waste, ahead of a planned protest dubbed the “poo wars” over the lack of proper sanitation in Cape Town.

Read the article.

Mapping infectious disease

Humanosphere, June 12, 2013

The Council on Foreign Relations, its global health program, has produced an excellent map of vaccine-preventable disease outbreaks worldwide.

Read the article.

A new day for cancer screenings

Guest contributor Dr. José Jeronimo is senior advisor for women’s cancers with PATH’s Reproductive Health Global Program.

It may sound like an oxymoron, but I recently attended a very exciting medical meeting.

I don’t come away from all professional gatherings fired up, but this one was special, in part because it was the culmination of a decade of work to improve the detection and treatment of cervical and breast cancers in low- and middle-income countries. But mostly, it was exciting because I saw such heartening signs of progress in improving the health of women and girls in a part of the world I used to call home.

I am Peruvian, and for years I practiced as a gynecologist and oncologist in Lima before emigrating to the United States. In those days, the Pap test was the norm for screening for cervical cancer. It’s still a familiar test for women in the United States and many other countries, and in some places it still can be effective in detecting cervical cancer early and saving lives.

Three women, wearing matching blue vests and nametags, link arms and smile for the camera. Photo: PATH/Tara Hayes Constant.

Peruvian health promotoras educate women about breast cancer. Photo: PATH/Tara Hayes Constant.

But in most low-resource settings, the Pap test doesn’t work very well. The test requires access to well-run laboratories and highly trained staff, both in short supply outside of urban areas in Peru and most developing countries. Pap is expensive and detects only about half of precancer cases. It’s inconvenient for women who must travel to health facilities miles from their homes and return several times for tests and treatment if their results aren’t normal.

As for screening for breast cancer, mammography simply isn’t available in many parts of Peru. Continue reading »

In the news: TB neither gone nor forgotten

By now, even casual observers of public health know that if tuberculosis ever was a disease of the past, it is no longer. This week, National Public Radio’s Jason Beaubien filed a moving story from Moldova, a small country once part of the former Soviet Union that’s been hit hard by forms of the disease tenaciously resistant to treatment. At PATH, the story sounded familiar. Since 2002 our staff has been working to improve detection and treatment of TB in another former Soviet republic, Ukraine. We have a great slideshow about the problem and our work to solve it. We’re also working in other regions of the world where TB is a serious threat, including Africa and Southeast Asia.

Faces of drug-resistant tuberculosis

NPR, June 4, 2013

Forms of tuberculosis are emerging that are costly, difficult, and, at times, nearly impossible to treat. This new, worldwide threat is called multidrug-resistant TB, and it occurs when the bacteria no longer respond to the most common TB medications. Doctors have to turn, instead, to older, less effective drugs that can have devastating side effects such as hearing loss, blindness, aches, and severe depression.

Read the article.

Two men like on single beds.

Two men share a room in a Kyiv hospital dedicated to tuberculosis treatment. Photo: PATH/Mike Wang.

UN: global malnutrition costs are unacceptable

Voice of America, June 4, 2013

Global hunger, poor nutrition, and obesity are costing the world trillions of dollars in health costs and lost productivity, according to a new report from the UN Food and Agriculture Organization. The report says fighting hunger is not enough. Tackling the more complex problem of malnutrition calls for action across the entire food system, from farm to fork.

Read the article.

HPV prevention: vaccination works

The Guardian, June 3, 2013

No one wants to become infected with human papilloma virus, commonly known as HPV. Not Michael Douglas, who has recently talked to the media about his HPV-induced oral cancer and how he thinks he caught it. Not Jade Goody or Anita Mui, two celebrities who died young of cervical cancer, which is entirely attributable to HPV. And not the estimated 600,000 men and women worldwide who each year develop a cancer linked to one of the ten varieties of HPV infection that are spread through sexual intercourse and promote genital and oral cancer. More than half of them will die of their cancer, many in the developing world and without receiving any treatment.

Read the article.

The new idealism of international aid

The Atlantic, May 29, 2013

In 2002, the Ethiopian Federal Ministry of Health set out to provide primary health care for the nation’s 85 million rural citizens—many of whom didn’t live within accessible distance of a hospital or even a doctor. The plan was shocking to some, said Dr. Kesetebirhan Admasu, Ethiopia’s Minister of Health. After all, they had given themselves only five years to implement it, and lacked both the resources and facilities needed to train an anticipated 30,000 community health workers. With only a year of training, these workers would be sent out to villages across the country to address disease prevention and promote general health. Since the program’s unlikely implementation, however, Ethiopia has seen decreases in the number of women dying in childbirth, and in children dying before the age of five, among other markers of success.

That Ethiopia’s health care development began with simple, community-driven improvements, instead of through “top-down” means like the creation of hospitals, is itself significant. Equally important, however, is that the idea was implemented by the nation’s own government.

Read the article.

Equity in immunization

Guest contributor Andy Seale is director of advocacy and communication for the Vaccine Implementation Technical Assistance Consortium, part of our Vaccine Access and Delivery Global Program.

Woman in white lab coat places items on wooden table.

A health worker in Ethiopia sets up a vaccination site. Photo: PATH/Carib Nelson.

Ethiopia’s capital Addis Ababa is in the grip of a noisy, dusty, and unprecedented construction boom that’s rapidly transforming it into a modern metropolis, complete with high-rise skyline, new roads, and a metro transit system. Meanwhile, life has remained unchanged for millennia in the remote northeastern Afar region, where a largely nomadic population moves with their livestock in search of water and grazing.

As I traveled home recently after an inspiring visit, I was once again struck by the dynamic and diverse nature of this beautiful, historic country of extreme contrasts. It was my fourth visit to Ethiopia, where I work alongside PATH colleagues and local partners to strengthen delivery of childhood vaccines.

Differences within the same country manifest themselves in striking ways when it comes to health. Children born in Afar are more than twice as likely as children born in Addis Ababa to die before their fifth birthdays. In Afar, the percentages of children who have received recommended childhood vaccines are some of the lowest in Africa. According to recent studies, only 14 percent of children in Afar, compared to 94 percent in Addis Ababa, have immunization record cards. Continue reading »

In the news: grab a cola and a condom?

Seems like Coca-Cola should be able to work this into a marketing campaign somehow: a young participant at this week’s Women Deliver conference remarked that while he can get a Coke anywhere, it’s not easy to find contraceptives. The Inter Press Service finds that while the circumstances of youthful delegates to the conference vary, all seem to call for one thing: increased access to reproductive health services.

Youth say Coca-Cola is easier to find than condoms

Inter Press Service, May 29, 2013

Manikin wearing condom dress.

Our mannequin wears a dress made from the Woman’s Condom at the Women Deliver conference. Photo: PATH/Amy MacIver.

“If I am thirsty and want a bottle of Coca-Cola I can get it, no matter where in the world I am. Why can’t I get contraceptives or sexual heath care?” asked Carlos Jimmy Macazana Quispe, a youth representative from Peru currently in Kuala Lumpur for the third edition of the Women Deliver global conference on the health and well-being of women and girls. There are over a hundred youth like Quispe participating in the three-day conference that started on May 28, most of them from developing countries in Asia, Africa, and Latin America where contraceptives are equated with condoms, teen pregnancy is on the rise, and child marriage is often considered a social norm.

Read the article.

2013 millennium development goal progress index—get the data

The Guardian, May 29, 2013

Thirty sub-Saharan African countries appear to have accelerated progress toward meeting the millennium development goals (MDGs) over the past three years, according to analysis from antipoverty group ONE, which aims to up-end perceptions of the region as wholly off track. Rwanda, Ethiopia, Malawi, Ghana, and Uganda are among sub-Saharan Africa’s top performers in this year’s MDG progress index, released on Wednesday as part of ONE’s flagship data report.

Read the article.

The other women’s movement: factory workers in the developing world

Harvard Business Review Blog, May 28, 2013

Factory jobs give millions of women what they can’t get anywhere else: a salaried wage. With it, they can begin to exert control over their future. Factory work isn’t just about making clothes; it’s also about a potential path toward gender equality. Because of this, we must reduce the risks women face and work to improve their lives. Beyond ensuring basic building safety, we also need to invest aggressively in the women employed in these factories to help them realize their full potential.

Read the article.

One quarter of world’s children struggling to learn because of malnutrition—study

NBC News, May 27, 2013

One in every four children in the world is suffering from chronic malnutrition that is affecting their ability to learn, according to a report by a charity. The Food for Thought report by Save the Children found that undernourished children were an average of 20 percent less literate than those who had a “nutritious diet.” It said that that malnutrition could affect global economic growth by $125 billion.

Read the article.

Good question: Amie Batson

Amie Batson has a dream global health resume: an early stint with the World Health Organization improving access to vaccines, followed by time at the World Bank developing new funding mechanisms to pay for them, capped by a US Agency for International Development assignment working with the President’s Global Health Initiative.

Portrait of Amy Batson.

Chief Strategy Officer Amie Batson. Photo: PATH/Patrick McKern.

Her latest challenge? Serving as the first chief strategy officer for PATH. On the job about a month, Amie already has a clear vision of what she wants to accomplish. “My hope,” she says, “is to ensure that PATH is having the absolute maximum impact on improving health and health equity.”

This week, Amie is taking part in Women Deliver, an international conference focused on the health and well-being of girls and women being held in Kuala Lumpur, Malaysia. On Thursday, she’s part of a press conference there, addressing our work on a non-pneumatic antishock garment to treat women experiencing postpartum hemorrhage.

Q. If you could put in place three interventions to improve women’s health, what would they be?

Amie Batson: One of the most impactful interventions we could put in place clearly is family planning. Enabling a woman to make her own decision about when to get pregnant is powerful. It could allow a girl to delay her first pregnancy until her body is more mature, or to stay in school longer. It enables her to have control over her body until she is ready for and wants children. All would have a dramatic impact on her health for the rest of her life. And after she’s had her first child, being able to control the spacing of future children, if she desires them, is something that’s going to directly affect her lifelong physical and mental health. Continue reading »

In the news: health of women and girls

It’s a complicated question: What role should large pharmaceutical companies play in improving health in developing countries? In The Guardian this week, Rwandan health minister Agnes Binagwaho sorts through the pros and cons in her response to an earlier commentary by reporter Adam Green.

Girl in blue school uniform receives injection.

A girl in Uganda receives human papilloma virus vaccine. Photo: PATH/Robin Biellik.

Both authors refer to Rwanda’s partnership with Merck to provide universal access to the human papilloma virus vaccine for the prevention of cervical cancer. Green points out that some have questioned the company’s motives and asked whether other public health interventions are more worthy of Rwanda’s support. But Binagwaho’s rebuttal is hard to dismiss. “When Rwanda already had 90 percent or higher coverage for vaccines against ten other diseases, when cervical cancer now rivals HIV and maternal mortality as a leading killer of our women, and when GAVI’s budget grew 42 percent last year,” she writes, pointing out that the GAVI Alliance has added the vaccine to its supported portfolio, “it is difficult for me to see this as some kind of dangerous precedent.”

Rwandan health minister hits back at critics of drug company deal

The Guardian, May 21, 2013

A hero of mine wrote from prison that “human progress never rolls in on wheels of inevitability; without hard work, time itself becomes an ally of social stagnation.” Martin Luther King’s words have long resonated with Africa’s struggle against global cynicism in the fight against AIDS. King’s words came to mind again recently when I read a commentary in The Guardian on pharmaceutical company donations in Africa.

Read the article.

Female condoms are _______

Girls’ Globe, May 20, 2013

When we talk about women’s reproductive health, we often talk about women being empowered to make the best decisions for our health, our families and our lives in general. When it comes to safe sex, women have many options to prevent pregnancy, but very few when it comes to taking charge of protection against STIs. The female condom is the only barrier method used by women that protects against pregnancy as well as sexually transmitted infections and HIV/AIDS.

Read the article.

Poor countries lack modern contraception

Voice of America, May 20, 2013

A new study says little is being done to meet the growing demand for modern contraception methods in poor countries. The Guttmacher Institute says there’s an increasing desire for smaller families. Guttmacher says between 2003 and 2012 the number of women wanting to avoid pregnancy—and in need of modern contraception—rose from 716 million to 867 million. The sharpest increase was seen, it says, in the 69 poorest countries “where modern method use was already very low.”

Read the article.

Breast cancer: One disease, three stories

PRI’s The World, May 17, 2013

Gertrude Nakigudde is an accountant in Kampala, Uganda. I’m a freelance reporter and journalism instructor in Seattle. Angelina Jolie is, well, Angelina Jolie. We’ve all had mastectomies, and we’ve all nursed parents through their final days with breast cancer. (In Gertrude’s case it was her father—men get breast cancer, too.)

Read the article.

A passion for saving mothers’ lives

Patience Cofie. Photo: PATH.

Patience Cofie. Photo: PATH.

Three decades ago Patience Cofie decided to dedicate her career to public health—specifically, to the health of women and children in her native Ghana and surrounding countries. Her reasons for the choice were perfectly logical. She had a thirst for knowledge, a good mind for management, and a talent for teaching—traits that would help her establish everything from a national strategy to increase childhood immunization to a community-based health insurance system to help poor women and their children access care.

But personal motivation fueled her passion as well.

“I lost my niece to postpartum hemorrhage,” says Patience, referring to the excessive bleeding during and just after childbirth that is the number one cause of maternal deaths worldwide. “And I thought if there ever is the opportunity, I should try hard to stop it.”

Opportunity arrives

Opportunity arrived in the form of an innovative product called the Uniject™ injection system, combined with a drug called oxytocin.

Oxytocin injection, when administered immediately after child birth, causes the uterus to contract and is effective in reducing the risk of bleeding. It’s usually given to women by health professionals in hospitals. But for women like Patience’s niece who give birth at home or in smaller health clinics, access to both the drug and a trained provider can be intermittent at best.

The Uniject™ injection system may help. It’s a single-use syringe that comes prefilled with a dose of medicine—in this case, oxytocin. It’s easy to use, injection ready, and potentially a lifesaver—if it’s available when and where women need it.

Dianna Peter, left,  received oxytocin to control excessive bleeding when she gave birth to a girl at her home in central Ghana. Hannah Abundu, trained by PATH, administered the injection. Photo: PATH/Evelyn Hockstein.

Dianna Peter, left, received oxytocin to control excessive bleeding when she gave birth to a girl at her home in central Ghana. Hannah Abundu, trained by PATH, administered the injection. Photo: PATH/Evelyn Hockstein.

That’s where Patience, who is taking part in next week’s Women Deliver conference on the well-being of women, comes in.

Advocating for transformative innovation

Just because a potentially useful technology exists doesn’t mean it will be adopted and used. Governments and others must be convinced of its safety, effectiveness, and value. Patience’s job is to be an advocate for reducing the risk of postpartum hemorrhage in general, and specifically, for use of oxytocin in Uniject™ packaged with time-temperature indicators. (The indicators measure cumulative exposure to heat and help prevent accidental use of spoiled oxytocin.) The advocacy effort Patience leads in Ghana has four major goals:

  • To ensure that oxytocin in Uniject™ is registered within Ghana so that it can be purchased by the government, which provides health care.
  • To include it with the government’s essential drug list and safe motherhood protocols as one of the standard treatments used for postpartum hemorrhage in community settings as well as in hospitals.
  • To make sure it earns a place in the “cold chain” of proper transportation, refrigeration, and distribution as the product travels from manufacturer to mother.
  • To authorize community-based health providers to administer oxytocin in Uniject™ to women in difficult-to-reach communities.

Meeting with the health ministry

To reach those goals, Patience is harnessing the power of partnership. A working group on postpartum hemorrhage is meeting to help focus the government’s attention on reducing maternal deaths. Tactics to reach that goal include using oxytocin in Uniject™, but Patience points out the ultimate aim is much higher, and in many ways more understandable.

“When I started this work,” she says, thinking back on her niece’s death, “I put in all efforts to ensure that we manage to save lives. My passion for the work comes naturally for somebody who is interested in making sure women do not die, particularly from excessive bleeding when we are giving birth.”

More information

Innovation in motion

Headshot of Steve Davis.

PATH President and CEO Steve Davis. Photo: Auston James.

This morning, I strapped on a tool belt and climbed up on a stage to talk to some 800 of PATH’s most loyal supporters—including Melinda Gates, whose family foundation has so generously funded our work and who spoke so eloquently on our behalf today.

“Bill and I feel in some ways like we have grown up with PATH,” Melinda told the crowd in Seattle. “PATH was certainly here first in the Northwest. And when we started to want to get to know about global health, it was really PATH that we turned to.”

Melinda went on to describe a couple examples of the work we and our partners have engaged in recently: the development and delivery of an affordable vaccine against meningitis A, which has protected 100 million children and young adults so far, and community-based training for families in India on how to care for their babies so that they survive and thrive, which has reached more than 24 million people.

My topic? Diarrhea.

I’ll admit it doesn’t sound like the most promising premise for our annual fundraising breakfast, where our supporters unstintingly provide us with the funding that is critical to the success of our work. But I’m sure they—and perhaps that includes you—were not put off by the message. In fact, I’m betting you were inspired, as I was.

So no child perishes

In addition to Melinda and two of our unstoppable board members, Phyllis Campbell and Dean Allen, this morning I shared the stage with Dr. Alfred Ochola, who holds one of the most meaningful job titles I’ve ever seen: technical adviser for child survival and development in Kenya. Alfred leads an initiative to control diarrheal disease in the country’s Western Province. He told the story of Jane Wamalwa, who buried three of her children before PATH-trained community health workers helped her learn how to fight the diarrhea that killed them before their sixth birthdays.

Now Jane is a PATH-trained community health worker herself. Her deeply personal understanding of diarrhea’s consequences makes her a powerful ambassador for the tools and techniques that can save children’s lives.

And that brings me to the tool belt I wore this morning. Continue reading »