Global health and development take center stage at World Economic Forum

Two moms and babies

In Davos there was an increased focus on accelerating progress towards development goals. Photo: PATH/Gabe Bienczycki.

A few reflections on the World Economic Forum (WEF) meeting in Davos, Switzerland, and the Gavi, The Vaccine Alliance’s pledging conference in Berlin from PATH’s president and CEO Steve Davis.

Portrait of Steve Davis.

Steve Davis is president and CEO of PATH. Photo: Auston James.

Through my roles at PATH and previous organizations, I have been fortunate to be invited to attend the annual WEF gathering in Davos over several years. In that time I have seen nonprofits and civil society organizations take increasingly important roles at these agenda-setting gatherings. While it is difficult to get a handle on the key trends in this multi-layered, complex environment, this year, the importance of inclusive growth and global development, and the role of nonprofits and civil society in that work, seemed to take center stage.

Yes, Davos has the jet-setting, celebrity, power-brokering aspect that gets played up in the media. But both there and at the Gavi pledging conference I attended in Berlin (where the global community pledged over US$7.5 billion for vaccine and immunization programs), there was an increased focus on the important leadership and partnership roles that nonprofit and civil society organizations like PATH are playing as we confront global challenges and work to solidify and accelerate progress towards development goals.

ChronDiseaseWEF15800

A WEF participant considers the notes from a discussion called The Globalization of Chronic Disease. Photo: WEF.

Resilience was a recurring theme

Many of the challenges discussed at Davos were not even on the agenda one year ago: new conflicts, new epidemics, new fiscal uncertainties, new evidence of accelerating environmental change. So this year the focus on growth was tempered by conversations about resilience.

Graphic table

We have made remarkable progress. How can we accelerate it? Click to see full-sized chart.

In some conversations, I got the sense that people and institutions are feeling overwhelmed by the sheer magnitude of global challenges. At a lunch panel with technology leaders like Marc Benioff (Salesforce), Marissa Meyer (Yahoo), and Satya Nadella (Microsoft), upbeat assessments of the transformative power of the Internet were tempered by concerns about the magnitude of global security challenges and the continued and growing public distrust of business and government worldwide.

But wise voices of optimism also spoke powerfully about the dramatic improvements in health we’ve achieved in poor countries, and the clear markers of progress over the past few decades. Today, we have unprecedented tools and collaborations that we can harness to accelerate impact.

One moment that drove this home was a breakfast on our renewed commitment to nutrition and food security, in which many senior business, government, and nonprofit leaders pledged to a more ambitious agenda. At several meetings on health there was very little skepticism about our ability to continue to dramatically reduce child and women’s mortality in the coming decade.

Global health and development takes a leadership role

It seems global health and development has moved to center stage in international discussions about security, development, and governance. Health has always been part of the WEF agenda, but this year in particular there were an exceptional number of discussions about health-related topics: nutrition, food security, Ebola, noncommunicable diseases like cancer and diabetes, digital health initiatives, mental health, reform of global health institutions like the World Health Organization, and more.

While this focus stems in large part from the Ebola crisis, it is also occurring because the sector can point to remarkable, measurable, rapid successes. It is very compelling to be able to describe tangible achievements at scale, like having reduced under-five child mortality by 50% since 1990, or vaccinating more than 200 million Africans against Meningitis A in five years.

2015 will be a huge year for the global development agenda, with a key meeting on new development financing models this July in Ethiopia, the finalization and announcement of the new sustainable development goals in September at the UN General Assembly, and perhaps the conclusion of a climate treaty at the end of the year in Paris.

In a remarkable plenary video message from Stephen Hawking, he described the resilience of the planet and species, acknowledging the specific challenges ahead in the global development agenda but expressing his profound optimism about the human ability to love, persevere, and thrive. It was a powerful moment.

Health systems in emerging economies can leapfrog to a new paradigm

WEF has released a new report and video on the idea of "leapfrogging." Illustration: WEF.

WEF has released a new report and video on the idea of “leapfrogging.” Illustration: WEF.

“Leapfrogging” was a word on many health sector leaders’ lips at Davos. Emerging economies have an opportunity to build accessible, high-quality, and cost-effective health systems while potentially leaping over problems embedded in the models and systems prevalent in developed economies.  The WEF has actively led this conversation, releasing a recent report and video. Having served as an advisor to these efforts, it was exciting to see them bear fruit, and be an active topic of conversation at the highest levels.

Headshot of a man speaking.

South Africa’s Health Minister Aaron Motsoaledi. Photo: MOH.

South Africa’s Minister of Health Aaron Motsoaledi and I led a Davos session on creating “ideal clinics” for primary care in his country. Can an emerging health system leapfrog some of the issues that challenge primary care in more developed nations, leverage digital technologies, and be intentional about a user-centered approach to systems design?

I travel to South Africa in a few days, and I want to pursue this idea and see what we can do to bring more of our partnerships, tools, and ideas to the Minister’s exciting commitment.

Innovation was central to almost every conversation I had all week. As we move towards the UN’s new sustainable development goals, we must learn from the last decade, and work to identify, fund, and support promising innovations as early as possible. This is a focus of many efforts, including the PATH-Norway-Gates Foundation partnership called Innovation Countdown 2030, which will release a major global health innovation report this summer.

Gavi’s remarkable funding conference

Of course, one of the most powerful public health interventions is vaccination. PATH’s growing and well-regarded vaccine platform was part of many conversations, especially at the Gavi replenishment meeting that took place in Berlin after Davos.

There, we heard stories from communities and countries where the impact of vaccines is being deeply felt. The MenAfriVac project’s groundbreaking work was highlighted: since vaccination began in 2010, the annual cycle of deadly meningitis epidemics has been completely stopped across much of what was formerly described as Africa’s “meningitis belt.”

Bill Gates on a large stage at a podium.

Bill Gates spoke passionately at Gavi about reducing child deaths. Photo: Gavi.

PATH is a founding Gavi partner, and we have partnered closely since the beginning. We have actively advocated for Gavi funding, and I was privileged to see this important organization receive the global support and pledges it needs to continue its transformative and lifesaving work.

Bill Gates, from the Gavi stage, described unequal access to vaccines as a global injustice that we have the power to correct, and led by example with a remarkably large pledge from the foundation. There is much work ahead before this injustice is rectified, but for one day in Berlin, as countries committed more than US$7.5 billion, there was palpable optimism and excitement.

A whirlwind trip

Overall, it’s been an exciting and exhausting trip: snowy shuttle rides, engaging conversations, the occasional celebrity sighting.

We have much work ahead of us, but after these meetings I am starting 2015 with renewed confidence that we can find new and innovative ways to partner across geographies, industries, sectors, and political philosophies in service to the larger goals we all share: equity, opportunity, and health for all.

Innovation Countdown 2030: early insights from our call for innovations

Woman in pink print sari smiles at the infant daughter she holds in her arms.

Many of the technologies and interventions we received from our Innovation Countdown 2030 (IC2030) initiative survey focused on maternal and childhood needs. Photo: PATH/Gabe Bienczycki.

Last summer, we challenged experts from around the world to imagine the year 2030 with us

Cover of Innovation Matters.

“Innovation Matters” features articles from global leaders exploring the critical role innovation can play in accelerating solutions to the world’s most urgent health challenges.

The purpose? To identify and dramatically accelerate progress toward solving the world’s most urgent health issues by the year 2030.

Imagine the impact we’d have by engaging a cross-section of people from around the world to identify these innovations and coordinate investment early on. How many more lives could we save over the next 15 years?

We surveyed thousands of health experts and thought leaders, including technology developers and industry players, and crowdsourced ideas from around the world via social media.

We received hundreds of innovations

Many focused on maternal, child, and neonatal health issues, as well as health delivery systems. Examples included: heat-stable uterotonics to address postpartum hemorrhage, malaria vaccine candidates, rats specially trained to recognize the scent of tuberculosis in sputum samples, health care workforce training tools, vital data collection systems, and rapid diagnostics to detect multiple diseases.

Responses came from around the world

We received over 500 submissions from a wide range of entrepreneurs, academics, investors, and donors representing 33 countries. In fact, 27% of innovations came from low- and middle-income countries—such as Brazil, India, Kenya, and Vietnam—signifying their growing role in global health innovation.

Claudia Harner-Jay.

Claudia Harner-Jay, senior commercialization officer at PATH. Photo: PATH.

Nongovernmental organizations (37%), industry (28%), and academia (24%), provided the majority of innovation submissions. Some participants submitted their own innovation ideas while many nominated innovations developed by others.

The next steps in our innovation countdown

There’s much more to do. We’re working with over 50 experts to assess which ideas show the most promise and potential for impact. From the many innovations that were received, they will identify a final set of 20 to 30 promising health technologies and interventions that we’ll feature in the Innovation Countdown 2030 report, later in 2015.

To learn more and follow our progress, visit the IC2030 website.

Our guest contributor is Claudia Harner-Jay, senior commercialization officer in the Devices and Tools program at PATH.

Innovative health sector financing: the Vaccine Independence Initiative

Photo of baby sitting on a bed with chart showing UNICEF's recommended immunization schedule for infants.

This week the UNICEF Board is considering expanding the Vaccine Independence Initiative (VII). This financing mechanism was launched almost 25 years ago in 1991 to decouple the procurement of vaccines from the payment for these vaccines by countries out of national budgets.

Portrait of Amy Batson.

Amie Batson is PATH’s chief strategy officer. Photo: PATH/Patrick McKern.

We caught up with PATH’s chief strategy officer Amie Batson, who has an intimate connection with this program.

Tell us about your connection to the origins of this UNICEF program.

It’s actually an idea I developed when I was getting my masters degree at Yale’s School of Management. Thanks to the vision of James Grant, the then executive director of UNICEF; Terrell Hill, the head of the UNICEF immunization program; and James Cheyne, programme leader at the World Health Organization, it became one of the first innovative health financing mechanisms when it launched in 1991.

What is VII, exactly?

The VII was developed to address procurement and financing challenges faced by national vaccine programs. Many low- and middle-income countries that were able to finance their vaccine programs still benefited from UNICEF procuring vaccines on their behalf, because when they ordered independently, small volume orders and poor credit ratings resulted in high prices and other challenges.

But for UNICEF, the challenge was that many governments had (and continue to have) a policy requiring goods be received in country before they could issue payment. This policy directly conflicted with UNICEF’s board-mandated requirement that it receive payment in advance of procuring and shipping goods.

In addition, some countries had frequent and long delays in issuing payment, which created financial risk for UNICEF if it prepaid for vaccines. The VII mechanism enables flexible credit terms, while providing financial security to UNICEF.

UNICEF uses the VII funds to purchase vaccines from the manufacturer, and the country they are shipped to then reimburses UNICEF (and the VII fund) once the vaccines are received. Each country has an established financial ceiling—a limit on the amount of funds that it can owe UNICEF—which mitigates risk and encourages countries to reimburse quickly in order to permit future orders.

The VII showed the immunization community that there were ways to support health programs and their financial sustainability through more innovative structuring of health financing. Since then, innovative financing in the health and development sector has become increasingly sophisticated and widely used.

Health center staff filling out vaccination paperwork while mothers and infants wait on benches.

National vaccination programs face complex logistical, financial, and technical hurdles. Photo: PATH/Doune Porter.

Tell us more about your role in its origins.

I developed the VII during my summer graduate school internship at the World Health Organization (WHO), and I was hired back after graduation to implement it at UNICEF.

Bringing VII to countries was a challenge. At the time, explaining financing concepts to health staff was, to say the least, novel. I had the added challenge of doing it in French since the first target county was Morocco. The WHO translator had to call his banking friends to get a translation for new words and concepts like “revolving fund.”

After Morocco, I was thrilled to be sent to the Pacific Islands to structure a VII that bundled demand and financing for 13 island nations. For my colleagues who doubted how hard I was working in Vanuatu, Fiji, and New Caledonia, I am happy to report that this specially adapted VII is still in use today, over 20 years later.

A nurse fills a syringe from a vaccine vial.

Vaccination in Laos. Photo: PATH/Joel Aaron Santos.

What is next for the VII?

During its meeting this week, the UNICEF Board is considering expanding the VII ten-fold (from $10 million to $100 million) to cover prefinancing of vaccines as well as many health products like bednets treated with long-lasting insecticide and supplies needed for Ebola response. As countries graduate from Gavi and other donor support, there are increasing demands for mechanisms such as the VII that create greater financial flexibility.

UNICEF is also proposing to use the expanded VII to support special contracting to improve pricing and supply security.

VII has given rise to many other examples of innovative financing. Today, it’s much more common to find innovative health financing mechanisms like the VII, advance market commitments, development bonds, and purchase guarantees. Each mechanism is designed to address inefficiencies caused by differences in certainty of market information, risk tolerance, and financing policies, to name but a few.

Amie Batson is PATH’s chief strategy officer. Her 20-year career in global health includes positions with the World Health Organization, the World Bank, UNICEF, and most recently, the US Agency for International Development, where she served as senior deputy assistant administrator for global health.

Friday Think: using sensors to tackle Deflategate

A football rests on a field.

The future of football may include more on-the-field data than you ever thought was possible, including whether or not the game ball is properly inflated. Photo: publicwallpapers.org.

Does your car have sensors that give you precise tire pressure information?

As the sports world prepares for Super Bowl XLIX amid the brouhaha surrounding Deflategate, an innovative tracking system may soon do that for footballs. It’s called active RFID technology and it’s already doing a pretty good job of tracking athletes’ on-field performances.

Friday Think logoA little background on RFID’s playbook

Radio-frequency identification or RFID tags are increasingly embedded in many barcode labels, plastic identification cards, wristbands, tags, library books, and even passports. When embedded inside sports equipment, they can collect and transmit data from smart shoulder pads, wearable tracking gadgets, and most recently, footballs. But there are some wrinkles in the turf, so to speak…

Here’s an excerpt from USA TODAY:

Sunday marked the first time a tracking device had been placed inside the ball—a joint project, Stelfox said, between Zebra, ball manufacturer Wilson, and the NFL, which tested it in practice with the New Orleans Saints and warmups with the Cincinnati Bengals this season.

The ball looks and feels normal outside of a faint vibration that can be felt upon contact because of the way the sensor is suspended inside, and that figures to become less noticeable as the product continues to be developed.

Like the other sensors, the ball can be tracked within about six inches by the three-member Zebra team in the press box, Stelfox said. As the technology improves, it could be used to indicate who has the ball at the bottom of the pile, or which quarterback throws the hardest.

And as for measuring the pressure inside the ball to make sure there’s not another Deflategate?

A man kicks a car's tires at a used car lot.

Will this technology provide useful data? It depends on who decides what’s important. Photo: ClassicStock.

“That would make a lot of sense,” Stelfox said. “Who knew that would be important? We thought torque and rotation and distance would be key.

“But it’s funny, because your tire has a pressure gauge like that. If your tire does, a ball can, too, and whether it’s us or Wilson, I’ll bet you that gets fixed with technology.”

Impress your friends with more facts during the Super Bowl. Read the article in its entirety at USA TODAY.

Each week, we scour the news for the hottest stories on innovation. Our weekly feature, The Friday Think, highlights one we’ve found particularly fascinating.

PATH is a leader in global health innovation. We tackle some of the world’s greatest health needs from our headquarters in Seattle. Coincidentally, Seattle is the home of another organization that tackles, and tackles quite well. And so on this Super Bowl weekend we say:

Seahwaks logo with the words Go Seahawks.

Denise Lionetti: champion for a well-rounded diet of nutrition and health

Woman holding infant; other women, and men sitting in surrounding chairs.

By integrating nutrition into other programs, PATH’s work helps bring them to scale. Photo: PATH/Evelyn Hockstein.

Today we profile Denise Lionetti, the deputy director of PATH’s Maternal and Child Health and Nutrition (MCHN) program. Denise also serves as project director for several projects within MCHN. She brings to this role more than 30 years of experience in nutrition, maternal health, health policy, reproductive health, HIV, and primary health care.

Q. What makes you so passionate about nutrition?

A. In general, maternal and child health get a lot of focus, and rightfully so. But since nutrition is one of the building blocks of health, it can get lumped in with everything else, and it becomes almost secondary.

Denise Lionetti.

Denise Lionetti, deputy director of PATH’s Maternal and Child Health and Nutrition (MCHN) program. Photo: PATH.

Nutrition is key to every health area that PATH works in, and malnutrition is an underlying cause of many diseases. Nutrition must be integrated into every phase of health care, from pre- and postnatal care to childhood, adolescent, and adult care. PATH’s work in nutrition focuses on integrating nutrition into other programs and helping to bring the work to scale.

Q. What are some ways PATH helps integrate nutrition into other programs and then brings them to scale?

A. We have a variety of programs that help us reach those goals. One is our Scaling Up Nutrition (MQSUN) project, funded by the Department for International Development (DFID) in the United Kingdom.

DFID asked us to develop a strategy to make it more possible to integrate nutrition into other sectors, such as poverty alleviation, agriculture, education, and health. We’re partnering with DFID to provide technical assistance while working with local governments to implement that strategy. This includes remote support and in-country work in more than 30 countries—predominately in Africa—and also large efforts in Bangladesh, Pakistan, and Yemen.

Q. You mentioned a focus on country governments. Can you tell us more?

A. The MQSUN project is a very successful mechanism for working with countries, because we don’t come in with our own agenda. It is truly driven by the needs of each country. We want to help them with any barriers they face to integrating nutrition into all the other areas.

One barrier is workforce planning. There is always a shortage of trained nutritionists. We help them plan for the future by building local capacity. We find in-country consultants and team members to help grow that capacity. We are always thinking, “How can countries do this on their own?” Through MQSUN, we are seeing that more donors and countries see the value in approaching nutrition work in a fully integrated way.

More information

Walking together: Steve Davis reflects on 15 years of Gavi partnership

Girl in hospital bed with tube up her nose and mother comforting her.

Six-year-old Namfon was hospitalized in Vientiane, Laos, after contracting Japanese Encephalitis, a vaccine-preventable disease. Her mother, Teo, comforts her. Photo: PATH/Aaron Joel Santos.

There is an African proverb that says,

“If you want to walk fast, walk alone; if you want to walk far, walk together.”

In many ways, this proverb illustrates the success behind PATH’s partnership with Gavi, the Vaccine Alliance. Since becoming a founding member 15 years ago, PATH has walked in step with Gavi toward the same shared destination: to create access to lifesaving vaccines and strong immunization systems that reach all children, everywhere.

By continuing to walk together, let’s see just how far we can go

This week on Gavi’s blog, Steve Davis, president and CEO of PATH, provided insight on what it takes to develop and strengthen a global community of scientists, policymakers, advocates, regulators, medical workers, and caregivers to continue our good work.

Here’s an excerpt from his post:

While new vaccine introductions and current vaccination programs are saving lives each year, it’s not just developing and introducing vaccines that matters. The vaccines need to be delivered to the right people, in the right place, at the right time, and in the right condition.

Steve Davis walks through a village in India with a group of children.

PATH’s CEO and president Steve Davis says we must accelerate the progress of getting vaccines to the world’s most vulnerable. Photo: PATH.

This is at the heart of Gavi’s and PATH’s core values: employing the power of innovation and partnerships to ensure that the world’s most vulnerable are protected through equitable access to vaccines. This requires advanced and innovative supply chain systems, including vaccine transportation and storage solutions as well as ways to track supplies and vaccination coverage with accurate data.

You can read the post in its entirety on Gavi’s blog, Vaccineswork.org.

Friday Think: HeroRATs are awesome!

At PATH we talk a lot about innovative solutions to global health problems that are effective, simple, and in the best cases, have multiple uses. But occasionally we’re given pause, like when we encounter innovations that snooze in kennels at night and eat bananas during the day.

Meet the HeroRATs

Yes, rats. Even if you’re not a fan of the rat, we encourage you to read on.

For years, African giant pouched rats have been used in an innovative program in Africa and Southeast Asia to safely and inexpensively detect landmines left behind by conflict. (They can smell the mines underground, but fear not, rats are not heavy enough to set them off.)

More recently, the Anti-Personnel Landmines Detection Product Development (APOPO) “hero rats” have added a new skill: to swiftly and accurately identify tuberculosis (TB) in sputum samples. The rats have an acute sense of smell and are easily trained.

Rat standing on its hind legs to nibble at a banana held in a hand.

One rat can evaluate, in 10 minutes, more TB samples than a lab technician can do in one day. They also love bananas. Photo: Wikipedia.

When you consider how a swine’s sensitive schnozz can sniff out truffles, or a bloodhound can track fugitives, remember that rats also possess similar olfactory gifts. Fully 1% of their DNA is devoted to coding olfactory receptors, an incredibly high percentage.

Here’s an excerpt from Vice News:

…Dr. Emilio Valverde, a tuberculosis expert with the Belgian aid organization APOPO, runs a lab working on a new—seemingly bizarre—way to test for the disease.

Giant rat sits on his trainer's shoulders.

An African pouched rat perches upon his trainer’s shoulder. Photo: Reuters.

Valverde trains African giant pouched rats to sniff out tuberculosis. The cat-sized creatures—each about a foot long and weighing roughly 10 pounds—use their keen sense of smell to detect the presence of tuberculosis in saliva samples.

“The rats can process more than 70 samples in 10 minutes,” Valverde told VICE News. “This is work [that would take] a lab technician at least two days.”

Valverde says the current TB detection system used in labs around the world “isn’t bad, it just isn’t practical for a rural country with weak infrastructure and high TB rates like Mozambique.”

Rat in a glass box sniffing a sample.

TB sample sniffing in action. Photo: Apopo.org.

Hospitals use microscopy to look for the presence of TB bacilli, but the process is expensive. The machines cost about $17,000, and each sample costs $10 to test. Valverde says his giant rats offer a much cheaper, more efficient alternative.

Curious to learn more? Skeptical? The organization behind this effort, APOPO, has lots more information on their website, including a page of peer-reviewed publications about their work.

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Each week, we scour the news for the hottest stories on innovation. Our weekly feature, The Friday Think, highlights one we’ve found particularly fascinating.

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Learn more about the Anti-Personnel Landmines Detection Product Development (APOPO) HeroRats tuberculosis project.

APOPO is looking for a few good volunteers, in your neighborhood.

 

Friday Think: new Gates Foundation policy requires open access to research and data

Library shelves with books.

The open access movement is changing the landscape of how knowledge is accessed and shared. Photo: Anna Creech/Flickr.

What kinds of innovation could be unleashed if all researchers, scientists, and tinkerers had access to all the knowledge within their fields, knowledge traditionally collected in peer-reviewed journals?

While many scientific journals follow a “paywalled” model that restricts access to most of their current articles to fee-paying subscribers, an “open access” movement has arisen in the last two decades to challenge that paradigm. And, as the name suggests, it’s creating easier access to scientific (and other kinds of) knowledge.

As of January 1 this year, the Bill & Melinda Gates Foundation has given that movement a boost, with a new and remarkably strong policy mandating open access to any research the foundation supports.

The website io9.com reports,

The policy will ensure that all peer-reviewed research funded by the Gates Foundation will be accessible—by the public, by other researchers, by anyone—the moment its findings are published. For free. The policy stipulates that published research be made available under a Creative Commons Attribution 4.0 Generic License, meaning it can be copied, redistributed, added to, even commercialized, by anyone. According to UC Berkeley Biologist Michael Eisen—a leading proponent of open science, and co-founder of the nonprofit open access scientific publishing project PLOS—the Gates Foundation’s policy “gets [open access] policy right,” and serves as a “model for funders, [governments] and universities.”

Chart about the changing landscape of open access publishing.

This chart details the changing landscape of open access publishing. Copyrighted by Macmillan Publishing.

The blog of the science journal Nature offered a slightly more skeptical perspective, saying,

This demand goes further than any other funding agency has dared. The Wellcome Trust, for example, demands a CC-BY licence when it is paying for a paper’s publication—but does not require it for the archived version of a manuscript published in a paywalled journal. Indeed, many researchers dislike the thought of allowing such liberal reuse of their work, surveys have suggested. But Gates Foundation spokeswoman Amy Enright says that “author-archived articles (even those made available after a 12-month delay) will need to be available after the 12-month period on terms and conditions equivalent to those in a CC-BY licence.”

How much research is currently available for free with open access? The European Commission published a report on that topic. (The report is, naturally, open access and not copyrighted.)

Nature blogs about that: Friday Think logo

More than half of all peer-reviewed research articles published from 2007 to 2012 are now free to download somewhere on the Internet, according to a report produced for the European Commission, published today. That is a step up from the situation last year, when only one year—2011—reached the 50% free mark. But the report also underlines how availability dips in the most recent year, because many papers are only made free after a delay.

To open the topic even further, here is a directory of open access journals. Enjoy.

Each week, we scour the news for the hottest stories on innovation. Our weekly feature, The Friday Think, highlights one we’ve found particularly fascinating.

Breaking the paradigm: how an essential vaccine was fast-tracked

Editor’s note: Recently, the World Health Organization (WHO) opened the door to include the meningitis A vaccine MenAfriVac® in routine childhood immunization programs. MenAfriVac is the product of a new development model that put country needs first and accelerated delivery of a new vaccine to those who needed it most.

Here to tell us more is guest contributor Dr. Kathy Neuzil, director of Vaccine Access and Delivery at PATH.

Mothers and babies in line under a shade tree.

The World Health Organization (WHO) has approved an innovative and affordable vaccine to protect infants from a major cause of deadly meningitis A. Photo: PATH/Gabe Bienczycki.

It’s an exciting day at PATH. We’re celebrating the World Health Organization’s (WHO) prequalification of an infant version of MenAfriVac®, a meningitis A vaccine that’s protected millions of children and adults from a devastating disease.

The prequalification serves as both a landmark achievement and an opportunity to reflect on our pioneering Meningitis Vaccine Project (MVP), made possible with funding from the Bill & Melinda Gates Foundation.

MVP was established 14 years ago, as a collaboration between WHO and PATH, in partnership with the Serum Institute of India Ltd. (SIIL) and public health officials across African countries.

Infant sleeping in a carrier on a woman's back.

Making an immunization essential for infants is the best option for long-term control, especially after it becomes part of a country’s routine health care. Photo: PATH/Gabe Bienczycki.

In 2001, MVP had one goal in mind: to eliminate epidemic meningitis in sub-Saharan Africa

For years, people living in the meningitis belt, a region that stretches from Senegal in the west to Ethiopia in the east, were regularly struck by meningitis A epidemics in which a sudden onset of disease could rapidly lead to death or permanent disability.

The epidemics would come in waves, affecting up to hundreds of thousands of people, with high mortality rates. The only existing meningitis A vaccine before MenAfriVac was ineffective in breaking these cycles, and expensive and difficult to deliver in hard-to-reach areas of sub-Saharan Africa.

Motorcycle with a box labeled BD

The MenAfriVac vaccine can survive hot, long-distance travel to remote towns and villages. Photo: PATH/Gabe Bienczycki.

MVP was unique and pioneering from the onset

Step one involved listening to the affected countries. Health ministers wanted a practical, affordable vaccine to alleviate the suffering of their people.

Step two focused on developing the tactics and strategy to achieve the goal. The latter wasn’t easy, and as one door closed, the MVP team made sure to open others, even when they were stuck, barred shut, or seemingly too small. If there was no door, then the team looked for a window.

The keys to success

It can take years, and often decades, for a vaccine to reach the public. This timeline is even longer in low-resource countries. Teamwork was critical to success.

MVP worked with an unprecedented number of global partners, including SIIL, the vaccine manufacturer, and Gavi, the Vaccine Alliance. Our partners were visionary and had the end in mind at the beginning. Despite political instability and outbreaks of other diseases in the region, the team forged ahead.

Close up of a child looking over a woman's shoulder as he is carried at the MenAfriVac launch.

Close up of a child at the MenAfriVac vaccination launch in Burkina Faso. Photo: PATH/Gabe Bienczycki.

Remarkably, the first large-scale vaccination campaigns began in 2010, the same year that MenAfriVac was licensed and WHO prequalified for people aged 1–29 years. To date, not a single case of meningitis A has been reported among the more than 215 million people who have been vaccinated.

With the wonderful news of the infant vaccine approval and availability, this protection can now be extended to all babies in the region with the other essential vaccines that are routinely delivered to keep them healthy.

Why this was all possible

Another key reason for our success is that our country partners were involved from the start. We worked directly with countries to focus on the end goal; ensuring a vaccine price, supply, and implementation plan that focused on sustainability.

This sets us up for the next challenge. MVP didn’t stop problem solving when outbreaks were over. They knew meningitis was still out there. Yet to succeed, the team kept moving ahead and working hard even when a meningitis outbreak wasn’t in the news.

Table with MenAfriVac vaccine in an insulated box and a disposal box for syringes.

A health worker prepares her table during the launch of MenAfriVac in Burkina Faso. Photo: PATH/Gabe Bienczycki.

I’m entirely confident that, although MVP is coming to a close, the success of this program will continue because of our emphasis to put country involvement and country ownership front and center from the very beginning.

PATH’s role in the future

The greatest sign of success for us is to have programs at PATH wrap up, and then watch them continue on after empowering countries and partners to own them.

While MVP has achieved its last milestone—prequalification of the infant MenAfriVac—PATH, WHO, Gavi, SIIL, and other partners will continue to work diligently to assist countries in ensuring that our successes live on.

While we wish that MVP didn’t have to close, it is in fact this ending that will seal its place in history. MVP’s legacy will be measured in lives saved and disability prevented.

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Friday Think: turning waste into something good

Friday Think logoAfter Sanga Moses sold all his worldly belongings to fund a startup, his girlfriend slammed the door in his face and said, “if you want to waste your life, waste yours alone.”

And that’s when Sanga Moses decided to wallow in the waste by turning it into something useful: fuel for communities in Uganda.

Here’s an excerpt from National Geographic’s 2014 Emerging Explorers profile on Moses:

Sanga Moses

Sanga Moses, a National Geographic 2014 Emerging Explorer. Photo: National Geographic.

“When I was young, our home was surrounded by national forests,” (Moses) says. “Now all those trees are gone, and children must walk longer and longer distances to gather wood.”

Searching for a solution to problems born of burning wood, Moses quit his job and began learning everything he could about renewable resources. Eventually he came across the increasingly popular practice of turning organic waste into fuel.

A briquette-making machine that can run without electricity.

Eco-Fuel Africa has recently developed a briquette-making machine that can run without electricity. Photo: Kat Keene Hogue, National Geographic Creative.

“Uganda is primarily agricultural, but farm waste is just abandoned.”

So Moses began working with engineering students to design kilns and briquetting machines.

Four years later, 2,500 farmers use his kilns to turn farm waste—coffee husks and waste from sugar cane and rice—into charcoal. A company that Moses founded, called Eco-Fuel Africa, buys the char and turns it into briquettes for cooking that burn cleaner and cost less than wood.

Read the full story at nationalgeographic.com to find out more about how Sanga Moses became a National Geographic 2014 Emerging Explorer, one of several individuals identified as “tomorrow’s visionaries—those making discoveries, making a difference, and inspiring people to care about the planet.”

Each week, we scour the news for the hottest stories on innovation. Our weekly feature, The Friday Think, highlights one we’ve found particularly fascinating.