A new era for malaria treatment

Woman in stock room looks at paper with shelves of medicines.

A pharmacist checks a stock of malaria drugs at the Gwembe District Medical Office in Zambia. Photo: PATH/Laura Newman.

Malaria drugs made with semisynthetic artemisinin make their way to patients

Portrait of David Kaslow.

Post author Dr. David Kaslow leads our drug development efforts. Photo: Merck.

This month, after nearly ten years of effort, the first batch of malaria drugs manufactured with a new, semisynthetic form of the key ingredient, artemisinin, will start reaching African countries battling the disease. The lifesaving drugs, manufactured by our partner Sanofi, a French pharmaceutical company, are the first of their kind to use semisynthetic artemisinin (ssART) in place of the plant-derived form of artemisinin used in the past. The new shipment marks a milestone in global health, potentially improving access to treatment for the millions of people, mostly African children, sickened by malaria every year.

The story of ssART—and the bold partnership that brought it from concept to use—highlights the crucial role international markets play in shaping global health, and the power of collaborative innovation to improve the systems that bring lifesaving products to the people who need them.

Soothing a volatile market

Asian sweet wormwood plant with green, feathery leaves.

Artemisia annua, or Asian sweet wormwood. Photo: Flickr/Scamperdale.

In 2004, doctors worldwide were increasingly using a powerful group of drugs called artemisinin-based combination therapies (ACTs), to treat malaria infection. That was good news for children and families everywhere. But as more countries sought ACTs, the supply and price of artemisinin, which was derived only from a slow-growing plant called Artemisia annua, or Asian sweet wormwood, fluctuated wildly. Changes in demand and supply from year to year created a volatile up-and-down cycle of pricing and supply. In 2005, for example, the price of artemisinin was at a high of US$1,100 per kilogram. That price sparked more farmers to plant sweet wormwood, creating an oversupply in 2007 that caused the price to plummet to just $180 per kilogram. That cut the incentive to grow sweet wormwood again, which resulted in a 2009 shortage that drove prices back up over the next two years, to an average of $530 per kilogram in 2011. These fluctuations strained markets, and made it difficult for leaders, manufacturers, and others to stabilize and plan global supply, risking a global shortage.

In short, the lifesaving drugs that millions of children, families, and communities relied upon were tied to a supply structure struggling under the push and pull of a volatile market.

Worldwide, a market challenge had turned into a crucial global health imperative.

Graphic showing time to grow (10 months) versus synthesize (3 months) artemesinin.

Producing semisynthetic artemisinin takes just three months, helping ensure a more stable supply to meet demand for ACTs. Graphic: PATH.

A groundbreaking partnership

Solving the challenge took a groundbreaking partnership, led by PATH’s Drug Development program, that brought together experts in research, pharmaceutical product development, and public health. In 2004, the partnership set out to develop a new manufacturing process to produce high quality, year-round, and affordable artemisinin to supplement the plant-based supply. Over a decade of work, our combined innovation and vision brought a promising concept from small laboratory batches, to large-scale production, and on to global markets.

Technician in protective gear holding an ACT antimalarial tablet.

Sanofi’s gold-standard ACT made with semisynthetic artemisinin, pictured here at the manufacturing plant in Morocco, is making its way to customers. Photo: Sanofi.

Now, as the first shipment of ssART-based malaria drugs—1.7 million treatments of Sanofi’s gold-standard ACT, Artesunate Amodiaquine Winthrop®—make their way to customers for the first time, we’ve reached the goal we set out to achieve ten years ago. Semisynthetic artemisinin opens a new future for the global artemisinin market. In doing so, it offers new security for the millions of people who rely on ACTs in countries where malaria is a constant threat. By providing a year-round source, ssART helps to manage imbalances in supply and demand, maintain stable and affordable pricing, and keep the market on an even course—ultimately expanding access to ACTs.

The future

Of course, ssART is only one part of the solution. Eliminating and controlling malaria requires a highly integrated strategy, including new vaccines and diagnostics, expanded surveillance and control, strong partnerships with governments, and much more.

I think I can speak for all of our partners when I say that we won’t be satisfied until that very last patient is cured of malaria. Until then, however, the sustained production of ssART, and the careful integration of our product into global markets, has the potential to change the landscape of global health. For the first time in history, artemisinin shouldn’t be a limiting factor in our work to develop and deploy lifesaving treatments. Even more, ssART provides clear evidence that with expertise, hope, and tenacity, it is possible for public and private sector leaders to achieve a bold humanitarian goal.

Together, we’re paving the way for a robust, reliable supply of antimalarial drugs.  And by continuing to work together, we can create a market where supply chains, farmers, extractors, manufacturers, and funders all align to create a healthier future for women and children worldwide.

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Going local: four reasons we’re investing in strengthening innovation ecosystems worldwide

Man in white lab coat sitting in front of a list of lab tests written on a wall.

The sign behind this clinician at a hospital in Kenya indicates the wait times for various lab tests. How can innovation improve this system or reduce the need to travel to a hospital for these tests? Photo: PATH/Gabe Bienczycki.

Through PATH’s new Global Health Innovation Hubs, we are collaborating with local partners and governments—starting in South Africa—to make sure that locally originated innovation translates into a healthier future for women and children everywhere. Dr. Anurag Mairal, a leader of this effort for PATH, explains.

Portrait of Anurag Mairal.

Dr. Anurag Mairal thinks innovation hubs can change the trajectory of health for women and children in communities with the greatest needs. Photo: PATH/Patrick McKern.

In many of the 70-plus countries where PATH works, entrepreneurs and innovators are conceiving and refining much-needed health technologies. But what’s often missing is the technical expertise to move these solutions to market through a complex process that includes product development, evidence building, manufacturing, and market introduction. This is especially an issue for innovations designed to improve the lives of the poorest and most isolated communities. As a result, too many lifesaving ideas never make it from a smart concept to lifesaving tools.

PATH’s newly launched Global Health Innovation Hub effort is closing the gap. This week we launch the Global Health Innovation Accelerator Initiative (GHIA) in South Africa, and we are preparing to establish a second hub in India. The idea is to combine PATH’s almost 40 years of experience in selecting and advancing high-impact technologies for low-resource settings; the capabilities of local entrepreneurs, academics, business leaders, and others; and the resources and political will of governments; in order to put more innovative technologies and solutions into the hands of the people who need them.

We think innovation hubs can change the trajectory of health for women and children in communities with the greatest needs—and that there has never been a better time. Here are four reasons why:

  1. We’ve reached a historic moment in global health.

The world is on the cusp of a sea change in how—and wherehealth technologies are developed. With the right support, countries worldwide have the economic drive, top-notch research and engineering resources, universities, companies, and entrepreneurs to bring their best ideas to life. Local innovation hubs meet the clear and urgent need to coordinate and accelerate that potential.

  1. We can save millions of lives—if we act now.

We know that innovation saves lives. Between 1990 and 2012, global efforts cut the number of children dying before the age of 5 by half. And a recent study by the Institute for Health Metrics and Evaluation showed that 4.2 million fewer children died in 2013 compared with 1990 as a result of new vaccines, drugs, diagnostics, and other innovations.

The catch? Many of the technologies that made that possible were already in development 15 years ago. We have a tremendous opportunity speed progress and save millions more lives in the next 15 years. But to do so, we must accelerate more locally appropriate health technologies, more quickly. Strengthening local innovation ecosystems is crucial to that effort.

  1. Innovation hubs are a smart investment.

First, accelerating technologies that improve the health of women is always a best bet. When women thrive, their children, families, communities, and countries thrive.

Second, innovation hubs can leverage investments already made in research and early development. By creating a clear path between these early activities and the crucial later-stage work of regulation, testing, and introduction, the hubs help early investments grow into useable products—unlocking their full potential and saving lives.

In South Africa, for example, the GHIA is working with local entrepreneurs and a US-based multinational to advance a device that can help health care workers diagnose and treat anemia (low blood iron) quickly, painlessly, and without a blood test. The investment in this technology, which is available and demonstrated to work in the developed world, is being leveraged by the local organization to create a product with appropriate features and price point for low-income communities in South Africa and beyond—saving more mothers and babies from life-threatening anemia-related complications in childbirth.

  1. Innovation hubs strengthen local systems, economies, and workforces.

Innovation hubs strengthen the national systems necessary to produce lifesaving technologies long into the future; support local and national economies; and create a legacy of investment in the health of vulnerable women and children. In addition, technologies developed and produced in hub countries have the potential to help people not only locally, but throughout their regions—increasing our impact exponentially while creating new markets and entrepreneurial ecosystems. Finally, as our network of hubs grows, countries can deepen their reach and impact by sharing expertise and resources.

The Global Innovation Hub project promotes a new paradigm in global health—one that shifts the nexus of innovation to the people who know their country’s needs best: its communities, entrepreneurs, and institutions. By tapping their resources and insight, the Hubs will strengthen the link between local needs and technology development, increase access to lifesaving technologies, improve social and economic conditions, and give millions more women, children, and families the chance to thrive.

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Human milk banking: making a powerful investment in newborn health

Hadija Akongo breastfeeding her baby.

Kenyan mother Hadija Akongo breastfeeds her infant, Ruth. Photo: PATH/Evelyn Hockstein.

August 1-7, 2014 is World Breastfeeding Week. This post’s author, Kiersten Israel-Ballard, MPH, PhD, leads PATH’s work on human milk banking. 

Breast milk is the natural first food for newborns; it provides all the energy and nutrients that the infant needs for the first months of life. One of the best things mothers can do for their newborn’s health is to initiate breastfeeding in the first hour of life, and maintain exclusive breastfeeding for the first six months of life.

Two incubators in a neonatal intensive care unit. Photo: PATH/Amy MacIver.

A neonatal intensive care unit. Photo: PATH/Amy MacIver.

But what about babies who are orphaned? Or who are isolated in neonatal intensive care units? Or whose mothers are too ill to breastfeed? Or who face other challenges in accessing breast milk?

“When I see children dying of malnutrition or HIV and I know that an intervention like breastfeeding can increase their chances of survival,” says PATH’s Sophy Mbasa, who works on the issue in South Africa, “it really pushes me to do more.”

Sophy speaking to breakfast audience.

Sophy Mbasa was invited to speak at PATH’s Breakfast For Global Health event, where she told an audience of PATH’s supporters about her work on newborn nutrition and human milk banking in South Africa. Photo: PATH.

Banking and distributing donated milk for at-risk babies

A technician handles small plastic bottles full of breast milk.

A human milk bank. Photo: Chelsea Milk Bank

Human milk banks, which rely on donated mothers’ milk, play an important part in ensuring that safe, pasteurized breast milk is available to babies whose mothers are unable to provide it. The banks are even more crucial for vulnerable babies—those who are premature, underweight at birth, severely malnourished, or orphaned. These babies are at high risk of illness and death.

However, scaling up this lifesaving intervention has been difficult in some poor countries—the very places where HIV, malnutrition, and other challenges lead to the highest numbers of at-risk infants.

PATH has become a global leader on this issue: partnering with milk banking organizations and experts around the world, developing guidance documents, and working to scale up innovative technologies that simplify milk bank processes to make them more low cost, efficient and effective.

FoneAstra device and smartphone monitoring the temperature of bottles of breast milk.

A prototype of the FoneAstra device for monitoring the pasteurization temperature of breast milk using a smartphone. Photo: PATH/Steffanie Chritz.

In honor of World Breastfeeding Week, we’re sharing a roundup of resources and stories to help accelerate the scale-up of human milk banks globally. Because we like to think of human milk banks as the most powerful kind of investment bank—investing in a a healthy start at life for all newborns.

PATH resources on human milk banking

Global breast feeding and human milk banking resources

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How to spur affordable, lifesaving health innovations

Two people in scrubs working on laptops and a large printed spreadsheet.

Improving health information systems leads to better outcomes. Here, nurses in Democratic Republic of Congo enter data to help monitor HIV patient care. Photo: PATH.

On August 18, 2014, we will be 500 days away from the target date to achieve the Millennium Development Goals (MDGs). Reflecting on this deadline, PATH president and CEO Steve Davis contributed an article to Devex entitled “Innovation Knows No Borders: Delivering on the Health MDGs.” This is an excerpt; read the full article at Devex.

Portrait of Steve Davis.

Steve Davis. Photo: Auston James.

How can we make it unheard of for a woman to die in childbirth? Or a child to die of diarrhea? How can we radically improve the course of human development? As we look to 2015 and beyond to the next phase—the UN’s Sustainable Development Goals—we need four things to spur affordable, lifesaving innovations:

  1. Financial and political support by UN member states for research, development, and delivery of new and improved health tools that target the leading killers in low- and middle-income countries. Continued investment in science, technology, and innovation is essential to building on the gains of the MDGs.
  2. Governments must integrate research into their strategic plans to achieve global health and development goals. By prioritizing and elevating science, research, and innovation, both developed and developing countries can help spur new vaccines, drugs, devices, and diagnostics.
  3. Increased collaboration between the private and public sectors and nongovernmental organizations. “Tri-sector” partnerships leverage the unique strengths of each partner to generate broad-scale impact that none could have achieved individually.
  4. Better use of data to inform policies, products, and health interventions. Improving health information systems and strengthening capability for monitoring and evaluation will support decision-making based on evidence and enable citizens to hold governments accountable.

With 500 days to go, we stand at a sensational juncture. Poised to build upon—and learn from—the MDGs, we have the opportunity to chart our future course and, in the process, make history.

Read the full article at the Devex site.

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With the Every Newborn action plan launched, what’s next for newborn health?

Newborn baby crying as his umbilical cord is tied off.

A newborn baby at the Lugube Primary Health Center in Nigeria. Photo: PATH/Evelyn Hockstein.

On June 30, Pauline Irungu, PATH’s senior policy and advocacy officer in Kenya, took part in the launch of the Every Newborn action plan in Johannesburg, South Africa.

Since the launch of the Every Newborn action plan, I feel more optimistic than ever about the future of newborn health, globally and in Kenya. At the Partnership for Maternal, Newborn & Child Health Partners’ Forum in Johannesburg last month, I joined hundreds of advocates, each deeply invested in the health of the world’s women, children, and newborns. We gathered to discuss the final months of the Millennium Development Goals (MDGs) and potential new health targets as the world transitions from the MDGs to the Sustainable Development Goals.

Portrait of Pauline Irungu.

Pauline Irungu is a senior policy and advocacy officer in our Kenya office. Photo courtesy of Pauline Irungu.

A key goal is to reduce the number of preventable newborn deaths. Over the past two decades, improvements in newborn death rates have failed to keep pace with improvements for older children. There is a growing commitment among the global health community to address this failure, and an understanding of what needs to be done to save these young lives. As a major, worldwide, first step, the landmark Every Newborn action plan outlines a strategy to prevent 2.9 million newborn deaths and 2.6 million stillbirths each year.

Where do we go from here?

Attention to newborn health is especially necessary in sub-Saharan African countries, which are making the slowest progress in reducing newborn deaths. I’ve already seen a dramatic increase in commitment to newborn health in Kenya as global initiatives like the MDGs, the Every Newborn action plan, and the UN Commission for Life-Saving Commodities for Women’s and Children’s Health have raised the profile of newborns and highlighted countries’ lagging progress toward health goals.

Newborn baby wrapped in printed cloth.

Photo: PATH/Evelyn Hockstein.

On behalf of PATH, I’ve been collaborating with partners and the Kenyan government to push forward two groundbreaking initiatives. The first is the Maternal and Newborn Health Scale-Up Strategy and Implementation Plan, which is set to become Kenya’s first policy to focus on key interventions for the three leading causes of newborn deaths: prematurity, sepsis, and birth asphyxia. The second is the development of maternal, newborn, and child health legislation that provides a legal framework to prioritize reducing the deaths of women, newborns, and children. Among other key provisions, the legislation will institutionalize the tracking of newborn deaths, which will help Kenya identify—and fix—gaps in its health system.

As a member of the Every Newborn Political Advocacy Working Group, which seeks to coordinate advocacy action and push for country-level policies that support the plan, I am excited to see Kenya make such strong commitments to newborn health.

Baby being admired with out of focus mother resting in background.

Photo: PATH/Evelyn Hockstein.

Action through innovation

Moving forward, we will need to harness the motivation I witnessed in Johannesburg and direct it toward technological, social, and systems innovations that can contribute to the end of preventable deaths. Kenya, for example, needs creative methods to get all mothers to give birth in health care facilities (40 percent still don’t). We also need inventive ways to keep babies warm in places with limited electricity, to transport newborns from remote locations to health care facilities, to develop technologies to help newborns breathe, and to ensure the financial sustainability of maternal, newborn, and child health services.

Watch Pauline Irungu speak about the importance of innovation for newborn health at the Partner’s Forum.

PATH is working on health innovations that promise to drive down newborn and maternal deaths. More than half of premature babies struggle to breathe, which is one of the reasons premature birth is the leading cause of newborn death. PATH is advancing an affordable bubble continuous positive airway pressure device that can save lives by gently flowing pressurized air into babies’ lungs. We’re also working on solutions for postpartum hemorrhage and preeclampsia/eclampsia—two of the leading causes of maternal death. Five of these groundbreaking newborn health innovations will be featured at USAID’s Saving Lives at Birth: A Grand Challenge for Development event from July 30 to August 1 in Washington, DC. These tools will save the lives of newborns as well as women, because babies are less likely to survive when their mothers don’t. According to the action plan, investments in quality care at birth could save the lives of millions of babies and women who die needlessly each year.

Though we—the global health community—have much work to do to end preventable newborn deaths, I am energized about global commitments and the motivating force of the Early Newborn action plan. This motivation will be critical to create real and lasting change for the world’s newborns.

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South Africa: scaling up care for community caregivers

Children play jumprope on a dirt road.

Children, including ten-year-old Itumeleng, play with friends in a township near Johannesburg, South Africa. Photo: PATH/Lynn Heinisch.

Editor’s note: This is the first of a three-part series of blog posts by PATH’s president and CEO Steve Davis about his experiences visiting PATH programs in three African countries this July.

In an impoverished township 35 miles east of Johannesburg, I met Dimakatso Sibeko. Wrapped in a wool blanket, the grieving 42-year-old mother sat in the dirt, leaning against the wall of her home, surrounded by other women. Last week, she buried her two-year-old daughter. A year ago, she buried her husband.  All she has left is her ten-year-old daughter, Itumeleng.

Woman and daughter in the sun.

Sibeko and her daughter Itumeleng. Photo: PATH/Lynn Heinisch.

While PATH is best known for our innovations in vaccines, drugs, devices and diagnostics, the only way these tools will have their intended impact is in the context of strengthened systems and services.

In fact, many of our programs focus on system and service innovations (PATH’s fifth platform”). Here in South Africa, we’re designing models and building evidence to improve the lives of orphans and vulnerable children like Itumeleng.

House-to-house community caregiving

Sibeko’s family lives in a makeshift settlement, bordered by a brick wall with barbed wire on top. Small, dark shacks with corrugated tin roofs crowd together on red dirt, with streams of water and sewage running down the streets where children play.

As part of PATH’s project, a community caregiver named Nomakhwezi Bafo visits Sibeko’s family a few times a month. She believes that Sibeko’s daughter and husband both died from AIDS. She says Sibeko is on antiretroviral drugs but doesn’t take them consistently, because she lacks food to eat with the medicine and can’t afford to travel to the clinic.

“The only thing I am sure of is the poverty. They had nothing. We used to find them eating pap [corn porridge] given to them by a neighbor,” Bafo said.

Steve Davis speaking with PATh staffer.

PATH staff member Yolanda Moyo described the toll that this work can have on the caregivers’ psychosocial well-being. Photo: PATH/Lynn Heinisch.

Bafo provides psychosocial support to 15 area families raising orphans and vulnerable children. Some of them are widows like Sibeko; others are grandparents, aunts, or neighbors who care for children who have lost parents; some are children who are heads of households. Bafo walks miles each weekday, checking on the families, listening to their needs, and referring them to resources when possible.

“It’s very emotional. It takes everything in you. When you meet with these families it takes you back to your past and it haunts you,” Bafo said. “You need to be professional. You need to be strong for them. They’ve got nothing.”

Caring for the caregivers

PATH partners with a community organization that provides training on psychosocial well-being for caregivers like Bafo so that they are better equipped to care for and protect children. This training is provided in all nine South African provinces, helping caregivers to hone their coping skills and access resources to support themselves and the families.

A workbook with blue ink and illustrations.

Part of the curriculum delivered to caregivers. Photo: PATH/Lynn Heinisch.

“They’ve got emotional burnout and pain. People are dying and they don’t know what to do,” said Sibongile Tloubatla, a psychologist who trains the caregivers. “They come back to visit the family after two days and the person has died. And how do you handle children who are in pain?”

Caregivers themselves can become traumatized and depressed, she said, so they learn in training how to manage the stress.

“They look after other people but they don’t look after themselves,” Tloubatla said. “We help them take care of themselves, so they can be effective in their work.”

Designing the best program for national scale-up

Given PATH’s emphasis on large-scale impact and partnering with the countries where we work, we will continue to test our models, design best approaches, and then transition this program to the government of South Africa late next year, so that it can be scaled up. In preparation, we are conducting studies on the effectiveness of the approach.

An estimated 2.5 million South African children have lost one or both parents to AIDS. The lives of the families I met this week are stark illustrations of the cyclical link between poor health and poverty. Some 20 percent of South Africans, roughly 10 million people, are unable to purchase enough food for an adequate diet. This extreme poverty both contributes to and is compounded by the AIDS crisis.

Talking with Bafo, Tloubatla, and the women who run the program, I was once again so impressed and inspired by the dedication, intelligence and compassion of community leaders and volunteers who are working so hard to improve the lives of children devastated by AIDS and poverty, and the people who care for them.

With the scope of the challenge, their one-by-one impact seems like a drop in the bucket. Yet, we all know that for any individual, just one person can make all the difference in the world. Our task then, is to leverage these results to have the greatest possible impact.

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If polio is on the run, why do we need new tools to help prevent it?

A baby held on mother's lap opens mouth to receive a drop of polio vaccine.

An infant receives oral polio vaccine in India, which was declared polio-free earlier this year. Photo: PATH/Gabe Bienczycki.

Guest contributor Laura Anderson is an editor at PATH.

In the past 25 years, global immunization efforts have eliminated polio from most regions of the world. Over the last two decades, the number of cases has dropped by more than 99 percent, bringing in sight the goal of eradication—no one with polio, anywhere.

This week, PATH and our partners announced a new contribution to this effort. A grant from the Paul G. Allen Family Foundation will help expand use of two new polio detection tools: a system to make it easier to check for polio in waste water and a simplified diagnostic test to find the virus in people.

Why do we need new tools when we’re already so close to wiping out polio? Dr. David Boyle, a PATH senior researcher, explains.

Not missing the polio virus—anywhere

Especially now, when eradication is within sight, we need to be sure we’re not missing the virus anywhere. Polio is very contagious, so a new epidemic can start with just one infection. Just this May, the World Health Organization (WHO) issued a formal warning that the virus is spreading internationally from Cameroon, Pakistan, and Syria, where conflict and other factors have interfered with elimination efforts. That puts progress at risk: it could spark new epidemics if leaders don’t step up to stop polio.

Aggressively looking for the virus allows us to adjust our strategy, catch outbreaks early, and respond quickly. It also tells us whether immunization strategies are working. Basically, we’re always asking, “Is the virus really not here or are we just not seeing it?” There’s no way to treat polio, so it’s important to keep people from getting it in the first place. Continue reading »

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What’s tiny, transformative, smart, and now 5 billion strong?

Guest contributor Laura Anderson is an editor at PATH.

Man holding a small bottle between his thumb and forefinger. A sticker on the vial features a purple circle.

Is the vaccine good to use or not? Vaccine vial monitors show health workers at a glance. Photo: PATH/Mike Wang.

Imagine you are a health care worker. Should you use or discard the vaccine at right?

For years, health care workers had no way to decide. Then, nearly two decades ago, PATH and our partners developed and introduced the tiny, powerful vaccine vial monitor (VVM).

VVMs change color as they are exposed to heat, letting providers know at a glance whether heat-sensitive vaccines have been damaged or can still be used for immunization.

As of 2014, 5 billion VVMs have been used, saving lives by ensuring vaccines are still potent when they are given.

Five billion is an enormous number. That many VVMs, end to end, would circle the globe. It’s more than two VVMs for every one of the 2 billion children on earth.

Woman in pink smock fills a syringe from a vaccine vial. A young girl looks on.

Thanks to vaccine vial monitors, health care workers, like this one preparing to vaccinate a young girl in Laos against Japanese encephalitis, can quickly see if the vaccine has been exposed to excessive heat. Photo: PATH/Aaron Joel Santos.

And our impact continues to grow. In the next decade, we estimate that VVMs will allow health care workers to recognize and replace more than 200 million damaged doses and deliver at least a billion more doses in remote settings.

Thanks to the vision and tenacity of PATH and our partners, we did what no other group could: unlock a simple, transformative innovation and drive it to lifesaving scale.

Exemplifying our role in leading global health innovation, PATH was selected as one of 30 leading American innovators for the US Global Leadership Coalitions’s (USGLC) 2014 Innovations in Smart Power Initiative, in which the VVM was selected as a top life-saving innovation.

Infographic showing VVM sticker changing color from heat exposure, with text, 'Vaccine vial monitors: saving lives, one dose at a time. As of 2014, 5 billion VVMs have been used, saving lives worldwide by ensuring vaccines are still potent when they're given.'

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Bike messenger: unlocking new voices to stop HIV/AIDS in Uganda

We share our deepest condolences with those who lost loved ones on Malaysian Airlines Flight MH17, including many colleagues on their way to the International AIDS Conference in Melbourne, Australia. In recognition of their dedication to the fight against HIV/AIDS, the conference is continuing.

Among our other activities at the conference this week, PATH staff are hosting a July 24th session on our Arise program, which gives vulnerable communities in Africa and India the tools to reduce their risk of HIV. For Mary, an Arise community case worker in Uganda, that meant regaining the most powerful tool of all—her own voice.

Mary Achaido standing next to her bicycle on a dusty road.

Mary Achaido, a case worker with PATH’s Arise program in Uganda, educates women and men in her community about family planning and HIV services. Photo: Pathfinder International.

If you see Mary Achaido sailing by on her bicycle, or hear her talking confidently with members of her Ugandan community, it’s hard to believe that just three years ago, she wasn’t sure her voice could matter.

For Mary, who struggled under the stigma of HIV, the change came during a community meeting. There, she heard that PATH’s Arise program needed case managers to help improve women’s access to family planning and prevent new HIV infections in their communities. The program particularly wanted women and men living with HIV. Mary joined immediately. “I wanted to relieve myself from the stigma of being HIV-positive,” she says.

Closing the gap in family planning

In Uganda, where many communities have only recently emerged from decades of conflict, it can be difficult for women to obtain family planning tools and information. Only 30 percent of married women use contraception; many more would like access but are restricted by a lack of supplies, education, and services. Women with HIV, who also have to navigate stigma, antiretroviral treatment, and HIV prevention, face even greater barriers.

Arise is closing that gap by building a confident cadre of community and clinic-based outreach workers to engage women living with HIV and their husbands and communities. Because many of these workers are themselves HIV-positive, they have the perspective to build trust and spark meaningful conversation. It’s a simple, powerful approach that is breaking longstanding barriers.

The role also supports the workers’ own health, explains Betty Inyakoit, a program supervisor. “When the project started, many [workers] were weak and stigmatized. Now, all of them are strong. . .able to ride bicycles, able to talk to their husbands, and all [have begun to use] family planning.”

A long way home

During her case management training, Mary learned about HIV counseling, family planning, and integrated care. Today, she uses that expertise (and a trusty bicycle) to raise awareness of HIV and AIDS through discussions, meetings, and home visits with other women living with HIV.

Of course, the work isn’t easy. For Mary, a long bicycle ride to a client’s home in blistering heat is just another day on the job. Sometimes, she has to stand up to strong resistance to family planning, particularly from men. Still, she loves her work and says she’ll continue to serve her community even after the Arise program has ended.

A healthier community

Since 2010, Arise has trained more than 85 community health workers and given thousands of Ugandan women and men access to family planning, empowering them to care for their health, prevent new infections, and plan when and whether to begin a family. The results are powerful. With every mile Mary pedals—and every discussion, meeting, and educational event she and her cadre make possible—Uganda moves closer to a future free of HIV.

Arise—Enhancing HIV Prevention Programs for At-Risk Populations—is made possible through financial support provided by the Canadian Government through the Department of Foreign Affairs, Trade and Development Canada, and via financial and technical support provided by PATH. Our work in northern and eastern Uganda is conducted in partnership with Pathfinder International and the National Community of Women Living with HIV/AIDS.

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How the right contraceptive can change a woman’s life

Backs of three women walking on a dirt road.

Women, no matter where they live, should have access to contraceptives that meet their needs. Photo: PATH/Eric Becker.

Guest contributor Sara Tifft is director of PATH’s Sayana® Press pilot introduction and evaluation project. Sayana Press was launched today in Burkina Faso.

Portrait of Sara Tifft.

Sara Tifft. Photo: PATH/Patrick McKern.

It’s about choice. All women, no matter where they live, should have access to a range of contraceptive options that allows them to make an informed choice and meets their needs—for the sake of their own health and the health of their children and communities. Because when a woman finds the right contraceptive, it changes her life.

Today in Burkina Faso, in the heart of West Africa, a new form of contraceptive is being launched to do just that. Sayana Press, which PATH helped to develop, has the potential to reach tens of thousands of women who want the choice of an injectable contraceptive, but who live far from clinics where the injections are given.

Sayana Press combines a lower-dose formulation of the widely used contraceptive Depo-Provera® with the BD Uniject™ injection system. Uniject, which PATH developed, is a small, prefilled syringe that is easy to transport, easy to use, and designed to reach people wherever they live.

Meeting a need in family planning

Almost a quarter of married women in Burkina Faso want to use family planning to space their children or to stop having them altogether but don’t have access to a form of contraception that meets their needs. These women well understand the value of family planning. Continue reading »

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