Mike Eisenstein: design, build, test, innovate

Bearded man in plaid shirt and safety glasses presses buttons on keypad of large silver machine.

Mike Eisenstein at work in our product development shop. Photo: PATH/Patrick McKern.

When Mike Eisenstein arrives at work, he pulls on a faded blue apron and tucks his essential tools—pen, highlighter, safety goggles—into the pockets.

“I’ve ruined a lot of clothes,” he explains.

Wardrobe destruction is a byproduct of managing PATH’s state-of-the-art product development shop in Seattle. Among an impressive array of machinery, Mike and his colleagues devise and adapt technologies with the potential to improve health care in developing countries.

Follow the bouncing idea

Ideas bounce around like ping-pong balls as engineers, technical experts, and others working in the shop come up with new ways to look at devices and products. For example:

Could an infusion pump that delivers antibiotics to hospital patients in the United States deliver anesthesia to patients in remote clinics in poor countries? Mike and his colleagues are developing a new, portable, battery-free infusion pump that could serve that purpose.

Could phase-change material that maintains temperatures in building construction also be used to protect vaccines during transport? Mike and others are advancing a project to develop a portable vaccine carrier that prevents vaccines from freezing or overheating.

A lifetime of fixing things

Managing the PATH shop is exactly where Mike hoped to land when he joined our organization in 2008. Newly married and with a unique résumé—from fixing bikes to running operations at a tech start-up to servicing wildlife tracking equipment to managing operations for a wine distributor—Mike worked first as a computer support specialist, then as a program assistant until PATH’s longtime shop manager, Bill Van Lew, announced his retirement. Bill, an expert model-maker, took Mike under his wing and guided him into the role.

It didn’t hurt that Mike had a lifetime of hands-on experience under his tool belt. Continue reading »

What’s advocacy mean to global health?

Man stands next to woman holding a young child.

Advocacy helps ensure solutions to challenges in global health reach the people who need them. Photo: PATH/Gabe Bienczycki.

Rachel Wilson is senior director, advocacy and public policy, at PATH.

Believe it or not, advocacy is as much a part of your daily life as it is mine. Have you ever signed a petition to show your support for a cause or approached friends to speak up for change that you felt strongly about?  Whether it’s working to place a stop sign on the corner of your street or to add newborn health protections to national health policy, advocacy is democracy in action.

Rachel Wilson

Rachel Wilson. Photo: PATH.

In global health, we talk a lot about the importance and influence of advocacy. Rarely, though, do we break down what this really means.

A champion for better global health

To put it simply, it’s not enough to invent or implement solutions to global health problems. The global health community must secure the support of decision-makers, policymakers, and others who can commit the necessary resources and enact supportive policies to bring these solutions to scale. It takes advocacy as well as ingenuity to ensure that existing solutions, as well as those in development, can reach the people who need them most.

What does it take to ensure that these innovations result in sustainable improvement? Resources and political will—informed by the experts and communities who understand what is needed.

How we approach advocacy

At PATH, our advocates work to ensure that donors and developing countries make funding and policy decisions that will have the greatest health impact.
At the heart of PATH’s work in advocacy is our distinctive approach to achieving public health goals through policy change. What makes our policy advocacy work unique is our diverse areas of expertise—as a research organization, as an implementer, and as an adviser on key global health platforms. We use this expertise to improve policies and leverage resources that will ultimately accelerate the delivery of global health services and innovations that save lives.

Staff at PATH work to influence government priorities and decisions by increasing awareness and engaging with policymakers, key constituencies, and other important individuals and groups. Each year, we determine the areas in which our advocacy work can have the greatest impact. Always among our priorities are child health, women’s and newborn health, infectious diseases, and research and development for global health technologies.

A powerful tool for change

Advocacy is one of the many powerful tools that PATH uses to drive transformative innovation to save lives. By influencing the priorities and actions of those in power, we work to create a policy environment that supports good health and equity around the world.

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Mali introduces rotavirus vaccine

Men marching with stringed instruments.

Musicians herald the arrival of vaccination against rotavirus in Mali on Tuesday. Photo: PATH/Kathy Neuzil.

Kathy Neuzil, leader of our Vaccine Access and Delivery Program, is in Mali this week as the country introduces a vaccine against rotavirus, the most common cause of severe and fatal diarrhea in young children worldwide. Her report follows.

As I watched the historic launch of rotavirus vaccines in Bamako, Mali, yesterday, I was reminded of an anxious time in my life more than a decade ago. I sat between two small beds in a hospital room in Seattle, where my daughter, 1, and my son, 6, were both receiving intravenous (IV) fluid for serious diarrhea. As a physician, I knew that rehydration with IV fluids is a simple and potentially lifesaving intervention. As a mother, I was worried.

Portrait of Dr. Kathy Neuzil.

Kathy Neuzil. Photo: PATH.

Fortunately, my children were able to return home with me the following day, fully recovered. I was grateful that the hospital was an easy 15-minute drive from my home and that advanced medical care was readily available.

Had I been a mother in Mali, I may not have been so fortunate—one or both of my children could have died from diarrhea. Mali is one of the poorest countries in the world. Mothers, fathers, and other caregivers often have to travel great distances over difficult terrain to reach health facilities. Depending on the location, IV therapy may not be available for their children. Lack of access to care is one reason more than 90 percent of diarrhea-related deaths occur in young children in countries with few resources. Continue reading »

Dexiang Chen: a life in science

Portrait of Dexiang Chen in blue shirt and wire-rim glasses.

Dexiang Chen pursued a career in science after nearly being assigned life as a farmer during China’s Cultural Revolution. Photo: PATH/Mike Wang.

Dexiang Chen was born in Linshu, a rural town in Shangdong Province, China. During the height of the Cultural Revolution, his career was chosen for him: he would become a farmer.

Dexiang now leads the vaccine stabilization and formulation technologies projects at PATH. In more than two decades as a scientist, he has advanced several patent applications, helped secure millions of dollars in funding for research and development, and coauthored more than 50 published research articles. But as a young boy from a small village in 1960s and ’70s China—son of a government worker and a farmer—local officials did not choose him to go on to middle school.

“It was my teachers,” Dexiang says, remembering the day his future changed. “They went to the middle school and said, ‘Take this student.’”

By the time Dexiang was ready for college, the Cultural Revolution had ended. Students were still told what they would study, but this time Dexiang was lucky. He was assigned veterinary medicine. It was an arbitrary decision made by an official he never met, he says, but it sparked two lifelong passions: an intense interest in infectious disease and a longing to apply his work to improve public health. Continue reading »

Five historic moments for malaria

Portrait of Manny Lewis.

Manny Lewis. Photo: PATH.

Guest contributor Manny Lewis is a communications associate with PATH’s Malaria Control Program. He wrote this post for the Making Malaria History blog.

Last year was an exciting time in the battle against malaria, with significant advances in resources and new tools adding momentum to the fight. The following is a roundup of the top five malaria-related stories of the past year, as determined by no algorithm whatsoever. So crank up Sarah MacLachlan’s “I Will Remember You” and take a stroll down memory lane, as we look at five moments that made malaria history in 2013.

1. Focus on elimination: Elimination took center stage at the two preeminent malaria conferences, the Pan-African Multisectoral Initiative on Malaria conference in October and the American Society of Tropical Medicine and Hygiene Annual Meeting in November, demonstrating the world’s growing commitment to stopping transmission of the disease once and for all.

2. Record levels of global support: $12 billion was pledged to the Global Fund to Fight AIDS, Tuberculosis and Malaria during last month’s replenishment conference—a 30 percent increase over the previous replenishment in 2010 and the largest amount pledged to date. And while we’re here, let’s not overlook the massive fist bump that the US Congress gave The United States President’s Emergency Plan for AIDS Relief (PEPFAR) in the form of the PEPFAR Stewardship and Oversight Act of 2013.

Man in white lab coat looks at a sample through a microscope.

Researchers at centers in Africa are involved in trials of malaria vaccine, results of which are one of our five notable moments in 2013′s malaria history. Photo: PATH/Eric Becker.

3. More lives saved: A big takeaway from this year’s World Malaria Report was new data showing that more lives were saved from malaria over the previous decade than originally thought, with deaths in young children falling by 51 percent since 2000. Continue reading »

The NGO challenge: stay ahead of the curve

Young girl in blue with dimples, holding a piece of orange-fleshed sweet potato.

Pauline’s family has benefited from better nutrition since her mother began growing sweet potatoes—the result of a project that got its start through a PATH fund. Photo: PATH/Gabe Bienczycki.

“With unprecedented disruption occurring in the global development sector, how can organizations capitalize on their distinct assets to stay ahead of the curve and meet the global challenges of tomorrow?”

Portrait of Steve Davis.

Steve Davis. Photo: Auston James.

Recently, FSG, a nonprofit consulting firm specializing in research, strategy, and evaluation, approached me and the leaders of other international nongovernmental organizations (INGOs) with this question, engaged us in conversation, and distilled insights from across our sector into a compelling report, Ahead of the Curve: Insights for the International NGO of the Future.

Four ways to have greater impact

The report identifies four key approaches that will allow INGOs to have greater impact:

  • Enhancing direct implementation, already under way, by leveraging technology, informing programs with cost-effectiveness data, and making other improvements.
  • Influencing systems change by utilizing all assets and bringing in other players to fill in gaps.
  • Harnessing the private sector through shared value that creates jobs, develops new products that address critical needs, and fosters prosperity in local communities.
  • Leading multisector action, turning pro forma partnerships into rigorous collaborations for complex problem solving.

Taking innovation to scale

PATH is one of the world’s largest and leading INGOs, and we’re thinking a lot about these questions and findings as we map out our approach to bringing more global health innovation to scale in the coming decade. The FSG findings closely mirror our approach, a fact underscored by the report’s authors.

PATH is “moving beyond the one-off, isolated, pilot, and implementation orientation that has dominated the sector,” they write. “PATH colleagues investigate the full spectrum of activities and players that are needed to bring health products to market and leverage market forces and partnerships to address regulatory, procurement, and distribution solutions while products are still in development.”

Need for flexible funding mechanisms

One challenge faced by international development nonprofits like PATH is the influence of donor funding, which is aligned to donor priorities, programs, and funding cycles. With staff and partners on the ground around the world, especially across Africa and Asia, and an emphasis on finding innovative solutions, we often need to move more quickly than traditional donor cycles allow, to take experimental approaches, to support proof-of-concept work, and to pilot transformative strategies.

The FSG report cites PATH’s Catalyst Fund as a model for other INGOs. Created in 2005 with support from foundations, corporations, and high net worth individuals, this internal fund provides flexible funding that we use to invest in organizational infrastructure, experiment with untested but high-potential innovations, and bring proven interventions to scale.

We’re exploring other potential mechanisms for future development, including deeper corporate engagement, fees for some technical services, and leveraging our intellectual property in more effective ways. I will expand on those ideas here in 2014.

Our sector is changing rapidly

There are many new and different actors in the development space and many new models for partnership and innovation, which provide exciting new opportunities. In this environment, the experience, technical expertise, resources, networks, and insights of INGOs are extremely valuable. PATH brings a unique combination of entrepreneurial spirit, scientific and public health expertise, global reach, and mission-driven commitment to health equity. But, as this report underscores, INGOs must continue to evolve, striving for greater efficiency, partnership, and impact as we tackle many of the world’s greatest challenges.

I commend FSG for developing this report, and I recommend it as essential reading for anyone devising strategies for greater impact with an eye toward the needs of tomorrow.

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Ashley Birkett: his metric is saving lives

Ashley Birkett, PhD, was a 14-year-old growing up just north of Birmingham in the United Kingdom when he chose the course of study that would define much of his life.

Portrait of smiling man.

Ashley Birkett left the private sector for the PATH Malaria Vaccine Initiative. Photo: Genelle Quarles/Burness Communications.

“From a pretty early age I wanted to apply science to a cause,” says Ashley, who recently became director of the PATH Malaria Vaccine Initiative (MVI). “I knew very early on that I wasn’t motivated only by discovery or an academic career. I was much more interested in the application of science to a medical intervention.”

After a decade-long career in industry, Ashley joined PATH in 2008 as director of preclinical research and development for MVI, which drives the development of safe and effective malaria vaccines. His tenure has coincided with a particularly exciting time, as the most clinically advanced vaccine candidate supported by MVI, GlaxoSmithKline’s RTS,S, has been in final testing. At the same time, Ashley and his colleagues have been working to realign MVI’s strategy toward an ambitious long-term goal: the eventual elimination of malaria.

See why Ashley is committed to developing malaria vaccines, and learn about their role in preventing the disease.

What’s it been like to be working at PATH MVI as the RTS,S vaccine candidate goes through testing?

It really is exciting, and it’s one of the things that drew me to MVI. I think the progress we have made to date with RTS,S is a tremendous achievement. It is one important building block as we move into the future and helps set the stage for what we need to do. It’s critical to learn from our successes and our failures, integrating the experience and knowledge that we’ve gained from RTS,S and other projects into the next generation of vaccines.

Equally as exciting, however, is the malaria vaccine community’s commitment to achieving the long-term goal of eradicating malaria altogether. There are tools available to control malaria today. But we still have 627,000 deaths from malaria each year, most of those young children in Africa. So, we don’t have all the tools we need. We think that vaccines that can prevent clinical disease are one of the tools—and RTS,S may be that tool—but we also need to develop vaccines that can prevent the transmission of the malaria-causing parasite between people and mosquitoes and break the cycle altogether.

Are there any successes in your career that you’ve found especially satisfying?

I have gained a great deal of satisfaction from bringing together groups with complementary technology platforms to form integrated teams that collaborate toward achieving a common goal. This type of operating model, while often challenging to implement, will be critical for us to achieve our mission of accelerating malaria vaccine development. I have particularly enjoyed advancing programs from a very early phase—from a point of interacting with academic experts to establish new programs, based on novel concepts—and advancing them to clinical trials.

Before joining PATH, I led several such projects with grants from the National Institutes of Health and PATH. In my first company, I was involved in raising money from individual investors and venture capitalists, too.

Did you enjoy that part of it?

I did. It was a challenge, but very rewarding. And it gives me a greater appreciation for the funders we have today. It’s not just the magnitude of the investments that I appreciate so much, but the unwavering commitment that our donors share with us for developing effective malaria vaccines. Developing the vaccines we need to prevent and ultimately eliminate malaria is not a venture for those with short-term investment horizons.

That’s one of the reasons I gravitated toward a nonprofit, because some interactions in the private sector can be quite challenging and the best science doesn’t always prevail. It’s all driven by financial returns, whereas our metric is saving lives.

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10 cool projects from PATH—and you

We’ve been telling you all month why you should give to PATH. Now let us show you a few examples of the kind of results your gifts support.

Hands holding three vaccine vials with vaccine vial monitor stickers.

Vaccine vial monitors. Photo: PATH/Yancy Seamans.

Vaccine vial monitor: The vaccine vial monitor is a small circle, no bigger than a dime, placed or printed on a vaccine vial. The circle changes color as it is exposed to heat, letting health workers know at a glance whether the vaccine has been damaged or can still be used for immunization. Over the next decade, it’s estimated vaccine vial monitors will allow workers to recognize and replace more than 200 million doses of damaged vaccine and confidently deliver more than a billion more doses—saving lives and reducing illness for countless people.

Two people standing outside a building, wearing hard hats and goggles.

PATH’s Dr. Ponni Subbiah and Dr. Wolfgang Laux of Sanofi tour a new semisynthetic artemisinin factory. Photo: PATH.

Semisynthetic artemisinin: Today, artemisinin, a drug derived from the sweet wormwood plant, is the main ingredient in the most effective treatment for malaria. But its supply depends upon a volatile crop. PATH and our partners figured out a way to create a new, stable supply of the drug. Large-scale production of semisynthetic artemisinin will bolster the botanical supply, expanding access to treatment. Up to 150 million doses will be produced in 2014.

A small, white box with a screen and a detached keyboard sits next to a larger white box.

careHPV™. Photo: QIAGEN.

careHPV™ cervical cancer screening test: The vast majority of women who die from cervical cancer live in developing countries where access to screening is rare. Since the 1990s, we’ve been working to bring screening to settings with few resources. One of our new tests signals if a woman is infected with one of the cancer-causing types of human papillomavirus (HPV). For women older than 30, current infection means higher risk of future disease. Working together with QIAGEN, the manufacturer of an expensive, hospital-based test, we created an easier-to-use, faster, and much less expensive version that performs well in basic labs. The test, called careHPV™, is considerably more sensitive than the Pap test commonly used in wealthy countries.

Young woman, standing, braids the hair of another young woman, sitting.

As part of HIV/AIDS prevention activities, Kenyan youth get vocational training, such as hairstyling, to boost their economic prospects and help them take charge of their future. Photo: PATH/Eric Becker.

APHIAplus Western HIV/AIDS services: Western Kenya faces a high burden of HIV/AIDS, malaria, tuberculosis, and other infections and diseases. Through a broad portfolio of integrated activities, we work across the health system to help some of Kenya’s most vulnerable people. For example, a community-based motorcycle ambulance service helps pregnant women in remote communities reach skilled care in time to give birth. This improves health outcomes and lowers rates of mother-to-child transmission of HIV. Our current work in Western Kenya builds off the success of a previous project that reached more than 700,000 people with information about HIV/AIDS. Continue reading »

The Global Fund: putting it on all on the line

A fully replenished Global Fund is our best bet for ending malaria, HIV/AIDS, and TB

Guest contributor Dr. Kent Campbell is the director of PATH’s Malaria Control Program.

Leaders from around the world gathered in Washington, DC, earlier this month and pledged a combined total of US$12 billion to support the Global Fund to Fight AIDS, Tuberculosis and Malaria. This is the largest sum ever committed to the Global Fund, an international financing institution created in 2002 to fight three of the deadliest pandemics in the world.

Portrait of Kent Campbell.

Kent Campbell, director of the Malaria Control Program at PATH. Photo: PATH/Patrick McKern.

As someone who has worked in the malaria field for more than 30 years, I have witnessed the transformative impact of the Global Fund. Just last week, the World Health Organization released new data showing that malaria deaths in children have been cut in half since 2000—a decrease that would not have been possible without the Global Fund. Though the malaria community has many generous partners that have worked to achieve unprecedented progress over the past decade, an incredible two-thirds of all donor funding to achieve this progress comes from the Global Fund. As a result, in a relatively short period of time, countries have gone from having health systems overburdened by malaria to being able to lay the groundwork to eliminate the disease altogether—something that would have seemed unthinkable just a few decades ago.

A remarkable commitment

What is uniquely remarkable about this year’s round of pledges is that it includes financial commitments from a number of small and low-income countries where malaria, HIV/AIDS, or TB still exact a heavy toll—like Kenya, Malawi, Nigeria, and Namibia. These countries are showing a growing capacity to build on Global Fund investments by providing national resources to fight disease. Countries are also increasingly able to purchase lifesaving tools like medicines, diagnostics, and bednets to support their own programs. Of particular note this year are Zambia, which has invested $24 million to fight malaria, and South Africa, which has invested $22 million. This is indicative of national governments beginning to experience tangible benefits from programs that combat malaria: healthier communities are producing stronger economies.

A woman extends her hand, which is held by a health worker who pricks it to draw a drop of blood.

A woman gives a drop of blood to be tested for malaria. Photo: PATH/Gena Morgan.

However, continued success must not be taken for granted. Infectious disease control is not an inherently stable state, and early successes can be alarmingly fragile. In the case of malaria, if we do not continue to make progress against the disease, we run the risk of losing the achievements we have already made. The malaria parasite is highly adaptive, and history has shown that the disease can resurge within months of relaxing control efforts, often to levels equal to or worse than before. Since 1930, the disease has resurged 75 times in countries where it had previously been under control; nearly all of these resurgences have been linked to decreases in resources and scaling back of malaria programs.

Maximizing impact

So while there is much to celebrate, the evidence is clear that a well-funded Global Fund is critical to be able to finish the work that has been started and end the threat of malaria, HIV/AIDS, and TB once and for all. To be successful, the global community must work to maximize the impact of pledged funds, while documenting the great value for money we are getting from these investments. We must increase the strategic targeting of funding to programs with the greatest promise of health impact and partner with national governments and others to demonstrate that these national programs are well designed and managed. In short, we must work harder and smarter, building the evidence base as we go—to ensure that the Global Fund’s next replenishment is even more robust and countries continue to invest in effective health programming.

Let’s join countries in their ambitious vision and be the generation that ends malaria, HIV/AIDS, and TB, once and for all.

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What do donors want?

Young girl places her hand over her upper arm where she's received vaccination, with the words "Share the health: donate now for 1:1 match."When you make a charitable gift at the end of the year, what do you really want? We’re willing to bet it’s not address labels, a calendar, or even an invitation to lunch with the CEO. We think it’s more likely you want your donations to make a difference.

“PATH’s pledge to donors says that we’ll use your gift in the most effective way possible,” explains Mike Kollins, our chief operating officer. “That’s a promise we take extremely seriously. Not only does our reputation depend upon our good stewardship and transparent use of funds, the lives of the people we serve very often do, too.”

Keeping our promises

Pie chart reading, "How we use funds: 39.8% emerging and epidemic diseases, 28.8% vaccines and immunization, 13.2% health technologies, 10.6% maternal and child health, 6.0% reproductive health, 1.6% cross-program initiatives."To fulfill our promise to you, we’re careful to manage every aspect of our work so that more than 85 percent of expenses are directed to our global health programs. We start with a detailed budget developed 12 months in advance. Once a quarter, we run reports on every single project to monitor exactly how funds are being used. The chart here shows our spending in broad global health categories.

You can get the bigger picture of our fiscal management from the overview of our expenses shown in the chart below. About half of our staff live in the countries where our work occurs, which helps support local economies and systems.

Pie chart with text that reads, "Our expenses: 86.4% program services, 12.5% management and general, 0.6% bid and proposal, 0.5% fundraising."We’re pleased to say that others have taken note of our high standards for sound fiscal management. Charity Navigator, America’s largest independent evaluator of nonprofits, has awarded us its highest possible rating—four stars—a designation we’ve received for nine years in a row. Only 1 percent of rated charities can say the same.

A commitment to measuring impact

An important companion to fiscal management is careful monitoring and evaluation of our work. We want to make sure that we’re making an impact. We start our projects with a clear statement of desired outcomes, monitor progress along the way, and measure results as work concludes. The lessons we learn help to make our future work even more effective.

We’re also interested in the performance of our organization as a whole over time. We’ve developed a set of cross-program indicators and organizational effectiveness indicators—measurable steps toward interventions that improve health. For those interested in the details, we’ve developed a brochure that explains our monitoring and evaluation planning and process.

Reporting back to you

These are just some of the ways we let you know how we use your donations, and how your generosity improves lives the world over. For more details, we invite you to see our yearly report to contributors and our most recent annual report.

“At PATH, our commitment to excellence extends to our management of your gifts,” says Mike. “We’re both proud of the trust you put in us and humbled by your support. Together, we’re changing lives for the better.”

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•   Donate to PATH
•   Our finances
•   Good stewardship

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