Dr. Manjari Lal: an award-winning formula

Portrait of Manjari Lal.

Dr. Manjari Lal. Photo: PATH.

Two of PATH’s leading female scientists were recently honored for their contributions to global health: Tala de los Santos, MBA, MS, as a Washington Global Health Alliance (WGHA) Rising Leader, and Manjari Lal, PhD, with a 2014 William Hunting Award. We’re proud to support the outstanding achievements of our technical teams, who often work “behind the scenes” to develop and advance transformative health care innovations for public health impact.

Part two: Today we feature Dr. Manjari Lal.

Manjari Lal, PhD

Manjari Lal, PhD, one of PATH’s scientists working in vaccine and pharmaceutical technologies, was recently awarded the 2014 William Hunting Award for her and her team’s crucial work to develop a heat-stable fast-dissolving tablet (FDT) formulation of Newcastle disease vaccine.

Each year, Veterinary Record, the prestigious peer-reviewed journal of the British Veterinary Association, bestows the Hunting Award to a research paper considered to have made the most useful contributions to veterinary science. The award-winning paper, “Development of a Low-Dose Fast-Dissolving Tablet Formulation of Newcastle Disease Vaccine for Low-Cost Backyard Poultry Immunisation,” was penned by Manjari, as lead author, in collaboration with authors from the University of Washington, the Southeast Poultry Research Laboratory of the United States Department of Agriculture, and the Global Alliance for Livestock Veterinary Medicine.

Newcastle disease is viral and highly contagious. It is capable of destroying entire chicken populations in a short period of time, and it has been identified as one of the biggest threats to rural poultry and livelihoods globally. It can also be transmitted to humans. The technical work described within Manjari’s paper reflects one of the many ways PATH is helping to build the evidence base for needle-free and thermotolerant vaccine and drug delivery technologies of critical importance to human and animal health in developing countries.

Manjari adjusting a spray dryer, which is drying a container of liquid vaccine.

Manjari uses a spray dryer to convert a liquid vaccine formulation into a powder. Photo: PATH/Scott Areman.

“Vaccines and essential medicines take up a lot of space. They involve many packaging and delivery parts, especially if they need to be refrigerated and/or reconstituted with a diluent prior to administration with a needle and syringe. By simplifying the equation, for example, by formulating vaccines as heat-stable tablets that can be swallowed or dissolved under the tongue, we believe we can achieve even greater public health impact in low-resource settings,” explains Manjari.

Manjari moved to the United States from India in 1995 through an exchange program for young scientists. Although she originally dreamed of being a medical doctor and helping people in a clinical setting, she hit her stride in bench research and stayed in the US to pursue additional opportunities. When Manjari interviewed with PATH in 2008, she says she knew immediately, “this is the place where I want to be.” At PATH, she could leverage her expertise in the biomedical sciences to improve health outcomes.

Manjari and her team have additionally developed fast-dissolving tablet (FDT) formulations for an enteric diarrheal disease vaccine candidate and oxytocin, a WHO-recommended injectable drug for reducing and preventing postpartum hemorrhage. Their heat-stable oxytocin tablet for sublingual delivery will soon be assessed in a first-of-its-kind clinical study set to launch in 2015. The study, a collaboration with the South African Medical Research Council, is part of PATH’s newly formed Global Health Innovation Accelerator—a key first step for expanding access to oxytocin in sub-Saharan Africa, where postpartum hemorrhage remains one of the leading causes of maternal mortality.

FDT formulations hold promise for transforming the means by which vaccines and essential medicines like oxytocin are typically packaged, stored, and delivered. Heat-stable tablets do not require refrigeration to ensure product quality (potency) during transport and storage. The novel product presentation also eliminates the need for safe injection equipment and training—an important feature for patients who may have limited access to skilled health workers or health care facilities.

Box full of blister packs of fast-dissolving tablets.

Manjari and her team have developed fast-dissolving tablet formulations for a veterinary vaccine for Newcastle disease, an enteric diarrheal disease vaccine candidate, and the injectable drug oxytocin. Photo: PATH/Patrick McKern.

We’re honored to have Manjari at PATH. Her transformative work is helping to resolve some of the most vexing challenges associated with health care access and delivery in low-resource settings.

Congratulations to Manjari!

More information

Tala de los Santos: a rising leader in diagnostics

Tala de los Santos works with her team on onchocerciasis diagnostic tests. Photo: PATH/Patrick McKern.

Tala de los Santos and a team member working in PATH’s laboratory. Photo: PATH/Patrick McKern.

Two of PATH’s leading female scientists were recently honored for their contributions to global health: Tala de los Santos, MBA, MS as a Washington Global Health Alliance (WGHA) Rising Leader, and Manjari Lal, PhD, with a 2014 William Hunting Award. We’re proud to support the outstanding achievements of our technical teams, who often work ‘behind the scenes’ to develop and advance transformative health care innovations for public health impact.

Part one: Today we feature Tala de los Santos.

Tala de los Santos

Portrait of Tala de los Santos.

Tala de los Santos. Photo: PATH.

Tala de los Santos, MBA, MS, was recently honored as a Rising Leader by the Washington Global Health Alliance (WGHA) through their Pioneers of Global Health award series. The Rising Leader award recognizes a creative and inspirational leader under 40 who has shown unique dedication to solving global health inequity.

As leader of the Diagnostics Group at PATH, Tala oversees a team of scientists, public health specialists, and business strategists focused on developing and introducing accurate point-of-care tests and assessment tools for use by people and health care programs in developing countries. This critical work requires multiple steps. Taking the three key phases of PATH’s product introduction framework—to innovate, introduce, and integrate—Tala and her team are able to advance a concept of health care to actual product implementation and use.

Exterior of a diagnostic device, similar to a short thermos, and the interior, containing insulation, PCR tubes, phase-change material, and a disposable pouch.

PATH is developing a self-heating device to help diagnose several diseases in low-resource settings without the need for electricity or batteries. Photo: PATH.

Advancing diagnostics for use in low-resource settings is challenging because of substantial resource and infrastructure limitations. It is extremely difficult work to take innovative ideas and transform them into affordable, user-centered products that help ensure health is within reach for everyone. Yet, Tala has guided her teams to strengthen and unify internal processes to better leverage collective efforts into impact. “At PATH, I work alongside talented and driven professionals making an impact on the greater good. I encourage young women in science and technology to consider applying their training to a mission-driven career. It is a privilege to work in a field as rewarding as global health,” says Tala.

Gloved hands holding a small, rectangular rapid test for onchocerciasis.

PATH is developing a rapid test for onchocerciasis, commonly known as river blindness, that is faster and less painful for diagnosing this neglected tropical disease. The product launches in November. Photo: PATH/Dunia Faulx.

Despite growing up with limited financial resources, Tala was a dedicated student and secured scholarships to leave her home in the Philippines at 16 to attend United World College USA in New Mexico. She found inspiration in the mission of the United World College movement—to build a healthier, more peaceful world by promoting the international exchange of ideas. In pursuit of this goal, Tala demonstrated strong personal motivation to apply herself academically and later attend some of America’s best universities, where she excelled.

Every day at PATH, Tala translates this inspiration into on-the-ground work to improve health care and health outcomes in developing countries. The WGHA announcement describes Tala as someone who “embodies success as a pioneering woman in science. She is a role model for other young women who seek to pursue scientific careers, especially mission-driven careers that combine rigorous scientific training with business expertise on behalf of the greater good.”

We’re honored to have Tala at PATH. Her transformative work is helping to resolve some of the most vexing challenges associated with health care access and delivery in low-resource settings.

Tomorrow we’ll feature Dr. Manjari Lal, whose work is helping to improve human and animal health in developing countries.

Learn more:

Making the case for health research and innovation

In this post, Claire Wingfield, product development policy officer at PATH, writes about a new paper (2.34 MB PDF)
exploring why research and development (R&D) of high-priority health tools for diseases and conditions affecting low- and middle-income countries (LMICs) should be a critical component of the post-2015 development agenda.

A young girl receives an innoculation from a health care worker.

The new paper makes the case for the inclusion of health research and innovation as a central component of the post-2015 agenda. Photo: PATH/Gabe Bienczycki.

A lack of adequate health technologies and interventions targeting poverty-related diseases means millions of people in LMICs continue to die each year from preventable and treatable diseases and conditions. Progress on developing new interventions has faltered because diseases such as HIV/AIDS, malaria, tuberculosis, and neglected tropical diseases occur almost exclusively among the world’s poorest and most marginalized populations. There continues to be little or no perceived commercial market encouraging companies to develop products targeting LMICs.

One major goal of the post-2015 development agenda is to achieve health for all within one generation, but the health burden imposed by poverty and social vulnerability remains far too high.

Bridging the divide

Cover of 'The Role of Research and Innovation in the Post-2015 Agenda' publication.

Click the image above to view The Role of Research and Innovation in the Post-2015 Agenda (2.34 MB PDF).

A new paper (2.34 MB PDF)—developed in partnership by the Council on Health Research for Development, the Global Health Technologies Coalition, the International AIDS Vaccine Initiative, and PATH—makes the case for the inclusion of health research and innovation as a central component of the post-2015 development agenda. The paper describes the impact increased investments in innovative health R&D have had—particularly for the world’s poorest—toward achieving the Millennium Development Goals (MDGs).

These investments have helped create a stronger environment for research in LMICs by increasing demand for new health technologies, expanding coverage of proven interventions, and strengthening their innovation infrastructure. And yet, much more needs to be done.

Building on the work of the Lancet Commission on Investing in Health—a group of renowned economists and global health experts—the paper discusses the need for increased R&D investments by all countries to achieve the dramatic health gains envisioned in the post-2015 agenda.

Adequate investment levels are critical for spurring the development of new health tools, provided they align with financing needs in R&D—notably predictability and flexibility. But investment alone does not guarantee that innovative products will be developed; ones that are suitable, acceptable, affordable, and accessible to populations most in need. It is essential that indicators for R&D for health tools primarily affecting LMICs address a comprehensive set of needs including financing, infrastructure and human resources, enabling policies, necessary partnerships, capacity strengthening, and access requirements.

Creating opportunity

Poor health and disability contribute substantially to poverty, while health research and innovation are linked to eradicating poverty and improving economic prosperity. Ultimately, the success or failure of the post-2015 agenda relies just as much on how the goals and targets are implemented as it does on how the progress will be measured.

The post-2015 development agenda is an opportunity for LMICs to set their own health agendas and research priorities and to assert their leadership in strengthening the R&D landscape focused on the poorest and most marginalized populations. There must be broad agreement among all of the relevant stakeholders that health research and innovation—which includes the scale-up of proven health interventions as well as the development of new and improved high-priority health technologies—is critical to meeting the ambitious goals of eradicating poverty and ensuring sustainable development for all within a generation.

Over 150 organizations and individuals recently signed a petition to United Nations (UN) Secretary General Ban Ki-moon and Member States urging the UN to keep the research, development, and delivery of new and improved health tools for diseases and conditions impacting LMICs at the heart of the post-2015 development agenda. It is our hope that the Member States and other UN officials shaping the agenda will advocate for this support.

More information

Accelerating innovation: a diverse and dynamic discussion in New York

Three panelists in conversation.

The event’s speakers included (l to r) Financial Times editor Andrew Jack, maternal and newborn health advocate Princess Sarah Zeid, and Manu Prakash, a TED fellow and assistant professor at Stanford University. Photo: Financial Times.

In a conference room filled beyond capacity atop a New York hotel this week, attendees were tweeting like mad. Why? Because they were on board with this simple directive: innovation matters when it comes to transforming global health.

Cover of Innovation Matters publication.

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

On September 24, the Financial Times and PATH hosted a high-level forum titled “Transformative Innovations for Health.” The event unveiled Innovation Countdown 2030. Led by PATH, the initiative is identifying and showcasing technologies and interventions with great promise to dramatically accelerate progress toward solving the world’s most urgent health issues. Participants received a copy of the initiative’s new publication Innovation Matters and were directed to the initiative’s website at www.ic2030.org.

Moderated by Financial Times editor Andrew Jack, the forum presented a diverse group of speakers including PATH CEO Steve Davis, maternal and newborn health advocate Princess Sarah Zeid of Jordan, Norway’s State Secretary Hans Brattskar, and Manu Prakash, a TED fellow and assistant professor at Stanford University. (You may have seen Dr. Prakash’s TED video on the 50-cent folding cardboard microscope.)

The crowd was engaged during the roundtable chat and presentation, asking bold questions, discussing opportunities, and lingering long past the event’s timeline. Amy MacIver, director of Communications at PATH, observed, “People stayed and talked, well after final call. It was one of the most diverse and engaged groups we’ve witnessed.”

Wide shot of conference room with speakers and attendees.

The crowd was engaged during the roundtable chat and presentation, asking bold questions, discussing opportunities, and lingering long past the event’s timeline. Photo: Financial Times.

How can we reach across sectors to “bend the curve?”

Topping the list of conversation points during the roundtable and forum was how to identify which high-potential innovations can accelerate dramatic improvements or “bend the curve.” In short, how do we disrupt the status quo, make lifesaving innovations “real,” and scale them more rapidly?

Dr. Prakash brought a synthesis of research, innovation, and political science to the table by identifying the links between health, education, energy, and funding. He requested global health partners quickly “take technologies into the field.” Oftentimes, successful processes happen at the frontline between trailblazers who are working on parallel projects. By recognizing all the variables at play, he suggested we could tap into unique processes and perhaps leap forward toward solutions.

“We can talk a lot about gadgets and about delivery, but there is a huge gap between those two places,” said PATH CEO Steve Davis. To narrow that gap, health care workers need to be trained to use innovative tools and technologies. Sometimes innovation isn’t a new gadget; it may be a new process to organize health systems or a novel way to encourage behavior change.

Another theme discussed during the forum was that health care workers need more support beyond the latest gadgets. They are the key component to getting the right technologies out there along with the tools they need. Dr. Adrian Thomas, vice president of Global Market Access at Global Commercial Strategy Operations and Global Public Health (GPH), touched on a partnership with PATH that intends to create diagnostics that will inform health workers what disease they’re dealing with before patients are taken to a health care facility.

Christopher Egerton-Warburton speaking a gesturing as Steve Davis listens.

Christopher (Edge) Egerton-Warburton, fund manager for The Global Health Investment Fund, explored the futurist’s perspective of innovation. Photo: Financial Times.

What’s the world going to look like in 2030?

Christopher (Edge) Egerton-Warburton, fund manager for the Global Health Investment Fund and founding partner of Lion’s Head Global Partners, launched into the futurist’s perspective of innovation, positing on global health challenges in 15 years’ time. He believes health care leaders and partners need to line up capital to address the world of 2030. The community needs long-term vision to anticipate the challenges faced in a decade and a half.

Sharing thoughts in real time

Participant’s tweets in the hashtag #IC2030 provided a real-time summary of the conversation as it unfolded. You can read a collection of the tweets here.

As the night wound to an end, Davis was quick to point out that we’ve only begun to change the world by tapping our radical potential. We invite you to be a part of the change by taking PATH’s Innovation Countdown survey.

Three reasons why PATH is celebrating World Contraception Day 2014

Kenyan woman in red shirt

A recent analysis of unmet need for family planning estimates that 222 million women worldwide who want to avoid pregnancy aren’t using modern contraceptives. Photo: PATH/Eric Becker.

Need a reason to celebrate World Contraception Day on September 26? PATH’s work in women’s contraceptives reached three milestones recently, one of which got thousands of people dancing:

  • US FDA cleared the Caya® contoured diaphragm for marketing.
  • Sayana® Press, an easy-to-transport injectable contraceptive, was launched in Africa.
  • People around the world kicked up their heels for the Global Female Condom Day Dance4Demand campaign.

OK, it’s fairly obvious which milestone got people dancing, but all three helped to make lives better by improving women’s health. And when women do well, their families, communities, and countries benefit. World Contraception Day is all about educating women and men on the range of options to prevent unintended pregnancy, space births, plan for the future, and reduce sexually transmitted infections.

Take a closer look at PATH’s recent contraception milestones:

Hand holding the SILCS diaphragm.

The neat thing about this one-size-fits-most diaphragm is that a woman doesn’t need a fitting exam to figure out which size she should wear. Photo: PATH/Glenn Austin.

The Caya® contoured diaphragm, a single-sized, nonhormonal contraceptive barrier, was cleared for marketing in the US by the United States Food and Drug Administration (USFDA). The diaphragm is easy and comfortable to use, already available in Europe and Canada, and is expected to be available to US consumers next year.

Learn more about Caya® in this recent short NPR interview with PATH staff.

Uniject injection system, a small, prefilled syringe.

Sayana® Press is a long-lasting contraceptive delivered in the single-use Uniject™ autodisable injection system. Photo: PATH/Patrick McKern.

It’s a challenge getting injectable contraceptives to women in hard-to-reach areas of sub-Saharan Africa and South Asia. This year, the Sayana® Press project launched in Burkina Faso as part of a four-country, public-private partnership to reach women in Senegal, Burkina Faso, Niger, and Uganda. 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.

PATH staff dancing outside of our headquarters.

The Dance4Demand flash mob outside PATH’s Seattle headquarters on September 26 caught the attention of our neighbors and the local media. Photo: PATH/Patrick McKern.

And most recently, PATH and partner organizations led the Global Female Condom Day Dance4Demand, a campaign designed to mobilize communities to show that women and men worldwide want to improve access to female condoms, the only woman-initiaited dual protection method available today. Thousands of people worldwide shook their tail feathers to show their support.

Join PATH in celebrating World Contraception Day 2014.

More information

Sayana® Press and Depo-Provera® are registered trademarks of Pfizer Inc. and/or its affiliates. BD Uniject is a trademark of BD.

PATH’s commitment: improve access to diabetes care for people worldwide

Hands filling a syringe from a vial, three medicine bottles of tablets, and a person having their blood pressure taken.

This week, PATH begins a new Clinton Global Initiative commitment, in collaboration with Novo Nordisk, to help turn the tide of diabetes, one of the world’s most common and damaging noncommunicable diseases (NCDs). The effort, announced at the Clinton Global Initiative 2014 meeting in New York, is a first step toward making lifesaving diabetes medicines and technologies more available to people who need them most. We caught up with Helen McGuire, director of PATH’s NCD program, to learn more.

Why are noncommunicable diseases like diabetes in the global spotlight now?

Portrait of Helen McGuire.

Helen McGuire leads our work in noncommunicable diseases. Photo: PATH.

Diabetes, cardiovascular disease, cancer, and other NCDs aren’t new, but in recent years, they’ve risen to become the greatest cause of illness, disability, and death worldwide. There are many reasons for this shift, but overall, people are living longer and their lifestyles are changing. Less physical activity and increased weight, smoking, and alcohol are putting more people at risk. Today, two-thirds of all deaths are caused by NCDs; a staggering 80 percent occur in developing countries. In fact, in the next 15 years, the World Health Organization (WHO) predicts that NCDs will become the most common cause of death in Africa.

NCDs exact an enormous toll. Because they so often hurt people in their prime—their years to work and raise children—they push families into poverty and reduce the productivity of their communities and countries. We also know that they compound the burden of other diseases, potentially eroding progress against HIV, tuberculosis, and other threats worldwide. It’s been estimated that by 2030, NCDs will cost the global economy more than $47 trillion dollars in lost output.

Chart showing 4 primary risk factors for cardiovascular disease, diabetes, cancer, and chronic respiratory disease.

Selected noncommunicable diseases and their shared risk factors. Graphic: World Health Organization.

What are global health leaders doing to stop NCDs?

I’m encouraged that we’re finally seeing an increase in global attention to NCDs. For instance, WHO’s new global action plan on NCDs calls for a 25 percent reduction in preventable death from NCDs by 2025 and an 80 percent availability of essential [NCD] medicines and technologies by 2020. And this year, the United Nations held a high-level follow-up meeting to review progress on NCDs since 2011, recognizing challenges and calling for continued commitment and accelerated action.

At PATH, our work to root out and address the causes of health inequality worldwide has put us at the frontlines of health for decades, so working with partners to intercept NCDs early on is a clear priority for us. Our NCD global strategy builds on our legacy of combating breast cancer and cervical cancer in low-resource communities. It focuses on innovation, advocacy, integrating NCDs into health care systems, and increasing the availability of essential medicines and technologies to improve lives.

How does PATH’s Clinton Global Initiative commitment fit in?

Our new diabetes commitment, led by PATH in collaboration with Novo Nordisk, is a great example of the innovative partnerships we’ll need to meet the WHO targets and other goals. It combines PATH’s leadership and experience in NCDs, Novo Nordisk’s expertise in improving diabetes care, and our shared commitment to accessible health care. Together, we’ll work to reduce preventable death and illness from diabetes by improving people’s access to essential diabetes medicines and technologies.

How did you choose this project?

An estimated 382 million people had diabetes in 2013; 80 percent lived in a low- or middle-income country. Yet crucial tools for diagnosis, treatment, and monitoring still aren’t getting to people in these areas. Imagine that your child desperately needs medicine, the local clinic or pharmacy is out, and there is nowhere else to turn. That’s a helplessness no parent should face.

We must make lifesaving medicines and technologies more available to health care workers and people living with diabetes. It’s the only way we can reduce preventable complications.

PATH is gathering the information to close the gap. We’ll begin by collecting data and taking a look at what we already know at the global level, and then work to uncover the root causes of poor availability in two low-income countries where rates of diabetes are increasing rapidly—Kenya and Nigeria.

Kenyan men, women, and children posing for a group picture.

PATH will begin work in Kenya and Nigeria, where the rate of diabetes is quickly growing. Photo: PATH/Gabe Bienczycki.

What’s next?

First, our goal is to recommend specific actions that national and global leaders, health care workers, and others can take to increase the availability of crucial technologies and medicines. On a global level, we’ll continue to put PATH’s NCD strategy to work to reduce preventable death by increasing access to NCD prevention and care. That means finding innovative ways to push new approaches and tools forward in low-resource settings; advocating to increase demand for NCD innovations; integrating NCD prevention and care with existing platforms; and increasing the availability of essential medicines and technologies.

More information

Seven secrets of the female condom

Display of 5 female condoms displayed on pegs.

There are multiple female condom products available today. Photo: PATH/Danny Ngan.

This post’s author, Kim Whipkey, is the advocacy and communications specialist on the female condom project at PATH.

Female condoms may be one of the best kept secrets in reproductive health. Even though the first female condom product was introduced about two decades ago, female condoms are still not well-known or widely available to most women and men worldwide. Use these seven secrets to increase your female condom knowledge and to advocate for improved access to this powerful tool for protection in your community.

Woman in orange jacket speaks into mic.

PATH’s Kim Whipkey speaks at the female condom Dance4Demand kickoff event. Photo: CHANGE/Devan Shea.

1. The female condom has a unique place in the prevention toolkit

The female condom is the only available woman-initiated method designed to provide “dual protection” from unintended pregnancy and sexually transmitted infections (STIs), and could go a long way in addressing unmet need among women. An estimated 222 million women in developing countries want to prevent pregnancy but aren’t using contraception. Why? Fear of side effects or infrequent sex are two of the main concerns—both which could be addressed by female condoms because they don’t contain hormones and can be used only when needed. HIV is the leading cause of death and disability among women of reproductive age globally, underscoring the need for prevention tools designed with women’s realities in mind. Female condoms can put the power of protection in women’s hands right now.

A woman shows her support for the female condom at a Global Female Condom Day event in 2012. Photo: PATH/Scott Brown.

A woman shows her support for the female condom at a Global Female Condom Day event in 2012. Photo: PATH/Scott Brown.

2. Men also favor the female condom

It’s true that female condoms are designed for women to wear. But it takes two to tango, and research shows that men like female condoms. Female condoms aren’t tight on the penis, and they don’t inhibit or dull sensation like male condoms. Some men appreciate the opportunity to share responsibility for dual protection and not always have to be the person wearing the condom.

A health worker shows a man the FC2 female condom.

A peer educator with Pathfinder International/Mozambique discusses the benefits of female condoms with other young men. Photo: PATH.

3. The female condom can increase sexual pleasure

One “sexier” secret about female condoms is that many women and men find that the product can enhance intimacy and pleasure. The female condom can be inserted prior to sex, so as not to “ruin the moment” to put on a condom. Some female condom products are made of heat-transmitting materials, which can feel more natural than latex condoms. And unlike male condoms, female condoms do not need to be removed immediately after sex so couples can stay in the moment together.

4. There are several different female condom products on the market

There are many different types of female condoms that exist. Some are latex-free, and all are hormone-free. The most well-known female condom is the FC2®, which is available in more than 130 countries worldwide, including the United States. Other products are beginning to enter the market that are designed to improve acceptability and/or reduce costs. One example is the Woman’s Condom, a new female condom developed by PATH, CONRAD, and local research partners through a user-centered process to be easy to use and comfortable to both partners. Read more about the different types of female condoms on the market and in development.

Woman's hand holding the Woman's Condom.

PATH and our partners developed the Woman’s Condom, a second-generation female condom. The Woman’s Condom was designed to provide dual protection and to be highly acceptable and pleasurable. Photo: PATH/Patrick McKern.

5. Female condoms can be a cost-effective form of protection

Female condoms are often decribed as “expensive.” But as the saying goes, a pound of prevention is worth a lifetime of cure. In fact, female condoms are a cost-effective public health intervention when compared to the costs of HIV treatment. Mathematical models have shown substantial cost savings to the health sector in several countries including Brazil, South Africa, and the United States (Washington, D.C.). recent analysis of the Woman’s Condom as a dual prevention method (family planning and HIV prevention) in 13 sub-Saharan African countries found the product to be very cost-effective in 11 countries and cost-effective in the other two.

6. When female condoms are added to male condom distribution, couples have more protected sex

More types of condoms means more protected sex? You bet! Studies in several countries have found that levels of protected sex increase when female condoms are added to the method mix, potentially reducing the risk of HIV infection and unwanted pregnancies. When both types of condoms are available, consistent users often switch between female and male condom use—boosting the overall number of condoms used. But remember, never use a female and male condom at the same time because this can lead to one or both condoms breaking.

Ten women pose in colorful dresses that incorporate condoms.

In 2012 PATH held a Global Female Condom Day fashion show to bring attention to female condoms through lighthearted condom fashions. PATH/Danny Ngan.

7. There is an international day dedicated to the female condom

To celebrate the female condom, PATH, the National Female Condom Coalition, the Universal Access to Female Condoms Joint Programme, and the Center for Health and Gender Equity launched Global Female Condom Day (GFCD) in 2012. GFCD is an annual day of education and advocacy recognized on September 16 to increase access, awareness, and use of female condoms. Since its inception, Global Female Condom Day has mobilized thousands of supporters across more than 50 countries. Raise your voice for female condom access and join our movement today!

More information

New tools to help strengthen local advocacy skills

This post’s author, Rachel Wilson, is senior director of Advocacy and Policy at PATH.

Group seated outdoors, listening to two men standing and speaking. Photo: PATH/Eric Becker

Local leaders in Kenya gather for a community meeting. Photo: PATH/Eric Becker.

At PATH, we focus a lot of attention on global health technologies, tools, and delivery innovation. Over the years, that’s been our strength. Our work has accelerated progress in improving the lives of hundreds of millions of women and children around the world. It’s work I have been proud to advocate for over the last eight years.

Portrait of Rachel Wilson.

Rachel Wilson. Photo: PATH.

Many will argue—myself included—that all too often there’s been a top-down approach to addressing public health at the global level: donor country “w” funds “x” project in country “y” that is “accomplished” by “z” international nonprofit organization.

Where does the local community fit into this equation?

More and more attention is being placed on this important question. And rightfully so. It isn’t that previous efforts have completely left the local community out—local support and involvement have always been essential components to in-country public health work. Where more attention—innovation even—is needed is on building the capacity for local advocates to advance policy change in their own communities and for countries to more efficiently bring lifesaving innovation to their neighbors and citizens.

Group of people sitting, raising their hands, and listening to a woman gesturing and speaking. Photo: PATH/Eric Becker.

Local Kenyan woman leads a group discussion. Photo: PATH/Eric Becker.

There are a growing number of successful efforts to build advocacy capacity at the local level that have contributed to current health gains. PATH is working to create sustainable advocacy impact in the communities we and our partners are serving now and in the future. This work helps ensure that our innovation in products, tools, and health system delivery have the greatest impact.

Graphic of PATH's 10-stage advocacy framework.

PATH’s 10-stage advocacy framework offers guidance for achieving advocacy success at the local level. Click the image to see a full-size PDF (562 KB).

Through years of development of testing of advocacy approaches in the field, PATH has developed an accessible ten-part advocacy impact framework (562 KB) that provides a deliberate method for achieving advocacy success at the local level. Our approach to advocacy is practical, outcome-oriented, and designed to build the skills and knowledge needed to foster positive policy change. Local advocates can independently apply these skills toward their local needs and goals. Local agenda setting is our top priority, and it is working.

We have been fortunate enough to work with partners in more than 50 countries, primarily within Africa and Asia, to strengthen their ability to influence policy changes that support local health objectives. I knew we were starting to reach our goals when our partner at African Family Health in Kenya told us: “I have used the methodology to assist three national civil society organizations to clarify their advocacy goals and objectives and to craft advocacy messages to articulate concerns about service delivery around the free maternity care policy in Kenya. The communiqué has now been delivered to the president in person by key religious leaders.”

Group sitting outdoors and listening to a man gesturing with one hand. Photo: PATH/Eric Becker.

A group meets in Kenya to discuss family health. Photo: PATH/Eric Becker.

Each of our partnerships is tailored to the specific needs of the clients we serve, with a specific focus on local ownership, cross-sector learning and networking, and close collaboration among advocates and technical health experts and practitioners.

Learn more about our advocacy tools and capacity support. No matter what the health issue, we aim to help new and experienced advocates maximize their advocacy impact to extend the scale and sustainability of effective solutions. We’re ready for whatever is next—let us know how we can help!

More information

Zambia: eliminating malaria step by step in the hot zones

Four children smiling up at the camera.

The Zambian government has set a goal of near-zero deaths and five malaria-free districts by 2016, and PATH is playing a lead role in supporting the country’s efforts. Photo: PATH/Dana Terry.

Editor’s note: This is the third in 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 summer. The first post, from South Africa, is about community caregivers, and the second post is about cervical cancer screening in Uganda.

Blue lake with peninsula.

Lake Kariba, Zambia. Photo: PATH/Lynn Heinisch.

Lake Kariba in southern Zambia is absolutely stunning. The world’s largest artificial reservoir is rich with fish, birds, crocodiles, hippos, and islands—and the lake’s shoreline town of Siavonga boasts a thriving tourism business. This beautiful area is also a breeding ground for the mosquitoes that carry malaria and is on the front lines of the Zambian government’s efforts to combat the disease.

When I met with Zambian Minister of Health Dr. Joseph Kasonde, he emphasized that the goal is not a “malaria-free Zambia” but malaria-free Zambians—stopping transmission of the disease by targeting the malaria parasite reservoir in humans. PATH is tackling malaria on many fronts, including improved drugs, diagnostics, vaccines, and systems. Key to this work is building evidence to support broad-scale use of these new innovations.

Portrait of Steve Davis.

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

At Lake Kariba, I met more than 50 community health workers, participants in a PATH-led training session, who are helping to reduce malaria in the country’s Southern Province. These men and women hike—sometimes as far as 12 miles—into hilly regions that are often inaccessible by vehicles to test and treat people and ensure they have preventative measures like insecticide-treated bednets. Such remote areas often are the “hot spots,” the breeding grounds that contribute to the spread of malaria.

“Malaria is a killer disease,” said Marie Antoinette Musanabera, a trainer from the Ministry of Health who attended the workshop. “For us to bring services closer to the community—to bring services to their doorstep—that is how you break the chain of malaria.”

Health worker drawing a drop of blood from a man's finger.

During the training, community health workers practiced using rapid diagnostic tests for malaria, which require taking a drop of blood from the patient’s finger and give results within 15 minutes. Photo: PATH/Lynn Heinisch.

Community health workers are the heroes of global health, and they have been instrumental in making Zambia a malaria success story. Health facilities reported a 66 percent decline in the number of malaria deaths from 2000 to 2009; the drop was especially steep after distribution of 3.6 million long-lasting insecticidal bednets between 2006 and 2008. During this period, parasite prevalence declined 53 percent nationwide. In recognition of the country’s achievements, in 2013 the United Nations awarded Zambia the African Leaders Malaria Alliance Award.

The Zambian government has set a goal of near-zero deaths and five malaria-free districts by 2016, and PATH is playing a lead role in supporting the country’s efforts. Our approach builds on successful methods (such as using bednets, insecticide spraying, strengthening surveillance and data reporting, and testing and treating). We also pilot new tools and strategies, such as proactively providing drugs that halt malaria transmission by killing the parasite even if someone is not showing symptoms and which temporarily prevent people from being reinfected. The lessons learned from PATH’s Malaria Control and Elimination Partnership in Africa (MACEPA) program in Zambia and three other countries (Ethiopia, Kenya, and Senegal) will inform subsequent adaption and adoption of these methods across Africa.

Group of children and adults holding packaged insecticidal bednets over their heads.

Future malaria-prevention efforts build on the experience learned in previous projects, including bednet distribution and other strategies. Photo: PATH/Paul Libiszowski.

The Siavonga residents shared with me the impact they’ve seen from the collaboration to reduce malaria in Southern Province.

“During the times of peak months (rainy season), we used to have a lot of people in the hospital,” said Florence Namwanza, a mother of six, who described her bouts with the disease and its symptoms of sweating, vomiting, fever, and backache. “Now, there are not so many.”

The district representative emphasized the large-scale implications of this effort. “Once malaria is controlled, the outlook of people’s lives will be better,” said Dr. Phallon Mwaba. “They will be more productive in fishing and farming. It may look today like we are just trying to control malaria but, ultimately, it will affect the economic status of the people.”

Steve Davis conversing with a gesturing man.

During breaks in the training, I spoke to many of the community health workers about the challenges of combating malaria in rural Zambia. Seeing their conviction was inspiring. Photo: PATH/Lynn Heinisch.

Malaria is estimated to cost Africans $12 billion a year, including the cost of health care, days off school and work, decreased productivity, and loss of investment and tourism. The disease kills an estimated 630,000 people a year, most of them African children.

The good news is that increased prevention and control measures have led to a reduction in malaria mortality rates by 42% globally since 2000. During this period, PATH has made tremendous strides in research and development for new tools and in partnering with governments to scale up malaria prevention and control. Across PATH, more than $79 million is committed to malaria activities this year alone, and our portfolio of malaria programs and projects includes more than 125 staff members.

Globally, there is growing interest in finding new tools and approaches to reduce the burden of malaria and to accelerate progress towards the goal of eradication. Because of its remarkable progress, Southern Province offers a good test case for elimination. Once methods are proven successful there, they can be scaled up to the rest of the country. If successful in its quest, Zambia would be the first country in sub-Saharan Africa to achieve this transformation.

Some of the men and women I met at Lake Kariba have been doing this work for decades—and their hard work and commitment is paying off. Seeing their dedication and that of the government representatives renewed my conviction that, together, we can turn the tide.

One of the trainers summed it up like this: “The major reason we are here is to actively detect malaria parasites in people and treat them, to ensure that we have cleared them, in the hope and belief that one day we will be free of malaria.”

More information

Projecting health: the power of locally made videos to change behavior

The Projecting Health project empowers communities to use inexpensive video gear to create and screen locally made health education videos. Video: PATH.

Suman Patel is beaming. You can see her pride in the pleasure in her smile and her eagerness to talk about her latest efforts as a community health work in rural India. She’s succeeding at one of the biggest challenges in community health—getting people to change their habits in favor of healthier behaviors.

Her secret? Amateur actors, simple video production equipment, a low-cost portable projector, and a white sheet. She’s a part of PATH’s Projecting Health project, empowering local communities with the skills and digital tools to create health education videos customized for local contexts, customs, and dialects. In the process, she’s part of an innovative shift—made possible by recent advances in digital technology—that empowers neighbors and peers to be onscreen messengers encouraging behavior change in their communities.

Man directs two women having a conversation as a woman films them with a smartphone on a tripod.

The Projecting Health project empowers communities to make locally appropriate, technically accurate health education videos. Photo: PATH/Branded Filmz.

The power of peer persuasion

Until about a year ago, Suman tried to influence pregnant women in her mothers’ groups through talks and games. Her visual tools were limited to posters and flip charts. While she had some success, she knew her toolkit was often not compelling enough to convince all of the women to change key behaviors.

Tiny video projector is adjusted by a woman's hand.

The increasing availability of inexpensive video technology makes the Projecting Health project possible even in rural communities. Photo: PATH/Branded Filmz.

Now she and other community health workers collaborate with village women to identify pressing health topics and train them to produce, act in, and edit videos that address local barriers to change. Enlisting local women to star in the videos is a key element, says Suman, because “people trust them.”

Fortunately, “there is no shortage of people who want to act in the videos,” says Kiersten Israel-Ballard, director of the Projecting Health project, who adds, “I’ve never worked on a project that was quite so community-driven.”

The women watch the videos in mothers’ groups and at village health and nutrition days. Seeing the topic played out on the screen (typically a sheet draped on a wall) by people they identify with leads to a more enriching discussion and sharing of experiences. If the women don’t understand something, they replay the video and discuss it until they do.

Women sit in a circle and discuss a video that is projecting onto a sheet hung on the wall behind them. Photo: PATH/Branded Filmz.

Women watch the Projecting Health videos in facilitated groups and discuss what they are learning. Photo: PATH/Branded Filmz.

Revolutionizing behavior change

Based on the project’s success in India, PATH and our partners plan to expand the Projecting Health model to countries in Africa and to other health topics, such as immunization, family planning, and adolescent health for girls. Says Dr. Ballard, “We feel it’s a method that can completely revolutionize behavior change across health topics.”

She and her team are particularly enthusiastic about how quickly the project is reaching a wider audience. So far, 35 videos have been made on such topics as breastfeeding, immunization, and preparing for childbirth. They’ve been screened locally more than 4,200 times and been played well over 40,000 times on YouTube.

Two men in colorful robes tiptoe across a carpet behind a smoking pot to speak to a man sitting on the ground.

Many of the videos are funny and engaging while delivering serious messages. Photo: PATH.

That the videos are accessed that often on YouTube is fantastic, but even more exciting is that women have taken the next step on their own. “We knew we wanted to take this mobile,” says Dr. Ballard, “but unbeknownst to us, the community had already figured out how to download the videos onto their cell phones. Women are showing the videos to their husbands and mothers-in-law and friends. The potential reach is huge.”

Early findings from a project evaluation make clear that all that viewing is having an impact on maternal and newborn care practices. Women who took part in Projecting Health showed significant improvements in their knowledge and behaviors around such critical activities as preparing for childbirth, breastfeeding, and preventing umbilical cord infections.

Suman can testify to the results: “When I used to visit a village and share health information, they would listen, but not put it into practice. Now when they see the films they understand. Now everyone practices what they see in the videos.”

More information