Author: awpain

Amanda Pain is a freelance health writer that helps organizations bridge message and mission. She is a strong storyteller, versed in several communication mediums, and works with organizations solving some of the world’s toughest problems such as; health equity, global development, developing and testing new drugs and vaccines, and climate change. Amanda has a dual masters in social work and public health and a bachelors in journalism. Her journalism education honed her skills in writing, developmental editing and interviewing, and she is skilled at promoting mission driven work to any audience. Since starting her business Amanda has written blogs, newsletters, reports, white papers, articles for peer-reviewed journals, literature reviews as well as B2B and B2C marketing materials. As a writer she utilizes her storytelling ability as a tool for social change Amanda has over 15 years of experience working for non-profits and academia. Her last full-time position was as a project manager working on the Global Burden of Disease research study at the Institute for Health Metrics and Evaluation (IHME). This immense global health study, funded by the Bill and Melinda Gates Foundation, measures disability and death from a multitude of diseases worldwide. As a project manager Amanda furthered the mission of IHME by coordinating data collection and analysis, and is co-author on several academic papers for publication in the both The Lancet and JAMA Oncology.  Amanda served as a Peace Corps volunteer in Uzbekistan after completing her undergraduate degree in journalism, and her experiences abroad strengthened her empathy and compassion to help others. Amanda has also worked as a clinical case worker with the mentally ill homeless population. She has done policy and advocacy work on women’s health issues, and rights for domestic violence victims as well as assisted with social marketing platforms to aid in public health campaigns. Amanda has also worked as a field research assistant on an HIV/AIDS study in Malawi, and conducted her own market research for her public health master’s thesis, on using text messaging as a platform to communicate with people during an influenza pandemic. Amanda works enthusiastically with people, sets ambitious goals for herself and is inherently a planner. Her educational and professional pursuits have all been instilled with her values of intellectual challenge, openness to change and optimism for making the world a better place.

Sustainable health through social enterprise

by awpain, posted in APHA IH Section, Health Systems, MDGs / SDGs

After five years of working towards the Sustainable Development Goals (SDGs) the global health community still has a long way to go to achieve health related goals by 2030. To improve health and well-being for all global health organizations need to reflect on the successes and challenges to date, as well as reflect on how to make programs more sustainable. One way to create and maintain sustainable health programs is through the social enterprise model.

Social enterprises are for-profit organizations that utilize business practices and the marketplace to advance social justice and development. To be defined as a social enterprise a program must address a social need, generate income mainly through commercial activities and primarily focus on the common good. Types of social enterprises include: one, opportunity employment – organizations that provide jobs to those with barriers to mainstream employment (i.e. Goodwill); two, transformative products or services – creating social or environmental impact through innovative products or services (i.e., World Bicycle Relief, Grameen Bank); and three, donate back – organizations that donate a portion of profits or goods to meet social needs (i.e. TOMS).

Global Health and Social Enterprise

There are several examples of successful global health social enterprises that can be leveraged to create new, or modify existing, programs. In some low-income countries the social enterprise model has been used to strengthen and empower the nurse and midwife workforce. In other examples, Unite for Sight, a non-profit organization working to deliver eye care to low-income countries, partners with clinics all over the world and engages with social entrepreneurs to increase patient access to vision care; and Dispensary of Hope, utilizes the donate back social enterprise model to provide free medications from pharmaceutical companies to health clinics all over the world.

Another successful social enterprise working to solve a global health problem is Days for Girls International. While on a trip to Kenya in 2008 founder Celeste Mergens discovered girls having their periods were sent to their rooms for days, sometimes going without food, and were forced to sit on cardboard until they stopped menstruating. Days for Girls set out to address this issue by designing a washable, long-lasting pad since many of the women and girls without access to menstruation products also lack access to sanitation and safe disposal of pads. 

To date Days for Girls has reached over 1 million women and girls in 125 countries with their Days for Girls Kits (DfG Kits). The Days for Girls Social Enterprise Program trains local women to produce and sell DfG Kits, as well as provide women with menstrual health education. According to the Days for Girls 2018 report, 81% of participants in the social enterprise program reported earning an income, and overall the program has created jobs and increased women’s confidence and ability to become business leaders in their communities.  

Untapped potential

 In the development world terms such as social enterprise and social entrepreneurship are often used, but not often defined. Social enterprises are businesses which maximize social good and financial return, while social entrepreneurship is about creating change agents by investing in the ideas of social entrepreneurs. While the latter is important it is equally, if not more important, for sustainable change in global health to invest in, create and support social enterprises that can provide in-country jobs and economic stability, as well as solve important health problems. 

As we head into 2020 and plan for achieving the SDGs in the next ten years, finding innovative ways to solve global health problems will be critical. Global health organizations need to capitalize on the success of current social enterprises, and partner with in-country social entrepreneurs in order to solve intertwined health and development issues. Creating sustainable change means moving beyond charity and finding ways for low-income countries to prosper; because in a global economy when low income countries thrive – everyone thrives.

 

 

 

 

 

 

 

 

 

 

 

 

 

Gavi is finding innovative partners we can all benefit from

by awpain, posted in APHA IH Section, Technology

Developing far-reaching global health interventions requires innovation, and with today’s constantly advancing technology opportunities for innovation are abundant. But ideas alone can not change the world. Ideas need a platform, financing as well as practical application measures to make an idea a reality. This is one reason why partnerships across sectors are vital.

Gavi, The Vaccine Alliance provides the perfect example of a successful partnership leading to innovation. Gavi is a public-private partnership bringing together the United Nation (UN), governments, the vaccine industry, private sector and civil society to improve childhood vaccine coverage in low income countries, as well as accelerate access to newly developed vaccines. Since 2000 Gavi has reached over 700 million children and prevented nearly 10 million deaths, but while this is important progress several challenges remain. Fertility rates in urban areas and fragile or conflict affected countries continue to grow which will make sustaining and increasing vaccine coverage more challenging. Additionally, the number of “zero-dose children,” children who have never received a vaccine, has not decreased since 2010. 

In order to address current challenges in vaccine coverage requires innovation. In 2016, Gavi launched the Innovation for Uptake, Scale and Equity in Immunization (INFUSE) program designed to improve vaccine delivery systems by connecting high-impact innovations with the countries that need them the most. Through building and utilizing partnerships over the last four years Gavi has hosted an annual call for innovators to submit proposals. Winners are chosen as “Pacesetters” who are then connected with investors and governments to help bring those ideas to market and scale.

This is made possible because of Gavi’s expansive network and reputation for successful partnerships.  While global health organizations could explore endless ways to replicate different Gavi efforts in partnership building, innovative funding strategies and technology advancement, global health organizations can also utilize Pacesetters’ innovative technologies for broader global health challenges. The call for innovations for 2019 was to address immunization issues specific to urban settings. Over the summer, three winners were chosen as Pacesetters out of 100 applicants.

  1. VillageReach – Praekelt.org. In partnership these organizations created a chatbot technology powered by AI and machine learning to increase access to information about immunization services. Praekelt.org is a non-profit organization, based in South Africa, that utilizes mobile technology to solve social problems. The organization works in over 65 countries designing products using human centered design and agile development processes, and has developed several global health focused products.
  2. ZMQ Development leverages the power of storytelling to boost immunization rates in the slums of New Delhi. This non-profit organization, based in India, creates and implements practical technology linked tools and solutions to empower communities by providing timely information and connecting them with life-saving services. ZMQ has developed several innovative programs for global health, including programs for women’s health, HIV/AIDS and polio.  
  3. Premise. Premise Data provides an analytics platform using crowd-sourced data to help governments improve and optimize immunization services. Premise is a for-profit company, based in San Francisco, that aims to close the information gap by empowering a network of thousands of individuals around the globe to collect and share information with decision-makers. Premise has worked with international development organizations all over the world to help collect and optimize data.

Through INFUSE, Gavi has not only encouraged new innovation, but also made these ideas more recognized among the global community. As global health professionals knowing the potential resources and partnerships available is critical to program success. Now Gavi is doing some vetting for the rest of us by highlighting innovative Pacesetters. Let’s capitalize on INFUSE to form new successful partnerships to solve real world global health problems.

 

 

 

 

 

Private Sector and Pandemic Preparedness: Beyond the $$

by awpain, posted in APHA IH Section, Emergency Preparedness and Response, Infectious Disease

The global health community knows that the world is unprepared for the next influenza pandemic. While public health practices have come a long way in terms of preparedness since the 1918 Spanish flu, which killed around 50 million people, we are still far from ready for an outbreak of that scale today.

According to PreventEpidemics.org, more than 100 outbreaks occur daily and can be spread worldwide in just 36 hours because of increased global travel. The cry for better pandemic preparedness is loud (Bill Gates, Margaret Chan, former director of the World Health Organization (WHO) and Robert Redfield, Center for Disease Control and Prevention (CDC) director) but is only being heard in certain circles; and the global health community needs the message to get out more broadly, especially in the private sector. 

The bottom line

Disease outbreaks, even if they only occur within a country or region, affect everyone and negatively impact the global economy. A World Economic Forum/Boston Consulting Group report stated that epidemics have negative impact on the private sector by impacting their employees, customer bases and operations. 

The World Bank projects that a large pandemic will cause an average annual economic loss of 0.7 percent of global gross domestic product (GDP) or $570 billion USD. The 2009 H1N1 pandemic resulted in an economic loss of 0.14 percent of GDP, or $1.09 billion USD, and the Ebola epidemic in 2014 resulted in an economic loss of $2.2 billion USD in GDP, threatening macroeconomic stability, food security, human capital development and private sector growth across West Africa. 

The private sector is no stranger to making financial contributions for pandemic preparedness and response. In 2014 the private sector contributed $500 million USD to the Ebola outbreak response, and these days the private sector can financially assist in pandemic preparedness through the World Banks’ Pandemic Emergency Financing Facility (PEF). However, while financial contributions are always needed there are other ways the global health community can engage the private sector to improve pandemic preparedness.

More than money

In 2018, the WHO surveyed member states to assess global pandemic preparedness and found levels of preparedness to be “far from optimal” even among high and middle income countries. Based on these survey results the WHO identified several areas for improvement in regards to preparedness, four of which are particularly advantageous for private sector partnerships.  

  1. Conducting simulation exercises to test pandemic plans

The Institute for Disease Modeling (IDM) is one example of a private sector partnership to assist in pandemic preparedness. IDM’s Epidemiological MODeling software simulates the spread of disease to help determine the combination of health policies and intervention strategies that can lead to disease eradication. There are a number of other modeling and simulation tools available for pandemic preparedness, however, some of these tools require financial and/or technical resources not available to a global health organization. Private sector companies that use, or produce modeling software could be favorable partners for testing preparedness plans, since these companies already have the modeling skills to use the software and interpret results. 

      2. Establishing mechanisms to secure access to vaccines during a pandemic

There are two notable private sector partnerships already working to secure access to vaccines, GAVI, the Vaccine Alliance, and the Coalition for Epidemic Preparedness Innovations (CEPI) are both working on improving vaccine supply chains and healthcare infrastructure in low-and middle income countries in order to increase access to routine vaccinations, as well as secure access to vaccines during a health emergency.

       3. Preparing mechanisms to conduct risk communications and community engagement during a pandemic

There is also potential for collaboration with the private sector in regards to risk communications and community engagement. Social media companies already have platforms to engage large audiences, as well as lucrative business platforms to sell ideas, information and products. Engaging people in preparing for and acting appropriately during a pandemic will require persuading an audience – something social media companies have already mastered.

      4. Establishing SOPs to conduct systematic influenza risk assessments using surveillance data

Several consulting companies offer pro bono services, such as Deloitte and PwC. Consulting  firms have the business acumen to offer services that could help design effective pandemic SOPs for multilateral organizations, country governments and agencies, as well as non-governmental organizations working on pandemic preparedness. 

Building these private sector relationships needs to happen now, and not in the midst of the next outbreak. Mutually beneficial partnerships will ultimately help the private sector, the global health community as well as the entire population when, not if, the next pandemic occurs.

Realizing the full potential of pharmaceutical industry partnerships

by awpain, posted in APHA IH Section, Pharmaceuticals

Successful partnerships between pharmaceutical companies and global health organizations have been increasing access to medicines and vaccines since the 1970s. From early partnerships in the Expanded Program on Immunization, to GAVI, the Vaccine Alliance and Access Accelerated the research-based pharmaceutical industry, which spends over $149 billion on research and development (R&D) every year, has an important role to play in global health.

Over the last 50 years the pharmaceutical industry has learned that global health is about more than just medicines and vaccines, and with the integrated nature of the Sustainable Development Goals, public-private partnerships are increasingly important. According to the International Federation of Pharmaceutical Manufacturers and Associations, the industry understands that global health requires building and supporting strong health systems, developing public health education and strengthening standards and regulations. This is why in 2018, 17 out of the 20 largest pharmaceutical companies (accounting for 70 percent of global pharmaceutical revenues) developed a business strategy, supported by goals and targets, to address access to medicines in low-and middle-income countries (LMICs), according to an Access to Medicine Foundation report. 

Good, but not good enough

However, much of the increased access to medicines has been made by a small percentage of pharmaceutical companies, and has overwhelmingly been focused on a handful of diseases. Of the 20 companies assessed by the Access to Medicine Foundation report, five companies (GlaxoSmithKline, Johnson & Johnson, Merck KGaA, Novartis and Sanofi) were found to be conducting 63 percent of R&D on products urgently needed by people in LMICS; and nearly all of the R&D from these companies was focused on five diseases: malaria, HIV/AIDS, tuberculosis, Chagas disease and leishmaniasis. 

While overall, pharmaceutical companies are entering LMIC markets, the industry still puts profits first.  Between 2008 and 2018 more medicines for profitable non-communicable diseases were developed for people in high-income countries, than medicines for diseases of poverty. Additionally, only four out of 20 pharmaceutical companies supported international trade agreements designed to ensure the world’s poor benefit from innovative medicines and vaccines. 

Closing the gaps

Public perception does matter to the pharmaceutical industry. According to the Reputation Institute, between 2017 and 2018 the pharmaceutical industry saw a 3.7 percent decline in its reputation score, and overall the industry had a significant decline in the public’s perception of industry transparency, openness and authenticity. The decline of public trust and confidence in the industry has also led to a decline in the public’s willingness to buy by eight percent between 2017 and 2018. One way to improve company reputation is through global health partnerships, and with recent negative media attention on the industry, between the opioid epidemic and price-fixing drugs, it is no secret that the industry could use a reputation boost.

So how can the global health community capitalize on this? The Access to Medicines Foundation has an effective recipe for engaging pharmaceutical companies in global health: one, setting clear priorities endorsed by global health experts; two, advocating for publicly funded mechanisms to reduce investment risk and shape less profitable markets; and three, finding sustainable funding support from multiple donors, including the government. One example of a mutually beneficial partnership is GAVI, which used pooled procurement mechanisms to encourage pharmaceutical companies to enter fragile markets in LMICs to strengthen the global vaccine market. 

In 2018 the reputation scores for the top 22 pharmaceutical companies were made public, creating an opportunity for global health organizations to engage poorly ranked companies. Global pharmaceutical sales are expected to reach over $1 trillion by 2022, so resources for global health partnerships are abundant, and organizations should consider targeting partnerships with companies impacted by negative public perception; turning a bad reputation into increased affordable access to life-saving medications. 

 

Building Global Health Funding Opportunities

by awpain, posted in APHA IH Section

By Amanda Pain

Sustainable funding in global health is often a rallying cry among practitioners. A consistent funding stream can make or break the effectiveness of a global health program, but this funding can be hard to come by. The need for additional funding for global health, especially in regards to achieving Sustainable Development Goal (SDG) 3, is great. In fact, researchers estimate an additional $371 million per year is needed to achieve SDG 3 by 2030 in Low and Middle Income Countries (LMICs). Overall funding for global health has plateaued since 2010, and changing political landscapes and priorities can make government funding ephemeral. With the current Trump administration’s proposed cuts to global health funding, organizations need to look for new funding streams.

Historically, the private sector has always played a role in funding global health initiatives. Private sector funding can not only offer more consistent funding for a program, but can also be more flexible in adapting programs to meet community specific needs in LMICs. Corporations also know that giving back to communities, and developing philanthropic endeavors, is good for business. While there are several private sector funders, many corporations are looking for non-profits and non-governmental organizations (NGOs) that have missions that align with company culture; and at times competition for these funding sources can be fierce. Therefore, looking beyond existing corporate funders to growing companies with nascent, or undeveloped philanthropy programs, presents global health organizations with a opportunity to secure sustainable funding, and assist in creating a corporate philanthropy program from scratch.

How can organizations find these successful growing companies?

Companies today have been waiting longer to announce an I.P.O. (initial public offering), sometimes waiting for Series F or G rounds of funding before going public. However, once a company receives Series C funding from venture capitalists and investors it is considered to be growing successfully, as well as making a profit. Additionally, after eBay set aside funds for charitable giving in 1998 before going public this became a growing trend in the tech industry. This means global health organizations do not necessarily have to wait until a company goes public before reaching out to partner on potential philanthropy initiatives. One example of a tech company partnering with global health organizations is the Tableau Foundation, which aims to make the world a better place with data. 

Of course organizations want to seek out companies where a potential partnership can be mutually beneficial, therefore identifying growing companies and understanding the business platform will be necessary before pitching ideas for philanthropic endeavors. Crunchbase.com is a platform that analyzes start-ups to help investors identify successful companies. Another resource is Gartner annual vendor ratings that showcase company strengths. Global health organizations can use these resources to identify viable companies as potential sustainable funders.  

While investigating growing companies will require staff time and resources the potential for a sustainable partnership with the private sector is worth the effort. Helping design a company’s philanthropic programs is an opportunity for global health organizations to build funding opportunities that are flexible and consistent, rather than trying to morph organizational mission and goals into the prescribed priorities of current funders.