Global health needs more strange bedfellows, unorthodox partnerships

Puppets walking into the audience at the SwitchPoint conference in Saxapahaw, North Carolina.

The was originally published on the Huffington Post on July 14, 2014.

In Tanzania, the non-profit group IntraHealth International works with a cotton gin to provide circumcision services to their male employees and collaborates with local police to bring together 400 motorcycle taxi drivers to learn about road safety and HIV prevention. Both projects are funded by the U.S. Centers for Disease Control and Prevention.

The African Christian Health Associations Platform, based in Kenya, is working with Novo Nordisk and Johnson & Johnson that provide Christian health associations in several countries with technical support, training and drugs to combat diseases like diabetes, HIV and opportunistic infections.

Those are examples of an increasingly common approach to development. It used to be that a donor would sit down with the ministry of health to work out the design and implementation of a new global health initiative, with no significant input or involvement of other stakeholders. Those days, thankfully, are long gone.

Nowadays, it's widely recognized that more stakeholders need to be consulted, both in the design and the execution of an intervention. Does this make the process more messy and complicated? It sure does, but this messiness is essential to take global health to the next level.

Condom flavors like strawberry and caipirinha key to social marketing success in Brazil

A print ad for DKT's new caipirinha condom brand.

This was originally published on the Huffington Post on June 10, 2014.

SÃO PAULO, Brazil — “DKT do Brasil,” the social marketing juggernaut of South America, started in 1991 with one variant of Prudence condoms (now called Prudence Clássico). Over 23 years, DKT has grown that product line into 40 variants, with its latest offering featuring the flavor and scent of caipirinha, the iconic Brazilian cocktail made from cachaça, lime and sugar.

Over that same time period, its condom sales increased from 30,840 in 1992 to 124 million in 2013. This is considerably more than the combined total sales of every other condom social marketing project in all Latin America — South America, Central America and the Caribbean — according to DKT contraceptive social marketing statistics.

And yet DKT do Brasil does not consider itself a commercial enterprise, but a social enterprise. All of its products make money, and yet all are within the contraceptive affordability index, which dictates that the cost of contraception should be less than 1% of a family’s annual income. In fact, its cheapest condom, Prudence Clássico, is only 0.22% and even its most expensive brand is less than 0.5%.

How has DKT do Brasil been able to become the largest social marketing operation in Latin America, and one of the largest condom distributors in Brazil, while remaining true to it mission of “improving lives by encouraging family planning, sexually-transmitted disease prevention, pleasure and well-being; offering products that are accessible, diverse, innovative and high quality in Brazil and South America”?

Kenya quietly takes public health approach with HIV most at-risk groups

Chief Rose Ayere talks to a group of injecting drug users in Nairobi.

This was originally published on Global Health TV on May 27, 2014.

NAIROBI and KISUMU, Kenya — Anti-gay legislation recently signed into law in Uganda and Nigeria has alarmed organizations implementing HIV prevention in Africa, fearing that such laws will further stigmatize and marginalize at-risk populations already hard to reach with health services.

So when I traveled to Kenya this month to interview men who have sex with men (MSM), injecting drug users (IDUs), and people working in programs trying to help them supported by the International HIV/AIDS Alliance, I wondered whether I would encounter “the next Uganda” in gay rights. I did not, but what I did find surprised me.

Social enterprise for health, Brazilian style

With the leaders of Saúde Criança at their headquarters in Rio de Janeiro.

This was originally published on Global Health TV on April 27, 2014.

RIO DE JANEIRO, Brazil — One is poised to become the condom market leader in Brazil, with 40 variants in its Prudence condom line. Its newest offering features the flavor and scent of caipirinha, the iconic Brazilian cocktail made from cachaça, lime and sugar. DKT believes it prevented over 9,000 HIV infections in 2013.

Another rescues the poorest and unhealthiest children from the urban slums of Rio de Janeiro, Sâo Paulo and other cities, and nurses them – and their families – back to health.  Since its creation, an estimated 50,000 people have benefitted from its work.

They are very different global health organizations, with very different operating models, but both call themselves social enterprises, Brazilian style, and both were created in 1991.

Tuberculosis finally catching up to 21st century

This was originally published on Global Health TV on March 24, 2014.

Tuberculosis (TB) treatment, which had been lost in a time warp for a century, seems to be finally joining the 21^st century.

Until recently, there were no new TB drugs on the market in half a century, little progress in the treatment of multidrug-resistant (MDR) and extensively drug-resistant (XDR) forms of TB and virtually nothing new on pediatric TB, according to David Greeley, the president and CEO of Accordia Global Health Foundation, who previously worked for the TB Alliance. The current vaccine, developed more than a century ago, is largely ineffective, he said. TB diagnostics were ancient, too, as is TB itself, which has been around since 4,000 B.C. Current treatment was cheap and sometimes effective but took a long time and misses a lot of people  (like children, and MDR and XDR patients).

Which is why the Stop TB Partnership has made those missing people the theme of this year’s World TB Day on March 24: “Reach the 3 Million.” That’s the number of TB patients the World Health Organization (WHO) estimates are “missed” by public health systems out of the 8.6 million who fall ill of TB each year.  Many of those 3 million live in the world’s poorest, most vulnerable communities and include groups such as migrants, miners, drug users and sex workers. Over 95% of TB deaths occur in low- and middle-income countries. India and China are the countries with the most TB patients.

In 2014, will family planning be able to sustain the euphoria of London and Addis Ababa?

Young Ethiopians partake in traditional coffee ceremony at the International
Conference on Family Planning.

This was originally published on the website of Global Health TV on Feb. 19, 2014.

2012 was a watershed year for international family planning, with the UK government and the Bill & Melinda Gates Foundation holding the high profile London Summit on Family Planning where new commitments of $2.6 billion were secured, enough to provide contraceptives for 120 million more women and girls in 69 very poor countries by 2020.

In 2013, this effort morphed into a global partnership dubbed Family Planning 2020 (FP2020). The process received a further moral and financial boost in November at the 3^rd International Conference on Family Planning in Addis Ababa, where five countries made new commitments (Benin, Democratic Republic of Congo, Guinea, Mauritania and Myanmar) and FP2020 released its first progress report on successes realized since the London Summit. Ethiopia was chosen as the conference site because of its status as an emerging family planning success story in Africa.

Movers, shakers, thinkers, doers converge on former N.C. mill town

This was originally published by the Huffington Post on April 9, 2014.

One is a British mobile phone guru who has become a storyteller of "reluctant innovators," propelling some of the most exciting social innovations outside the traditional development system.

Another is an architectural wunderkind from Togo in West Africa who leads a team that recycles old plastic bags into building materials.

And a third is a San Francisco Bay Area global health tech innovator who is building a web platform to help African countries make better decisions about HIV drug procurements. He speaks English, Punjabi, Spanish and Mongolian.

The three are very different but have at least two things in common: First, they are hellbent on changing the world. Second, they are converging on the tiny former mill town of Saxapahaw, North Carolina later this month to share their distinctive world views with hundreds of other global thinkers and doers.