NOVARTIS ACCESS IN KENYA

In September 2015, MSH collaborated with Novartis and the Kenyan government to launch the pilot of Novartis Access—the first pharmaceutical industry program to focus on affordability and availability of medicines addressing chronic diseases. With Novartis Access in Kenya, MSH is working to ensure lifesaving medicines for cancer, diabetes, and heart and lung disease are delivered at affordable prices to the right place and at the right time to people in low-income communities. MSH facilitates this groundbreaking social business model by supporting inventory management and distribution channels to get affordable drugs to those affected and ensuring they understand how to use them. The five-year program will eventually be rolled out to 30 countries.

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MSH AND NOVO NORDISK: A CALL TO ACTION AT THE WORLD HEALTH ASSEMBLY

As a call to action to put gestational diabetes on the global development agenda, MSH and Novo Nordisk sponsored a technical advocacy event at the 68th World Health Assembly in Geneva. Moderated by Dr. Jonathan D. Quick, President and CEO of MSH, the event examined the growing burden of gestational diabetes and showcased solutions and lessons learned from Ethiopia, Colombia, and Nigeria.

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THE FCI PROGRAM OF MSH

With our recent addition of Family Care International (FCI) staff and projects, the FCI Program of MSH raises a powerful advocacy voice for the health and rights of women and communities. The UN’s 2030 Sustainable Development Goals and updated Global Strategy for Women’s, Children’s and Adolescents’ Health offer unique opportunities for MSH to work with international and local partners to save lives. Our work helps ensure the relevance and effectiveness of these development frameworks and holds countries, development partners, and program implementers accountable for keeping their promises to women, newborns, adolescents, and families.

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DR. ZIPPORAH KPAMOR

MSH Country Representative for Nigeria

I joined MSH in 2012, as director of the Community-Based Support for Orphans and Vulnerable Children (CUBS) project and was appointed MSH Nigeria Country Representative in July 2013. 

I grew up in a small, patriarchal village. But thankfully, my family was revolutionary. My father was one of few who attended school, and when he became ill, he told my mother: “You must promise me this, if I’m not around, and you are forced to choose between whom to send to school, always choose the girl. The boy will inherit the land; he will always have a livelihood. The girl child needs an education to find a livelihood for herself.” Thanks to that early support, I went on to become a doctor. Unfortunately, that is not the typical case in Nigeria.

Patriarchal traditions and lack of education are impediments to girls having control over their sexual, reproductive, and overall health. As if that weren’t enough, Boko Haram has added violence and terror to the equation. And whenever there is civil disturbance, women and children suffer most. 

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PROVIDING ACCESS TO LIFESAVING MEDICINES

Cost-effective, reliable, secure supply chains can save millions of lives. The Supply Chain Management System (SCMS), funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR)/USAID, has virtually eliminated central-level stock-outs of AIDS medicines and supplies in PEPFAR-supported countries and helped to reduce the annual cost of antiretroviral medicines. In 2015, SCMS procured 70 percent of the drugs that go to treat 5.7 million patients in 25 countries. 

Over the life of the project, the average price of antiretroviral drugs dropped to around $110 per patient, per year. To build local capacity, SCMS trains and certifies local country partners on best practices for maintaining international standards for medicine quality, transportation, and storage, and identifies local sources to secure high-quality medicines where possible. Stockouts, overstocks, expired and low-quality medicines, and waste due to weak supply chain management are far less likely. Thousands of lives have been—and will be—saved. 

SCMS, established in 2005, supplies lifesaving medicines to HIV & AIDS programs around the world and is led by the Partnership for Supply Chain Management (PFSCM), a nonprofit organization established by Management Sciences for Health (MSH) and John Snow, Inc. 

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SUPPORTING UNIVERSAL HEALTH COVERAGE

Through the publication of its new manual, Management of Medicines Benefit Programs in Low- and Middle-Income Settings, MSH is working to expand the understanding of what is required to implement health benefit packages as a component of universal health coverage—such as public and private health insurance. By incorporating medicines into universal health coverage programs, countries reduce out-of-pocket payments and ensure equitable access to quality care. The manual presents best practices from high-income countries to create awareness of the key considerations for designing a sustainable medicines benefit program in low-income countries.

MSH is also developing an accompanying Medicines Benefit Program Assessment Tool for Developing Countries. Through the USAID-funded SIAPS Program, MSH piloted the first version of the assessment tool in Ghana, Namibia, and South Africa. 

As more countries join these pilot countries working to achieve universal health coverage, MSH will work to ensure programs are in line with best practices, international standards, and driven by the best data available. 

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NEGUSSU MEKONNEN

MSH Country Representative for Ethiopia

When I started with MSH, I initially thought my assignment would be short term. Instead, the prospect of strengthening health systems and improving the lives of my countrymen and women was compelling. It has been professionally satisfying to work with an organization that is focused on building health systems from within by empowering local stakeholders and the citizenry. After making real progress against the AIDS epidemic in Ethiopia, we have been working to build the capacity of public, private, and civil institutions.

When I think about our success in building up capacity in my country, one example that comes to mind is Auditable Pharmaceutical Transactions and Services, otherwise known as APTS, which restructured pharmacy services by creating transparency, accountability, efficiency, and a strong inventory management system. After APTS was introduced, all medicines became traceable. Clients were no longer being turned away due to lack of supplies. Where APTS has been implemented, everyone can see the improved service quality. That’s why regional health bureaus, as well as the Minster of Health himself, have become advocates. 

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INTEGRATED DIABETES SCREENING: SAVING LIVES IN NIGERIA

Gestational diabetes is an often-overlooked cause of maternal and infant deaths. Without proper care, gestational diabetes can cause serious complications during pregnancy and childbirth, endangering the life of a woman and her baby. MSH works with countries and health facilities to integrate diabetes screening into prenatal care and existing HIV and AIDS programs. In Nigeria, in addition to screening, MSH is introducing mobile phones for health workers to monitor diabetes care and minimize the need for women to travel long distances to health facilities. 

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NO MORE EPIDEMICS® CAMPAIGN: A CALL TO ACTION

While the science and the know-how to detect outbreaks exist, there is still a lack of leadership and coordination for epidemic prevention, preparedness and effective response.

In September 2015, MSH, the African Field Epidemiology Network (AFENET), International Medical Corps, and Save the Children announced the No More Epidemics® campaign before global business leaders at the Clinton Global Initiative in New York City. In November the campaign was officially launched in Johannesburg, South Africa, and endorsed by David Nabarro, the United Nations Secretary-General’s Special Advisor on the SDGs and then the Special Envoy on Ebola at the UN. 

A core belief that drives the No More Epidemics® campaign is that disease surveillance and epidemic preparedness cannot stand in isolation from strong health systems. While countries and partners may prioritize specific health issues, they must also invest in effective, integrated health systems that include strong disease surveillance and epidemic preparedness and response capabilities. Integrated prevention and response plans and strong leadership and coordination will protect people, save lives, and limit the impact of any epidemic. 

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IMPROVED HEALTH SYSTEMS PREVENT DEADLY OUTBREAKS: LIBERIA AFTER EBOLA

In 2015, with the Government of Liberia, MSH began leading the USAID-funded Collaborative Support for Health (CSH) program. One of its key components is to restore and improve the health system following the Ebola crisis. Before Ebola, Liberia’s maternal mortality ratio was already one of the highest in the world. During Ebola, that rate increased. Many clinics and hospitals closed their doors or women feared going to the facilities and contracting the disease. After the epidemic, fewer skilled attendants were available at deliveries because so many health workers had died. Hemorrhage and limited access to emergency care also contribute to Liberia’s maternal deaths. 

As Liberia shows, high maternal mortality is the result of a combination of factors, all of which must be addressed through a strengthened health system. CSH provides health systems capacity-building support for leadership and governance, managing the water supply infrastructure (essential to combating infectious disease), improving the pharmaceutical supply chain, improving health care quality, making health care affordable, and monitoring the health sector, as well as the health status of Liberians. 

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OLEHILE MAURICE BADA PHARASI

MSH Country Representative for South Africa

I grew up in South Africa under apartheid. Early in my career, as an exile, I did my pharmacy internship in Zimbabwe, five years after that country’s independence, when they started implementing their Essential Drugs Action Program. I was exposed to a whole new world of health services delivery and it had a major influence on the next stage of my work back in South Africa.

I look back at the 1990s with pride. I was able to contribute to two major developments: encouraging stakeholders to brainstorm on medicinal policy issues and leading the development and implementation of South Africa’s National Drug Policy.

All of this helped prepare me for my work at MSH, where we are working hard to strengthen health systems and turn the promise of quality health care for all citizens into reality.

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