Improving Access to Healthcare in the Developing World. Renuka Gadde VP, Global Health 21 October 2012

Transcription

1 Improving Access to Healthcare in the Developing World Renuka Gadde VP, Global Health 21 October 2012

2 BD Overview Medical technology company founded in 1897 Global turnover $7.8 billion, 44% in US 29,000 employees in 55 countries World class quality and medical technology Life Sciences Diagnostics Recognized for business ethics and social responsibility Company purpose: Helping All People Live Healthy Lives Medical Devices

3 BD Legacy of Health Impact 1897 Company founding 1906 First U.S. syringe and needle factory 1924 First insulin injection device 1942 First penicillin injection device 1949 First evacuated blood collection tube 1952 First sterile disposable device 1954 First disposable syringes for Salk Polio campaign 1962 First mass produced syringes and needles 1968 First automated blood culture system 1972 First fluorescence activated cell sorter 1988 First safety-engineered syringe 1991 First auto-disable syringe

4 BD Shared Value Progression 1. Social need transforms BD s business (1988) 2. Parallel need in developing countries (1988) 3. Envisioning the Future (1998) 4. Training and technical service as strategic enablers (2000) 5. Front line experiences motivate global health strategy (2003) 6. Social responsibility informs new business models (2004) 7. Embedding Shared Value as management practice (2009)

5 BD Global Health Strategy Innovate. Collaborate. Accelerate WHO WHAT HOW DEMOGRAPHIC EXPANSION 70% of the world s population presently underserved but seeking improved health access in emerging markets GH active in Africa, SE Asia, China, India, with the potential to expand in LA and CCA MARKET DEVELOPMENT Access Pricing Agreements Partnerships for Technical Assistance Market Sensing for New Technologies COLLABORATION External Engagement with International Agencies, NGOs, and Governments Drive Policy and Upgrade Clinical Practice

6 CSR Informs New Business Models

7 Organizations BD Collaborates With

8 BD-PEPFAR Collaborations BD and the President s Emergency Plan for AIDS Relief (PEPFAR) collaborate in five areas, which include: lab strengthening, wellness centers for healthcare workers, safer blood collection, preventing violence against girls, and addressing breast and cervical cancer in the developing world. These collaborations are designed to strengthen healthcare systems and address root causes of the spread of disease in the developing world.

9 PEPFAR PPP 1 - Lab System Strengthening Launched in Uganda, Ethiopia, Mozambique and South Africa; Uganda first to participate in BD associate volunteers Taught 475 healthcare professionals effective practices for lab quality management and planning; specimen referral, safety and record keeping; and TB culture identification and drug susceptibility testing Coordinated specimen referral networks in two countries ~ 25,000 specimens successfully referred Mapped 702 healthcare centers in Uganda, enabling clinicians to determine actual rates of multi drug-resistant TB (MDR-TB) and request second line drugs needed for patients

10 Lab Strengthening Results: Uganda Lab Quality Management Training, PPP EQA, and Results: the introduction Uganda of GIS/GPS have contributed to a reduction of specimen turnaround time for TB testing and culture: from 3 weeks at baseline (prior to 2007) to 3 days

11 Lab Strengthening Results: Uganda PPP Results: Uganda Increased Number of TB Samples Referred to NTRL

12 Lab Strengthening Results: Uganda Improved data for decision-making and case management PPP Results: Uganda MDR TB Cases in Uganda The GIS support led to the finding that 14 percent of Uganda s retreatment TB cases have multi-drug resistant TB - a much higher rate than the 4.4 percent that was previously recorded (2009 World Health Organization data). The assessment team is in the processing of confirming the data from NTRL.

13 Lab Strengthening Results: Ethiopia 293 Ethiopian lab and postal workers have been trained in specimen referral, handling, and transportation. 554 health facilities (including Health centers and hospital laboratories) have been linked with the next hospital or regional reference laboratories capable of doing advanced diagnostic tests to increase access for patient care. Health Facilities with MDR Cases mapped using GIS/GPS Dried Blood Spot (DBS) for early infant diagnosis of HIV is being referred from many facilities all over the country to eight (8) diagnostic centers (regional and national reference laboratories). Improved Specimen Referral System in Ethiopia has enhanced access to laboratory diagnostics, decreased turn around time for collecting specimen and reporting results, and decreased number of specimens rejected for testing.

14 Lab Strengthening Results: ACILT 150 people trained from 14 countries in courses supported by the PPP (130 in TB Culture and Identification, 12 in TB Drug Susceptibility Testing, and 8 in National Laboratory Strategic Planning). Participants achieved improvement from pre-test to post-test (by varying degrees); however, linkages to improved laboratory practices are difficult to concretize due to lack of evaluation studies. DST Course: Molecular Module Test Scores: December 2011 TB Microscopy Course Pre and Post Test Results, November 2011

15 Global Result: PPP-Supported Trainings Country Number of People Trained Uganda 779 people trained (120 local trainers and lab workers trained in LQM, 10 trained in information systems, and 649 focal persons trained in quantitative analysis of TB SRS data) Ethiopia South Africa 293 people trained (95 in Pilot Specimen Referral System and Safety Training in Addis Ababa, 71 in SRS Regional Training in Bahir Dar, 42 in SRS Regional Training in Adama, 38 in SRS Regional Training in Awassa, 26 in National SRS ToT Training, 12 in Arc-GIS Software Training, and 9 in GIS Training) 150 people trained from 14 countries in courses supported by the PPP (130 in TB Culture and ID, 12 in TB Drug Susceptibility Testing, and 8 in National Laboratory Strategic Planning) Mozambique 50 people trained (8 lab managers mentored, 21 auditors trained, 20 SLMTA managers/lab managers trained in Planning and Leading Projects, and 1 lab manager mentored in program management) Total 1,272 people trained in all countries

16 Why Safer Blood Collection?

17 PEPFAR PPP 2 - Safer Blood Collection Launched June 2010 in Kenya, June 2011 in Zambia and September 2012 in Tanzania 25 BD associate volunteers Trained nearly 3,000 healthcare workers as a result of our train the trainer model on safe phlebotomy practices Facilitated sessions at 43 sites between Kenya, Zambia and Tanzania Developed the Center for Excellence in Phlebotomy and Specimen Collection at the Kenya Medical Training College Kenyan trainees increased assessment scores from 45 percent to 85 percent from pre- to posttraining on safer blood collection knowledge and skills

18 PEPFAR PPP 6 - Labs for Life Lab System Strengthening Launched July 2012 at International AIDS Conference Builds on prior five-year PPP that focused on improving overall lab systems in sub-saharan Africa and will expand to include India. Focus will be on: Quality improvement for lab services to attain national, regional, or international accreditation Lab Human Resources training on pathology, forecasting and optimization Curriculum development and training on equipment maintenance Collaboration with ACILT and ASLM to strengthen local capacity and promote country ownership Deploy POC guidelines Leverage systems and capabilities established for HIV to also effectively address diabetes

19 Incepted in December 2004, to improve TB diagnosis by increasing access to critical TB technology in the developing countries. Demonstration sites in Africa, Eastern Europe and Asia were established to introduce advanced culture technology for rapid diagnosis and drug sensitivity testing of TB. Subsequent to WHO endorsement of liquid culture, BD and FIND established a pricing agreement for liquid TB culture diagnostics. In March 2012, the existing pricing agreement expanded to increase the number of accurately diagnosed TB patients in India s Karnataka state. The initiative, in partnership with Kasturba Medical College, also seeks to establish a new collaboration model in which a private hospital provides medical services to public patients. FIND Collaboration

20 Earth Institute Collaboration in Mali The BD BACTEC MGIT is 3 times sensitive than microscopy, indicating that more cases of subjects with TB are not retained for treatment and therefore are not screened for HIV. The MDR rate is about 25 percent, there is an indication to validate this data in order to review the therapeutic scheme of TB treatment in Mali. Most of new cases are MDR, there is a suggestion that the primary infection is due to resistant strains. Other pulmonary infections may be associated other bacteria.

21 Closing Remarks The continuum of shared value allows for BD to leverage our core competencies in health system strengthening to address unmet healthcare needs. Strengthening healthcare systems can yield greater impact and revenues for businesses. He who has health has hope and he who has health has everything - Arabic Proverb

22 The most successful companies in the future w i l l c o l l a b o r a t e w i t h g o v e r n m e n t s, international agencies, non-government organizations and civil society to help solve the world s most important problems. They will help to promote and achieve global stability and prosperity. In doing so, they will become the most sustainable companies, s t a n d i n g t h e t e s t of t i m e.

23 Thank You