PATH in Uganda: Paving the Way to Better Health Through Innovation

Publication date: 2017

Despite high levels of maternal and infant mortality and other challenges, Uganda has made great strides in improving health in recent years. PATH has facilitated many advancements, working closely with the government of Uganda since 2002. Together, we have introduced promising new technologies and interventions to meet Ugandans’ health needs. PATH’s work in cervical cancer is a prime example. Collaborating with partners from both the government and private sector, we are tackling the disease from every angle. Uganda is now a model for other countries in how to fight this leading cause of cancer-related deaths in African women. In every effort—from vaccines to family planning to malaria, tuberculosis, HIV, and more—we empower Ugandans to make positive changes in their families and communities. PATH in Uganda Paving the way to better health through innovation Cover photo: PATH/Will Boase Foundational work in vaccines and immunization PATH generates data for the introduction of new vaccines. In Uganda, we studied the optimal way to reach young adolescent girls with a vaccine against human papillomavirus (HPV), the cause of nearly all cervical cancers. Guided by our findings, the Uganda Ministry of Health has since introduced HPV vaccine and immunized hundreds of thousands of girls aged 10 to 13, offering vital protection from this deadly disease. PATH is also supporting the country to prepare for possible future adoption of a malaria vaccine. In this way, Uganda can be one of the first to benefit once a vaccine becomes available. Clearly recognizing the importance of immunization, the government of Uganda is investing in improved, next- generation supply chains. These networks, employing the latest in refrigeration and monitoring technologies, are fundamentally shifting the way vaccines are delivered to communities. PATH is at the forefront of these efforts, providing expert technical guidance. project and oFFice locations in uganda a wide-ranging HistorY in uganda PATH’s extensive work in Uganda has included: • Evaluating new health technologies for factors such as acceptability, consumer demand, supply chain, and policy environment. • Generating evidence on how best to introduce vaccines—for example, to protect girls from future cervical cancer and young children from diarrheal disease. • Supporting the government in making key decisions around malaria vaccine introduction. • Providing technical assistance and advocacy to improve the immunization supply chain. • Introducing an innovative, easy-to-use injectable contraceptive that can be delivered in communities. • Assisting in the development of a strong national cervical cancer program. • Improving the quality and availability of health and social services through advocacy. • Ensuring supplies of essential medicines for major diseases, such as HIV, tuberculosis, and malaria. • Participating in international and regional caucuses to improve women’s and girls’ health. Kampala Mbarara Mbale path office project area by district, for projects that are not nationwide Improving the supply chain through peer-to-peer learning In 2016, PATH led a tour of Vietnam’s immunization supply chain with officials from Uganda and Vietnam, so both groups could exchange insights. The tour provided a unique opportunity for Ugandan health officials to see firsthand the systems and protocols their Vietnamese counterparts had developed to address similar challenges in access and infrastructure. PA TH /W ill B oa se than a decade, PATH has partnered with the government of Uganda to reduce high rates of the disease through prevention, early detection, and treatment. With our support, the Uganda Cancer Institute (UCI) has become a center of excellence for Uganda and a regional training center for other African countries. In partnership with UCI, PATH has trained health workers across the country on a simple, effective, affordable, and fast screening method—visual inspection with acetic acid. Also with support from PATH, Uganda was among the first countries in Africa to assess the careHPV™ DNA test, which can use self- collected vaginal samples—saving time for busy health center staff. We are exploring possible introduction in Uganda of this exciting new approach that could radically transform screening programs. In additional efforts, PATH has trained health workers to treat precancerous lesions with cryotherapy. In the future, we hope to evaluate the operational feasibility, ease of use, and cost of other ablative therapies (minimally invasive procedures where abnormal cells are destroyed) in a few selected health facilities in Uganda. We are also analyzing Uganda’s market for precancer treatment equipment. innovations in FamilY planning A key focus of PATH’s work is ensuring that women have access to a variety of safe and affordable contraceptive options. Now, a groundbreaking new form of injectable contraceptive, Sayana® Press, has reached thousands of women through country-led pilot introductions coordinated by PATH. Sayana Press combines a lower-dose formulation of Depo-Provera® with the PATH-developed, prefilled Uniject™ injection system. Known locally as the “all-in-one,” Sayana Press is easy to use and can be delivered by community health workers. During Uganda’s pilot introduction, more than 130,000 doses were administered— nearly one-third to new users of modern family planning. Hundreds of women in Uganda also took part in studies on self- injection. Results indicate that most can successfully administer the contraceptive themselves, potentially increasing women’s control of and access to family planning. Large-scale studies are currently assessing whether women who self-inject with Sayana Press will continue using injectable contraceptives longer than women who receive intramuscular injections from a provider. a compreHensive approacH to cervical cancer Uganda is a leader in the fight against cervical cancer, the most common and lethal form of cancer for women in Uganda and many African countries. For more “Sayana Press is easy, and it can be used in private. It’s simple to handle. . . and there is no need to go to the hospital. I like that I can use it myself more privately.” --Sayana Press client in Uganda, age 19 PA TH /W ill B oa se January 2017 Phone: 256.312.393200 uganda office Mailing Address PO Box 7404 Plot 17, Golf Course Road Kololo Kampala Uganda Street Address Mariba House Plot 17, Golf Course Road Kololo Kampala Uganda PATH is the leader in global health innovation. An international nonprofit organization, we save lives and improve health, especially among women and children. We accelerate innovation across five platforms—vaccines, drugs, diagnostics, devices, and system and service innovations—that harness our entrepreneurial insight, scientific and public health expertise, and passion for health equity. By mobilizing partners around the world, we take innovation to scale, working alongside countries primarily in Africa and Asia to tackle their greatest health needs. Together, we deliver measurable results that disrupt the cycle of poor health. www.path.org advocacY For better HealtH PATH helps Ugandan citizens and civil- society organizations improve the quality and availability of health and social services through effective advocacy. Key to this effort is the Advocacy for Better Health project, which mobilizes communities to demand their rights and hold all levels of decision-makers accountable for health-related goals and commitments. One of these goals is attainment of the global 90-90-90 targets for HIV (by 2020, 90 percent of all people living with HIV will know their HIV status, 90 percent of all people with diagnosed HIV infection will receive sustained antiretroviral therapy, and 90 percent of all people receiving antiretroviral therapy will have viral suppression). Other goals include supportive policies, budgets, and programs for tuberculosis, family planning, malaria, nutrition, and human resources for health. With an eye toward the United Nations Sustainable Development Goals (SDGs), PATH is also focused on advocacy to enhance the health of women and girls. In 2016, we co-sponsored eight advocacy caucuses at the Women Deliver conference in Copenhagen, including one on East Africa. Organized by PATH, Women Deliver, and White Ribbon Alliance, these gatherings provided an opportunity for diverse stakeholders to engage in dialogue, strengthen networks, and create action plans to accelerate progress toward health goals—specifically, how to adapt the SDGs to the local context. toward a brigHter Future PATH’s commitment to Uganda continues as we explore new methods, new tools, and new partnerships designed to bring positive changes to the country—and bring health within reach for all. Funders Key funders supporting PATH’s work in Uganda include the Bill & Melinda Gates Foundation; Children’s Investment Fund Foundation; Gavi, the Vaccine Alliance; and the US Agency for International Development. Forestalling disaster In late 2015, health facilities in Uganda faced a severe shortage of tuberculosis and HIV drugs. Concerned about the impending crisis, PATH and our partners assembled a coalition to urge the government to take immediate action. The coalition disseminated evidence on district stockouts, developed radio spots, held press conferences, and met with top government officials. Within a month, the government responded with both short- and long-term measures. The advocates’ swift action and partnership with decision-makers averted a major public health crisis and has led to ongoing dialogue and funding for crucial health services. Sayana Press and Depo-Provera are registered trademarks of Pfizer Inc.; Uniject is a trademark of BD; careHPV is a trademark of QIAGEN.

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