Joni Zurawinski, Advocate for Equal Access to Healthcare, at Roche Diagnostics, speaks to the importance of healthcare partnerships.
Nearly half of the world’s population (47%) does not have access to diagnostic testing. Low-to-middle-income countries (LMICs) are among the worst affected, with large diagnostic access gaps leading to premature deaths. In Africa, there is also a glaring shortage of healthcare workers; for example, pathologists, with a ratio of around one pathologist for every one-million people.
According to the World Health Organization (WHO), however, between 2000 and 2018, new HIV infections in Africa fell by 37% and HIV-related deaths by 45%, with 13.6 million lives saved due to access to testing and anti-retroviral treatment. This significant impact resulted from tremendous efforts made through partnerships – between governments, development and technical agencies, implementing organizations, civil society, and the private sector.
The Global Fund partnership, one of the world’s largest funders of global health, is one of the shining examples of partnership in practice, having saved more than 50 million lives over the past 20 years and reducing death rates from HIV, tuberculosis, and malaria by more than half.
The past has shown us that progress is possible, and the challenges faced across Africa cannot be solved by any one organization alone. As WHO suggests, and the Global Fund has demonstrated, we need a diversity of partners, thought, and solutions to move ahead. Leveraging the strengths and expertise of a broad range of partners brings solutions to solve complex challenges into better focus.
When established with purpose, transparency, and trust, with an aligned mission from all parties, partnerships have proved to be robust mechanisms in delivering impact. Partnership is the core of much of the success we’ve seen so far in delivering access for patients, and will be one of the key mechanisms to saving many more lives in years to come.
Why do we need the private sector for sustainable healthcare across Africa?
The private sector typically comes with technical expertise, speed, efficiency, and the ability to stretch every dollar to create maximum healthcare impact. When resources are scarce, this can offer an immense benefit for global, regional, and local health.
With a focus on growth, private sector companies aim to build technologies and innovations, understanding how and where the technology will work best for the benefit of patients and customers. In many cases, private sector companies have extended global reach to bring diverse best practices and leverage experience from a myriad of markets.
Private sector organizations invest heavily in product research and development and these investments can have greater impact for countries when they are directed with input from a diverse set of stakeholders.
The impact of public-private partnerships in action
Public-private partnerships have historically demonstrated an impact in driving access for people who need it and in building sustainable health systems that work.
Project Last Mile brings together the Global Fund to Fight AIDS, Tuberculosis, and Malaria, the President’s Emergency Plan for AIDS Relief (PEPFAR), the United States Agency for International Development (USAID), the Bill & Melinda Gates Foundation, and the Coca-Cola Company.
This cross-sector partnership taps into Coca-Cola’s business network – one of the widest-reaching business systems in Africa – and leverages top skills and experience within the supply chain and service providers to strengthen health systems and improve the availability and reach “to the last
mile” of life-saving medicines. In 2021, the project achieved some key milestones across 12 countries in Africa, having affected more than 35 million lives since its inception in 2010.5
Johnson & Johnson is among several public and private sector partners expanding access to tuberculosis treatment in LMICs and non-governmental organizations. For example, in South Africa, starting in 2015, around 50,000 courses of MDR-TB medicine have been procured for patients in need to date. The initiative also supports efforts to train health workers and raise community awareness to find the “missing millions” of undiagnosed individuals with tuberculosis.
These are just a couple of examples that demonstrate the value and impact of public-private partnerships in addressing the access challenges across Africa. I’ve seen a similar sense of community in action in my own organization.
Roche was the first company to establish a formal diagnostic access program – the Global Access Program – in 2014, together with the Clinton Health Access Initiative (CHAI) and other partner organizations, including USAID, PEPFAR, and the Global Fund, to support much-needed scale up for access to HIV viral load tests to monitor anti-retroviral treatment efficacy across LMICs.
The Global Access Program has since expanded beyond HIV to ensure reliable testing solutions are available to patients in LMICs, focusing on critical infectious diseases, including tuberculosis, hepatitis B and C (HBV and HCV), COVID-19, and HPV (cervical cancer).
The Global Access Program was designed to provide end-to-end, sustainable, local solutions that would go beyond providing reduced pricing of diagnostic and monitoring tests, building capacity, and strengthening healthcare systems – in particular, diagnostics infrastructure. By working together with international agencies, non-governmental organizations, and governments at the global, regional and local levels, it takes a holistic and collaborative approach to improve health system diagnostic capacity.
As part of the Global Access Program, through continued partnership, over 8 million African patients are tested annually to manage their HIV infections. Over the past 7 years, more than 11 million babies have been tested for HIV, and over 8,300 laboratory technicians have been trained. Additionally, 33 African countries have installed Roche molecular diagnostics systems, enabling reliable testing – a critical step to realizing global elimination goals.
Between 2007 and 2017, Roche contributed to several Public-Private Partnerships specifically aimed to address barriers to access and scale up of HIV viral load and early infant diagnosis across Africa. This included partnerships with UNITAID and the Clinton Health Access Initiative (CHAI) to create “Turnkey Laboratories” to improve access for early infant diagnosis, where over 900,000 tests were made available, 300,000 infants were enrolled into care and treatment, leading to more than 100 laboratories across Sub-Saharan Africa offering PCR testing.
In 2012, Roche and PEPFAR announced a public-private partnership to strengthen certification programs, educational resources, and molecular diagnostic laboratory systems to improve HIV and AIDS prevention, treatment, and outcomes.
Some partnerships bring together unlikely matches, but thinking outside of the usual suspects can lead to significant impact. A great example is (RED), the organization founded by Bono and Bobby Shriver in 2006 to fight AIDS and the injustices that enable pandemics to thrive. (RED) leverages big brand presence and influencers to create unique products and experiences. These all raise money for the Global Fund to fight HIV/AIDS.
Roche Diagnostics, was the first diagnostics company to partner with (RED), embarking on a shared mission to create greater awareness of the importance of diagnostics in fighting pandemics and to encourage continued investment in health system strengthening. Over the last 3 years, the Roche and (RED) partnership has broken new ground in shifting awareness forward with new audiences via docu-style stories that helped keep the spotlight on HIV/AIDS and the importance of diagnostics throughout the COVID pandemic.
The continued role of public-private partnerships
The nature of partnerships should continue to evolve, building from past successes, lessons learned, and then adapting to meet new challenges. To reach more patients, we must understand the real-world conditions in public health facilities across the continent and foster cooperation with all the stakeholders to develop new models for access.
We need a diversity of capabilities, expertise, and perspective at the table to work together to tackle complex challenges for healthcare delivery. Partnerships created with purpose and aligned along shared missions and values have demonstrated impact and have shown what can be accomplished – including with the private sector.
“If everyone helps to hold up the sky, then one person does not become tired,” said Dr. Askkari Johnson Hodari.
I am fortunate to work for Roche, an organization committed to driving access to diagnostics for all – regardless of social, economic, or geographical barriers.
At some point in our lives, every one of us has been a patient and has seen a beloved family member or friend tackle health issues. If we remain mindful of this and work together within trusted, transparent, and purposeful partnerships, we can build strong health systems that provide equal access to the care and treatment people need, no matter where they live.
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