Foundation Activities To Improve Health Around The World

Abstract

GrantWatch Health AffairsVol. 32, No. 4: The ‘Triple Aim’ Goes Global Foundation Activities To Improve Health Around The WorldLee L. PrinaPUBLISHED:April 2013Free Accesshttps://doi.org/10.1377/hlthaff.2013.0209AboutSectionsView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsDownload Exhibits TOPICSDiseasesHIV/AIDSGlobal healthAccess to careDiabetesUniversal coverageSystems of careQuality of careResearchersResearch and developmentGrantWatch Blog New GrantWatch content appears online at http://www.healthaffairs.org/blog/grantwatch . Sign up for an RSS feed or a monthly e-mail digest of GrantWatch news from the blog. Foundation Activities To Improve Health Around The WorldThis month, GrantWatch looks at what various foundations and their grantees are saying and doing about global health. Funders are supporting efforts to prevent, treat, and eliminate specific diseases in developing countries. Others are working to better understand, compare, and improve health system quality and capacity around the world.What follows is just a small sampling of where foundations are putting their money and how grantees are using it.Advancing Health In Developing Nations The Bill & Melinda Gates Foundation provided more than $8 million in funding to the Institute for Health Metrics and Evaluation at the University of Washington to update the Global Burden of Disease Study. The institute’s Chris Murray and his colleagues collaborated on the project with five other universities and the World Health Organization. In its December 13, 2012, issue, the medical journal Lancet released seven papers on Global Burden of Disease 2010. In sum, this huge study of 187 countries included 488 coauthors from 303 institutions. Among the key findings, according to a summary report: “Most countries have made great strides in reducing child mortality, people are living longer and the population is growing older.” The researchers also found that in most regions, noncommunicable diseases and disability, such as musculoskeletal disorders, mental health, and injuries, “caused a greater share of health loss in 2010” than in 1990. Conditions in sub-Saharan Africa do not follow that pattern, however.Another interesting finding was that deaths from traffic accidents rose 46 percent from 1990 to 2010. This increase made road injuries the eighth leading cause of death worldwide.Building on the study’s findings, Murray and colleagues made its country-specific findings available in March 2013 through an innovative “suite” of web-based tools that allow researchers to build visual representations of data and compare countries.PolioA priority for the Gates Foundation is eradication of polio. According to Bill Gates’s 2013 Annual Letter, there have been fewer than 1,000 cases of polio worldwide for the past two years. These last few cases have been tough to eradicate. Many people with the virus show no symptoms but still spread it. “Health workers have to vaccinate nearly all children under the age of five multiple times a year to achieve the necessary immunity thresholds,” Gates wrote. Measurement is crucial: “Timely, accurate, local measurement” allows health officials to determine where immunity thresholds are too low and then fix them. “Basically, polio is at its lowest levels ever, with fewer cases reported from fewer districts in fewer countries than ever before,” wrote Oliver Christiaan Rosenbauer, a spokesman for the Global Polio Eradication Initiative, which is funded by the Gates Foundation , United Nations Foundation , and others. Eliminating polio in India was a major accomplishment for the initiative, which was spearheaded by the World Health Organization, Rotary International, Centers for Disease Control and Prevention, and United Nations Children’s Fund. In the countries where the virus is endemic—Afghanistan, Nigeria, and Pakistan—officials have launched Emergency Action Plans to end the disease. Other countries are seeing imported cases, though. Neglected Diseases The Gates Foundation is also among the current funders backing the Carter Center’s fight to eradicate guinea worm disease, which is contracted by drinking water contaminated with guinea worm larvae. In January 2013 former President Jimmy Carter announced that the campaign, which began in 1986, is in its final stages. In 2012 only 542 cases were reported worldwide, mostly in South Sudan. Emory University’s Institute for Drug Development is a recent recipient of $800,000 in Gates Foundation funding to maintain and further develop the Global Health Primer . Emory received the funding as a competitive award from BIO Ventures for Global Health, which launched the primer. According to a news release, this free, online resource tracks drug, vaccine, and diagnostic products for twenty-five of “the world’s most devastating but neglected tropical diseases.” HIV/AIDS The Millennium Development Goals Report 2012 said that as of late 2010, all regions of the world had seen an increase in access to treatment for people with HIV or AIDS. In November 2012 Funders Concerned About AIDS and the European HIV/AIDS Funders Group released U.S. and European Philanthropic Support to Address HIV/AIDS in 2011 . The publication, supported by the Joint United Nations Programme on HIV/AIDS, notes that AIDS-related funding from private philanthropies in the United States and Europe increased 5 percent in 2011 compared with funding in 2010. The majority of dollars from US-based funders were “directed to projects with a global aim.” Few new US-based funders are entering the field of HIV/AIDS philanthropy. Many of the organizations that provided funding are taking innovative approaches. For example, Fondation Total , a funder in France, has supported a prevention program in Morocco for truck drivers, “who represent a mobile population that can be at high risk for HIV infection.” DiabetesDeaths from noncommunicable diseases are increasing and are hitting the developing world hardest, the World Health Organization reported in 2011. After the United Nations General Assembly adopted its Political Declaration on Noncommunicable Diseases in 2011, the World Health Organization developed a “global monitoring framework” to track progress in preventing and controlling specific diseases, including diabetes. The Abbott Fund , a corporate foundation affiliated with the health care company Abbott, has been working in Bolivia to combat the increasing incidence of diabetes. Since 2006 the fund has awarded $375,000 in grants, and the company has donated $180,000 worth of blood glucose meters and test strips, according to the fund’s website. This investment has allowed more than 80,000 people to be screened for diabetes. Abbott and the Abbott Fund work with the global humanitarian organization Direct Relief International along with local partner Clinica Vivir con Diabetes. As part of its commitment to reducing health disparities, the Bristol-Myers Squibb Foundation launched a five-year, $115 million initiative in 2010, called Together on Diabetes, to improve health outcomes for adults living with type 2 diabetes in China, India, and the United States. Separately, the foundation recently awarded a grant to Project HOPE, a nonprofit nongovernmental organization that publishes Health Affairs . The funding supports a pioneering program that uses cell phone text messages to educate low-income pregnant women and new mothers in Mexico City about preventing and managing gestational diabetes. Research Strategy The Qatar Foundation for Education, Science, and Community Development unveiled a major national research strategy at its Annual Research Forum in October 2012 in Doha. Qatar aims to position itself as an intellectual center for research and development excellence and innovation, not only in the Arab region but internationally. Qatar’s head of state, the Emir Hamad bin Khalifa Al Thani, has committed to spending 2.8 percent of the nation’s gross domestic product on research (estimated at $3.5 billion). Qatar Foundation, established in 1995, serves as steward for the funds. Faisal Mohammed Alsuwaidi, foundation president of research and development, said at the forum: “This event represents one more step towards the process of transforming Qatar from a carbon economy into a knowledge-based economy.” Health and the life sciences constitute one of the four research pillars of the national strategy. The health goals “focus on better care and better outcomes for our society,” said Thomas Zacharia, executive vice president of research and development at Qatar Foundation, in the forum’s keynote address. He said plan objectives focus on national health priorities such as the growing problems of diabetes and cancer and on innovations such as e-health technology. A national cancer research strategy also was unveiled at the forum. The Qatar National Cancer Committee chair Ara Darzi of Imperial College London noted that Qatar aims to “become a leading cancer research center internationally and regionally, and build a foundation for academic and commercial development for the next generation of cancer-specific technologies.”Qatari researchers also have demonstrated a commitment to stem cell research following a fatwa (an official ruling issued by Islamic scholars) in 2009 that permits the use of embryonic stem cells for research and therapy in the country. The Qatar Foundation and James A. Baker III Institute for Public Policy, Rice University, organized a meeting of international researchers, ethicists, and policy makers in Doha in February 2012 to review the latest in stem cell research and policy options for developing therapeutic applications.Universal Coverage The Rockefeller Foundation funded a May 2012 planning meeting, cohosted by France, Mexico, Thailand, and the World Health Organization, on universal health coverage and health system reform. According to the foundation’s website, universal coverage in this context means “access to appropriate health services for all at an affordable cost.” The meeting aimed to discuss how countries could reform their health systems and move toward universal coverage, cooperating to place it “at the top of the international development agenda,” according to a Rockefeller news release. This work falls under the Transforming Health Systems initiative at the foundation.Representatives from different countries at the meeting agreed on the importance of an umbrella approach: addressing financial considerations, economic constraints, and political and social determinants together. They also agreed to “push for” a United Nations General Assembly resolution on universal health coverage, which was later adopted on December 12, 2012.At the January 2013 Global Health Summit, Rockefeller president Judith Rodin noted that much work remains to be done on universal coverage, “but we are on our way.” The foundation awarded a $699,696 grant for 2013–14 to the United Nations to help countries move toward universal coverage.Building Capacity And Knowledge The Aspen Institute’s Ministerial Leadership Initiative for Global Health, which concluded in 2012, aimed to strengthen the leadership capacity of health ministries in Ethiopia, Mali, Nepal, Senegal, and Sierra Leone. With funding from the Gates Foundation and the David and Lucile Packard Foundation , the initiative had three goals: financing that would ensure equitable care for all; collaboration of donors to support individual countries’ priorities; and expanded access to reproductive health. EnCompass released a final evaluation of the initiative in February 2012. In November 2011 the Milbank Memorial Fund published Health Worker Shortages and Global Justice , by Paula O’Brien and Lawrence Gostin. The report’s foreword notes that the global shortage is “of staggering proportions.” One important cause of shortages is “the reliance of developed countries on foreign-trained health workers to meet their workforce needs.” The authors note that at the time the report was written, more than 60 percent of countries with “critical shortages” were in Africa. The tragedy is that without enough health workers, “people cannot enjoy the good health that will enable them to flourish.” The authors write, “The United States has an important role to play in addressing this shortage, as do many other rich countries.” The Henry J. Kaiser Family Foundation’s US Global Health Policy web portal is chock-full of information. With an interactive map, the portal offers “fast facts,” for example, on the number of people with HIV/AIDS, tuberculosis, and malaria, in developed and developing countries. With a custom data feature, it is easy to compare up to five countries’ performance on numerous health indicators, such as access to clean water. The portal also has a glossary of global health terms, a “policy tracker” with recent information on congressional and Obama administration actions, and headlines from the Kaiser Daily Global Health Policy Report.High-Income NationsOf course, the US health system is somewhat different from the health systems of high-income countries in Europe and elsewhere. But they have many common concerns, such as quality of care, rising costs, health information technology, and an evolving workforce. In December 2012 the Commonwealth Fund released an issue brief on the “highly politicized topic” of health care for migrants, especially those lacking documentation, according to an e-alert. The debate involves ethical and humanitarian concerns, possible public health concerns, and the “overall burden on the health care system,” the brief says. The authors examine various European nations’ approaches to care for undocumented migrants. Although the European Union has adopted legal conventions granting this population the right to care, there is much “variation in policy and practice,” and “formidable” barriers exist, the e-alert reports. In addition to supporting international policy research, some grantmakers also cosponsor fellowships that allow for international exchange of ideas. The Commonwealth Fund sponsors the Harkness Fellowships in Health Care Policy and Practice. Commonwealth’s international partners in this effort include the Nuffield Trust and the National Health Service’s National Institute for Health Research, which cosponsor the UK fellows. Fellows from nine participating countries spend up to a year in the United States conducting a policy-oriented research study, observing innovative models of health care delivery, and working with leading policy experts. The Commonwealth Fund’s International Health Policy Center also offers a tool to compare countries—in this case, using data on such topics as health costs from the fund’s international surveys. Commonwealth now includes the United States, Australia, Canada, New Zealand, and seven European countries in its surveys. The London-based Nuffield Trust , funded primarily by an approximately $89 million endowment, is “an authoritative and independent source of evidence-based research and policy analysis for improving health care” in the United Kingdom, according to its website. In July 2013 Nuffield and Commonwealth will jointly convene health policy makers and experts from the United States and the United Kingdom to discuss “improving health care system quality and efficiency,” Commonwealth says. The Jewish Healthcare Foundation’s Pittsburgh Regional Health Initiative recently released “PPC Goes International: The Israel Healthcare Quality Partnership.” PPC stands for Perfecting Patient Care, which is an approach to improving health care quality modeled after innovative engineering strategies like those developed by Toyota to streamline its manufacturing process and reduce inefficiency. The report’s executive summary reviews the results of the initiative’s partnerships with Israel’s leading social and health policy think tank and largest health maintenance organization to find out “how Israel achieved universal coverage and excellent health care at low cost,” said an e-alert. The initiative anticipates ongoing “intellectual and professional exchanges” between US health providers and policy makers and their counterparts in Israel. Key Personnel ChangesKerry Diaz, president of the Quantum Foundation, in West Palm Beach, Florida, a funder focused on promoting health and access to care, will step down from her post on June 1, 2013, to spend more time with her family. Eric Kelly , vice president of programs, has been promoted to executive vice president. As “part of a succession plan to ensure a seamless transition,” he will succeed Diaz as president, according to a news release. Judy Woodruff, coanchor and senior correspondent for the PBS NewsHour , has been elected to the Duke Endowment’s board of trustees. Woodruff also hosts a program on Bloomberg Television. The endowment, based in Charlotte, North Carolina, is the largest private foundation in the Southeast. Compiled and written by Lee L. Prina, senior editor Loading Comments... Please enable JavaScript to view the comments powered by Disqus. 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