ImprovIng the health of Women & ChIldren around the World by 2015 6 8 10 12 14 4 2 MDG Health Alliance Pillars 3 Who We Are | Leadership 4 Improve Child Health 6 Improve Maternal Health 8 Near-Zero Malaria Deaths 10 Near-Zero Transmission of HIV from Mother-to-Child 12 Save One Million Lives from Tuberculosis 14 One Million Community Health Workers 2 | www.mdghealthalliance.org mdg health allIanCe pIllars IMPROVE CHILD HEALTH: Reduce the number of children under 5 dying from 8 million per year to 4 million per year by the end of 2015 In collaboration with UNICEF and other partners, in countries with the largest concentrations of child mortality, increase access to medicines that prevent and treat the leading causes of under 5 deaths, including oral rehydration with zinc, pediatric antibiotics, bed nets and malaria medicines, and interventions that prevent the leading causes of neonatal deaths; with a particular emphasis on increasing private sector contributions to achieving MDG 4. IMPROVE MATERNAL HEALTH: Reduce the number of women dying in childbirth from 350,000 per year to less than 180,000 per year and achieve universal access to reproductive health by the end of 2015 In collaboration with the H5 agencies (UNFPA, UNAIDS, UNICEF, WHO and the World Bank) the United Nations Foundation and the United Nations Commission on Life-Saving Commodities for Women and Children, tap into the vast potential of private health providers and health businesses to deliver high quality, aordable and accessible care and products to women at highest risk of maternal mortality and support governments’ eorts to achieve MDG 5. NEAR-ZERO MALARIA DEATHS: Reduce the number of deaths caused by malaria from 655,000 to near-zero by the end of 2015 In collaboration with the Roll Back Malaria Partnership, the African Leaders Malaria Alliance, the Global Fund, the World Bank, WHO, the United States and the United Kingdom, UNICEF, and other key partners, in countries with the largest concentrations of malaria deaths, ensure continued universal coverage of bednets as well as aggressive deployment of diagnostics and treatment integrated with community case management in both the public and private sectors. NEAR-ZERO TRANSMISSION OF HIV FROM MOTHER-TO-CHILD: Virtually eliminate the transmission of HIV from mother-to-child by the end of 2015 In collaboration with UNAIDS, PEPFAR, the countries suering the greatest burden and other partners, virtually eliminate the transmission of HIV from mother-to- child by 2015 worldwide. The Business Leadership Council for a Generation Born HIV Free, consisting of globally recognized private sector leaders, has been formed to bring to bear the collective resources and acumen of the private sector to achieve the 2015 deadline. The BLC will identify concrete, actionable roles for businesses to maximize their impact on vertical transmission rates in high-burden countries. SAVE ONE MILLION LIVES FROM TUBERCULOSIS: Reduce the trajectory of the number of HIV+ patients who will die of TB, currently estimated at 1.3 million people, by the end of 2015 In collaboration with Stop TB and other partners, increase the TB cure rate by providing screening programs to test for infections every three years, provide treatment to TB-positive individuals, provide preventive TB treatment to all women living with HIV at risk of TB exposure, examine all pregnant women for signs and symptoms of TB, assess whole-family risk, and develop new child- friendly diagnostics. ONE MILLION COMMUNITY HEALTH WORKERS: Recruit, train and equip 1 million community health workers to advance maternal and child health by the end of 2015 In collaboration with WHO and UN Agencies, leading telecommunications and high-tech firms, academic institutions, and leading NGOs and foundations, accelerate the provision of community health workers with training and equipment to diagnose, prevent and treat the leading causes of maternal mortality and child mortality in the highest burden countries. www.mdghealthalliance.org | 3 Who We are The MDG Health Alliance is convened by MDG Advocate Ray Chambers. The Alliance is comprised of eminent leaders from the private, public, and nonprofit sectors working in conjunction with the Health and Education Cluster of the Secretary- General’s MDG Advocates. Together, we seek to fulfill the vision articulated in the UN Secretary-General’s Every Woman Every Child movement by mobilizing public-private partnerships. Private Sector Leaders + Alan Batkin Vice-Chairman, Eton Park Capital Management + Kathy Calvin CEO, UN Foundation + Peter Chernin Former President and CEO of News Corporation, Chairman of Chernin Entertainment + Jack Dorsey Founder and Executive Chairman of Twitter and CEO of Square + Leith Greenslade Private Social Investor and Partner, Acumen Fund + Austin Hearst CEO and Chairman, Chestnut Holdings LLC + Gabriel Jamarillo General Manager, The Global Fund for HIV/AIDS, TB, and Malaria + Ellen Lambert Merck Foundation + Charlie MacCormack Formerly President and CEO, Save the Children + John Megrue CEO, Apax Partners US + Brad Palmer Managing Partner, Palm Ventures LLC + Naveen Rao, M.D. Lead, Merck for Mothers + Cliord Sobel and Barbara Sobel Former US Ambassador to Brazil + Diana Taylor Managing Director, Wolfensohn Fund Management + Jerey C. Walker Former Chairman of CCMP Capital Advisers, LLC Improve Child Health Leadership: Alan Batkin and Leith Greenslade Improve Maternal Health Leadership: Naveen Rao, M.D. Near-Zero Malaria Deaths Leadership: Suprotik Basu Near-Zero Transmission of HIV from Mother-to-Child Leadership: John Megrue Save One Million Lives from Tuberculosis One Million Community Health Workers Leadership: Jeff Walker MDG Health Alliance Pillars Six Pillars underpin the work of the Alliance, each led by a respective Chair or Co-Chair, who is responsible for ensuring forward progress and coordination across agendas, convening networks of new and traditional partners, raising visibility, awareness, and resources, advocating in favor of increased public sector financing, and assisting with logistics and in-kind resources: 4 | www.mdghealthalliance.org Accordingly, since 2004 the public health community has recommended ORS and zinc for child diarrhea, however, not one of the countries with the highest burden of child diarrhea mortality has achieved significant coverage of either product, as the table below shows. Private Sector Opportunity An opportunity exists for the commercial distribution of quality ORS and zinc at aordable prices and in a variety of formulations (tablets, syrups, food supplements, soil fortification etc) throughout the developing world. There are 560 million children under 5 living in the developing world and they each average 3 episodes of diarrhea every year. In addition, there are 140 million underweight children who are at greater risk of death from infection who would benefit from zinc supplementation. In most of the high child mortality countries, consumers have already demonstrated a willingness to pay for diarrhea treatments, typically buying products from local, private pharmacies or kiosks and incurring costs up to US$5.00 for medicines that do not treat dehydration or strengthen a child’s Millennium Development Goal 4 calls for a reduction in early childhood deaths to 4 million per year in 2015. This goal will not be met without new global eorts to prevent and treat the leading causes of child mortality (pneumonia, diarrhea, preterm birth, birth asphyxia, malaria and neonatal infection) in the countries where deaths are concentrated, particularly India, Nigeria, DRC, Pakistan, China and Ethiopia. As undernutrition is the leading risk factor for death among children in the developing world, all strategies need to incorporate a strong nutrition component. ORS and zinc treat- ment for diarrhea should appeal to any donor seeking a high return on investment and the ability to have a rapid eect on child mortality, and donors who have an interest in pursuing private sector approaches would be particularly well placed to oer initial support”. — Clinton Health Access Initiative GLOBAL CHALLENGE IMPROVE CHILD HEALTH Reduce the number of children under 5 dying from 8 million per year to 4 million per year by 2015 MDG Health Alliance Priorities Phase 1 of the Alliance’s child health agenda will focus on preventing child diarrheal deaths in the two regions of the world where they are most concentrated — the northern states of India and Nigeria. In Phase 2 this approach will be extended to the other high child mortality countries along with eorts to reduce child pneumonia deaths and neonatal deaths. Phase 1: Reducing Child Diarrhea Deaths Diarrhea is the second leading cause of death for children under 5, claiming 1.3 million every year with India and Nigeria accounting for one third of all deaths. Diarrhea continues to kill millions of children every year despite the existence of highly eective, low cost treatment options — oral rehydration solutions (ORS) and zinc. ORS prevents dehydration — the leading cause of child diarrhea deaths — and zinc boosts the immune system, reducing the duration and severity of a diarrheal episode and preventing new infections for two to three months. If used routinely ORS and zinc could prevent 90% of child diarrhea deaths, saving more than 1 million children every year. Country Annual Number Under 5 Deaths from Diarrhea ORS Treatment Coverage Zinc Treatment Coverage India 237,000 26% 0.3% Nigeria 200,000 26% 1% DRC 100,000 31% 0% Pakistan 74,000 41% 0% Ethiopia 73,000 26% 0% WHO, 2008 and UNICEF, 2009 “ www.mdghealthalliance.org | 5 Led by Alan Batkin and Leith Greenslade, the Child Health Pillar of the MDG Health Alliance works in partnership with UN Agencies, the private sector, nonprofit organizations, academic institutions and others to support country efforts to accelerate progress toward achieving Millennium Development Goal 4. The Pillar operates in support of Every Woman Every Child, an unprecedented global movement spearheaded by the United Nations Secretary-General to mobilize and intensify global action to improve the health of women and children. n child@mdghealthalliance.org immune system. There are also large groups of consumers who either treat diarrhea with home remedies or not at all, making it one of most undertreated illnesses in the developing world. Shifting existing consumer and health provider demand towards quality, aordable, child- friendly ORS and zinc and generating new demand from those who are currently not seeking treatment outside the home represents a significant opportunity for manufacturers of ORS and zinc. New Public-Private Partnerships The Alliance is working in partnership with UNICEF, the United Nations Foundation, the Clinton Health Access Initiative, PATH and the Bill and Melinda Gates Foundation to mobilize new private-public partnerships to increase the supply of, demand for, and distribution of ORS and zinc in countries where child diarrheal deaths are concentrated, beginning with India and Nigeria. Further, to build momentum and support for new partnerships, MDG Health Alliance Business Councils will be established in India and Nigeria to advocate and mobilize resources for the diarrhea challenge and other Alliance priorities. Key goals of the Public-Private Partnerships to End Child Diarrheal Deaths in the target countries include: 1 Increase household and health provider demand for ORS and zinc through: + commercial advertising campaigns using traditional media (particularly radio, television and print) and mobile communications (particularly text messaging) + incentives for consumers to use ORS and zinc and for health providers to stock and promote their use, particularly amongst the extensive informal private pharmacy networks that exist in most of the target countries 2 Ensure an adequate supply of child- friendly ORS and zinc that meet quality standards at prices aordable to the poorest households by: + matching product design and packaging to consumer preferences + supporting the regulatory changes necessary to increase access to ORS and zinc (e.g. achieving “over-the- counter” status for zinc in all target countries) + working with local pharmaceutical manufacturers to stimulate local supply, including co-packaged and/or co-dispensed ORS and zinc products + training and incenting local pharmacy networks and health workers to sell the products 3 Mobilize local distribution networks to maximize access to ORS and zinc focusing on those regions within countries where diarrheal deaths are concentrated, by: + leveraging the knowledge, expertise and assets of the leading private sector distribution channels in target countries so as to broaden the outlets that will sell ORS and zinc to include local kiosks and pharmacies In the countdown to 2015, country- led demand for new private sector partnerships to increase the use of ORS and zinc is strong creating an opportunity for collective impact that could save the lives of one million children under 5. 6 | www.mdghealthalliance.org Every day, approximately 1000 women die due to complications of pregnancy and childbirth — nearly all of these deaths are preventable. Millennium Development Goal 5 will not be met without significant global eorts to prevent and treat the two leading causes of maternal mortality worldwide — post- partum hemorrhage and hypertensive disorders during pregnancy, such as preeclampsia. Access to family planning is also known to play an important role in reducing maternal mortality. MGD 5 is one of the goals furthest o track and we need to accelerate progress on maternal health. Together, through strategic public- private partnerships we can make the tragedy of a woman who dies while giving life a memory, rather than a crisis. aordable and accessible care and products to those at greatest risk of maternal mortality. Initially, the Alliance will work in India and Nigeria, which together account for one third of maternal deaths worldwide, and Uganda where an estimated 6,000 women die each year. In Phase 2, the Alliance will explore opportunities to work in additional countries with a high burden of maternal mortality. Phase 1: Identify Sustainable and Innovative Business Solutions The governments of these target countries are committed to strengthening their health systems and improving maternal health. And many communities in these countries have a strong business sector which facilitates opportunities for innovation in public- private partnerships at the local level. GLOBAL CHALLENGE IMPROVE MATERNAL HEALTH Reduce the maternal mortality ratio by 75 percent and achieve universal access to reproductive health by 2015 MDG Health Alliance Priorities Governments are increasing their reliance on private health providers and local health businesses as an ecient way to extend services and provide essential medicines to hard-to-reach communities. In all regions of the world, utilization of private providers of health-related goods and services is growing — across all income levels. Phase 1 of the Alliance’s Maternal Health agenda will focus on helping governments reach MDG 5 through innovative ways of engaging private health providers and businesses to expand their maternal health eorts and reach women in rural and underserved urban communities. The Maternal Health Pillar will tap into the vast potential of these providers and businesses to supplement the eorts of the public health system to deliver high-quality, www.mdghealthalliance.org | 7 Led by Naveen Rao, M.D., the Maternal Health Pillar of the MDG Health Alliance works in partnership with UN Agencies, the private sector, nonprofit organizations, academic institutions and others to support country efforts to accelerate progress toward achieving Millennium Development Goal 5. The Pillar operates in support of Every Woman Every Child, an unprecedented global movement spearheaded by the United Nations Secretary-General to mobilize and intensify global action to improve the health of women and children. n maternal@mdghealthalliance.org The business community has expertise that could be valuable in developing and supporting innovative business solutions and bringing them to the public sector in developing countries to accelerate progress in reaching MDG 5. Private Sector Opportunity Approximately 80% of the population in India and 50% in some parts of Africa receive their health care from private providers — and these percentages are growing. Women in low and middle income countries are using a range of private clinics, fee-for-service providers (including traditional birth attendants and midwives), pharmacies and health shops for their care. These private providers and entrepreneurs have tremendous reach into high- need communities. They are based in the communities they serve, have many touch points with families and, as businesses, have learned how to establish trust and build customer loyalty. They are also often owned by women. New Public-Private Partnerships The Alliance is working in partnership with the H5 agencies (UNFPA, UNAIDS, UNICEF, WHO, and the World Bank), and the United Nations Foundation to increase the supply of and demand for midwifery services. The Alliance will also work with the United Nations Commission on Life-Saving Commodities for Women and Children to mobilize new partnerships to increase the supply of and demand for life-saving medicines to combat post-partum hemorrhage and preeclampsia (specifically, oxytocin, misoprostol and magnesium sulfate), and facilitate access to key family planning products. Further, to build momentum and support for new partnerships, MDG Health Alliance Business Councils will be established to advocate for and mobilize resources to strengthen maternal health and other Alliance priorities, including policy and financing eorts to encourage an enabling environment for health businesses to thrive. Key goals of the Maternal Health agenda in the target countries include: 1 Improving quality of private health services + Identify and support innovative solutions and partnerships to help upgrade the quality of private care 2 Expanding access to goods, services, education and referral + Explore opportunities to equip local health shops and providers with essential maternal health information and supplies, and help them link women to quality health services 3 Making goods and services more aordable + Investigate innovative financing mechanisms to subsidize the cost of care for vulnerable populations and encourage them to seek care 8 | www.mdghealthalliance.org this overall need for commodities has already been committed — a testament to the increased partnership between endemic countries and the international community — leaving a cumulative gap of $3.2 billion over four years. Should this gap not be filled, we are at risk of reversing the gains we have made. The principal funders remain overwhelm- ingly The Global Fund to Fight AIDS, TB and Malaria (approximately 70% of all external funding for malaria), The World Bank’s International Development Association, the United States’ President’s Malaria Initiative, and the United Kingdom’s DFID. While the Malaria Pillar will look to support eorts to continue and increase contributions from these vital partners, a more diversified financing strategy will provide more sustainable support for progress towards our 2015 goal, including domestic support from sub-Saharan African countries given their improving economic growth and access to conces- sional loans. On World Malaria Day 2012, Millennium Development Goal 6 calls for the halting and reversal of malaria trends by 2015. In April 2008, United Nations Secretary-General Ban Ki-moon issued an even bolder call: to protect all those at risk of malaria with treatment and prevention interventions with the ultimate goal of reaching near zero deaths by 2015. An estimated 655,000 persons died of malaria in 2010. 86% of the victims were children under 5 years of age, and 91% of malaria deaths occurred in the WHO African Region. Rapid increases in access to prevention and treatment inter- ventions have saved over one million lives — 85% over the past five years alone. GLOBAL CHALLENGE NEAR-ZERO MALARIA DEATHS Reduce the number of deaths caused by malaria from 665,000 to near-zero by 2015 International funding to combat the disease surged from US$200 million a decade ago to US$1.8 billion in 2010, with over US$3 billion mobilized since the Secretary General’s call to action in 2008. Since 2000, malaria deaths have declined by one third. However, the current global funding crisis threatens the achievement of the Millennium Development Goals, including those specifically related to malaria. There is a risk of reduced resources for malaria control, which could lead to significant increases in malaria cases, and deaths, and a serious reversal of the gains achieved. MDG Health Alliance Priorities The first priority of the Malaria Pillar of the Health Alliance will be to support eorts to secure the necessary funding and get to near zero deaths by 2015. This strategy requires $6.7 billion between 2012 and 2015 for commodity procurement and distribution across sub-Saharan Africa. $3.5 billion of [...]... new infections in children were reduced by 30% between 2002 and 2010 Eliminating Motherto-Child-Transmission of HIV is within our grasp, but the time is now to harness the momentum and push for 2015 as a deadline to achieve this goal 10 | www.mdghealthalliance.org The Global Plan towards the Elimination of New HIV infections Among Children by 2015 and Keeping Their Mothers Alive: 2011 -2015 This Global... HIV by 2015 G lo bal Challe n g e Millennium Development Goal 6 calls for the halting and reversal of TB by the end of 2015 For the 33.3 million people living with HIV worldwide, antiretroviral therapy (ART) has given patients the promise of a full and fulfilling life Now people living with HIV can raise their families, work and pursue their dreams And yet, too many patients are falling prey to another... 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 n Global Fund www.mdghealthalliance.org | 9 Near-Zero transmission of HIV from mother-to-child Virtually eliminate the transmission of HIV from mother-to-child by 2015 G lo bal Challe n ge Millennium Development Goal 6 calls for the halting and reversal of the spread of HIV by 2015 34 million people are living with HIV globally and 1.8... living with HIV in need of services Intensified efforts are also needed to support countries with low HIV prevalence and concentrated epidemics to reach out to all women and children at risk of HIV with the services that they need The Global Plan supports and reinforces the development of costed country-driven national plans MDG Health Alliance Priorities The first priority of the MDG Health Alliance is... Led by Suprotik Basu, Managing Director of the office of the UN Secretary-General’s Special Envoy for Malaria, the Malaria Pillar of the MDG Health Alliance works in partnership with UN Agencies, the private sector, nonprofit organizations, academic institutions and the African Leaders Malaria Alliance, to support country efforts to accelerate progress toward achieving Millennium Development Goal 6 The. .. smartphones, mHealth, and multimedia will seek to increase the effectiveness and quality of CHW service delivery through the use of technology Led by Pillar Chairman Jeff Walker and Vice-Chairs Austin Hearst and Brad Palmer, the Community Health Worker Pillar of the MDG Health Alliance works in partnership with UN Agencies, the private sector, nonprofit organizations, academic institutions and others to... mothers to children by 2015 BLC members are a select group of leaders who represent media, finance, telecommunications, health, technology and retail The BLC is committed to treating 2015 as a deadline, not a goal and bringing business acumen and resources to the challenge The BLC is chaired by John F Megrue, Jr., CEO of APAX Partners US The BLC Advisory Board is comprised of Dominic Barton (Worldwide Managing... and they and their families may face financial catastrophe Children may have to leave school and go to work or stay at home to care for an ailing parent Parents who die of TB leave behind millions of orphans (according to the World Health Organization, there were 9.7 million children who were living as orphans due to parental death in 2009) Health workers, one of our most precious resources in the. .. isoniazid, HIV testing and TB screening across the population every three years and TB care MDG Health Alliance leadership will complement the work of partners to: +  ake health services more widely M available In 2010 less than a third of people living with HIV sought care for TB at a clinic That needs to double by 2015 +  mprove the quality of TB care By I 2015, the cure rate for TB among people living... recognized for their notable success in reducing morbidity and averting mortality in mothers, newborns MDG Health Alliance Priorities and children CHWs have been crucial The first priority of the CHW Pillar of the MDG Health Alliance is to identify concrete, actionable roles for businesses to maximize their support and investment in Community Health Workers in high-burden countries The focus will be . ImprovIng the health of Women & ChIldren around the World by 2015 6 8 10 12 14 4 2 MDG Health Alliance Pillars 3 Who. eliminate the transmission of HIV from mother-to-child by 2015 The Global Plan towards the Elimination of New HIV infections Among Children by 2015 and