The future of fighting disease in low and middle income countries is becoming more complex. Today, we continue to tackle the longstanding problems of infectious diseases, and the challenge of improving access and strengthening healthcare systems on the ground. But now, we are also facing the rise of non-communicable diseases such as diabetes, cancer, hypertension and asthma, which are creating a double disease burden these countries are ill-equipped to bear.
At the Novartis Foundation, we see this as a challenge we can overcome by continuing to explore and implement innovative healthcare models. One way we do this is by bringing experts together in a variety of ways to discuss strategies, share ideas and collectively move efforts forward.
To this end, we co-hosted a collaboration workshop on community health workers in June that brought together Ministry of Health and Finance representatives from several African countries with private sector partners, donors, NGOs and academia. The goal was to discuss strategies for scaling up community health worker programs towards the goal of achieving universal health coverage. We know that community health workers can be an effective, relatively low-cost health way to bring healthcare to underserved populations. The workshop explored financing and resourcing to scale up and better deploy these workers where they are needed.
In August, we also brought together a group of experts from the global health and anti-leprosy community to discuss the current state of leprosy treatment and care, and how best to move forward together our effort to finally eliminate leprosy. The meeting, which took place in Brasilia, Brazil, helped us take another step forward toward our goal of eliminating leprosy once and for all in the coming years.
Technology is shaping our world, and so communication and idea sharing is happening in the online world as well. To that end, we are very excited to have just joined Twitter. You can follow us @NovartisFDN. It’s a great way to stay up to date with our activities – and at the same time, it gives us a new platform to participate in real time discussions with the online global health community. Don’t miss the chance to make your voice heard!
If reading only 140 characters on Twitter is not your style, you can catch-up on our last two years of activities by downloading or ordering our Annual Report 2013 - 2014 from our website.
We’ve also added some exciting new experience to our Board of Directors to help propel us into the future. We added four new members to our Board of trustees, including Chairman Dr. Joerg Reinhardt, who succeeds Dr. Andrin Oswald as Chairman of the Novartis Foundation. Prof. Peter Piot of the London School of Hygiene & Tropical Medicine and Dr. Rebecca Weintraub of Harvard Medical School joined the board along with Rainer Boehm from Novartis Pharmaceuticals. The appointment of these new board members is significant because they bring a wealth of experience and insights to the Novartis Foundation. I am looking forward to hearing the fresh ideas and new perspectives each of them can bring to our work.
Expanding the reach of telemedicine to empower more community health workers in rural Ghana
At the Novartis Foundation, we aim to pioneer innovative healthcare models that have a transformational impact on the health of the poorest populations. In Ghana, we are working with one such model, using mobile technology to centralize expertise and coach community healthcare workers in their patient care through telemedicine.
From June 9 – 11, 2015, we co-hosted a south-south collaboration workshop with the One Million Community Health Workers Campaign, the Ministry of Health in Ghana and the Ghana Health Service in Accra, Ghana. The workshop brought together Ministry of Health (MOH) and Finance representatives from several Africa countries with private sector partners, donors, NGOs and academia to discuss strategies for scaling up community health worker (CHW) programs towards the goal of achieving universal health coverage, an important aspect of Sustainable Development Goals (SDGs).
Related to our own work strengthening the capacity of community health workers our telemedicine project was presented. The telemedicine project was piloted and validated from 2012 to 2014 in collaboration with the Earth Institute at Columbia University, Millennium Promise, the Ghana Ministries of Health and of Communications, Ghana Health Services, with technical support from Airtel and Ericsson.
During the pilot, the teleconsultation center (TCC) received calls about cases ranging from complicated labor and pregnancy, malaria, fever, diarrhea, hypertension and diabetes. Of all teleconsultation cases in 2013, 54% were resolved by phone through the TCC and including 31% avoided referrals.
The program is currently being scaled to the entire district and a national roadmap for telemedicine in Ghana is being established with the Ministry of Health and all project partners to cover the whole country with telemedicine services by 2017. This expansion will empower more community health workers, supporting the efforts of the Ghana Ministry of Health and the One Million Community Health Workers Campaign.
Novartis Foundation confirms new members of its Board of trustees
We recently announced four new members of our Board of trustees, including Novartis Chairman Dr. Joerg Reinhardt, who succeeds Dr. Andrin Oswald as Chairman of the Novartis Foundation. Prof. Peter Piot of the London School of Hygiene & Tropical Medicine and Dr. Rebecca Weintraub of Harvard Medical School join the board along with Rainer Boehm from Novartis Pharmaceuticals. Dr. Juergen Brokatzky-Geiger, Head of Novartis Corporate Responsibility and Dr. Ann Aerts, Head of the Novartis Foundation remain on the Novartis Foundation Board.
“The Novartis Foundation has been committed to improving and innovating healthcare among the poorest populations for more than 35 years,” said Joerg Reinhardt. “I am happy to contribute to the continuation of this important work and to welcome two external board members who bring a wealth of experience and expertise in global health as well as a fresh perspective on the Novartis Foundation.”
Rebecca Weintraub, M.D., is an Assistant Professor of Medicine at Harvard Medical School, an Associate Physician in the Division of Global Health Equity at Brigham and Women’s Hospital and Faculty Director of the Global Health Delivery Project at Harvard University. Peter Piot, MD, PhD, is currently the Director of the London School of Hygiene & Tropical Medicine. Formerly, he was the founding Executive Director of UNAIDS and he is the co-discoverer of the Ebola virus.
For their contribution over the years, the Novartis Foundation extends gratitude to its outgoing Chairman, Dr. Andrin Oswald, and Board members, George Gunn and Prof. Dr. Jean-Marie Lehn.
The Novartis Foundation convenes experts to help finish the last mile in leprosy elimination
In August, the Novartis Foundation convened experts from the global health and anti-leprosy community to discuss the current state of leprosy treatment and care, and how best to move forward together in the mission to finally eliminate leprosy. The two-day dialogue event “The last mile to leprosy: innovation, integration and collaboration” was held in Brasilia, Brazil and was co-hosted by the Novartis Foundation, the Nippon Foundation and Coordenação Geral de Hanseníase e Doenças em Eliminação in the Ministry of Health, Brazil.
The 95% reduction in prevalence of leprosy since the 1980s is often cited as a major public health achievement. However, it also resulted in leprosy elimination efforts becoming a victim of their own success: with fewer patients detected, funding, political commitment, and knowledge of the disease drastically declined. The disease remains endemic in high-burden pockets in many countries in Asia, Africa and Latin America and a large proportion of patients are diagnosed late and often with severe disabilities. The challenge of the last mile in the fight against leprosy is to interrupt transmission and to put leprosy back on the global health agenda.
This historic meeting brought many players from the anti-leprosy community together in a unified voice on the need to have a renewed commitment toward leprosy elimination, taking a global perspective in addition to examining specific challenges and opportunities in Latin America.
Many ideas and examples on how to move forward were presented and discussed, including integrating leprosy programs with other neglected tropical disease programs such as school screenings and awareness campaigns; mobile community-based screening programs to penetrate difficult to reach areas; contact tracing, screening and preventative treatment; the need for better diagnostic tools and training; and increased awareness to improve early diagnosis and to reduce stigma and reinvigorate rehabilitation and treatment for those with nerve damage and other secondary disabilities.
Two additional themes were clear throughout the two days. First, that the global health community needs to re-define elimination. Second, that there is no shame in having increased case detection numbers as countries improve their leprosy elimination efforts – this is part of the journey toward elimination.
A full summary of the event, including summaries of each of the speakers and panel sessions, will soon be available on our website.
If you’d like to learn more in a visual way about why leprosy should be in the spotlight and what we need to be doing to win the fight against it in the future, our leprosy infographic provides the highlights in an easy to read, easy to remember format.
The infographic is included at the end of this newsletter.
Building the Next Generation of Scientists in the developing world
This year, Randolph Ngwafor from the University of Yaounde, Cameroon participated in the Novartis Next Generation Scientist Program. Over three months, he carried out work that aimed to identify leprosy biomarkers, supporting the Novartis Foundation’s leprosy program. We asked Randolph more about his research and his experience at the Novartis Foundation.
Can you tell us about your project at the Novartis Foundation, which aimed to identify leprosy biomarkers? Randolph: Leprosy is the second most common mycobacterial infection in the world after tuberculosis. Despite availability of effective therapy – which is also free – new leprosy cases continue to be reported, and 60% of these are multibacillary, the most advanced form that is rapidly transmissible. The bacterium is also slow growing, so for most patients this means a long interval from time of infection until the detection of clinical symptoms. Therefore a standard diagnostic test to detect early and asymptomatic cases would therefore make a big impact in a leprosy disease elimination strategy!
One way of developing a standard diagnostic test is to identify the most important and relevant biomarkers available. A large amount of research has been done across the scientific community to detect these markers. However, it is not clear which ones are important for diagnostics and which ones are not. My role in the project team was therefore to provide information on which biomarkers might be important to lay emphasis on for diagnostics.
Why did you choose this project? Randolph: As a clinician, it was impossible to ignore the increase in incidence and mortality due to recurrent infectious diseases in the community I worked in. The top five main causes of death in my country, Cameroon, are all infectious diseases. This is quite disturbing as these infections can be treated and prevented but individuals are diagnosed too late. This motivated me to focus my professional interest in public health and infectious diseases. I wanted to find ways to reduce transmission; treat those exposed as quickly as possible and avoid complications. Early diagnosis was the key factor! I was therefore given the opportunity to get involved with the Novartis Foundation’s goal in the contribution to the elimination of leprosy.
How did you go about doing this? Randolph: I carried out a systematic review from existing literature, by performing database searches to identify articles relevant to leprosy biomarkers. These articles had to fit the eligibility criteria and were further assessed for quality.
What were your conclusions? Randolph: A total of 122 leprosy biomarkers were identified from 119 retrieved articles. The most cited biomarkers were anti PGL-I IgM antibody and multiple gene fragments of the Mycobacterium leprae genome. Multi-field studies should be carried out on these biomarkers, in regions of Asia, Latin America and Africa to span all endemic zones of the disease.
What impact do you hope this research, and other work you are doing, can have in your home country? Randolph: I will use and transfer the new skills I learned here to study biomarkers in other infectious diseases in Cameroon. Malaria, HIV and other mycobacterial infections come immediately to mind. In doing so, new approaches could be adopted from our findings to combat these diseases.
The Novartis Next Generation Scientist Program is an intensive internship program for talented and motivated research scientists from emerging countries. This internship aims to build scientific and leadership capability in emerging countries by enhancing the skills of local scientists and by facilitating the knowledge transfer to their wider scientific communities upon their return home.