Program for Appropriate Technology in Health (Path)

“The form 990 was prepared by an outside accounting firm using information provided by path accounting services staff. Path senior management reviewed the draft form. A copy of the draft was sent to the board of directors for comment. After the comment period, the chief of accounting signed the form.”

“Path has policies and procedures to address conflicts of interest. Path management and all staff at a designated level or higher within the organization must complete a conflict of interest disclosure form each year. All forms are reviewed and kept on file. A conflict management plan is developed for any employee with a significant actual or perceived conflict of interest. Path also has a well-defined procedure for identifying and reporting actual and potential conflicts of interest among board members. New board members are asked to complete a conflict of interest disclosure form within 30 days of joining the board and to complete a new form annually thereafter. In addition, members are reminded to report any new issues that arise outside of the annual disclosure period. The disclosure forms are reviewed by path's general counsel, and if any actual or potential conflicts are identified, general counsel makes a recommendation to the chair of the governance committee and the chair of the board for a management plan to properly manage any conflicts. A formal management plan is then agreed upon with the board member, and the entire board of directors is informed at the next regularly scheduled board meeting.”

“The board's executive compensation committee annually reviews salaries and benefits for executive employee positions and provides guidance to the president/chief executive officer (ceo) on compensation decisions for executive positions. The compensation and benefits for path's president/ceo are reviewed and approved by the entire board of directors each year. Path routinely uses the services of external firms to assess and benchmark executive compensation (president/ceo, vice presidents, and executive team members). The most recent major review was completed by the board compensation committee in 2017. At the request of the board, path engaged mercer (a compensation, benefits, and human resources consulting firm) to review current and proposed base salaries of path's president/ceo, vice presidents, and executive team members. Mercer used data from multiple sources to evaluate current and proposed base salaries for these positions. The board's executive compensation committee reviewed the mercer report and approved the use of the report to establish a framework within which the president/ceo is delegated authority to establish the total compensation packages of the vice presidents and executive team members. Additionally, mercer reviewed the proposed total compensation and benefits package for the president/ceo position and obtained a significant number of data points to ascertain its reasonableness and appropriateness. The board approved the committee's recommendation for the president/ceo's total compensation package.”

“Path governing documents, conflict of interest policy, and financial statements are available to the public upon request; most documents are also available online.”

“Path is a global organization that works to accelerate health equity by bringing together public institutions, businesses, social enterprises, and investors to solve the world's most pressing health challenges. With expertise in science, health, economics, technology, advocacy, and dozens of other specialties, path develops and scales solutions-including vaccines, drugs, devices, diagnostics, and innovative approaches to strengthening health systems worldwide. Since 2011, path and our partners and supporters have reached an average of more than 150 million people each year with lifesaving health solutions.”

“Path continued to pilot innovations to reach most-at-risk populations in vietnam. We equipped social and support groups operated by members of key populations to generate demand for services among their peers through targeted outreach via social media, linkages to hiv testing services through mobile applications, and scale-up of hiv self-testing and prep. Path also engaged the government of vietnam to introduce new models of hiv testing, including expanding access to hiv lay- and self-testing and partner notification services, introducing and scaling fee-based prep, launching three local condom brands marketed for key populations, and developing better low-dead-space syringes for people who inject drugs. Path also brings global health expertise and innovative approaches to the fight against tb. We work directly with public- and private-sector laboratories to strengthen capacity to quickly diagnose drug-susceptible, multidrug-resistant, and extensively drug-resistant tb patients. We also support facilities and laboratories with infrastructure, such as solar panels and computer systems, to run tb diagnostic equipment and ensure a sustainable plan for maintenance and care. In ukraine, path led the usaid-funded serving life project, working to reduce tb, hiv, and hepatitis c transmission in pre-trial detention centers, prisons, post-prison settings, and the community. Strategies included increasing case detection, strengthening linkages to care, and employing a case-management approach to ensure that institutionalized or community-based key populations who have tb, hiv, or hepatitis c can complete treatment. In a related effort, path partnered with the ministry of justice to ensure that all newly incarcerated individuals are routinely screened for tb upon entry, annually, and prior to release, and that those confirmed with active tb receive treatment during incarceration or a referral to a tb treatment facility after release. Under the usaid-funded eradicate tb project in zambia, path engaged directly with prison administrators to promote tb screening upon entry, annually, and prior to release. In tanzania, under the challenge tb project, path strengthened the capacity of six civil-society organizations to provide community-based tb treatment adherence support. Path also developed a treatment adherence app that sends treatment and appointment reminders to people with tb via text message. After its launch in september 2018, more than 7,500 people enrolled in the app. In addition, path developed and launched a self-screening app to raise awareness about tb and increase tb case detection. Those who self-report as presumptive for tb receive referral messages to go to a nearby health facility for confirmatory testing. In india, we continued to implement the public-private interface agency (ppia) project to improve private health care providers' contributions to tb control across 15 wards in the urban slums of mumbai. In 2018, the project further engaged with formal and informal practitioners, laboratories, chemists, and hospitals to provide standardized tb diagnosis and treatment services. Path also supported a voucher mechanism to connect patients from local informal providers to qualified physicians, diagnostic services, and treatment support. The project has dramatically improved access to tb services. The breath for life project in vietnam developed and tested a model that addresses health system challenges contributing to low detection of tb among children. Our efforts through this project resulted in decentralized pediatric tb diagnosis and treatment, a doubling of tb diagnosis among children, and a fourfold increase in eligible children on tb preventive therapy. Building on our pediatric work under breath for life, path coordinated with the zambia ministry of health in 2018 to finalize childhood tb training materials. Measurement and learning continued to serve as cornerstones for path's tb programming. Under the eradicate tb pr”

“Newborn, and child health and nutrition problems. Sexual and reproductive health path's work in sexual and reproductive health is guided by the key principles of choice, equity, and dignity for all women. Because we understand the complex social, behavioral, and gender dimensions of women's reproductive health, we build evidence around tools and services that are best suited to address women's diverse needs and circumstances. We specialize in reducing barriers to access. Path continues to champion the right of women to manage their own sexual and reproductive health needs by creating and advancing improved tools and practices that make women's self-care possible. An integrated approach to women's health includes attention to contraception, cervical and breast cancer, sexually transmitted infections, the right to decide whether and when to become a mother, and gender-based violence prevention and care services. We spearhead discussions on the practices, behaviors, and tools that enable women to self-assess and self-manage their sexual and reproductive health needs. Among the recent woman-initiated products introduced by path are an all-in-one injectable contraceptive that can be self-administered and a vaginal self-sampling kit for human papillomavirus (hpv) testing in cervical cancer screening programs, as described below. Path's research and coordination to expand access to the injectable contraceptive subcutaneous dmpa (dmpa-sc, or sayana press) continued in 2018, primarily through the self-injection best practices and access collaborative projects. The self-injection project in uganda launched to gather information about how the practice can be designed and implemented at scale. By the end of 2018, at least 7,000 women were self-injecting across four districts through this program. The dmpa-sc access collaborative works with ministries of health and partners across sectors in ten countries to facilitate dmpa-sc country introduction and scale-up planning for a range of contraceptive options. In 2018, the collaborative provided technical assistance to ensure implementation of each country's total market plan. Furthermore, the collaborative facilitated learning across countries by exchanging information, results, and lessons learned; troubleshooting challenges; and accelerating the adoption of best practices. Path also worked with partners worldwide and in several countries to improve the prevention, detection, and treatment of cervical precancer, which is caused by infection with hpv. We continued our partnership with the ministries of health in guatemala, honduras, and nicaragua to support the scale-up of hpv testing in the public-sector health system. We provided technical support for procurement of tests, supported advocacy and dissemination events at the ministries of health, and made progress toward transitioning leadership of the program to the ministries themselves as the project began its final year. We dedicated additional efforts to evaluating follow-up and treatment strategies to ensure women receive appropriate care during each stage of a comprehensive cervical cancer prevention program. In myanmar, we engaged with the ministry of health and other stakeholders to design an operational plan for cervical cancer control. Path experts also participated actively in who's call for global cervical cancer elimination by attending international meetings to define elimination targets and shape strategies for low- and middle-income countries. To combat breast cancer, we worked with the national cancer institute in peru and other regional stakeholders to implement a model for early detection of breast cancer that is appropriate and feasible for low- and middle-resource settings. We built the capacity of numerous health professionals to implement this model and conducted advocacy activities among health officials to ensure breast cancer stays on the agenda and women receive screening and treatment even in the absence of mammog”

“Outbreaks. With support from the us centers for disease control and prevention, the team worked with national leaders in the drc, senegal, tanzania, and vietnam to strengthen their public health systems and build their capacity in epidemic preparedness and response. The team also began work as a major subgrantee under icf international for surveillance activities in the usaid-supported infectious disease detection & surveillance project. This project works to improve the detection of high-priority infectious diseases and identification of antimicrobial resistance through improved diagnostic and surveillance systems. Our cross-organizational impact team focusing on epidemic preparedness and response continued to be at the forefront of the ebola response in the drc, providing a key role in surveillance, detection, and resource mobilization. The team is developing and introducing innovations to strengthen electronic health information systems, advancing novel vaccine platforms, preparing medical countermeasures for pandemic influenza, and defining path's role in combating antimicrobial resistance. Digital health solutions path uses information and communication technologies to improve health and save lives. In 2018, our growing digital health team applied its expertise to several projects. Key accomplishments included launching the who-path strategic collaboration on innovation and global digital health. This collaboration will bring together a cross-sector network of digital health experts and investors to support who in developing a global digital health portfolio. Path also launched the center of digital and data excellence, a body designed to coordinate digital health efforts across path. We continued work under digital square, a path-led initiative. This is a partnership of the world's leading digital health experts from more than 40 organizations and countries working together to strengthen digital health systems in emerging economies. In addition, we collaborated with the joint learning network for universal health coverage to continue a peer learning network that includes professionals from ministries of health and national health insurance agencies in ten countries. These professionals are working to improve their health care data systems, which will help their countries achieve universal health coverage. We continued implementation of the tanzania data use partnership, which supports the government of tanzania to improve countrywide health information systems and implement its digital health investment road map. The bid initiative, a collaboration between path and the governments of tanzania and zambia, has empowered these country governments to enhance immunization through improved data collection, quality, and use. This project ended in 2018, and project close-out activities included the documentation and sharing of project learnings. The digital health team also supported the immunization data: evidence for action review. This initiative reviewed available evidence on what works to improve the use of immunization data, synthesized the findings, and distributed the findings through an advocacy and communications campaign. Country programs path's country programs support work ranging from small-scale pilots to large, multicountry efforts. In 2018, we operated full-scale "country" offices in the drc, ethiopia, india, kenya, myanmar, senegal, tanzania, uganda, ukraine, vietnam, and zambia, as well as smaller "project" offices in many other countries. Examples of our country program work are highlighted below, focusing on the drc, kenya, and india. In response to recurring ebola outbreaks in the drc, path has focused on strengthening global health security and epidemic preparedness in collaboration with the ministry of health (moh). In may 2018, the drc experienced its second ebola outbreak in less than 12 months. In collaboration with the moh, path deployed the first wave of 12 moh investigators, 10 epidemiologists, and”

“Of diagnostic kits and drugs to treat the disease. The project also strengthened the quality of surveillance systems by building the capacity of local government. We supported the government to regularly perform data quality checks and conduct data visualization to identify newly affected villages. This enabled more timely decision-making and actions on prevention and treatment. Path also continued innovative urban tb control efforts in india. The ppia project, working to enhance the role of private health care providers in tb control, provided free or subsidized services to patients in mumbai who would otherwise be unable to afford this care. From the project's launch through 2018, 202,468 presumptive tb cases were screened after being referred from the private sector, and 62,633 people (31 percent) were diagnosed and notified. A total of 49,856 patients were supported for treatment adherence monitoring, and 2,790 tb patients were linked to public-sector support.”

“For the year ended december 31, 2018, the organization adopted the financial accounting standards board's accounting standards update (asu) no. 2018-08 - not-for-profit entities (topic 958): clarifying the scope and the accounting guidance for contributions received and contributions made for revenue transactions. The update assists entities in (1) evaluating whether transactions should be accounted for as contributions (nonreciprocal transactions) or as exchange (reciprocal) transactions and (2) determining whether a contribution is conditional. The primary effect of adoption of this asu for the organization is that certain awards received that were previously treated as unconditional are now treated as conditional. As a result, revenue for these awards is recognized when the conditions are met during the award term, whereas previously revenue had been recognized when the awards were awarded. Path has elected to adopt the changes from this asu retrospectively to the 2017 financial statements. The net effect of this change is presented as an other change in net assets. -378,755,643.”