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 up solutions-including vaccines, drugs, devices, diagnostics, and innovative approaches to strengthening health systems worldwide. Since 2011, path and our partners and supporters have improved health for more than 150 million people on average each year. The largest investments in path's programmatic work in 2019 were organized into three primary portfolios: global health programs; essential medicines; and technology, analytics, and market innovation. See below for descriptions of these programs.”

“In ukraine, path leads the usaid-funded serving life project, which reduces tb, hiv, and hepatitis c transmission in pretrial detention centers, prisons, post-prison settings, and the community. Strategies include increasing case detection, strengthening linkages to care, and employing a case-management approach to ensure treatment completion. In 2019, we worked in 12 regions in 75 pretrial detention centers, prison colonies, and correctional centers, and 12 probation centers. We tested approximately 30,000 people for hiv, linked around 3,000 newly identified plhiv to treatment, and supported about 2,500 people in prison on hiv treatment. In 2019, we also partnered with the ministry of justice to launch a pilot program to provide opioid-substitution therapy to people who inject drugs, the first time this intervention has been provided in a prison in ukraine. In another advancement, we rolled out the use of a smart pill box that reminds patients to take their tb medication and notifies providers if doses are missed, resulting in 90% treatment completion among patients using this technology. We will continue to build on these successes as a partner under the unitaid-funded adherence support coalition to end tb project, launched in 2019. For more information on our work in ukraine, see the country programs section. In vietnam, path continued to pilot innovations in hiv. In 2019, we equipped social enterprises and private clinics led by key populations to generate demand for and provide hiv services. Innovative online chat bots offered information on hiv self testing (hivst) and pre-exposure prophylaxis (prep); care providers then served these clients offline in communities or at clinics. Path also engaged the government of vietnam to scale up new models of hiv testing, including expanding access to hiv lay- and self-testing and partner notification services. The project tested approximately 50,000 people in 2019. Working again with the government and key population service providers, path introduced a variety of service models to rapidly scale up prep nationwide; in 2019 alone, we doubled the number of people on prep. Path also focused on tb control. In 2019, the breath for life project worked with vietnam's national tuberculosis program to develop and test standard operating procedures to address the specimen collection challenges that contribute to low detection of tb in children. Our efforts resulted in updated national guidelines that facilitated countrywide scale-up of stool xpert testing for tb diagnosis among children. In india, path developed tools and applications to enhance monitoring of hiv service delivery through improved data quality and automated data compilation. To improve tb services, we piloted artificial intelligence to streamline chest x-ray readings, enabling quicker diagnosis and initiation on tb treatment. Further, we worked closely with the national tb program to develop public-private partnership guidelines, and we continued engaging the private sector to link drug-resistant tb patients to public-sector care. In tanzania, path and our partners developed a mobile phone application that enabled almost 229,900 people to self-screen for tb. In zambia, path continued to implement the eradicate tb project, supporting 249 health facilities across six provinces. The project tested more than 125,000 people for tb and initiated more than 8,000 people on treatment. For more information, see the country programs section. Also in 2019, path began work on a new tb project in central asia that provides clinical technical support and drug safety monitoring to national tb programs in tajikistan, kazakhstan, and uzbekistan. Maternal, newborn, and child health and nutrition: path works with partners to improve maternal, newborn, and child health and nutrition around the world. Together we develop, adapt, and scale technologies and approaches to reduce illness and death and give children the best possible start in life. In”

“In 2019, path continued to champion the right of women to manage their own sexual and reproductive health 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, and a woman's right to decide whether and when to become a mother. 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 2019, primarily through the self-injection best practices and dmpa-sc access collaborative projects. Our self-injection project in uganda took a user-centered approach to develop and introduce models for contraceptive self-injection and disseminated information on how the practice can be implemented at scale. More than 7,000 women self-injected dmpa-sc across four districts through this program. The dmpa-sc access collaborative continued working with ministries of health and partners across sectors in seven countries to facilitate dmpa-sc introduction as well as scale-up planning for a range of contraceptive options. In 2019, the collaborative provided technical assistance to ensure implementation of each country's total market plan. The collaborative facilitated learning across countries by exchanging information, results, and lessons learned; troubleshooting challenges; and accelerating the adoption of best practices. Path worked with global and country partners 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 and honduras to support the scale-up of hpv testing in the public sector. We provided technical support for procurement of tests, supported advocacy and dissemination events, and made progress toward transitioning leadership of the program to the ministries as the project was in its final year. We also evaluated follow-up and treatment strategies to ensure women receive appropriate, comprehensive care. Path participated in who's call for global cervical cancer elimination by helping shape strategies for low- and middle-income countries. In myanmar, we engaged with the moh and other stakeholders to design a cervical cancer control plan. A path-led consortium also worked closely with the moh to strengthen the knowledge, capacity, and coordination of decision-makers, service providers, and community members to understand sexual and reproductive health services and rights and to influence the development and implementation of related policies. To combat breast cancer, we worked in peru with the national and regional cancer institutes and other stakeholders to implement a model for early detection of breast cancer appropriate and feasible for low- and middle-resource settings. We built the capacity of health professionals to implement this model and shared evidence with moh representatives from el salvador, guatemala, honduras, and nicaragua. We also conducted advocacy among health officials to ensure breast cancer remains on the agenda and women receive screening and treatment even in the absence of mammography services. Path continued to serve as the secretariat for the reproductive health supplies coalition, a global partnership of more than 400 public and private entities and ngos working to expand access to critical sexual and reproductive health and family planning supplies and services. Noncommunicable diseases: path is at the forefront of the fight against noncommunicable diseases (ncds), including diabetes and cardiovascular disease, in low-resource settings worldwide. The burden of thes”

“Country programs: path's country programs support work ranging from small-scale pilots to large, multicountry efforts. In 2019, 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 this year focus on senegal, ukraine, and zambia. In senegal, path works closely with the government to accelerate progress toward health system milestones. We do this in part by building a culture of data use. The macepa program, described earlier, has worked with senegal's ministry of health and social action (mohsa) and national malaria control program since 2010. In 2019, macepa provided technical assistance in data quality and data-driven decision-making, operational research, development of national policies, and collaboration on cross-border issues with neighboring countries; for instance, path supported coordinated planning between senegal and the gambia for the development of a shared data platform and the mass distribution of long-lasting insecticide-treated bednets. During 2019, path's global health security team, also described earlier, focused in senegal on strengthening laboratory, surveillance, and information systems, and on preventing antimicrobial resistance. In 2019, path supported the mohsa to improve electronic reporting from hospitals. We also supported publication of key policy documents related to the national laboratory system, including a quality assurance action plan and five-year strategic plan. We also strengthened real-time, community-based surveillance for priority human and zoonotic diseases with epidemic potential. As part of the dose per container partnership, path conducted formative research that contributed to the vaccine innovation prioritization strategy work led by gavi. Path also conducted a refrigerator temperature monitoring study in private pharmacies in two urban districts and organized cold chain management training workshops for the chief regional supply pharmacists in all 14 regions of the country. In 2019, path provided technical assistance to the government of senegal to scale up safe oxygen delivery. Activities included quantifying the demand for, and the existing in-country supply of, oxygen. In addition, we provided technical assistance to a coalition of partners led by the mohsa to collect data on the availability of medical devices, including oxygen and pulse oximeters, within all public health facilities. Through the better hearts better cities project, path put in place an action plan for the mohsa and national supply pharmacy to improve the availability and accessibility of hypertension medications. We also established a coalition of private companies to raise awareness and increase health literacy around noncommunicable diseases. The goal was to change the mindset from treatment to prevention, with a business case developed to demonstrate the gain for both companies and employees. Path has been a key partner to the government of senegal since the inception of its hpv vaccination demonstration program in 2013. Providing support each year, activities in 2019 included multi-age cohort vaccinations of 9- to 14-year-old girls. Per the government's request, path continued to assist with program planning and preparation, social mobilization, vaccine delivery, monitoring and evaluation, and grant renewals. Finally, as part of a project funded by the clinton health access initiative, path and the mohsa worked together to train 1,672 providers (about 200 more than anticipated) on self-injection of the contraceptive dmpa-sc. The project exceeded training targets across all cadres of health workers and significantly contributed to the mohsa's objective of scaling up dmpa-sc self-injection nationwide. Path in ukraine engages directly with key moh and national center for public health (ncph) stakeholders to ensure that the programs we implement are”

“Path also built upon the better immunization data project by bringing together a consortium of technical experts and partners working with the government of zambia toward a common goal: accurate, improved, and equitable vaccine coverage rates. This work is funded by gavi. Key achievements in 2019 included refresher trainings for 562 health care workers in 320 health facilities.”

“Drug development: through our work on drug development and introduction, path helps ensure that people around the world, especially children in low-resource settings, have reliable access to lifesaving medicines. Over the years, our work has advanced solutions for a range of urgent global health challenges, including enteric and diarrheal diseases, neglected tropical diseases, hiv/aids, and malaria. Drawing on an enduring commitment to health equity and a unique partnership approach that spans the academic, private, nonprofit, and government sectors, our work overturns barriers to health at every stage of drug development and use-from early research to policy introduction. In 2019, the diarrhea innovations group, an international network of child health stakeholders housed within and co-chaired by path, moved forward a critical guidance for diarrhea management among children: the addition of co-packaged ors and zinc to the who essential medicines lists. Co-packaged administration, now recognized as essential, could increase access to this lifesaving treatment and accelerate progress toward child health goals. Also in 2019, we continued our work on developing new therapeutics for cryptosporidium, a deadly diarrhea-causing parasite for which no highly effective treatment is available. Additionally, we began enrollment in a phase 2 proof-of-concept clinical trial of iowh032, a novel antisecretory drug for the treatment of cholera. We also continued to advance our work on a new assessment tool for environmental enteric dysfunction (eed)-an intestinal disorder responsible for a significant portion of the growth stunting of approximately 140 million children worldwide. Known as the "micronutrient and environmental enteric dysfunction assessment tool" (meedat), the tool is designed to measure multiple biomarkers, including those of eed, systemic inflammation, growth hormone resistance, and micronutrients.”

“Market dynamics: path's market dynamics program encompasses efforts to evaluate markets, assess shortcomings, and design market-based interventions to improve health outcomes. This work complements path's other efforts, such as product development and introduction. It builds upon our existing strength in commercialization, aligns expertise across teams, and expands our capacity to address market-based issues. In 2019, our work focused on assessing markets and improving market functioning for malaria drugs and drug intermediates, malaria diagnostics, and oxygen therapy devices. Center of digital and data excellence: path uses digital technologies and data-led action to improve health and save lives. In 2019, the center of digital and data excellence applied its expertise to several projects. Key accomplishments included the who-path strategic collaboration on innovation and global digital health. This collaboration brings together a cross-sector network of digital health experts and investors to support who in developing a global digital health department and portfolio. Work continued under digital square, a path-led initiative. This initiative brings donors and partners together to improve how the global community designs, uses, and pays for digital health tools and approaches. Path also continued implementation of the tanzania data use partnership, which supports the government of tanzania to improve countrywide health information systems and implement the tanzania digital health investment road map. In 2019, the partnership supported launch of the country's 2019-2024 national digital health strategy. 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. Path continued to support the scale-up and sustainability of electronic immunization registries in both countries while providing mentorship and peer learning opportunities to other countries pursuing similar digital health solutions. In addition, path collaborated with the joint learning network for universal health coverage to continue a peer learning model that includes professionals from ministries of health and national health insurance agencies in ten countries. Path also increased participation in high-level coalitions, including the digital transformation for uhc 2030 coalition, the lancet/financial times joint commission on governing health futures 2030, and the digital connected care coalition.”