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 principal financial officer 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 and division chiefs). The most recent major review was completed by the board compensation committee in 2021. At the request of the board, path engaged future sense (a compensation, benefits, and human resources consulting firm) to review current and proposed base salaries of path's president/ceo and division chiefs. Future sense used data from multiple sources to evaluate current and proposed base salaries for these positions. The board's executive compensation committee reviewed the future sense 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 division chiefs. Additionally, future sense 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 nonprofit dedicated to achieving health equity. With more than 40 years of experience forging multisector partnerships, and with expertise in science, economics, technology, advocacy, and dozens of other specialties, path develops and scales up innovative solutions to the world's most pressing health challenges.”

“(1) improving access to medical oxygen and related respiratory care products in lmics. As part of that work, we supported our government partners in the development and execution of comprehensive respiratory care plans to meet the demands of covid-19. Beyond the pandemic response, we also helped prioritize and improve access to oxygen therapy and other essential respiratory care equipment as an integral part of national and global health systems strengthening. In india, kenya, senegal, and tanzania, we advanced access to affordable and appropriate tools such as pulse oximetry and electronic clinical decision-support algorithms to help health care workers identify critically ill children and refer them for treatment without delay. (2) supporting introduction and scale-up of malaria health products. Through our role in the partnership for vivax elimination, we continued to foster access to critical malaria drugs and diagnostics for adults and children across 15 malaria-endemic countries. Epidemic preparedness and response path's epidemic preparedness and response team continued to innovate for the prevention, detection, and control of infectious disease outbreaks. Under the usaid discovery & exploration of emerging pathogens - viral zoonoses project, the team supported global data management and sharing and led project start-up in senegal and vietnam. The team worked as a major subgrantee on the usaid infectious disease detection and surveillance (idds) project and led in senegal, tanzania, uganda, and vietnam. In these countries, our cross-organizational impact team also supported covid-19 outbreak response activities, while remaining at the forefront of antimicrobial resistance and genomic surveillance in vietnam, in particular. With support from the u.s. Cdc, path worked with national leaders in myanmar, senegal, tanzania, and vietnam to build capacity for epidemic preparedness and response. Other efforts included strengthening electronic health information systems, advancing diagnostic network capabilities, and linking this work with the development of new diagnostics, vaccines, and data tools. Malaria and neglected tropical diseases path partners with governments, the private sector, and funders around the globe to bring the world closer to malaria eradication. Our malaria and neglected tropical diseases program includes more than 100 path staff members in ten countries. Our strategy includes optimizing the delivery of current tools and approaches to ensure they reach the people who need them, designing new strategies and developing next-generation tools to overcome emerging challenges, and creating innovative partnerships and funding models to ensure our programs are sustainable and effective. In 2021, our malaria control and elimination partnership in africa (macepa) program continued to support the governments of ethiopia, senegal, and zambia toward their malaria elimination goals. For instance, macepa provided mathematical modeling and data analytics support, including estimating the catchment population of each health facility in zambia and using human migration data to capture population flow at the district level in ethiopia. Macepa also conducted exploratory activities in the democratic republic of the congo (drc) and nigeria (e.g., analyses of current malaria surveillance systems) to inform technical assistance needs and recommendations for those geographies. The pamo plus project, funded by the u.s. President's malaria initiative (pmi), provided technical and material assistance to the zambia ministry of health (moh) in malaria case management, malaria in pregnancy, social behavior change, disease surveillance, and data management and use. Work in 2021 involved mentoring health workers in the project's four focus provinces on adherence to malaria case management standards as well as training, deploying, and supporting community health workers who test and treat malaria at the community level. Additionally, pamo pl”

“Primary health care path's primary health care (phc) department employs a comprehensive, one health, people- and community-centered phc model that addresses broader determinants of health (e.g., social, economic, environmental). We focus on innovative, evidence-based tools and approaches to meet people's needs and preferences across their lifetime. Phc at path is composed of six teams, described below. Maternal, newborn, and child health and nutrition together with partners around the world, path's maternal, newborn, and child health and nutrition (mnchn) team develops, adapts, and scales up technologies and systems to reduce illness and death among mothers and children and give children the best possible start in life. To ensure that all infants have access to human milk, path focuses on breastfeeding promotion, provision of specialized lactation support for mothers of small and sick newborns, availability of safe donor milk through local human milk banks, and uptake and use of global standards for human milk banking. Using human-centered design, we continued creating a digital adaptation kit for optimal newborn feeding and the provision of lactation support, which is being developed in kenya as a global good for all settings. Path continued supporting ariadne labs as a subject matter expert and performed a feasibility assessment in india, malawi, and tanzania on the use of donor human milk for low-birthweight infants. These findings are being disseminated globally and through multiple peer-reviewed publications. In ghana, path is leading a four-year effort, advanced newborn care in ghana: beyond making every baby count initiative (mebci 2.0), to reduce perinatal mortality in four high-volume referral hospitals. In 2021, mebci 2.0 engaged with the ghana health service to operationalize its newborn action plan, mobilize regional stakeholders and resources, and drive advocacy and policy action. Through the neolens project, path documented country-level journeys in establishing in-patient care for small and sick newborns in low-resource settings. To showcase lessons learned in ethiopia, india, malawi, and rwanda, we created case studies for each country and partnered with mass design group to develop an interactive, virtual experience. Following a path project that documented uptake of 14 key mnchn assets in 81 countdown to 2030 countries, in 2021 path conducted a subnational inquiry in five focus countries on the inherent barriers and enablers to scale-up of these commodities. We developed complementary interactive dashboards to provide the data in a user-friendly interface. In collaboration with the ghana health service and with funding from the pfizer foundation, path initiated the integrated antenatal care project in the bono east region of ghana. The project aims to avert infectious disease mortality and morbidity in neonates and mothers by implementing an improved, comprehensive infectious disease screening program during pregnancy. Also in 2021, mnchn staff served globally in leadership roles related to covid-19 and the protection of women and children. We participated in global technical working groups, presented (mostly virtually) at key global and national meetings, and authored and contributed to high-profile peer-reviewed journal articles, book chapters, global reports, and systematic reviews. These efforts advanced thinking on broad, effective solutions to the most pressing challenges in mnchn. Recognizing that nutrition is affected by a variety of economic and environmental factors, path's nutrition team drives novel approaches to address the massive burden of malnutrition in communities around the world. Together with path's climate change community of practice, path's nutrition team continued to advocate for sustainable climate-friendly alternatives, such as cultured proteins and edible insects. As a reflection of our expertise, path leads the biomarker collection and analysis components of the demographic health”

“In western kenya, path successfully closed out the pepfar-funded afya ziwani project. Over the project lifetime, 1,586,802 people were tested for hiv, of which 25,569 were diagnosed with hiv and linked to care and treatment. In mid-2021, path transitioned the programming to two new initiatives: (1) a comprehensive package of health, social, and economic strengthening services for children, adolescents, and young people through the pepfar-funded nuru ya mtoto project, for which path is prime; and (2) high-quality clinical hiv and tb/hiv services for people living with or at risk of hiv through the pepfar-funded boresha jamii project, for which path is a key subpartner leading the clinical work. Path also led the chak a chaka project, which strengthens economic skills among young women in kisumu, homa bay, and migori counties to reduce hiv risk and vulnerability. In 2021, path helped 1,225 young women build savings and entrepreneurial skills through access to business development trainings and insurance funds. In india, through the u.s. Cdc-funded strengthening strategic information management systems project, path continued to support the national aids control program at the state and district level in mumbai and andhra pradesh as well as nationally to further streamline data reporting systems and enhance data use for program improvement and planning. Among other activities, we created site-level systems to improve follow-up with clients, deployed a monthly district-level planning process in andhra pradesh to improve hiv testing and linkages to service, and created national-level dashboards to better monitor hiv program performance against epidemic control indicators. In support of tb programming in india, path introduced artificial intelligence to streamline chest x-ray readings, enabling quicker diagnosis and initiation on treatment. With support from usaid, path facilitated a needs assessment for technical support units to foster local private-sector engagement across five indian states. Path also supported revisions and updates to tb control standards in partnership with who and the national tb program. In zambia, path continued to implement the usaid-funded eradicate tb project, which screened 1,967,914 individuals for symptoms of tb, among whom 223,337 (11%) were presumed to have tb. Samples from 200,899 (90%) of those were then tested in the laboratory, resulting in 9,872 (5%) confirmed tb cases. Of these, 9,521 (96%) were successfully initiated on treatment. The project also strengthened the laboratory network to more efficiently and effectively diagnose and monitor people with tb. An external quality assessment showed that 90% of health facility laboratories achieved 95% correct results. The project continued to train frontline health care workers in the six supported provinces on childhood tb detection and drug-resistant tb case management. In tanzania, the usaid-funded idds project supported key functions at the central tb reference laboratory, facilitated reporting from sites using the genexpert platform, completed an assessment of the tb diagnostic network, and prepared for introduction of new diagnostic methods. Through this project in vietnam, path continued to support the national tb program by assessing progress on the "double x" strategy (chest x-ray and genexpert test), supporting the application of artificial intelligence for reading chest x-rays, and performing analyses to improve specimen transport systems and diagnostic access. Also in vietnam, the usaid/path healthy markets project introduced new hiv products to optimize choice for clients, supported the development of critical new policies (including a first-ever hiv private-sector engagement plan), and rapidly pivoted key population platforms to deliver lifesaving covid-19 and hiv care during vietnam's severe fourth surge of covid-19. In december, the team transitioned the project to usaid/path steps, a five-year pepfar-funded initiative that builds on”

“Sexual and reproductive health path's work in sexual and reproductive health (srh) is guided by the principles of choice, equity, and dignity for all people and grounded in an understanding of the complex social, behavioral, and gender dimensions of srh throughout the life cycle. We build evidence around tools and services that are co-designed with and for women and girls to address their diverse needs and circumstances, reduce barriers, and expand options. Path is a leader in the self-care movement, supporting individuals and families who choose to manage their own health. In senegal, the moh, path, and partners are advancing policy through the self-care pioneers, a coalition of champions leading the development of senegal's self-care guidelines. These will be among the first national self-care guidelines in the world, and the first in francophone africa. With assistance from path and partners, countries have continued to accelerate scale-up of the contraceptive innovation, self-injection with subcutaneous dmpa (dmpa-sc). Led by path in partnership with john snow, inc., the dmpa-sc access collaborative in 2021 provided technical assistance to 20 countries and collected data from 11 countries showing more than 315,000 client self-injection visits. In uganda, path and the moh are implementing groundbreaking person-centered programs to demonstrate how self-injection can be offered at scale. For decades, path has been at the forefront of evidence-based strategies to address the inequitable burden of cervical cancer in lmics, from human papillomavirus (hpv) vaccine research and delivery to cervical cancer screening and treatment. Globally, path helped shape strategies for lmics as part of who's call for global cervical cancer elimination, and we continue to pursue opportunities for secondary prevention (i.e., early detection) interventions. In peru, path implemented a model for early detection of breast cancer appropriate and feasible for these settings. We partnered with the moh to design and implement a real-time digital patient tracking system for breast cancer detection. Through the usaid improving market partnerships and access to commodities together project in madagascar, path and public- and private-sector champions supported the government to develop a strategy for a total market approach to improve access to high-quality health products for family planning (fp), maternal and child health, and malaria. In india, path implemented several supply chain strengthening initiatives to help ensure availability of fp products. We piloted an informed push model to reduce stockouts, introduced kits for last-mile fp availability, designed a supply chain management e-learning course, and facilitated a partnership between the odisha state government and the india post for fp delivery. We conducted a policy and regulatory landscape for private-sector fp delivery and contributed to india's fp2030 draft commitments on strengthening supply chains. In myanmar, path is fulfilling the growing need for information and services to address gender-based violence (gbv) and sexual and reproductive health and rights (srhr) amid the current local political situation and covid-19 pandemic. With funding from who, we increased gbv awareness in the peri-urban yangon migrant community; supported women in crisis with food, shelter, and transportation; conducted a well-being workshop and webinar; and facilitated a 16-day srhr and gbv activism campaign. Path continued to serve as the secretariat for the reproductive health supplies coalition, a global partnership of more than 540 public and private entities and nongovernmental organizations working to expand access to critical srh and fp supplies and services.”

“Path published several articles on the economic impact of respiratory syncytial virus (rsv) and other acute respiratory infections among infants in lmics, and on the importance of maternal immunization and the strengthening of rsv assays. Additionally, path updated our rsv vaccine and monoclonal antibody snapshot, which provides an overview of the intervention product landscape, and our trial tracker, which provides information on related clinical trials. 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 introduction. In 2021, we continued developing new therapeutics for cryptosporidium, a deadly diarrhea-causing parasite for which no highly effective treatment is available. We demonstrated that our lead compound is effective in dairy calves, a key model that mirrors human clinical symptoms. With our manufacturing partner quansys biosciences, we commercially launched the micronutrient and eed assessment tool (meedat), a new tool for assessing environmental enteric dysfunction (eed) - an intestinal disorder responsible for a significant portion of the growth stunting of approximately 140 million children worldwide. Meedat was used in studies of children in zambia and tanzania, with additional studies planned in other low-resource settings. Path also explored new uses and partnerships for iowh032, a drug candidate we previously developed for treatment of cholera, which also has potential for treating other diseases.”

“Through the idds project, path supported the ministry of agriculture, animal industries and fisheries (maaif) to instruct the first-ever iso/iec 17025:2017 (the quality standard for operation of laboratories) trainer of trainers cohort in the country as part of a global health security effort to improve detection of priority zoonotic diseases. Working with relevant national stakeholders, path drafted and operationalized a uganda strategy for coordinated and integrated surveillance of these diseases. Path supported the national animal diseases diagnostics and epidemiology center and the animal health national reference laboratory within maaif to improve data entry, quality, analysis, and reporting. Also through idds, path revitalized facility- and community-based surveillance for covid-19 in eastern uganda. Path also supported the development of standard operating procedures and waste management guidelines for covid-19 vaccination rollout and provided regulatory support to the moh to expedite covid-19 vaccine authorization and shipment into the country. Furthermore in uganda, path supported countrywide cold chain equipment repair and maintenance whereby more than 100 nonfunctional cold chain devices, such as vaccine refrigerators, were repaired. We expanded the scope of the cold chain information system to include country-specific requirements and inventory data for improved cold chain equipment management. Through the unitaid hiv star iii initiative, uganda has achieved significant scale-up in hiv self-testing (hivst) services. The country is set to distribute 3.5 million hivst kits annually, making it the largest hivst market globally. Path developed the post-market surveillance national plan and standard operating procedures for hivst. Path also introduced two who-prequalified blood-based kits into the country to expand choice and access. Path integrated the kits into the supply chain and other systems, leading to the government's review and adoption of hivst training materials for health care workers and development of training materials for peer hivst distributors. Zambia in partnership with the zambia government, path supported high-quality, cutting-edge research on pressing health issues, from covid-19 to malaria to tb. Furthermore, path implemented new digital health tools and approaches across the country, from our private-sector partnership "visualize no malaria" to the better immunization data initiative. In 2021, we continued to support the government response to the covid-19 pandemic. One new opportunity was a bayer-funded project to support the moh on key aspects of covid-19 vaccine rollout and disease surveillance. Additionally, path continued to provide technical support to the moh on covid-19 protective measures. In 2021, the living labs project in zambia engaged frontline immunization health workers to improve vaccine delivery and coverage. Through this project, the workers helped advise on labeling for covid-19 vaccines and how to best accelerate vaccine distribution in their communities. Their feedback will improve vaccination coverage for covid-19 and beyond. Our work in malaria in zambia included groundbreaking research by our laboratory team based at the national malaria elimination center, evaluation of new vector-control tools (such as the attractive targeted sugar bait), and training of health workers on new malaria control guidelines and procedures, including at the community level. Path also increased the number of people tested and treated for tb in zambia, expanded tb care, and created strategies to address pediatric and drug-resistant tb, including training health workers on new guidelines and investing in effective diagnostics at laboratories across the country.”