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 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 in 2022. 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 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 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. The largest investments in path's programmatic work in 2022 were organized into three primary portfolios: programs & innovation, essential medicines, and the africa region.”

“In 2022, we also accomplished a design lock and subsequent execution of a technology transfer, license, and commercialization agreement with lifeassay diagnostics ltd. For a point-of-care rapid diagnostic test for primary immunodeficiency (pid). Pid are a rare class of hereditary diseases that affect the immune system, resulting in incomplete immune responses that make individuals more vulnerable to diseases. People with some forms of pid are at risk of prolonged infection and shedding of poliovirus into their communities. Identifying those with pid can help disrupt community outbreaks and disease cycles. Medical devices and health technologies the medical devices and health technologies program supports product development at path. The program works with public- and private-sector partners around the world to develop, test, introduce, and scale up affordable innovations to improve the health of people around the world. In collaboration with local stakeholders and researchers, we develop fit-for-purpose health technologies such as the ellavi uterine balloon tamponade (ubt), a lifesaving intervention for postpartum hemorrhage manufactured in south africa available in 16 countries. The caya diaphragm, another path-developed medical device, achieved regulatory approval in brazil in 2022, bringing the global total to 40 countries where the device is now available and marketed. In the areas of vaccine and pharmaceutical technologies, we convened a third global syringe manufacturer workshop and produced an autodisable syringe gap analysis model to inform global stakeholders and us decision-makers. The path microarray patch center of excellence continued our cross-sector work to advance this needle-free delivery technology platform including evaluating the usability of candidate products and the potential total cost to deliver measles and rubella vaccine with a patch. In addition, we advised uganda's ministry of health (moh) on the country-wide adoption of a path-advanced vaccine cold chain inventory and performance tracking system. Finally, scientists in the formulation team submitted a patent application for a novel heat-stable insulin formulation, suitable for oral administration. Market dynamics path's market dynamics program works to increase equitable access to health products and services by diagnosing the root causes of market failures, designing appropriate solutions, and developing sustainable and inclusive health markets. This work is done in close collaboration with national ministries of health, global agencies, commercial partners, civil society organizations, and path's country programs. In 2022, our largest areas of work were: (1) improving access to medical oxygen, respiratory care systems, and critical medical devices in lmics. As part of that work, we supported global and country efforts in respiratory care capacity-building and implementation, strengthened advocacy to elevate oxygen to global and national agendas, and enhanced research and monitoring, evaluation, and learning on oxygen with a goal to equitably improve access to high-quality oxygen services at all levels of the health care system. 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. As part of this work, we improved access to tools at facilities, trained health care workers, and informed national policy and advocacy efforts toward scaling these critical devices at the primary health care (phc) level. (2) supporting the introduction and scale-up of malaria health products with the aim of eliminating the p. Vivax strain of malaria. With partners, our work included developing appropriate strategies to address p. Vivax, sharing high-quality evidence to inform policy and decision-making, and supporting the development and availability”

“We coordinated partners working on atsb research in kenya, mali, and zambia, together with israel-based manufacturer westham ltd. And uk-based funder innovative vector control consortium. Under the rapid malaria assessments to support appropriately tailored subnational intervention packages in burkina faso project, funded by the gates foundation, path also provided technical support to the centre national de recherche et de formation sur le paludisme to explore new data sources, collection methods, and indicators to provide granular and timely data for decision-making including to support subnational planning and global fund grant assessments. Path also led a usaid initiative to support malaria operational research and program evaluation. Under the pmi insights project, path coordinated the work of several partners to strengthen national policies, strategies, and guidelines for malaria control and elimination. In senegal and the gambia, path continued to integrate malaria into the scope of national emergency operations centers (eocs). In senegal, we supported the ministry of health to create and resource regional eoc-malaria units. With a regional presence, the eoc can more rapidly respond to potential public health threats. In drc, path began to support the recently created national public health institute's efforts to set up a single, central eoc to manage the multiple health emergencies drc has to manage, including developing an integrated data platform to support decision-making. Path's laboratory team at the national malaria elimination center in lusaka, zambia, has developed a cost-effective and scalable antimalarial drug resistance assay for p. Falciparum malaria utilizing nanopore sequencing. In 2022, path received funding from the gates foundation to integrate nanopore sequencing into routine malaria surveillance in zambia, expand nanopore sequencing to new geographies through collaboration and capacity building, and optimize existing and develop novel nanopore sequencing assays for malaria molecular surveillance. The vivaction project works to catalyze adoption and eventual scale-up of p. Vivax tools. In ethiopia, path continued studying whether it is operationally feasible to provide optimized radical cure treatment to p. Vivax patients who are eligible based on treatment guidelines. In 2022, path focused on development of the country protocol, including multiple series of working sessions with the armauer hansen research institute, which were essential for alignment across the different workstreams. In india, path continued to provide strategic technical assistance in the state of uttar pradesh, supporting the national vector borne disease control program in dengue-chikungunya control and malaria elimination through capacity building, outbreak investigation, and data management. Path has supported the state in sustaining elimination level of visceral leishmaniasis (vl) transmission in the vl-endemic districts, through effective disease surveillance and vector control measures by the state health system. Path provided technical support for successful implementation of a phased mass drug administration campaign, as well as morbidity management and disability prevention services across all lymphatic filariasis-endemic districts in the state. Path has also supported the state health system in maintaining a case fatality ratio of <10 percent from acute encephalitis syndrome in uttar pradesh. In the state of bihar, path supported successful implementation of the japanese encephalitis vaccination campaign in 14 new endemic districts, followed by introduction in their routine immunization program. The goal of the zambia digital community health project is to develop a unified platform to coordinate health service delivery by community health workers. In 2022, the team continued to develop a digital community health work platform that addresses service delivery and decision support, data quality and management, and a data c”

“Path also coordinated the sample collection for a global donor milk composition study from four countries' human milk banks. 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 specifically the ridge hospital (also known as the greater accra regional hospital), tema general hospital, eastern regional hospital (koforidua), and bono regional hospital (sunyani). As part of this initiative, the ghana health service (ghs) and path are responsible for advocacy, policy, and procurement of lifesaving neonatal equipment to improve advanced neonatal care in all four hospitals. Path procured and installed equipment within the four facilities and supported trainings of hospital staff on the proper use of the neonatal equipment. Additionally, path and ghs successfully developed a comprehensive training manual (with input from kybele, our implementing partner) to orient nurses at antenatal and postnatal care delivery points within the mebci 2.0 facility catchments. The manual was also used to orient facility and district health promotion officers, as well as regional newborn champions, on the importance of raising awareness and providing education on the continuum of care for small and sick newborns, creating demand for high-quality newborn care. In collaboration with the ghs and with funding from the pfizer foundation, path continued implementing 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. As of december 31, 2022, more than 3,000 women have been screened for infections including sexually transmitted infections and urinary tract infections, more than 450 health workers have been trained in screening and management of maternal infections, and more than 59,000 community members were reached through community mobilization, outreach, and sensitization activities or mass media campaigns for demand creation. In laos, path continued serving as a short-term technical assistance partner to john snow inc. (jsi) on a usaid maternal, newborn, and child health project operating from september 2021 to august 2026 across five provinces in the north, central, and south regions of the country. Path's core technical responsibilities focus on newborn and child health, nutrition, and early childhood development. The path southeast asia regional hub provides administrative support, while the mnchn team provides technical leadership, including travel to laos to work with the local jsi team. 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. Where policy or guidelines supporting fortified rice already existed, path continued its work with governments, private sector, world food program, and nongovernmental organizations (ngos) on rollout. As a partner in the demographic and health surveys program, path supported biomarker data collection including both standardized, routine monitoring of key nutrition indicators like stunting and anemia and innovations to expand biomarker measurement in household-based surveys conducted around the world. We also concluded work on a data repository tracking the status to scale up of key mnchn interventions, including several that would improve nutrition. Finally, path concluded the bridge collaborative to address human and planetary health. Early childhood development in 2022, path continued to expand our global an”

“Path also worked to advance self-testing for hepatitis c (hcvst)in india and vietnam with funding from unitaid. 2022 activities included: kicking off procurements of hcvst kits and working with local research partners to submit and advance study protocols through research approval processes in india, coordinating with local distributors and manufacturers to import two hcvst products (one blood-based and one oral fluid) into vietnam, and engaging with stakeholders and community entities to create demand-generation materials for hcvst in vietnam. As a partner on the unitaid-funded adherence support coalition to end tb project, path worked to establish a global market for digital adherence technologies (dats) and completed a market access country stakeholder survey and an analysis of dat platforms. We completed enrollment for dat research in four regions of ukraine, scaled up the use of dats in six additional regions through successful advocacy with the ukrainian government, and initiated a qualitative study of health worker experience with dats. In partnership with the tb alliance, path worked to advance a shorter treatment (bedaquiline, pretomanid, and linezolid, known as bpal) for multidrug-resistant tb, completing roadmaps to introduce bpal in peru and ukraine. In drc, path continued to advance person-centered approaches for hiv and tb prevention, testing, treatment, and monitoring services through the usaid-funded integrated hiv/aids project in haut-katanga. In 2022, path facilitated the introduction of a shorter regimen for tb preventive therapy, enabling more people to successfully complete their regimen. Path also introduced a hub-and-spoke networking model to extend the reach of vertical mother-to-child transmission of hiv prevention by training providers at non-project supported maternity hospitals to offer hiv testing services and referring those testing positive for treatment initiation. The project also continued to optimize the provision of viral load monitoring services, introducing a monthly tracker to closely monitor viral load samples across various stages of the analysis and results return process and more quickly deploy technical assistance to address backlogs delaying results return. Use of this tool decreased the overall turnaround time for viral load results by seven days within seven months. In india, path expanded our footprint in supporting the national aids control program with their hiv response, building on our work to strengthen national- and state-level (mumbai and andra pradesh) strategic information management and data use systems to integrate hiv prevention and testing programming for key populations and migrants in three northeast states of india. This work included introducing innovative models for decentralized prevention and testing services, such as deploying mobile units on motorbikes to offer hiv testing, linking to prevention and treatment services in rural areas, and establishing standalone centers that provide a tailored package of hiv and phc services for young people, people who inject drugs, and trans people. In support of tb programming in india, path introduced artificial intelligence to streamline chest x-ray readings, enabling quicker diagnosis and initiation of 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 2022 in kenya, path continued to provide a comprehensive package of health, social, and economic strengthening services for children, adolescents, and young people through the pepfar-funded nuru ya mtoto project supporting 327 health facilities to deliver: clinical services to prevent vertical transmission of hiv, tb/hiv coinfection services, cervical cancer screening and treatment, and viral load monitoring. Path also implemented the c”

“Noncommunicable diseases path is at the forefront of the fight against noncommunicable diseases (ncds), including diabetes, cardiovascular disease, and mental health in low-resource settings worldwide, where the burden of these diseases is rising disproportionately. In 2022, path continued to serve as the secretariat of the coalition for access to ncd medicines and products. This global, multisectoral collaboration works to increase access to ncd medicines and health products in lmics. In addition to global advocacy, the coalition led the development and implementation of a forecasting program for ncd medicines and products in kenya and uganda and began expansion into ghana. Path implemented ncd projects in ghana, kenya, mali, mozambique, rwanda, senegal, tanzania, uganda, and vietnam that build stronger phc systems, greater access to essential ncd medicines and products, and data-driven decision-making all critical components of health system resiliency. Our efforts in ghana included supply chain strengthening and implementation of the ncd navigator, a first-of-its-kind, locally managed, ncd digital information system for resource planning and allocation in all of ghana's 16 regions. In partnership with the ghana health service, path's healthy heart africa project conducted more than 700,000 blood pressure screenings and linked those diagnosed to treatment. In kenya, path implemented a cutting-edge program that enables community and household screenings for hypertension, remote blood pressure and blood sugar monitoring, telemedicine, community-based drug delivery, and enhanced data management. We transitioned ownership of the ncd navigator to the ministry of health but continued to provide technical assistance. We also began implementing several innovations to strengthen supply chains such as a stock tracker, an electronic medical records module for ncd facility data, and last-mile distribution. Additionally, path implemented an hiv-hypertension integration project in three facilities in western kenya to increase access to care. Our primary health care model in vietnam uses public-private partnerships, digital tools, and community health workers to support screening and linkages to care. In 2022, we disseminated results from a supply chain assessment to determine the availability and affordability of ncd medicines at the phc level and trained health care and supply chain personnel to support supply management. In senegal, tanzania, and rwanda, path implemented the healthy heart africa project focused on hypertension management at the community level. Path also continued to implement and expand the diabetes carepak in kenya, mali, mozambique, tanzania, and uganda an innovative bundling solution of the commodities needed for safe administration of insulin and diabetes self-care. Path has also conducted several research and landscaping assessment projects. We completed an ncd situational analysis and landscaping assessment of challenges and opportunities, specifically focused on hypertension and diabetes. We also initiated a secondary research project on the mental health landscape of 22 countries to outline the research, policies, and practices around mental health in a variety of low, middle, and high-income countries. Finally, path led and contributed to convenings to raise awareness of ncds and orchestrate action to improve access to ncd prevention and care. 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, create tools and resources, and provide services that are co-designed with and for women and girls to address their diverse needs and circumstances, reduce barriers, and expand options. In 2022, path renewed its commitment to family planning (fp) through the fp2030 initiative”

“In addition, we completed data collection for an hpv cost-of-delivery study in six countries with hpv vaccination programs and began data analysis. Finally, we partnered with lmics on the planning, implementation, and ongoing monitoring of national hpv vaccination programs. Path published several articles on the economic impact of respiratory syncytial virus (rsv) and other acute respiratory infections among infants in lmics. Additionally, path updated our rsv vaccine and monoclonal antibody snapshot, which provides an overview of the intervention product landscape, and our clinical 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 2022, we continued developing new therapeutics for cryptosporidium, a deadly diarrhea-causing parasite for which no highly effective treatment is available. With our commercial manufacturing partner quansys biosciences, we continued to implement 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 kenya and malawi. 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.”

“Also, under the mebci 2.0 project, path worked with ghs to develop a training manual for providers at the phc level on the care, effective communication with mothers, and referral protocols for critically ill and small babies to the four project hospitals. Afterward we supported the training of 126 health providers from 24 phc facilities. With approval from global health media, path also translated videos on caring for small and sick newborns into two popular local languages for use in education and awareness raising at the point of care and in communities. Path also worked to strengthen immunization programs in ghana in 2022. With funding support from open philanthropy recommended to path from givewell, we supported the expansion of the rts,s malaria vaccine to 51 new districts in ghana. Path's other areas of focus to support immunization programming included continuing to support the national response to covid-19, supporting the introduction of hpv vaccination into routine immunization programs, expanding the use of geo-enabled digital microplanning, and supporting the launch of national guidelines for introducing immunization service delivery through community pharmacists. With funding support from astrazeneca, path supported ncd programming in ghana through the healthy heart africa program. In 2022, path helped improve the quality of hypertension service delivery in ashanti and bono east regions by supporting 11 districts and 50 health facilities with over 300 blood pressure devices and training over 200 health workers on hypertension prevention and management. We also supported the integration of hypertension care across multiple points of care within facilities including child welfare clinics, family planning units, wellness clinics, and national immunization days to improve access to hypertension care and reduce missed opportunities for screening. Path also conducted targeted community advocacy campaigns and screenings for priority groups. As part of these efforts, we supported the development of the hypertension champions program, which leveraged influential community members as agents for hypertension awareness, prevention, and control. Path worked with the ghs ncd program to introduce and scale the use of the ncd navigator tool to all 16 regions of the country. Path also supported the multistakeholder high-level ncd roundtable forum held in ghana in april 2022 and delivered a presentation on financing ncds on behalf of ghana's ncd steering committee. Path worked to strengthen supply chain leadership and governance with funding from the access accelerated partnership. We introduced a forecasting tool and trained key health providers around procurement, medicines and supplies, health information and data management, and forecasting for clinicians. Path also conducted a baseline study on insulin integration into ghana's cold chain system and supported an ongoing pilot of this intervention at the ga-west municipality in the greater accra region. Kenya the tools for integrated management of childhood illness (timci) project is a four-year project (july 2019-march 2024) funded by unitaid. The primary goals are to improve phc workers' ability to diagnose severe disease by equipping them with pulse oximetry (pox) and clinical decision support algorithms (cdsa) and to accelerate the development of noninvasive devices that augment the features of standard pulse oximeters with one or more additional vital sign measurements. The timci project implementation phase was rolled out in 2022 in three counties: kakamega, kitui, and uasin gishu. Sixty health facilities collected routine pox and cdsa case data on sick children, while the university of nairobi conducted research on pox and cdsa feasibility and cost-effectiveness in 19 phc facilities. Once the data analysis is completed, path aims to use the results to inform county leadership engagement for prioritization and budgeting for pox, health care provider training and scale-up o”

“With financial support from the gates foundation, path's living labs project partnered with health care workers using a human-centered design approach to co-create solutions for improving health worker motivation and increasing vaccine coverage. Path living labs also collaborated with adolescent girls and young women and prep service providers in homa bay county to jointly develop five solutions aimed at enhancing agyw adherence to prep. Path living labs has, through user engagement, established the significance of the mother-child health booklet in promoting nurturing care for early childhood development (ncfecd). In 2022, we continued to focus on the development of training guides and operating procedures aimed at empowering health care workers and community health volunteers to effectively integrate ncfecd at facility and community levels and ensure high-quality implementation. Our living labs and m-rite teams collaborated to review and evaluate the m-rite crista framework, which focuses on assessing the transferability of covid-19 digital systems to routine immunization. This framework provides a systematic process for collecting evidence and generating recommendations to support the transfer of digital systems from covid-19 to routine immunization programs. To assess the tool, the living labs team conducted expert interviews and desk reviews and provided valuable feedback on the usability and effectiveness of the tool, aiming to enhance its overall functionality. In collaboration with the national vaccines and immunization program (nvip) team, we undertook the task of redesigning hpv materials with consideration of the feedback received from 16 counties with low performance in hpv vaccination. The goal was to improve the effectiveness and relevance of the materials, ensuring they address the specific challenges faced by these counties. By incorporating the valuable insights gathered from a workshop with representatives from low-performing counties, we aimed to create redesigned hpv materials that are better suited to meet the needs and overcome the barriers encountered in promoting hpv vaccination. Path living labs, in collaboration with the digital square team, was involved in enhancing the moh's chanjo ke portal for covid-19 vaccination services. As part of this initiative, we conducted an assessment of chanjo ke utilization in kajiado and nakuru counties. The assessment yielded valuable insights that will guide the enhancement process. Additionally, we facilitated a workshop involving key stakeholders such as the nvip, moh digital health teams, county health management teams (chmt), and health care workers. This collaborative workshop was hosted to review the utilization findings, define what needs to be enhanced, and co-create and refine system features for enhancement. Living labs also partnered with other path teams to design a newborn nutrition digital adaption kit (nndak) that provides data-informed guidance to optimize critical feeding according to clinical care guidelines. The nndak has the potential to reduce hospital stays, improve newborn nutrition, and reduce morbidity and mortality associated with lack of optimal nutrition early in life. Malawi in 2022, path worked closely with the health education services (hes) in the ministry of health to develop the communication strategy; messages; and information, education, and communication materials for the introduction of the rts,s malaria vaccine in malawi. As part of the advocacy, communication and social mobilization subcommittee, path also worked with hes and other partners in getting the messages to communities through posters, leaflets, flyers, community meetings, and volunteers. With funding from open philanthropy, path supported the expansion of rts,s from the initial 147 pilot facilities to 281 health facilities. We also worked with partners in developing and distributing messages and materials for the introduction of the typhoid conjugate vaccine. Throug”

“Path continued supporting the senegalese government in conducting two biomedical equipment inventories in health facilities and covid-19 treatment centers to collect data on existing medical equipment, including oxygen devices, and identify gaps in oxygen access and utilization. Path donated through the access to covid-19 tools accelerator initiative oxygen devices worth $1 million to support the moh in covid-19 response. We also supported the assessment of the online maintenance management system to identify challenges that may deter future scale-up of access and utilization of oxygen devices and developed a value-based procurement guide to support the procurement of medical equipment. Path also contributed to the development of a manual of standard operating procedures to support procurement and management of ntd drugs to rationalize resources during mass drug administration in senegal. Path, through its macepa program, continued supporting senegal's national malaria control program (nmcp) during 2022 in the implementation of malaria surveillance and elimination activities in eligible areas. The macepa team supported senegal's health care system in the timely detection, documentation, and treatment of malaria cases. Path also supported data quality audits and supervisions of the dhis2 tracker to improve data quality and strengthen the capacity of proividers to use of the tool to capture malaria case investigation data. In 2022 under the macepa iv project, path's senegal staff also provided technical and financial support to nmcp for the introduction of case-based malaria surveillance in the north bank regions of the gambia. Key accomplishments include the development and validation of case-based malaria surveillance guidelines, standard operating procedures, and data collection tools. Eighty-two health care workers were trained on case-based malaria surveillance and 31 health care workers on the dhis2 tracker. Field testing of the dhis2 tracker was conducted to ascertain the effective functioning of the app. As part of cross-border collaboration between senegal and the gambia, path supported a joint workshop where a common data visualization platform was set up for the synchronized mass long-lasting insecticidal nets (llin) campaign conducted in 2022 for the two countries. In partnership with resolve to save lives, path supported establishment of the public health emergency operation centre (pheoc) through the development of the legal framework; supported provision of information and communication technology equipment to support watch, alert, and response functions; and subsequently supported the response to acute kidney injury outbreak (juloct 2022). We facilitated monthly collaboration calls between senegal and the gambia pheoc for cross-border learning and published monthly expanded programme on immunization (epi) bulletins using the dhis2 dashboard. Following successful introduction of the hpv vaccine in the gambia, path signed a service agreement with gavi for the vaccine visibility system and ongoing hpv vaccine technical assistance and implementation (to begin in 2023). The digital square team carried out various activities as part of the global vax initiative in senegal. These included the development and validation of the work plan and budget, as well as participation in coordination bodies for covid-19 control and routine immunization. The main objective was to support the availability of quality data for better immunization management. Digital square participated in coordination meetings with usaid partners and the kaffrine medical region to discuss the results-based financing initiative. In addition, a virtual meeting was held with usaid implementing partners, the permanent secretariat of one health senegal, and governors to officially launch covid-19 immunization scale-up activities at the regional level. A key focus of this work was the retrospective entry of covid-19 vaccination data into the national dhis2 pl”

“To facilitate rapid and secure data transmission, digital square provided 180 internet connectivity kits (known as flyboxes) with 6-month internet packages to the moh to support the national immunization center and health districts in six medical regions (bamako, kayes, sikasso, koulikoro, sgou, and mopti) responsible for covid-19 vaccination data collection. Digital square also helped update dhis2 forms, ensuring their relevance and alignment with the specific needs of covid-19 immunization data collection. The team developed a user guide for the covax dhis2 package, as well as a specific guide for data analysis. These guides provide detailed instructions on how to use the covax dhis2 and interpret vaccination data. South africa in 2022 path established a technical assistance partnership with the private office of the president (pop) in south africa, which grew from our support to the president in his leadership role with the african union (au) covid-19 commission. We advised the president on global and regional policy processes aimed at increasing access to health technologies, especially sustainable manufacturing. For example, we drafted a concept note for positioning south africa as host for a regional centre of regulatory excellence (rcore), a partnership between the pop and the south african health products regulatory authority (sahpra). We also advocated through the au covid-19 commission, targeting multilateral procurement agencies such as gavi and unicef to purchase at least 30 percent of vaccines from african manufacturers. Additionally, along the sidelines of the world health summit, path co-convened a session in partnership with the pop that brought together high-profile delegates, including the south africa deputy minister of health, representatives from gavi, and the president of the south african medical research council (samrc) to deliberate on matters affecting sustainable manufacturing such as pooled procurement of african-manufactured medical products, offset guarantees, and mechanisms for effective technology transfer. Stemming from path's relationship with the pop in south africa as well as path's memorandum of understanding with the africa cdc, path drafted a proposal for the harmonised entity of african leaders in technologies for health (health), which will be housed by the africa cdc and the au covid-19 commission with a mandate to ensure coordinated efforts on sustainable pharmaceutical manufacturing in africa and reduce importation of biotechnology and health technology. As part of our priority to advance manufacturing policies and increase demand for local products, path secured a seat on the south africa health products master plan working group. This group enables path to directly influence and provide support to south africa's plans, therefore supporting skills transfer and strengthening the research and development (r&d) policy environment. We also participated in the samrc sub-saharan africa funders forum where we disseminated research and reflections from path's diagnostics and center for vaccines innovation and access teams to inform this group's priorities. We continued to advocate on the african medicines agency (ama) ratification. In south africa, we saw the cabinet approve the ama treaty and initiate the process of submitting documents to parliament for ratification. To achieve this milestone, path provided technical assistance to the south african national department of health's directorate of international health, including preparing technical briefs and talking points. Path has worked over the past several years with sahpra to improve its regulatory capacity and to improve transparency and communications. To sustain vibrant r&d advocacy at country and regional level, path continued to provide technical assistance and capacity strengthening to a local coalition, the south africa health technologies advocacy coalition. Tanzania in 2022, the data use partnership project an initiative led”

“The uganda self-injection (si) scale-up project made significant progress in collaboration with the moh and partners to scale up self-injection nationwide, with self-injection available in 85 percent of public-sector facilities. Path addressed gaps in si scale-up training, supervision, and monitoring, and distributed tools and guidelines in 20 districts that lacked partner support. Path also supported integration of dmpa-sc and si into the national pre-service training curriculum in uganda and oriented 197 instructors on the content, who then trained over 3,000 health workers. In partnership with insupply kenya, path conducted a dmpa-sc supply chain analysis as part of the regional technical assistance mechanism. This led to the development of an action plan to address key gaps and recommendations with the moh and partners, which are part of the updated 20222024 national dmpa-sc self-injection scale-up plan. Path actively participated in the development and piloting of the self-care guidelines using self-injection as a springboard to other self-care interventions. Through the advocacy and public policy program, path supported the moh, alongside who and unicef, to draft and cost the national immunization strategy (nis) 2022-2026. In 2022, path facilitated reestablishment of the uganda parliamentary forum on immunization (upfi) and supported development of a five-year strategic plan including a set of key performance indicators to guide their work. Path also trained and mentored 25 local immunization partners and facilitated opportunities for them to input into key policy processes, such as the nis. Additionally, we successfully led the advocacy efforts for the government to fulfill its co-financing obligations to gavi. Path supported the countrywide rollout of cold chain information system (ccis), an odk-x based tool, to digitize the cold chain equipment (cce) inventory and generate actionable data for the maintenance, management, and repair of cce assets. Path also successfully trained over 150 district cold chain technicians from 136 districts and 25 national-level technicians/super users, equipped them with mobile devices with the app installed, and facilitated them to conduct cce inventory updates. Through the covid-19 delivery support project, path seconded two technical officers to the moh immunization program to fill the human resources capacity gap due to the covid-19 pandemic. As part of the hilton-funded aqua stream project, path conducted joint monitoring visits with the moh to observe the functionality of the aqua stream onsite chlorine devices and the benefits that the devices offered to the ten pilot health facilities. Numerous strong user testimonies on how the aqua stream has contributed to infection prevention and control at the ten pilot health facilities were obtained. With recommendation from the health policy advisory committee after a presentation of aqua stream pilot project results, path conducted a joint evaluation visit with the national advisory committee on medical equipment to health facilities where the aqua stream was deployed and determined that the aqua stream chlorine was found to be non-corrosive to medical instruments and furniture. In november 2022, path worked with the moh's clinical service department on the deployment of two aqua stream disinfectant generators to support the national ebola virus disease response efforts. Zambia in 2022, path continued to collaborate with zambia's moh. To accelerate zambia's journey to elimination, path's malaria control and elimination partnership in africa supported the moh, through the national malaria elimination programme, to launch malaria case investigation (mci) as part of its ongoing efforts to end local transmission of malaria. Mci builds on a central plank of the country's national strategy: training community health workers (chws) to test, treat, and track malaria in their home communities. Path and the moh continued training health facility st”

“Funded by the bayer foundation, the support for covid-19 vaccine preparedness, rollout, and surveillance project in zambia initiated the engagement of traditional leadership with support from the special advisor to the president. Path oriented 57 headmen (indunas) and 5 chiefs to the project. Path also helped develop a wastewater surveillance protocol (approved by relevant research authorities), procured a novel testing method, and trained key personnel on environmental surveillance for sars-cov-2 and other pathogens sampling. In 2022, qualitative insights from living labs were amplified with quantitative analysis and data visualization to describe 26 root causes of demotivation among frontline immunization providers and analyze commonalities in hcd-derived theories of change. Path created the insights explorer tool, an interactive dashboard to facilitate the exploration of these root causes, and published it online with public access. This web-based interactive communication platform documents living labs' hcd processes and outputs in kenya and zambia in a format that facilitates exploration and understanding of key project qualitative insights. The goal is to advance previous efforts in hcd global health projects by increasing transparency of the continuum of contextual challenge through to the process of generating prototypes with end users. Path's living labs supported the development of the reli delivery system, a low-cost, hybrid pneumatic-electric infusion pump designed to address challenges found in resource-constrained health systems. It is a low-cost, reliable, sturdy, and easy-to-use alternative to conventional electric infusion pumps. The living labs team supported the design of the reli's electronic subsystems and conducted a user assessment in zambia to understand the context of use and user perceptions of the reli, which is essential to achieve optimal design of the system. The assessment aimed to: (1) provide prospective users with an opportunity to conduct a simulation of an infusion using a prototype of the reli delivery system and to assess user experiences of the usability of the various components of the device. (2) gather user input on the acceptability and ease of use of the reli delivery system including setting up the system, activating the system, and completing a simulation using the reli delivery system. Path and find partnered to improve data collection and mitigate current pain points associated with covid-19 diagnostic testing in low- and middle-income settings. The teams worked to develop standards and enhance the interoperability of patient and diagnostic data collection platforms while incorporating them into mobile health tools. Living labs in zambia and senegal engaged end users to identify and validate needs and priorities and worked with application developers to iteratively test and refine the digital health solution, using operational research at community health facilities.”