Nancy Ferguson / Partners In Health Commissioners and participants of the opening meeting of the Lancet Commission on Reframing NCDs and Injuries for the Poorest Billion, in the lobby of the Wellcome Trust.
Nancy Ferguson / Partners In Health Commissioner Agnes Binagwaho joins the meeting via video conferencing.
It was attended by 21 of the 23 commissioners, with commissioner Agnes Binagwaho joining via video conferencing, and included days at the Wellcome Trust and The Lancet offices.
At the opening dinner, commissioners revisited the history behind Lancet Commissions, and The Lancet editor-in-chief Richard Horton set the stage by emphasizing the opportunity before the Commission to reinvigorate the NCD movement through this work. The commissioners also had a chance to to hear from co-chair Ana Mocumbi and commissioner Yogesh Jain on their experiences and the urgent need for a strong NCD and injury response in Mozambique and rural India, respectively.
Nancy Ferguson / Partners In Health Commissioner Margaret Kruk speaks to the group on the first day of meetings.
Day 1 introduced the objectives of the Commission, and the core analytical constructs upon which the work was to be situated. Gisela Robles of the Oxford Poverty and Human Development Initiative discussed technical issues in poverty measurement and presented new analysis performed for the Commission on the characteristics and geography of the “poorest billion.” The commissioners also heard from Robert Beaglehole on the history of the Lancet NCD Action Group and complementarity with existing efforts within the NCD community. There was spirited discussion around these constructs, with commissioners weighing in on core objectives, communication strategies, key definitions, and proposed country partnerships.
Nancy Ferguson / Partners In Health Discussions on the working groups dominated the second day of the meeting, hosted by The Lancet.
On day 2, the commissioners spent the majority of the day discussing the objectives, work plans, and timelines for the four working groups:
WG 1: Poverty and Disease Burden
WG 2: Integrated Delivery, Multisectoral Action, and Priority Setting
WG 3: Financing and Commodities
WG 4: History, Advocacy, and Governance
Lancet editor-in-chief Richard Horton and co-chairs Gene Bukhman and Ana Mocumbi provided final comments and next steps on Friday. The commissioners will meet again in the summer of 2016. To learn more, visit www.ncdipoverty.org or follow @NCDIpoverty on twitter.
Maia Olsen / Partners In Health Dr. Nancy Charles Larco from Fondation Haïtienne de Diabète et de Maladies Cardo-Vasculaires (FHADIMAC) presents their efforts to ensure access to diabetes care to patients in Haiti after the 2010 earthquake at the World Diabetes Congress 2015 in Vancouver on Dec 2.
From November 30th to December 4th, experts from over 200 countries gathered in Vancouver, Canada to celebrate scientific advances in global diabetes control at the 2015 World Diabetes Congress. Despite impressive progress, many of the world’s poorest patients, including many children and young adults with type 1 diabetes, do not have access to the life-saving care they need.
Partners In Health Dr. Hermione Risselin Louis, pediatrician with PIH Haiti / Zanmi Lasante, and NCD Synergies team member Maia Olsen at the IDF conference in Vancouver in December, 2015.
“Many children with diabetes arrive at our hospital in Mirebalais in serious condition – it’s a problem we must address in Haiti.
Life is too precious. It is necessary to recognize the symptoms and diagnose diabetes early so we can prevent diabetic coma and death.
Training and support of health workers, addressing stigma in the community, and education for families are also critical to improve treatment and control of diabetes.”
Dr. Hermione Risselin Louis, pediatrician with PIH Haiti / Zanmi Lasante
With leadership from clinicians in Haiti and Rwanda, PIH is working to change the unjust realities that our diabetes patients face. With support from The Leona M. and Harry B. Helmsley Charitable Trust, PIH is collaborating with Ministries of Health in these countries to integrate pediatric diabetes care within NCD programs at public health facilities in the regions where we work, in addition to supporting technical assistance and operational research in diabetes and NCDs at the national level.
In 2015, the NCD teams in Haiti and Rwanda made some great strides in this work, including:
Developing protocols and providing advanced diabetes and NCD training to over 180 doctors, nurses, and social workers across Haiti and Rwanda.
Providing care to children and young adults diagnosed with type 1 diabetes, including food and transportation support to over 58 families in Rwanda to help mitigate challenges that povertyposes to young patients facing chronic disease.
Improving medical supply chain systems to continue to ensure access to necessary diabetes and NCD medicines in the facilities we support.
Increasing case detection for diabetes by improving diabetes screening protocols and standard-of-care diagnostics at our facilities in Haiti and Rwanda.
In Rwanda, the PIH team is also partnering with the Rwanda Diabetes Association on supporting type 1 patients and providing necessary medical equipment. In Haiti, the PIH team is collaborating with the Fondation Haïtienne de Diabète et de Maladies Cardo-Vasculaires (FHADIMAC) on health worker training.
“Patient education is essential for diabetes management. As a Haitian physician, I’ve experienced how economic and social barriers such as poverty and illiteracy can become major obstacles to providing the best care possible to our patients living with chronic diseases.”
Dr. Waking Jean-Baptiste, NCD physician at PIH Haiti / Zanmi Lasante
In addition to PIH’s efforts focused on care delivery and public sector accompaniment in Haiti and Rwanda, the Helmsley Charitable Trust has extended their commitment to expanding access to quality diabetes care through other global partnerships such as a research study called “Addressing the Challenge and Constraints of Insulin Sources and Supply” (ACCISS), led by Health Action International, Boston University, and the University of Geneva. For more information about these related initiatives, read the April 2015 Lancet Commentary.
“Ensuring access to insulin would be a turning point in the fight against NCDs in Haiti. When there is poor access to insulin and routine secondary care, it can be very difficult for patients to manage their disease and prevent life-threatening complications.”
Dr. Waking Jean-Baptiste, NCD physician at PIH Haiti / Zanmi Lasante
A commitment to addressing inequities in access to necessary medical care is imperative for the world’s most vulnerable diabetes patients. In Vancouver, we are honored to stand alongside our inspiring colleagues committed to addressing diabetes and poverty in Haiti, Rwanda, and low-income countries worldwide.
Dr. Paul Farmer discusses the Partners In Health commitment to support the Lancet Commission on Reframing NCDs and Injuries for the Poorest Billion announced at the Clinton Global Initiative.
Through NCD Synergies, Partners In Health has worked to highlight the way NCDs and injuries (NCDIs) impact the world’s poorest people, building partnerships with governments, implementing organizations, and academic researchers. Now the program will support a new Lancet Commission co-chaired by Dr. Gene Bukhman and Dr. Ana Olga Mocumbi.
The Commission will work with a group of ten low-income countries, to be announced in January 2016, to investigate policies and integrated delivery platforms which would bring their NCDI outcomes in line with higher-performing, middle-income countries.
NCD Synergies will provide the Commission with an existing network of public-sector NCD Divisions and technical advisors, and will collaborate in developing investment cases on an individual country basis. The partnership will aim to assist countries in all aspects of implementation readiness, including absorption of human and financial resources.
To learn more, visit the Commission website at www.NCDIpoverty.org or read the commentary – Reframing NCDs and injuries for the poorest billion: a Lancet Commission (direct link; PDF, 615 kb) – published Sept. 21 in The Lancet.
NCDs are real.
NCDs are in Africa.
NCDs are in Kenya.
– Dr. Joyce Nato, WHO, opening remarks at 29 May meeting Choosing Targets to Address the Burden of NCDs and Injuries in Kenya: Incorporating an Equity Perspective
Maia Olsen / Partners In Health Dr. Joseph Kibachio presents on the burden of NCDs and injuries in Kenya from an equity perspective at the May 29 meeting in Nairobi.
On May 29, 2015, the Kenya Ministry of Health and NCD Synergies gathered nearly 50 stakeholders for a meeting on improved target setting and metrics for NCDs and injuries in Kenya. Led by Dr. Joseph Kibachio (NCD division, Kenya MOH), the meeting featured presentations and panels from diverse perspectives over three distinct sessions.
Session 1, “The Kenyan Context,” was facilitated by Zachary Ngewa of the NCD Division and included:
Nancy Ferguson / Partners In Health The panelists from Session 1, “The Kenyan Context,” answer questions from attendees at the May 29 meeting in Nairobi.
Kenya Burden of Disease Review (audio, 34:25), Dr. Joseph Kibachio (Division of NCDs, MoH)
Data Sources – HMIS structure and function, capacity assessment and service readiness, Vital Registration (PDF, 349 kb; Slides/audio, 28:51), Dr. Martha Muthami (Division of Health Management and Informatics, MoH)
Disaggregated Burden of Disease analysis from the Kisumu DHS Site (PDF, 1.1 MB; Slides/audio, 15:03), Dr. Frank Odhiambo (CDC/KEMRI)
Panel Discussion (audio, 58:11), Dr. Tom Achoki (IHME, Director of African Initiative), Dr. Albert Karagu Maina (DNCD, MoH), Gregory Kabadi (NCD synergies / MoH Tanzania), Dr. Elizabeth Ogaja (Minister of Health, Kisumu County Government)
Maia Olsen / Partners In Health Attendees of the May 29 meeting chat over lunch between sessions at the Fairview Hotel in Nairobi.
Session 2, “East African perspectives on target setting for NCDs and Injuries” was facilitated by Dr. Gladwell Gathecha of the NCD Division, and included:
Rwanda’s experience with target setting (80x40x20) (PDF, 197 kb; Slides/audio, 11:03), Paolo Reggio d’Aci (PIH/NCD Synergies, Rwanda)
Targets and indicators for acute care in the context of monitoring UHC for NCDs and injuries (PDF, 1.4 MB; Slides/audio, 12:42), Dr. Benjamin Wajira (AKUH/AFEM)
Panel Discussion and Plenary (audio, 53:02), led by Dr. Martien Burgdorff (CDC Western Kenya) and Dr. Gene Bukhman (NCD Synergies/PIH and Harvard Medical School), with participation from the full group of attendees.
Session 3 was five parallel working groups focused on the process for NCD and injury target setting in Kenya.
Following an engaged and enthusiastic meeting, the attendees agreed to form a smaller working group to look more closely at specific targets and metrics over the next several months and report back to the full group. The meeting report (Meeting Report and Outcome, 121 kb) illustrates the deep commitment of the Kenyan NCD community to finding a pathway to better metrics and data that will enable them to reach the poorest Kenyans faced with NCDs and injuries. The first meeting of the working group is in mid-July 2015.
Nancy Ferguson / Partners In Health Dr. Gene Bukhman, shown at right, and the NCD Synergies team join other members of the WHO Global Coordination Mechanism on the Prevention and Control of NCDs in the opening session of the Dialogue on NCDs and development cooperation, 20-21 April 2015 in Geneva, Switzerland.
On April 20-21, 2015, the NCD Synergies team attended the WHO Dialogue on NCDs and Development Cooperation, which was an opportunity to bring the international community together around noncommunicable diseases, poverty, and development. The meeting in Geneva was hosted by the WHO Global Coordination Mechanism on NCDs, and included representatives from Permanent Missions to the United Nations, eight different United Nations organizations, as well as civil society attendees from academic institutions, NGOs, and philanthropic institutions.
Photo credit: WHO Attendees of the WHO Dialogue on NCDs and development cooperation, 20-21 April 2015, including the NCD Synergies team and partners from ministries of health in Rwanda, Kenya, Malawi, and Tanzania.
NCD Synergies director Dr. Gene Bukhman, who sits on the WHO GCM working group on financing for NCDs, opened a panel discussion on the first day of the meeting on “NCDs, Injuries, and Extreme Poverty” that also featured keynote speakers Dr. Marie Aimee Muhimpundu of Rwanda and Dr. Beatrice Mwagomba of Malawi. Dr. Bukhman’s presentation (Bukhman. Session 3. Presentation, PDF, 950 kb) was a strong call to the WHO and attendees to include the needs of the very poor in global NCD financing strategies. The presentations from Rwanda and Malawi made clear that much of the NCD burden among the poor is falling on children and younger adults. Little of this burden was explained by so-called lifestyle risk factors, and a treatment action agenda appropriate for these populations is an urgent need.
Maia Olsen / Partners In Health Dr. Gene Bukhman, Dr. Beatrice Mwagomba, and Dr. Marie Aimee Muhimpundu give their keynote presentations in Session 3 of the WHO GCM Dialogue on NCDs and development cooperation on April 20, 2015.
NCD Synergies partner country representatives Dr. Joseph Kibachio of Kenya and Dr. William Kafura of Tanzania also gave keynote presentations as part of other sessions during the dialogue. In addition to the WHO discussions, the NCD Synergies team held several side meetings featuring the voices of our colleagues and partners in Rwanda, Kenya, Malawi, and Tanzania.
For more information or to read the conference report, visit the WHO GCM website.
In December 2014, the Leona M. and Harry B. Helmsley Charitable Trust announced a $3 million gift to Partners In Health, linking support for integrated care for pediatric diabetes with a global analysis of implementation gaps for the poorest billion. In a press release dated Dec. 18th, 2014, Partners In Health and the Helmsley Charitable Trust said the funding will “create sustainable, accessible approaches to type 1 diabetes (T1D) care that can be integrated within the noncommunicable diseases in Haiti and Rwanda, where widespread poverty and limited access to health care hinder chronic disease management.”
Through the grant, Partners In Health seeks to:
Strengthen training for pediatric diabetes care
Improve follow-up care for diabetes and other NCDs at the health center and community health worker level
Improve case detection through screening and community engagement programs
Define a scalable model of training and delivery of care
Engage Ministries of Health to share lessons learned
NCD Synergies is taking a central role in knowledge sharing throughout the course of the grant. The NCD Synergies project will host an international conference focused on diabetes care in the poorest billion in 2017, support the development of a chronic care toolkit, and engage Ministries of Health to share lessons learned throughout the grant. NCD Synergies will also conduct research on diabetes financing and programs in low-income countries, investigating the role that integrated NCD platforms play in supporting care delivery for pediatric diabetes.
NCD Synergies is thrilled to introduce Paolo Reggio D’Aci and Dr. Jutta Jorgensen, who have joined the NCD Synergies project team as Senior Management Consultants to be seconded to the Rwanda Ministry of Health and Kenya Ministry of Health and Social Welfare, respectively.
Paolo D’Aci
Juttta Jorgensen
Paolo has supported the Ministry of Health in Rwanda in planning, costing, and budget negotiation related to national strategic planning in the health sector, HIV, TB, and NCDs. His current work extends the relationship with MOH Rwanda, focusing on national planning for NCDs and injuries.
Jutta has expertise and experience in clinical medicine, epidemiological research and health sector strategic planning within an African environment that will inform her support for the NCD unit in the MOHSW of Kenya.
