PSI Impact Issue 19 by PSI Population Services International

No. 19

Cutting edge global health coverage from

7 Questions for the US Global Development Labâ&#x20AC;&#x2122;s Ann Mei Chang | 6

The Tool Kit: Read Primers on Human-Centered Design, mHealth Solutions, Working with the Private Sector and more... | 20

The Results Are In: Find out what youâ&#x20AC;&#x2122;ll need to be a

21ST CENTURY

Development Professional

Find your place on the Global Innovation Exchange.

Help an innovator

Provide feedback on innovations

Test an innovation

Find an expert and/or mentor

Join a conversation

Share your research and/or resources

Join a community

Find funding

The next Evolution of Development is upon us.... Request Beta access to: The Global Innovation Exchange Sneak Peak for PSI readers only.... To get pre-launch access, email: info@globalinnovationexchange.com Subject line: "sneak peak"

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EDITOR'S NOTE

The Future is Now

THE MAGAZINE OF PSI

EDITOR-IN-CHIEF Marshall Stowell Vice President, External Relations and Communications mstowell@psi.org

MANAGING EDITOR Karen Sommer Shalett Senior Manager, External Relations and Communications kshalett@psi.org CONTRIBUTORS Minal Bopoaiah Aaron Britt Devex Sophie Greenbaum Karl Hofmann Shazina Masud Regina Moore Tarek Rabah Caroline Roan Merrick Schaefer US Global Development Lab at USAID Jonathan Wong Kate Warren PSI is a global nonprofit organization dedicated to improving the health of people in the developing world by focusing on serious challenges like a lack of family planning, HIV and AIDS, barriers to maternal health and the greatest threats to children under five, including malaria, diarrhea, pneumonia and malnutrition. psi.org

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IN LESS THAN A DECADE, we’ve seen countless industries turned on their heads — many of us don’t buy CDs anymore, we download music, watch shows on Netflix, stay in an Airbnb or call an Uber instead of a taxi. Political campaigns are launched on Facebook and Twitter. Less covered in the mainstream press, but equally exciting, is a range of innovations in global health that has accelerated progress on meeting the Millennium Development Goals, cut child mortality in half and put us within reach of an AIDS-free generation. The funding landscape is changing as well. Government donors are reducing their global footprint and focusing shrinking resources in countries with the most pressing health needs. In countries where government donors have exited, social enterprises are replacing donor-funded projects and creative development models like franchised health centers and new for-profit condom brands are expanding. Corporations are moving away from a model of corporate social responsibility where they hoped to amass social capital by "doing the right thing" toward a model of shared value where their social and business objectives meet and fortify each other equally. Philanthropists are seeking measurable results and a much deeper level of engagement where they can share their time, talents and financial resources in the prime of their lives, not at the end. The business of eliminating extreme poverty in our lifetime is changing, and so must its workforce. We partnered with the US Global Development Lab at USAID and Devex in an extensive survey of development professionals on a range of issues from funding sources to hard and soft skills. Some of the results follow trend, but others surprised us. Also in this issue, we speak with DFID about their innovation hub and UNITAID discusses the importance of accelerating the introduction of new health solutions. Design thinker and social entrepreneur Pam Scott breaks the mold of yesterday’s philanthropist and talks about her work to reduce unintended teen pregnancy in Tanzania through human-centered design. When we began to put this issue together, we choked a bit on the word innovation. It’s so overused, it’s been nearly rendered meaningless. But, as the Director of the Global Development Lab Ann Mei Chang says in our Q&A on page 5, innovation for innovation’s sake is hardly the point – it’s about creating something new that actually delivers real value. The world is watching as Nepal begins to rebuild amid aftershocks from the earthquake on April 25, 2015. (As I am writing this — two months after the initial quake — Kathmandu suffered three more shocks this morning). Innovation in the delivery of health products and services is critical. We, at PSI, along with many of our partners and peer organizations, are stepping in to make sure that much-needed health solutions are in place. We'd love to hear from you as to what new approaches, Marshall Stowell tools and interventions are most vital in your work. As Editor-in-Chief, always, we welcome your comments and thoughts. n Impact

youtube.com/HealthyBehaviors

psi.org | impact

PSI NETWORK

CONTENTS

T HE GUIDE FIELD

CAN A BAJAJI CHANGE A TEEN GIRL'S LIFE?

4 Support Continues for Nepal By Shazina Masud, PSI Nepal 2014 HAS BEEN PSI’S MOST IMPACTFUL YEAR YET AROUND PSI

12 LEADING VOICES

6 Seven Questions for Ann Mei Chang, US Global Development Lab at USAID

What is a DALY? 5 or a year of It’s a disability adjusted life year, Most Impactful 8 healthy life lost to illnessOur or death. When PSI averts one DALY, it means that Year we prevent the loss Yet, Getting to of one DFID's Innovation Hub year of productive, healthy life.Toilets and PSI's 10,000 Wants You New HIV Director By Jonathan Wong, DFID By Regina Moore, PSI Sophie Greenbaum, PSI Over the course of 2014, PSI and its network members averted an estimated 53,695,019 DALYs globally. 53,695,019 No. 19

Cutting edge global health coverage from

7 Questions for the US Global Development Lab’s Ann Mei Chang | 6

The Tool Kit: Read Primers on Human-Centered Design, mHealth Solutions, Working with the Private Sector and more... | 20

The Results Are In: Find out what you’ll need to be a

21ST CENTURY

Development Professional

COVER CREDIT: SOPHIE GREENBAUM

impact | No. 19

What Will the Global Professional of Future Look Like? By Kate Warren, Devex

Bringing Innovation to the Front-Line of Global Health With Lelio Marmora, UNITAID

Disrupting Global Health Get inspired by five cutting-edge programs. By Minal Bopaiah, PSI

TH E MAGAZ I N E OF PSI | NO. 19 | 2015

More Online “ZEROING IN ON EBOLA”

TOOL KIT

LAST WORD

Expanding the Bottom Line: Realistic Sustainability By Tarek Rabah, AstraZeneca

Who Will Finance the Modern Development Enterprise? By Karl Hofmann, PSI President and CEO

Beyond the pages of Impact magazine, PSI features news, video, audio and other new content every day. Subscribe to The Five to get five mustn'tmiss articles delivered to your inbox every Thursday at psiimpact.com.

22 Can a Bajaji Change a Teen Girl's Life? By Aaron Britt, IDEO.org

26 Zeroing in on Ebola By Merrick Schaefer, USAID

30 Getting Out of the Box By Caroline Roan, Pfizer

GETTING OUT OF THE BOX As Caroline Roan details on page 30, Pfizer empowers its employees to go into the field for a variety of learning exchanges. See how Pfizer Global Health Fellows are helping to transform the business practices of PSI's social franchises, in Tanzania and around the world in this video at psiimpact.com.

NEPAL TRIBUTE

WEEKS AFTER THE INITIAL 7.9 MAGNITUDE earthquake and powerful 7.3 and 6.3 aftershocks devastated Nepal, the situation is improving, but the Nepalese still face a long journey toward recovery and rebuilding. As the monsoon season begins, heavy rains are triggering landslides in many of the earthquakeaffected districts, exacerbating an already complex situation on the ground and threatening what fragile progress has been made. Our hearts and minds are with the entire nation, including our fellow 150 PSI staff members and their families. To meet the continuing need for safe drinking water and help protect vulnerable households from water borne illnesses, PSI Nepal is distributing Procter and Gamble's Purifier of Water sachets in several of the most affected districts in Nepal through our community workers. In addition, we are facilitating trainings for other organizations who are distributing the product. We are also supporting providers in both the public and private health sectors by supplying trainings, materials and mentoring on the provision of emergency Integrated Management of Neonatal and Childhood Illness. Through our existing network of private providers, we continue to provide essential reproductive health and family planning services as well. If you would like to support PSI and our long-term efforts on the ground in Nepal, please go to psi.org/ donate-Nepal. â&#x20AC;&#x201D; Shazina Masud Country Representative, Nepal

ÂŠ ASSOCIATED PRESS

Support Continues for Nepal

year of productive, healthy life. AROUND PSI

FORMER HIV ADVISER FOR OGAC JOINS PSI

OUR MOST IMPACTFUL YEAR YET

2014

IN 2014,PSI’s 63 in-country network partners averted an Over the course of estimated 53,695,019 DALYs 2014, PSI and its (Disability Adjusted Life Years) — network members our highest number yet. When PSIaverted averts one DALY, it means that an estimated we prevent the loss of one year 53,695,019 DALYs globally. of productive, healthy life. This is a 35 percent increase over 2013.

Nina Hasen recently joined PSI as its Director of HIV and Tuberculosis. Hailing from the Office of the Global AIDS Coordinator (OGAC), which 53,695,019 oversees the President’s Emergency Response for AIDS Relief (PEPFAR), Hasen brings not only expertise in HIV and WHAT GOES INTO CONSTRUCTING 10,000 TOILETS? AIDS programming and policy, but also a strong scientific background and RECENTLY, PSI-INDIA'S SANITATION PROJECT SURPASSED keen management skills from 10,000 toilets in rural Bihar, one of the poorest states in India, where 99 her academic and nonprofit million reside more than 80 percent practices open defecation. Ensuring hose are a lot ofand years– work in the US and the UK. the construction of one toilet is a relatively easy task, but scaling the solution you were to go back Hasen joins PSI at a turning takes a more systemic approach. Here’s how we’re doing it: point in the global HIV response, time 53.6 million THE DESIGN where the funding landscape Designed in ears ago, you would see collaboration with PATH is changing and new research, With funding from the Bill and That’s a including the much-cited Melinda Gates Foundation, and in* alm trees in Antarctica. collaboration with our partners GOOSENECK Strategic Timing of AntiRetroviMonitor-Deloitte, PATH and Water 35% increase PIPE For People, PSI launched its Prevents flies, Treatment (START) data, as sanitation project to improve usage smell and over 2013. ral and access to quality toilets. well as recently released studies contact with feces. on pre-exposure prophylaxis, puts antiretroviral medication (ARVs) at the center of the global response. DID YOU KNOW? The pit in use can contain “I want us to become the up to 5 years-worth of PITS sludge. While one pit is in 'fixers' of the HIV response in the Each toilet can use, sludge in the other pit have two pits. will compost and be safe countries where we work, underWhen one is 2.7+ million to remove over time. full, the other standing the market failures is used. DALYs averted that underlie gaps in prevenin Mali THE MARKET tion, care and treatment and Getting from Design to Use. Having a working to address them” says great product means nothing if people Of the 10,000 toilets can’t afford it. So PSI worked with local constructed, approximately Hasen, whose strong leadership partners to 36% of these have been and intimate knowledge of HIV make it easier households have sold to households below for people to purchased their toilet the poverty line. policy positions PSI well to enter buy and install through a sanitation loan, facilitated a toilet in their a new era of HIV programming. by PSI. home. “Our clients will be facing HIV — either as people living with the virus, or as people at high risk of PSI-trained sanitation businesses have been able to take out will be disbursed in loans for sanitation in Bihar getting the virus — for decades loans to expand their business as a result of PSI’s partnership with Friends of to respond to the growing to come. Let’s take the lead in Women’s World Banking. demand for toilets. using the power of markets to 9+ thousand THE IMPACT ensure they have access to the ALYs averted very best products and services More security More dignity. Less diarrheal Less environmental n Guatemala for women. disease. damage. in HIV prevention, care and treatment for themselves and 693+ thousand 18.8+ million AND 10,000 TOILETS DALYs averted their family.” DALYs averted

681

OVER $2 MILLION

are just the beginning. Learn more about how you can partner with us to reach our next goal of 100,000 toilets at www.psi.org.

in the Democratic Republic of the Infographic by Sophie Greenbaum, PSI Congo

in Pakistan

—Regina Moore, PSI

psi.org | impact

LEADING VOICES

Seven Questions for Ann Mei Chang The first executive director of the US Global Development Lab at USAID is breaking bureaucratic barriers aiming to make risktaking and iteration the rule rather than the exception in global health.

Ann Mei Chang has worked for some of the most forward-thinking companies in the world. Her turns at Google and Apple, before transitioning to Mercy Corps and now the helm of USAID’s Global Development Lab, perfectly situate her to harness the power of the public and private sectors, all while helping to transform the way the US “does development.” We ask her for a few tips on what the best kind of innovation looks like to her.

Ann Mei Chang brings extensive public and private sector experience to her newest role as executive director to the US Global Development Lab at USAID.

➊ To start, what is the US Global Development Lab? The Lab is the newest bureau within USAID and leads the agency in transforming our development efforts through modern tools and approaches. By using science, technology, innovation, and partnerships, we believe we can find ways to end extreme poverty better, faster, cheaper and more sustainably.

➋ What defines an innovative project, or rather a successful innovative project? The difference between simple invention and innovation is that invention is creating something new, while 6

impact | No. 19

innovation is creating something new that actually delivers real value. The success of an innovation should not be judged based on a glitzy demo, but rather on the impact it delivers. We believe that a strong evidence-based and iterative approach is necessary to enable innovations to succeed by ultimately improving the lives of millions.

➌ Do you have an example of bad innovation (in the development or private sector)? Perhaps, it is something the 21st development professional should avoid at all costs? I’m sure we’ve all heard of numerous “innovations” which tell a great story, but have never been adopted by more

LEADING VOICES

“ The difference between simple invention and innovation is that invention is creating something new, while innovation is creating something new that actually delivers real value.”

than a few thousand people. Good innovations focus on the problem and user first, focus on collecting evidence to create a tight feedback loop, rapidly iterate and fail fast.

➍ What are some critical skills development professionals need in their efforts to foster innovation? We need to reframe innovation, even at the individual level, as “how” we do things, not what we do. Individuals can focus on delivering health projects for example, but they should be asking themselves: “How could data provide me with greater evidence? How could human-centered design help me design for greater impact? How could mobiles or e-payments enable us to reach more people, more cheaply? Is there a way I could crowd-source ideas for a better result?” Development professionals who ask and seek to harness the new “how” of development are the people I love to work with.

➎ How can organizations support

➐ What innovation from the Global

these creative thinkers — modern tool-users — within their ranks? Reward innovation, allow for failure, and embrace learning and change. Don’t limit your teams based on their current role or program, but rather encourage out-of-the-box thinking. More importantly, focus on execution over flashy ideas. I fundamentally believe innovation is 1 percent inspiration, 99 percent perspiration.

Development Lab are you most excited about right now? Chlorine Dispensers — they are cheap, convenient and safe. Chlorination can reduce the incidence of diarrhea up to 40 percent and provide safe water for 72 hours. In randomized control trials, distributing tablets in communal water source dispensers, rather than to households, showed usage increase to 49 percent compared to the current usage at 5 percent, all at around 50 cents per person, per year at scale. With support from USAID, these can now be seen popping up at community water sources around East Africa, reaching millions in Kenya, Uganda and Malawi. n

➏ What stifles innovation in an organization? Fear of failure. If people fear failing, they’ll take the safe approach and the result is mediocrity. I’m a big fan of “Fail Fairs,” which have been popular in the Information and Communication Technologies For Development (ICT4D) sector. They encourage sharing stories, learning from failures, and making it all fun.

psi.org | impact

LEADING VOICES

DFIDâ&#x20AC;&#x2122;S INNOVATION HUB WANTS YOU Up for venture-style funding, online competition and creative collaboration? Then you just may be the future of development.

By Jonathan Wong

impact | No. 19

LEADING VOICES

IT’S AN EXCITING TIME FOR INNOVATION IN GLOBAL DEVELOPMENT. New actors are looking for new, transformative solutions. Foundations and social impact investors are looking to invest in innovation and technologies that have the potential to deliver both high social impact and economic returns. The technology, design and creative industries are exploring how their skills and expertise could have an impact in the developing world. At the same time, more young people want to start enterprises with an engrained social purpose. Some of the most promising development innovations are being pioneered by commercially sustainable social enterprises that aim to deliver positive social change. We are entering the age of the social entrepreneur. In order to meet the challenges and exploit the opportunities this landscape provides, new ways of stimulating innovation and new models for effective collaboration are needed.

A VENTURE-STYLE APPROACH

I’m really proud that DFID has recently launched the Global Innovation Fund (GIF), a partnership between the UK, US, Swedish and Australian governments and the Omidyar Network. A notfor-profit organization headquartered in London, the £125 million fund will invest in social innovations to improve the lives and opportunities of people living in poverty in the developing world. Borrowing from the experience of venture capital, GIF offers three stages of financing to pilot, test and scale innovations. The fund supports innovators who are committed to using and generating rigorous evidence about what works, and invests in innovations that can demonstrate evidence of success. GIF seeks innovative solutions that can scale up commercially, through the public or philanthropic sector, or through a combination of both in order to achieve widespread adoption. The organization will also support innovations through the funding "valley of death" — that is, the funding gap between early-stage donor grant funding and seed-capital and mid-to-later stage social and commercial investment. It will do this by providing funding to get innovations market-ready and to an investable state, and by brokering links with social impact and commercial investors. GIF is grounded in the belief that good ideas can come from anywhere and anyone. It’s open to innovations in almost any developing country, across any sector, from any organization and from early seed testing to later-stage scale.

A COLLABORATIVE APPROACH

While GIF will work to take proven ideas to scale, there is still work to be done in terms of sourcing new ideas from fresh perspectives — and finding ways to make development more accessible and collaborative. Working in partnership with the humancentred design firm IDEO.org and OpenIdeo (see

page 22 for more on IDEO.org), DFID’s Amplify program is a place to experiment with the process for identifying innovative solutions to stubborn development challenges. It will tackle 10 development challenges over five years using an open, collaborative design process, and will provide funding and design support to the most promising solutions from each of the 10 challenges.

“ GIF supports innovators who are committed to using and generating rigorous evidence about what works, and invests in innovations that can demonstrate evidence of success.” The program works by setting a challenge and sharing it on OpenIDEO.com, a platform of over 50,000 participants in IDEO.org’s online community. The participants then work through a four-stage design process, tackling the challenge in phases — from research to an open call for ideas into shortlisting and refinement, and finally evaluation and funding. At DFID, we developed Amplify and GIF to support a broader base of innovators, entrepreneurs, technologists and designers to apply their skills to development challenges. I’m looking forward to seeing whether they are successful in developing more relevant, impactful, cost-effective, sustainable and scalable solutions. What is certain is that new approaches are required to exploit the potential of the rapidly shifting innovation development landscape. n

JONATHAN WONG is the head of DFID's Innovation Hub.

psi.org | impact

LEADING VOICES

Bringing Innovation to the Front Line of Global Health Lelio Marmora, UNITAID executive director, discusses how to accelerate introduction of effective new health solutions.

Among other priority projects, UNITAID works to allow generics manufacturers to access patents for life-saving medicines and devices to prevent or treat HIV/ AIDS, TB and malaria.

What role does UNITAID play in fighting HIV/AIDS, tuberculosis (TB) and malaria? LELIO MARMORA: UNITAID is in business to find smart new ways to prevent, treat and diagnose all three of these diseases more quickly, more cheaply and more effectively. Working with our partners, such as USAID and the Global Fund, we encourage them to “scale up” the use of the best gamechanging innovations that we can find in health programs across the globe. How do you go about your work? LM: We trawl through the world of innovation in universities and industry for ground-breaking drugs and diagnostic methods. And if we are persuaded they can work, UNITAID provides the capital to help test their viability and speed up their introduction, using buying power to secure price reductions, quality improvements and to build a solid base of evidence backed by data. Is UNITAID’s approach effective? LM: UNITAID has played a pivotal role in many of the advances over the past few years against HIV/AIDS, TB and malaria. By helping to reduce costs of new better-performing health solutions we can maximize the impact of every dollar spent to improve the lives of the millions of people who are most exposed to these lethal diseases. In short, UNITAID bridges market gaps to kick-start the introduction of new, better, faster-acting and more affordable medicines, technologies and systems as quickly as possible.

impact | No. 19

LEADING VOICES

What are your biggest contributions to fighting disease? LM: UNITAID was instrumental in greatly expanding the use of the GeneXpert diagnostic technology for tuberculosis. This is speeding up detection of a disease as old as humanity itself. The launch of GeneXpert, which had originally been developed to detect anthrax in the US, is especially well-timed. The health community urgently needed improved testing capabilities following decades of neglect in development of new TB diagnostics. Are there pros and cons to GeneXpert? LM: GeneXpert can be used in remote health facilities to reach more people and provide results in just two hours, compared with older methods that take up to two months. Patients can then immediately start treatment, helping to halt the disease’s transmission. However, a challenge we faced early on was that the test cartridges used by GeneXpert were prohibitively expensive, contributing to doubts over its viability as a practical solution.

So how did you deal with that challenge? LM: In 2012, UNITAID invested in the largest global scale up of its kind at the time, when machines were installed in 21 high burden countries. A steep reduction in the price of the test cartridges, available for 145 countries, was negotiated with UNITAID’s partners, generating global savings of more than $70 million to date. The technology was shown to be a practical and affordable new tool in TB detection, especially of drug resistant strains that are harder to diagnose.

established the Medicines Patent Pool in 2010 to make it easier for generic manufacturers to tap patent licenses. How does it work? LM: It allows more affordable versions of key medicines to be produced and for new improved formulations to be created, resulting in more people being treated and with better medicines. Licenses have been secured for 11 priority antiretroviral drugs.

What is the focus of your latest work with PSI? LM: Finding more of the currently undiagnosed patients is a global priority and the focus of one of UNITAID’s latest initiatives. We are partnering with PSI to explore the viability of oral self-tests as a way to expand testing options to reach some of the 19 million people estimated to be living with HIV who are still undiagnosed. (see page 16 or pulse.psi.org for more on HIV self-testing)

What has the payoff been? LM: Success has been swift. In 2014, WHO noted that 60 percent of affected countries now included GeneXpert in their national plans and also recognized the significant contribution the diagnostic technology had played in increasing worldwide detection of drug resistant TB. It is estimated that by 2020, GeneXpert could help to avert up to 1.5 million deaths from the disease.

Where do you see the greatest potential in fighting malaria? LM: Using anti-malarial drugs to prevent disease during the high transmission season, particularly in high burden countries, can drastically reduce cases of malaria. WHO has recommended such an approach since 2013 and estimates that up to three quarters of all cases and deaths could be prevented by administering these drugs to under five-year-olds at monthly intervals during the high transmission season. However, only 3 percent of eligible children received this prevention, known as seasonal chemo prevention, last year in part due to supply issues.

What is the Medicine Patents Pool? LM: Intellectual property remains a significant barrier to accessing HIV medicines in developing countries. New, better-performing drugs are likely to be granted 20-year patents, even in low- and middle-income countries. Patents keep prices of such life-preserving medicines prohibitively high and hinder the development of new formulations. In response, UNITAID

What are you doing to remedy the situation? LM: UNITAID is now investing in the large-scale implementation of seasonal chemo prevention. The project we are funding will help increase the number of suppliers of the drug to increase production capacity, reliability of drug supply and cut delivery costs. We estimate up to 70 percent of children in all targeted areas can be protected and 50,000 lives saved over two years. n

LELIO MARMORA is Executive Director of UNITAID.

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WHAT WILL THE NEXT GENERATION OF DEVELOPMENT PROFESSIONALS LOOK LIKE? By Kate Warren, Devex Infographics by Sophie Greenbaum, PSI

WHO ARE THE SURVEY RESPONDENTS?

65%

Of the 1,041 respondents, 65% have at least 10 years of experience working in the global development industry.

Respondents come from a broad variety of development sectors, particularly:

New sources of funding, new actors and new technologies are changing development. This led us to wonder, what will the next generation of development professionals look like and what will they need to be successful?

1 ECONOMIC DEVELOPMENT

In partnership with the US Global Development Lab at USAID and PSI, Devex surveyed development professionals to see what tools, skills and approaches the next generation will need to thrive.

4 EDUCATION

One finding was clear: 83 percent of respondents believe that in 10 years, the technology, skills and approaches used by development professionals will be significantly different than they are today. The results paint the picture of a well-rounded, flexible professional who takes a holistic view of development work. Just as likely to be a venture capitalist or high-tech whiz as your traditional aid worker, the future development professional will need to be agile, collaborative and constantly learning new skills.

2 MONITORING AND EVALUATION 3 ADMINISTRATION/POLICY

5 HEALTH

Respondents are most experienced in the following regions:

#4 EUROPE #5 MIDDLE EAST #3

THE CARIBBEAN & LATIN AMERICA

#1 AFRICA

#2 ASIA

impact | No. 19

MALE

FEMALE

Gender balance was slightly skewed towards male participants, who made up 62% of all respondents.

WHO’LL BE THE DEVELOPMENT PROFESSIONAL OF THE FUTURE? Respondents believe the following types of professionals will be most in demand in ten years:

A sharp departure from the current-top down approach, respondents say individual beneﬁciaries and their communities will have the most say in how aid is invested.

47% INTEGRATORS 27% SPECIALISTS 16% GENERALISTS 10% DISRUPTERS

Integrators are particularly important to climate change professionals at 59%, while they are least important to procurement specialists at 34%.

41%

INDIVIDUAL OR COMMUNITY BENEFICIARIES

34%

HOST GOVERNMENTS

26%

TRADITIONAL AID DONORS AND ORGANIZATIONS

While overall respondents ranked host governments second in decision-making, host governments ranked themselves last, putting aid organizations ﬁrst and individuals second.

of respondents believe in 10 years it will be more important for professionals to have a basic understanding of working with a wide range of funders than a deep specialization working with one PERCENT speciﬁc funder.

While traditional development organizations will continue to have an outsized impact, respondents predict people working in global development are more likely to come from a high-tech ﬁrm, social enterprise, corporation, large scale fund or venture capitalist ﬁrm than they are today. The following organizations will have the most growth in impact on global development in the future:

HIGH TECH FIRMS AND SOCIAL IMPACT INVESTORS

82%

CORPORATIONS

79%

VENTURE CAPITALISTS

67%

31% of all respondents believe militaries will have less impact. But 58% of health professionals believe that militaries will have more impact than they do today.

MILITARIES

33%

Among health professionals, 94% believe that high tech ﬁrms will have more impact on development than they do today.

WILL THE TOOLS OF THE TRADE CHANGE?

84 PERCENT

of respondents believe in ten years the technology, skills and approaches used by development professionals will be signiﬁcantly diﬀerent than they are today.

88% of

professionals working for international NGOs believe the same about technology, skills and approaches.

However, of professionals working with multi-lateral agencies, 15% FEWER believe that technology, skills and approaches used by development professionals will be signiﬁcantly diﬀerent in ten years.

psi.org | impact

WHAT APPROACHES WILL THEY TAKE?

Percentage of respondents who believe that 10 years from now development professionals should be highly proﬁcient with digital development/ mobile technology.

49% 54% Percentage of respondents who believe that 10 years from now development professionals should be highly innovative.

7. LEARNING AND KNOWLEDGE MANAGEMENT

8. CROSSDISCIPLINARY/MULTIDISCIPLINARY APPROACH 9. PRIVATE-PUBLIC PARTNERSHIPS

THE TOP

6. IMPACT EVALUATION

10. DIGITAL DEVELOPMENT/ MOBILE TECHNOLOGY

approaches respondents believe will be important for future development professionals to be highly proﬁcient in:

5. INNOVATION

4. DATA-DRIVEN AND EVIDENCE BASED PROGRAMMING

1. SUSTAINABILITY

70% Percentage of respondents between 25-44 years old who believe that 10 years from now development professionals should be highly proﬁcient with sustainability.

2. CAPACITY BUILDING

3. COMMUNITYBASED APPROACHES

However, 43% of respondents from for-proﬁt implementing organizations favor technical skills over people skills.

MEN

78%

Percentage of people who believe people skills are either as or more important than technical skills for project leaders.

WOMEN

20%

Women were more likely than men to rank capacity building as an important approach for future development professionals.

Percentage of respondents who believe that 10 years from now development professionals should be highly proﬁcient in the following:

47% HUMAN-CENTERED DESIGN 41% MARKET-BASED APPROACHES 22% CROWD-SOURCING SOLUTIONS 13% GAMIFICATION 14

impact | No. 19

Even more health professionals, 55% in fact, believe proﬁciency with humancentered design is of the utmost importance.

46% of respondents between 25-44 years old believe that 10 years from now development professionals should be highly proﬁcient with market-based approaches compared to just 37% of respondents who are over 45 years old.

WHAT SOFT SKILLS WILL THEY NEED? Respondents believe these will be the top 5 most essential soft skills for future development professionals to have:

1 2 4 RESOURCEFULNESS

IMPLEMENTATION AND EXECUTION ABILITY

2.3

FLEXIBILITY AND ADAPTABILITY

3 ABILITY TO WORK IN TEAMS

5 EMPATHY

Skills Gaps: Respondents identiﬁed the Top 5 approaches they wish to gain more training and education in:

1 DATA- AND EVIDENCE-BASED PROGRAMMING 2 MULTI-DISCIPLINARY APPROACHES 3 IMPACT EVALUATION 4 NEW METHODS OF DEVELOPMENT FINANCING 5 INNOVATION Respondents above the age of 44 are 2.3 times more likely to rank ability to work in teams as the number one soft skill of the future, compared to those 25-44 years old.

Health professionals ranked data-driven and evidence-based programming as the NUMBER ONE for which to gain more education.

79% of respondents believe

professionals will need a graduate level education to succeed in international development in 10 years.

72 PERCENT of respondents believe professionals will need to be ﬂuent in at least two languages to be successful, with English ﬂuency increasing in importance.

65%

75%

65% of respondents believe that in 10 years, Arabic will be more important than it is today across all development sectors. 75% believe the same for English.

psi.org | impact

Disrupting Global Health Get inspired by five cutting-edge programs from around the world.

BY MINAL BOPAIAH

PSI is not your grandfather’s iNGO. We foster creativity and innovative thinking because everyone here – from our headquarters staff to our 63 in-country network partners – knows that iteration is the best way to truly serve our beneficiaries in a rapidly-changing world. Our latest innovations, all of which are the result of strategic collaboration with either corporations, other NGOs or donor organizations, help the global health sector address systemic problems in HIV prevention, maternal health, sanitation and non-communicable diseases like hypertension. Read on to learn more (and feel free to steal an idea or two).

A Major Shift for HIV Testing in Africa

750,000

HIV self-test kits will be marketed and disseminated over the course of two years.

The first-ever widespread dissemination of oral-swab HIV self-test kits in Africa is poised to dramatically increase access to HIV testing and impact HIV prevention, care and treatment goals. PSI, UNITAID, the World Health Organization and other partners are making oral-swab HIV self-test kits widely available in Malawi, Zambia and Zimbabwe for the first time ever. The pilot program will generate crucial information about the distribution, feasibility, acceptability, and impact of HIV self-testing in the developing world, with hopes of scaling the program further. Funder: UNITAID | Partners: London School of Hygiene and Tropical Medicine, Liverpool School of Tropical Medicine, University College of London, World Health Organization See page 10 for more on how Unitaid chooses its innovative projects.

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A Smartphone App that Delivers Vital Maternal Health Information in Myanmar

700,000

downloads of the maymay maternal app expected by 2019

In Myanmar, more than 1,500 women die every year while giving birth, more than any other country in Southeast Asia. Using the latest mobile phone technology, PSI, telecom operator Ooredoo and local tech startup Koe Koe Tech have created maymay, an award-winning mobile app that sends women in Myanmar essential health information and reminders throughout their pregnancies and in their child’s early years. In many cases, it is the only health information the women receive. The app sends three push notifications weekly on how to keep an expecting mother, and later her baby, healthy. 2015 updates include a doctor and clinic locator, a call-in hotline for urgent health questions and a way for mothers to share information with other mothers and health experts. Funder: Groupe Speciale Mobile Association mWomen Programme | Partners: Ooredoo, Koe Koe Tech, USAID, Myanmar Ministry of Health, Mobile Alliance for Maternal Action

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Building a Market for Toilets to End Open Defecation in India 2.6 billion people — about 40 percent of all humans — either have no toilet at all, or one that is unsafe, such as an unsealed pit. By addressing constraints in supply and demand, PSI and its partners are improving sanitation and creating sustainable markets for toilets and emptying services. PSI’s project will enable households to purchase and use high-quality, desirable toilets. PSI has initially reached people with access to safe sanitation in Bihar, India, then leverage the learnings from this project and elsewhere to improve sanitation through marketbased approaches for 750,000 people in 12 countries. Funder: Bill and Melinda Gates Foundation | Partners: Monitor Deloitte, PATH, Water for People See page 5 for more on the market forces behind the first 10,000 toilets.

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Reversing the Rise of Cardiovascular Disease in Kenya

10,000,000

people to be treated for hypertension in Africa by 2025 through a partnership with PSI, AstraZeneca and others.

By 2030, non-communicable diseases (NCDs) will be the most common cause of death in Africa, exceeding the combined mortality of communicable diseases, nutritional diseases and maternal and perinatal deaths. Hypertension, or high blood pressure, is a major risk factor for cardiovascular diseases, including stroke. In collaboration with AstraZeneca, PSI is working through the Healthy Heart Africa partnership to reach clients with lifesaving information on the prevention and treatment of hypertension. PS Kenya, a PSI network partner, is increasing the impact of their Tunza social franchise network by adding hypertension screening and treatment to the package of services they offer, reaching thousands in need of this life-saving information. Our work together in Kenya is part of a larger program that is improving health across Africa by delivering the right education and medicines; training healthcare workers; and collaborating with cross-sector partners, especially government, to build a sustainable program. Funder: AstraZeneca | Partners: AMPATH, AMREF Kenya, the Christian Health Association of Kenya, Jhpiego, the Mission for Essential Drugs and Supplies, Abt Associates

See page 20 for more on this project and a how-to for maximizing corporate partnerships.

HIV Cyber-Support Reaches At-Risk and Hidden Populations in Central America People living with HIV and men who have sex with men are among the most stigmatized and discriminated populations in Central America. PSI’s Central American network member PASMO has pioneered a groundbreaking program that provides at-risk and hidden populations with safe, secure and confidential access to comprehensive HIV care by using online forums and a Unique Identifier Code system. In 2014 alone, PASMO reached over 13,900 individuals through online peer education. Operating within online chat rooms and social media outposts, PASMO’s team of “cyber-educators” reach men who have sex with men (MSM) and people living with HIV through confidential online outreach, and referrals to counseling and testing sites when needed. Funder: USAID | Partners: International Planned Parenthood/Western Hemisphere Region (IPPF/WHR), Cicatelli Associates Inc, Milk N Cookies

To learn more, explore pulse.psi.org for extras on each of these innovations, including interactive quizzes, videos and galleries.

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Expanding the Bottom Line: Realistic Sustainability The private sector takes on a public health challenge.

AstraZeneca launched Healthy Hearts Africa, a hypertension screening and treatment program, in Kenya with the hopes of scaling it across the continent.

AS BILATERAL DONORS and development banks put increasing pressure on governments in low and middle income countries (LMICs) to cover a greater proportion of their national health budgets, developing sustainable solutions for public health challenges has never been more important. The private sector has a key role to play in the effort to make sustainable impact. While governments in these countries will increasingly take responsibility for their health care costs over time, private sector investments in health systems that offer a financial return will support ministries of health to achieve their goals more quickly and sustainably. In recognition of this, AstraZeneca has made an organization-wide commitment to make available its knowledge, skills and products to address Africa’s growing non-communicable disease burden. Nearly a third of African adults were estimated to have high blood pressure in 2014, the highest prevalence of any region.1 HEALTHY HEART AFRICA, our first large-scale initiative in this effort, seeks to tackle the burden of hypertension across the continent by investing in the health systems required to address this highly treatable condition, while ensuring patients can access affordable low cost of supplied anti-hypertensive medicines. This innovative and sustainable approach aims to reach 10 million hypertensive patients across the continent by 2025, supporting the WHO’s target of reducing the global prevalence of hypertension by 25 percent by the same year.

1. World Health Organization. Global Status Report on non-communicable diseases 2014. http://apps.who.int/iris/bitstr eam/10665/148114/1/9789241564854_eng.pdf?ua=1. Accessed 5 February 2015.

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By Tarek Rabah

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TOP TIPS HOW PRIVATE SECTOR PARTNERS CAN INCREASE HEALTH IMPACT

Launched in October 2014 in Kenya, Healthy Heart Africa is partnering with the Ministry of Health and seven on-the-ground organizations – Abt Associates, AMPATH, AMREF Kenya, CHAK, Jhpiego, MEDS and PSI’s network partner PS Kenya, – to work against three main pillars: • Education & Awareness. Conducting prevention and disease awareness raising activities that will encourage people to live healthier lifestyles and seek screening and diagnosis when needed. • Training & Guidelines. Training healthcare workers to provide comprehensive and appropriate hypertension care, based on guidelines developed in collaboration with professional societies and the Kenyan Ministry of Health. • Access & Affordability. Strengthening the supply chain and ensuring patients can access affordable, high-quality anti-hypertensive medicines. Successful components of this demonstration phase will be scaled in Kenya and to other countries beginning in 2016. Our hope is that this approach will allow the millions of adults with hypertension on the continent to have greater access to the care and treatment they require, not only today, but in 10 years from now. n

TAREK RABAH is AstraZeneca’s Area Vice President for Middle East and Africa.

Multi Sectorial Partnership. Investments in global health require collaboration between the private sector, governments and nongovernmental organizations to effectively coordinate and deliver sustained healthcare solutions. Invest in Technical Assistance. Enhancing human resources and healthcare infrastructure such as training healthcare providers, ensuring strong supply chain infrastructure, and task shifting healthcare delivery, have high impacts in global health. Look Beyond the Pill. Preserving the health and wellbeing of populations requires more than treatment. It requires investments in systems that help individuals become appropriately informed, stay healthy, and when needed, enable access to high-quality, affordable treatment.

Read more about the Healthy Heart Africa campaign on page 19 and at pulse.psi.org.

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Can a Bajaji Change a Teen Girlâ&#x20AC;&#x2122;s Life? How Pam Scott, IDEO.org and PSI brought Human-Centered Design to Teen Pregnancy in Tanzania By Aaron Britt and Karen Sommer Shalett

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In Tanzania, 44 percent of girls under 18 are already mothers. Pam Scott, IDEO.org and PSI used human-centered design to learn how to give teen girls a chance for a different future.

“HUMAN-CENTERED DESIGN has a role in solving every problem,” says Pam Scott, a serial design thinker whose career has wended from advertising to customer research to a board seat at IDEO.org to a current chapter that might be dubbed activist philanthropy. A born connector, Scott has spent nearly three decades working at the intersection of design and impact, and much of her power lies at getting the right people in the room and prompting them to ask — and answer — the right questions. “It’s only from a place of deep empathy and connection, that you can have real impact. That’s our creative starting point,” says Scott of what is at the base of a methodology that marries a handful of cutting-edge techniques resulting in a “new form of human-centered design that not only deeply engages community members in the creative process, but also the NGO that serves that community.” Scott, one of a growing number of female philanthropists inspired to focus on women and girls, chose to sponsor a project with PSI to address unintended pregnancy in Tanzania. “It’s very unpopular. Acknowledging that unmarried teens can be sexually active is a lightning rod issue, leaving a good number of donors less inclined to support teen pregnancy prevention,” she says. “I wanted to take some risks and I knew the best partner to do that would be PSI.” “First, I did a six-month third-party data review,” she says, “to build on an insight my colleagues at IDEO.org shared: ‘Teens do not believe that family

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planning clinics are for them, largely because they aren't planning a family.’ Everything I studied supported this insight. I also discovered that programs all over the world treated unintended teen pregnancy as a medical challenge. And it’s not. It’s a social challenge with a medical component. Knowing that, I knew we had to understand the social context in which unintended teen pregnancies exist. And the only way I know how to do that is to talk to teens and all of those who satellite around them.” Over the summer of 2014, Scott began to design a creative process to take on the challenge. She wanted to involve great thinkers from PSI, other social sector organizations and for-profit institutions to develop fresh approaches. She believed there was an opportunity to disrupt the traditional approach to adolescent reproductive health by making it more teen-friendly and ultimately impactful. By fall, she had enlisted PSI board member Rebecca Van Dyck, a tribe of IDEO.org designers (led by creative director Patrice Martin) and her husband former Yahoo! CEO Tim Koogle to join her in partnering with PSI Tanzania’s Susan Mukasa and her team on the effort. Together they would conduct a weeklong design immersion in Bagamoyo, Tanzania. But Scott thought the team wasn’t complete. “Gandhi’s credited with saying ‘What you do for me but without me

“ It’s only from a place of deep empathy... you can have real impact. That’s our creative starting point.” — Pam Scott Design Strategist/ Philanthropist

you do against me.’ Not only did PSI need to have a strong voice in the creative process but so, too, did the people of Tanzania,” she says. To that end, the project’s first phase would be an insight-gathering trip to Tanzania. In January 2015, team members from IDEO.org and PSI traveled around Tanzania meeting teen girls and the influential people — parents, teachers, boyfriends, and town elders, among others — central to their lives. Insights revealed there was a complex web of cultural influences that unintentionally supported the likelihood that girls would become pregnant. Studies showed that these 24

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influences were, in fact, at least partly responsible for 44 percent of girls in Tanzania becoming mothers by age 18. Using the research insights as inspiration, Scott and her team agreed on five design strategies that might inspire new thinking: ➊ Leverage youth culture to spark a teen-centric conversation about contraception. ➋ Motivate health care providers to offer products and services in teen-friendly ways. ➌ Create or build on existing opportunities for girls to thrive. ➍ Dispel myths by rebranding modern forms of contraception. ➎ Inspire men and boys to be part of the solution. Come April, with briefs in hand and a team of 34 people assembled, the design immersion kicked off in the town of Bagamoyo. Participants represented an array of perspectives — doctors, educators, businesspeople, marketers and designers — who came together for the week. Even though a great number were from Tanzania, the first day team members concentrated on getting to know the people of the village. Split into pairs and triads, they went out on learning journeys. “Everyone buzzed around the village meeting with locals to get a greater appreciation and respect for how teen pregnancy lives within and is influenced by societal norms and culture,” Scott wrote to friends the night before prototyping was to begin. Now spilt into five design teams, the next day brought team members to their knees — with paper, markers and scissors to mockup designs of the ideas they’d brainstormed. With tangible models to share, design teams immediately got feedback on their concepts from the people of the village. “Some of the ideas teams loved best died fast,” says Scott. “Others thrived and got better with feedback from the villagers.” Soon six ideas started to rise to the top. One design team dreamt up a fleet of girl-friendly bajajis (a three-wheel motorcycle taxi) — driven only by young women trained

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HOW TO USE HUMANCENTERED DESIGN Discovery. There’s no better way to understand the people you’re designing for than by immersing yourself in their lives and communities. Start with hearing the voices and understanding the lives of the people you’re designing for. Talk to them in person, where they live, work, and lead their lives. Once you’re there, observe as much as you can. Record exactly what you see and hear, but also pay attention to your impressions.

in sexual and reproductive health. Within 24 hours, the design team rented a bajaji, completely transformed it, and recruited and trained a female driver. “Come Thursday morning, they were in business, giving girls rides around town,” says Scott. Contraception messages were posted inside and perhaps most encouraging, the girls who rode in the vehicle said they'd love to make money as a driver of one. Scott’s design team created some edutainment called Girl Nation Radio and recorded a show in a fully kitted-out studio until the wee hours of the night. When she and her team took it into the field, they were shocked to learn that the six-minute piece resonated beyond girls. “The content was just too juicy not to listen!” says Scott. “Women and men were sucked in by the drama of the mini-novella and didn’t even flinch when some potentially shocking content was shared.” “Human-centered design offers a chance to upend business as usual in the social sector,” said IDEO.org’s Martin. “It’s an approach that gets us farther faster because we learn from the people we’re designing for, quickly get our ideas into their hands, and then iterate based on the feedback they give us.” Human-centered design can be a pretty radical shift. It asks you to learn first hand, synthesize disparate ideas, and test a solution by making it tangible. It’s an approach that starts from the point of view that you don’t know the answer, but the people you’re designing for probably do. While the immersion process led to several very promising ideas that will be further vetted in the months to come, Scott was equally excited by the fact that, “Everyone who participated in the immersion now has a much deeper understanding of human-centered design and how to create impact by starting from a place of deep empathy.” n Aaron Britt is the senior editor for IDEO.org; Karen Sommer Shalett is the managing editor for Impact magazine

Conversation Starters. Get a reaction and spark dialogue by coming up with a bunch of ideas around a central theme. If you’re working in sanitation, you could ask, what is the toilet of the future, the toilet of the past, a super toilet, the president’s toilet? As the person you’re designing for shares her take, be open to however she interprets the concepts. You can learn a lot about how she thinks. Brainstorm. Observe a handful of rules when you brainstorm, the goal of which is to promote openness, to generate lots of ideas, and to prize creativity and innovation over immediate feasibility. Brainstorms work best when the group is positive, optimistic, and focused on dreaming up as many ideas as possible. Rapid Prototyping. Prototypes are tangible expressions of your ideas, and they can take an array of forms from models to storyboards to skits to physical mockups. Build your idea in just enough resolution to test it, get feedback, and understand how to push things forward. Prototypes are meant only to convey an idea — not to be perfect. So build them so that you can quickly move through a variety of iterations, each time incorporating E TH GUIDE what you’ve learned from the people FIELD you’re designing for. For more, check out Design Kit, IDEO.org’s suite of teaching tools, www.designkit.org

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“Zeroing in on Ebola” Increasing data collection and connectivity helped stem the tide of the disease, but what needs to happen to finish the job?

LO C AT I O N : The YWCA in Monrovia Ebola mobilizers are being taught what to say when they go out into the communities to talk to and train the communicators in Monrovia.

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By Merrick Schaefer

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Ebola survivor Dao Golafaly participated in the Mercy Corps and PSI E-CAP program. He's pictured with his friends William Kromah, Faumata Kiawu, Massie Sonii, and Jartu Sesay. The program used mHealth solutions to teach about Ebola prevention and stigma reduction.

Ebola Survivor, DAO GOLAFALY

AS THE EBOLA EPIDEMIC IN LIBERIA has been stamped out, but new cases continue to be reported in Sierra Leone and Guinea, USAID continues to work to get to zero. It’s the number that the global community must reach to end the outbreak, enabling us to build a lasting bridge to recovery. It’s also a number that will require ongoing monitoring and surveillance to maintain. For USAID, this continues to require focus on a data-driven approach to developing a dynamic, sustainable response in the fight against Ebola. Access to timely, accurate information throughout the most acute period of the crisis depended heavily on person-to-person contact led by dedicated response workers. During the global community’s response, new applications of technology, data and innovation emerged as key elements in supporting efforts to stem the spread of the disease.

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SPOTLIGHT ON...

Addressing the persistent and complex challenges of the Ebola epidemic required diverse solutions. To reach people faster, better and more efficiently means identifying and using new ideas and information. Two particular areas that are potentially invaluable to the global response to Ebola and other crises quickly became clear: data and connectivity. When the Ebola epidemic began, access to reliable information with geographic specificity on confirmed and suspected cases was limited, creating significant challenges for response workers to contain the outbreak through rapid diagnosis, safe isolation and contact tracing. Contradicting data points and the absence of accurate, real-time data made it difficult to orient the response. Gaps in connectivity also obstructed the demand for and delivery of recovery aid. In some cases, areas with weak mobile and broadband connectivity continue even today to handicap data collection, response efforts and recovery ability.

LO C AT I O N : Sinje, Grand Cape Mount Ebola burial team members receive training from Doctors Without Borders.

LO C AT I O N : Tienii, Grand Cape Mount Town Chief Foday Massaquoi helped spread messages about reducing the stigma of Ebola to his community.

HIGH TECH MEETS LOW TECH

HOW PSI AND MERCYCORPS USED mHEALTH COMMUNICATIONS SOLUTIONS DURING THE EBOLA OUTBREAK IN LIBERIA THIS YEAR, trust between communities and health facilities was severely damaged as facilities struggled to respond to pressing health needs while communities felt they were in the dark. PSI/Liberia worked in close partnership with Mercy Corps, implementing their USAIDfunded Ebola Community Action Platform (E-CAP), to spread accurate information and critical messages throughout the country. While mHealth technology played a major role in data collection, making the messages that everyday Liberians received relevant and meaningful was equally important. Critical community insight and personal stories of Ebola survivors helped frame the discourse, while PSI/Liberia and partners disseminated strategically crafted messages through community radio, billboards and interactive in-person trainings called the Listen. Learn. Act. program. Conducted by PSI-trained community mobilizers, interactive trainings allowed community members to share their personal experiences, fears, biases and successes on Ebola-related topics with each other. They then learned basic information on the topics and identified methods to change or improve their communities. The participants were offered examples of ways to educate their peers, including inviting an Ebola burial team member to speak to a large gathering, setting up a hand-washing station outside a mosque or simply saying hello to an Ebola survivor. To date, PSI has trained 872 mobilizers to conduct trainings with communicators tasked with spreading the messages they learn. What has been key in this model is that it is an entirely community-led response. While doctors and clinicians play a critical role in addressing Ebola, the efforts of community members, like these communicators, are equally valiant. They were most frequently reported as being the “most trusted person” in their communities for Ebola-related information, and the participatory nature of the E-CAP model has made it widely-recognized in Ebola-affected regions. While there is still a long way to go in reducing stigma and restoring the trust between health facilities and the people they serve, programs like this are making significant strides.

—Regina Moore 28

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Over time, data accuracy and availability improved. This was the result of a variety of efforts from multiple stakeholders. Private sector partners like Facebook provided short-term connectivity expansion through satellite deployment. NGO and government teams made use of radio, mobile phones and cell phone apps to support contact tracing and deliver behavior change messages to decrease disease transmission risks. Leadership of affected country governments, including the Liberian Ministry of Health, took steps to ensure that data reporting and analysis could be centralized and streamlined through its Emergency Operations Center. The Fighting Ebola Grand Challenge for Development also buoyed a team of innovators addressing gaps in the Ebola response, including two proposed solutions. CommCare, an open source mobile platform from social enterprise Dimagi, would support a range of Ebola-management needs: screening, triage, diagnostics, lab tracking, contact tracing and map-based visuals — all to help ease the communication burden and disconnect currently experienced on the ground in Ebola-affected countries. Similarly, a dynamic, integrated health worker communication and coordination system called ‘mHero’ provides tools to help countries tackle the core communication gaps for health workers. mHero is an SMS-based mHealth platform developed by UNICEF and Intrahealth. It is designed to extend and enhance existing national health information systems to support rural and remote health workers. Data collection has been essential to an effective response. More must be done to harness this information to shape decisions in humanitarian response environments. The limitations of current digital infrastructure revealed by the recent Ebola outbreak exposed the need to strengthen the capacity to prevent and respond to crises. Eradication in both rural and urban areas will largely depend on the affected communities themselves. And enhanced connectivity and real-time data systems have the potential to support these efforts and dramatically improve preparedness for future epidemics. n Merrick Schaefer is the Lead for Mobile Data at the US Global Development Lab at USAID.

ROMEL GYRMAH, 23 During the height of PSI's Live. Learn. Act. program, Gyrmah was a mobilizer with Wongosol, PSI and Mercy Corp's local partner in Monrovia, Liberia. She worked with eight communicators in two different communities in Monrovia, and met with them three times a week. Romel says there was a “sense of denial” in the community, and rather than take in information, community members would want tangible "fixes," such as buckets. Gyrmah said that school tuition has gone up since the Ebola crisis, because fewer children are going to school, forcing schools to raise tuition, affecting the ability to go to school for many, and others to have money for much else. Seeing communicators and others who continue to work on raising Ebola awareness buoys her own commitment. That, and when she meets people in the community who are genuinely interested in learning how to stay healthy. Gyrmah had a close friend who became sick with Ebola and yet survived. Reducing stigma as people reintegrate back into the community is of the utmost importance to Gyrmah. "I do it [work as a mobilizer] with all my heart," she says. "I saw people dead on the street, families and neighbors in tears.”

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DEPLOYING mHEALTH COMMUNICATIONS SOLUTIONS Make sure the message is relevant to the community it seeks to address by incorporating community feedback first. Ensure connectivity and access to the technologies you seek to use by partnering with private sectors, NGOs and country governments. Use real-time data systems to orient the response to where it is needed. Integrate a wide range of communications tools including radio, mobile phones, and apps, to support the intended behavior response.

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Getting Out of the Box A Business Case for Engaging Senior Leadership in the Field

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FIFTEEN YEARS INTO THE 21ST CENTURY, health advances have already resulted in longer lives worldwide. Investments that improve living conditions and reduce infectious diseases continue to have a positive impact. However, many global health challenges remain, such as governments’ inability to unilaterally address populations’ needs, the increasing difficulty and costs associated with discovering new medicines and the additional strains on health care systems caused by shifting demographics. As these and other challenges become more complex, multinational corporations are becoming engaged in development efforts joining governments, NGOs and civil society organizations to help less-developed countries meet the needs of their populations, often through public-private partnerships. As companies like Pfizer become more engaged in development work, we have a responsibility to learn how it functions and what it takes to succeed. Since 2003, Pfizer has partnered with over 40 international development organizations, including PSI, through our signature international corporate volunteering program, Global Health Fellows (GHF). Through the GHF program, Pfizer employees volunteer in three- to six-month specialized assignments, working hand-in-hand with community-based partners to help improve health care systems while gaining new perspectives on global health challenges and how the public and private sector can work together to address them. In 2010, Pfizer launched its Global Health Teams (GHT) program to expand and diversify skill-based volunteer opportunities beyond individual Global Health Fellowships. The GHT program offers a short-term, team-based volunteer option. In 2014, a Pfizer Executive Global Health Team (PEGHT) program was created, specifically designed to bring company leaders into the field to enhance their understanding of and engagement in Pfizer’s commitment to improving health care services for underserved communities around the world. The PEGHT was embedded within a leadership development program sponsored by Pfizer’s CEO and created by Pfizer’s talent management function to develop a targeted group of Pfizer’s senior executives. This executive program is designed to deepen leaders’ understanding of how a large biopharmaceutical company engages external stakeholders. The program

Members of the Pfizer Executive Global Health Team listen as a PSI India community health worker gives a family planning lesson.

By Caroline Roan

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“ I left with a much clearer understanding and appreciation of the role of NGOs in the delivery of health solutions and the critical importance of public-private partnerships in addressing unmet health needs.” provides a select group of senior leaders with key experiences including engagement with various global health stakeholders through the PEGHT assignment. The first PEGHT worked with PSI, a global nongovernmental organization with a strong social mission and a diverse client base. In a 10-day pro bono team assignment, 12 senior executives volunteered their skills and expertise to help PSI find new and more efficient ways to support its consumer base. In exchange, team members would learn firsthand about the challenges PSI works to address, such as helping clients understand the threats of HIV and AIDS, a lack of family planning and other barriers to maternal and child health. Their task was to provide a set of recommendations to PSI’s leadership to help them achieve its strategic goals (growth, relevance, value) while maintaining its core mission, to create healthier lives. The PEGHT team visited PSI headquarters in Washington, DC, and spent time at country offices and sites in Ethiopia and India. Through the immersive PEGHT initiative, Pfizer leaders became eyewitnesses to the challenges PSI confronts in providing access to health in resourceconstrained environments. They also saw public health strategies in action and developed a better understanding of the role global development plays in our own business. “I observed, firsthand, the delivery of healthcare in India and the complexities that health care workers face on a daily basis in the developing world,” says PEGHT member Chris Scully, Pfizer Global Established Pharmaceutical Business Chief Commercial Officer. “I left with a much clearer understanding and appreciation of the role of NGOs in the delivery of health solutions and the critical importance of public-private partnerships in addressing unmet health needs.” Following the project, 88 percent of team members found the experience relevant to their work and believed their ability to build external partnerships improved as a result. They also agreed that it helped further shape their CAROLINE ROAN global mindset. is the vice president of Ultimately, our senior leaders were able to share their Corporate Responsibility business acumen to help PSI advance its public health for Pfizer Inc. and mission. Immersive global pro bono programs like PEGHT president of The Pfizer offer a compelling argument for encouraging corporate Foundation. leaders to get away from their desks and into the field. n

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MAXIMIZING THE CORPORATE/NGO FIELD EXPERIENCE For corporate participants: Be like water. In the scope of work for PEGHT, PSI reminded team members that their objective was not to change PSI’s core business, but rather “to propose new efficiencies and strategies.” When embarking on this type of assignment, be prepared to be fluid and adjust to the assigned task. For companies, project organizers and corporate participants: Timing is everything. When team members return to work after their field experience, they are often consumed with business needs that have accumulated during their absence. Organizers should keep this in mind when scheduling post-program surveys and related-project work. As for participants, be sure to carve out time for personal reflection and to share your experience and insights.

Watch the accompanying video about the Pfizer Global Health Fellows' work on strengthening social franchising in Tanzania at psiimpact.com.

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LAST WORD

Who will Finance the Modern Development Enterprise? The shrinking landscape of public funding demands a few new creative solutions.

By Karl Hofmann, PSI President and CEO

FISCAL PRESSURES IN THE US AND EUROPE mean that genuine political courage is required more than ever to defend investments in development. There certainly are hopeful signs still — the US Senate recently overwhelmingly rejected a proposal by presidential hopeful Rand Paul to slash US development assistance by 50 percent. The UK has retained its ambitious .7 percent of GDP target for aid despite years of austerity. But few development practitioners feel as though there are days of plentiful public financing ahead. What does this mean for institutions that aspire to be Modern Development Enterprises? Raj Shah coined this phrase to describe USAID’s trajectory under his leadership, but to become one is a worthy objective for all of us working to channel public resources to address the causes and effects of extreme poverty, disease and misery. For PSI, we see four pathways to greater financial sustainability and longer term impact of our work:

NEW PHILANTHROPISTS We sense a palpable hunger on the part of entrepreneurs and the recipients of the vast inter-generational wealth transfer now underway, to find impactful social investment opportunities. This new generation of givers demands also to be shapers. This is not a simple check-writing generation, nor one thinking about bequests. The new philanthropists are co-creators, aiming to understand, influence and co-own the development outcomes they wish to finance. The Modern Development Enterprise will have offerings and approaches that speak to this new generation of philanthropists.

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CORPORATIONS The era of corporate social responsibility is ceding to the era of shared value and joint profit-loss calculations. Corporations are not perfect but they are great at delivering value to consumers and to shareholders — if not, they cease to exist. The Modern Development Enterprise can find synergies with corporations in terms of scale, innovation and business operations. The modern corporation often looks with interest at the “marketplace” of development NGOs because it is the genuine base of the global pyramid where corporations will find their future growth.

INNOVATIVE FINANCING Much is written about impact investing, development impact bonds, social impact bonds and other forms of performancebased financing. The reality is that rhetoric does not always match our aspirations, but the Modern Development Enterprise is working to unlock this source of funding, where measurable social return can partner with respectable financial return and yield new impact for all parties.

THE GLOBAL SOUTH Financial sustainability is on the lips of most donors these days. Our redoubled efforts to eliminate extreme poverty in the world — the underlying premise of the MDGs, the explicit policy of the USG, and the clarion call of the draft SDGs — demand that domestic resources in the developing world play a bigger role than they have up to now. Modern Development Enterprises will be in the position to offer cost-effective health and development solutions to their host country governments, and must be positioned to find funding from among those lower-income clients and consumers who are direct recipients of their services. Universal Health Coverage does not mean Universal Free Coverage. It means accessible and affordable coverage — health for all, without undue financial hardship. The Modern Development Enterprise will be a part of this evolution within host countries in the Global South. Modern Development Enterprises are working on all these fronts to increase their impact, enhance their relevance, and meet the development challenges of the 21st century. n

KARL HOFMANN President and CEO, PSI

Cutting edge global health coveragefrom PSI & partners

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UPCOMING ISSUES FOR IMPACT MAGAZINE

FALL 2015

The Private Sector Perspective on the Sustainable Development Goals Print and online distribution, corresponding event • Why do these goals matter to commercial interests? • Who will ﬁnance fulﬁlling these far-reaching goals and how? • Will public-private partnerships be more important than ever before?

Why Should Global Health Organizations Tackle Non-Communicable Diseases (NCDs)? And How? Print and online distribution, corresponding event • Why are NCDs capturing the attention of some donor budgets? How much more do they need? • What are some of the most innovative approaches to reducing the WINTER 2015 risk factors for NCDs in the developing world? • What are the latest treatments to be scaled for NCDs in the developing world? Top Ten Moments in Global Health for 2015 Online distribution only • What were the innovations, advances, crises, partnerships and other news events that have marked 2015? FINAL ISSUE OF 2015

To pitch ideas or articles for these and future issues or to learn how you can participate in partnerships and events surrounding the launch of these publications, contact Karen Sommer Shalett at kshalett@psi.org.

1120 19th Street NW Suite 600 Washington, DC 20036 www.psi.org

Check out 5 health innovations from around the world.

PSI PULSE

is a quarterly interactive report of the global health organization’s most innovative approaches and their health impact. See what’s new and bold at pulse.psi.org.