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Tucker JD, Day S, Nwaozuru UC, Obiezu-Umeh C, Ezechi O, Chima K, Mukuka C, Iwelunmor J, Sturke R, Vorkoper S. Sustaining sexual health programs: practical considerations and lessons from the President's Emergency Plan for AIDS Relief. Sex Health 2024; 21:SH24064. [PMID: 38917298 DOI: 10.1071/sh24064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 06/06/2024] [Indexed: 06/27/2024]
Abstract
Enhancing the sustainability of sexual health programs is important, but there are few practical tools to facilitate this process. Drawing on a sustainability conceptual framework, this Editorial proposes four ideas to increase the sustainability of sexual health programs - early planning, equitable community engagement, return on investment, and partnerships to address social determinants. Early planning during the design of a sexual health program is important for sustainability because it provides an opportunity for the team to build factors relevant to sustainability into the program itself. Equitable community engagement can expand multi-sectoral partnerships for institutionalisation, identify allies for implementation, and strengthen relationships between beneficiaries and researchers. From a financial perspective, considering the return on investment could increase the likelihood of sustainability. Finally, partnerships to address social determinants can help to identify organisations with a similar vision. Existing sustainability frameworks can be used to measure each of these key elements. Several approaches can be used to enhance the sustainability of sexual health programs. The President's Emergency Plan for AIDS Relief provides potential lessons for increasing the sustainability of sexual health programs in diverse global settings.
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Affiliation(s)
- Joseph D Tucker
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK; and Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Suzanne Day
- Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ucheoma C Nwaozuru
- Implementation Science, Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Chisom Obiezu-Umeh
- Center for Dissemination & Implementation Science, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Oliver Ezechi
- Centre for Reproduction and Population Health Studies, Department of Clinical Sciences, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Kelechi Chima
- Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Juliet Iwelunmor
- Division of Infectious Diseases, John T. Milliken Department of Internal Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Rachel Sturke
- Fogarty International Center, US National Institutes of Health, Bethesda, MD, USA
| | - Susan Vorkoper
- Fogarty International Center, US National Institutes of Health, Bethesda, MD, USA
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Rosenberg N, Stolwijk NN, van den Berg S, Heus JJ, van der Wel V, van Gelder T, Bosch AM, de Visser SJ, Hollak CEM. Development of medicines for rare diseases and inborn errors of metabolism: Toward novel public-private partnerships. J Inherit Metab Dis 2023; 46:806-816. [PMID: 36938792 DOI: 10.1002/jimd.12605] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/12/2023] [Accepted: 03/16/2023] [Indexed: 03/21/2023]
Abstract
Medicine development for rare diseases, including inborn errors of metabolism (IEMs) is challenging. Many academic innovations fail to reach the patient, either by stranding in the translational stage or due to suboptimal patient access related to pricing or uncertain effectiveness. Expanding and solidifying the role of the academic in public-private partnerships (PPPs) may present an innovative solution to help overcome these complexities. This narrative review explores the literature on traditional and novel collaborative approaches to medicine development for rare diseases and analyzes examples of PPPs, with a specific focus on IEMs. Several academic institutions have introduced guidelines for socially responsible licensing of innovations for private development. The PPP model offers a more integrative approach toward academic involvement of medicine development. By sharing risks and rewards, failures in the translational stage can be mutually absorbed. If socially responsible terms are not included, however, high pricing can impede patient access. Therefore, we propose a framework for socially responsible PPPs aimed at medicine development for metabolic disorders. This socially responsible PPP framework could stimulate successful and accessible medicine development for IEMs as well as other rare diseases if the establishment of such collaborations includes terms securing joint data ownership and evidence generation, fast access, and socially responsible pricing.
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Affiliation(s)
- Noa Rosenberg
- Medicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC - University of Amsterdam, Amsterdam, The Netherlands
- Department of Endocrinology and Metabolism, Amsterdam UMC, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Expertise Center for Inborn Errors of Metabolism, MetabERN, University of Amsterdam, Amsterdam, The Netherlands
| | - Nina N Stolwijk
- Medicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC - University of Amsterdam, Amsterdam, The Netherlands
- Department of Endocrinology and Metabolism, Amsterdam UMC, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Expertise Center for Inborn Errors of Metabolism, MetabERN, University of Amsterdam, Amsterdam, The Netherlands
| | - Sibren van den Berg
- Medicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC - University of Amsterdam, Amsterdam, The Netherlands
- Department of Endocrinology and Metabolism, Amsterdam UMC, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Expertise Center for Inborn Errors of Metabolism, MetabERN, University of Amsterdam, Amsterdam, The Netherlands
| | - Joris J Heus
- Innovation eXchange Amsterdam (IXA) Office Amsterdam UMC, Amsterdam, The Netherlands
| | - Vincent van der Wel
- Medicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC - University of Amsterdam, Amsterdam, The Netherlands
- Orfenix B.V., Leiden, The Netherlands
| | - Teun van Gelder
- Department of Clinical Pharmacy & Toxicology, LUMC, Leiden University Medical Center, Leiden, The Netherlands
| | - Annet M Bosch
- Department of Pediatrics, Division of Metabolic Diseases, Emma Children's Hospital, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM), Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Saco J de Visser
- Medicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC - University of Amsterdam, Amsterdam, The Netherlands
- Centre for Future Affordable & Sustainable Therapy development (FAST), The Hague, The Netherlands
| | - Carla E M Hollak
- Medicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC - University of Amsterdam, Amsterdam, The Netherlands
- Department of Endocrinology and Metabolism, Amsterdam UMC, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Expertise Center for Inborn Errors of Metabolism, MetabERN, University of Amsterdam, Amsterdam, The Netherlands
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Siddiqi S, Aftab W, Venkat Raman A, Soucat A, Alwan A. The role of the private sector in delivering essential packages of health services: lessons from country experiences. BMJ Glob Health 2023; 8:bmjgh-2022-010742. [PMID: 36657810 PMCID: PMC9853132 DOI: 10.1136/bmjgh-2022-010742] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 12/10/2022] [Indexed: 01/20/2023] Open
Abstract
Many countries are adopting essential packages of health services (EPHS) to implement universal health coverage (UHC), which are mostly financed and delivered by the public sector, while the potential role of the private health sector (PHS) remains untapped. Currently, many low-income and lower middle-income countries (LLMICs) have devised EPHS; however, guidance on translating these packages into quality, accessible and affordable services is limited. This paper explores the role of PHS in achieving UHC, identifies key concerns and presents the experience of the Diseases Control Priorities 3 Country Translation project in Afghanistan, Ethiopia, Pakistan, Somalia, Sudan and Zanzibar. There are key challenges to engagement of the PHS, which include the complexity and heterogeneity of private providers, their operation in isolation of the health system, limitations of population coverage and equity when left to PHS's own choices, and higher overall cost of care for privately delivered services. Irrespective of the strategies employed to involve the PHS in delivering EPHS, it is necessary to identify private providers in terms of their characteristics and contribution, and their response to regulatory tools and incentives. Strategies for regulating private providers include better statutory control to prevent unlicensed practice, self-regulation by professional bodies to maintain standards of practice and accreditation of large private hospitals and chains. Potentially, purchasing delivery of essential services by engaging private providers can be an effective 'regulatory approach' to modify provider behaviour. Despite existing experience, more research is needed to better explore and operationalise the role of PHS in implementing EPHS in LLMICs.
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Affiliation(s)
- Sameen Siddiqi
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Wafa Aftab
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - A Venkat Raman
- Faculty of Management Studies, University of Delhi, New Delhi, India
| | - Agnès Soucat
- Division of Health and Social Protection, France Development Agency (AFD), Paris, France
| | - Ala Alwan
- London School of Hygiene & Tropical Medicine, London, UK
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Portuguese Volunteer Firefighters in the Context of the Challenges Posed by the COVID-19 Pandemic. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci11070285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic is producing not only epidemiological consequences on a global scale, but also political, economic, and social repercussions. The health care professionals that have been on the front lines fighting the pandemic need the support and assistance of other organizations to meet the many daily challenges. Volunteer firefighters stand out for their outreach approach and implementation of the Human2Human paradigm that has enabled them to meet the needs of the most vulnerable population that have been hit the hardest by the pandemic. This study adopts an ethnographic-action method considering Portuguese volunteer firefighters to explore the characteristics and relevance of these initiatives in areas such as combating isolation, medical assistance, containing the spread of COVID-19, and promoting public–private partnerships. The findings reveal that factors associated with altruism are central elements in the emergence of these initiatives, although some locally or nationally coordinated initiatives have been replicated in other contexts. It is also noteworthy that volunteer firefighters also present initiatives that can be fit into more than one category.
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