Tuesday, December 20, 2005

VENTURE STRATEGIES : For Health and Development

Quick quiz. What are the United Nations' 8 Millennium Development Goals ? If you don't know you may want to assess your commitment to improving the Quality of Life in he global community. Okay, so maybe that was cruel of me to pop that on you like that. So here is an easier question. What is the 5th Millennium Development Goal? Now if you think that is a hard question it means that you didn't even go to the link I gave you above to see what the eight goals are. Well, if you didn't look and don't know what the 5th goal is, I'll tell you. It's to: "Reduce by three quarters the maternal mortality ratio."

While this problem has diminished somewhat, there is still a long ways to go. For centuries people have talked about reducing maternal mortality, but very few people have concerned themselves with doing anything about it. Let me take a point of privilege and tell you a true story. My father was a rural physician in Virginia from the early 1930s until the 1980s. I once told me that when he was a medical student in the 1920s the popular wisdom was that was a new mother should be confined to her bed for several days after delivery because so many of them dropped dead when they got out of bed. The keepers of the common wisdom finally figured out that the women were dropping dead because they had been confined to their beds for days after a delivery - and this allowed blood clots to form. These clots found their way to the heart, or other vital organ once these new mothers got out of bed and their cardiovascular systems began efficiently pumping the clot to a lethal position. My father used to say: "Modern medicine may be the best we have, but it still is not perfect."

There is a lot more to do to improve the health of new mothers and reducing maternal mortality. One organization that is doing something about it is Venture Strategies For Health and Development. This is a nonprofit organization that was created to improve the health of low-income people in resource-poor settings. Venture Strategies strives to do this by making use of existing market forces around the world.

In their Mission Statement they say that they are a unique nonprofit organization that combines scientific evidence about tractable problems in health with opportunities inherent in existing market forces around the world. They use "business approaches to find ways to help large numbers of low income people."

It is their belief that they are also "redefining how a U.S. nonprofit working internationally should function, and what it should be able to achieve by leveraging donor funds."

Because government health services in developing countries too often do not have the ability to reach most of their low-income populations. Because of this, these poorer people must pay for a higher percentage of the cost of their health care out of their own pockets. And in many instances, when the people have the ability to pay something, the needed products are not available to them at affordable prices.

Working globally with medical leaders, government officials and pharmaceutical manufacturers Venture Strategies is trying to find ways to make high quality, low cost, off-patent products available to low income people through market distribution systems.

They do not look for these solutions to health problems only in the area of pharmaceuticals. For example, they have launched an initiative to reduce respiratory disease by developing markets for cleaner burning stoves for home use, and "setting up monitoring mechanisms as an important step in moving forward to ensure cleaner air for families who cook indoors in resource-poor settings."

The organization's web site says that to qualify as a venture strategy, "a project must have reasonable odds of achieving helpful systemic change in one or more developing countries on a significant scale in the near term, using opportunities offered by existing market structures. In doing this, a venture strategy is creating, implementing and/or expediting a selected lever on change."

Their Operating Principles are stated as follows:

"We focus on opportunities for achieving sustainable systemic change.
Scale and cost effectiveness are of overriding importance.
We concentrate on barriers to progress that can be reduced soon.
Our work is organized around a scientific evidence base.
Prices for the poor must not contain costs in the U.S. or Europe.
We are committed to staying administratively compact.

Because of their innovative work Venture Strategies has recently won a Global Giving Competition prize for social entrepreneurship for their work in Africa with misoprostol - which brings us back to the issue of maternal health.

According to an article in the International Journal of Gynecology and Obstetrics (2005) "Controlling postpartum hemorrhage after births in Tanzania"a copy of which is posted on Venture Strategies web site: "Globally, postpartum hemorrhage (PPH) accounts for a quarter of all maternal mortality, and in parts of Sub-Saharan Africa the proportion is even higher (Burkina Faso, 59%; Ivory Coast, 37%; Guinea, 43%). The high prevalence of anemia among women in developing countries predisposes them to PPH, and even a modest blood loss can be life threatening." (Footnotes are contained in the article as it appears at it site, but are omitted here.)

I know that sounds very technical, but to put it in layman's terms, a lot of women are dying in developing nations due to postpartum hemorrhaging.

According to the article, a drug known as "Misoprostol" is a proven uterotonic increasingly used in obstetrical and gynecological practice, including the control of PPH. It is also relative easy to administer, "is inexpensive, easy to store, stable in field
conditions, and it has an excellent safety profile."

In spite of this, according to the article misoprostol as an underused technology to reduce maternal mortality even though misoprostol is the only option currently available to
prevent or treat PPH where a trained health professional is not present. Venture Strategies intends to change that by making misoprostol more available in developing countries.

At the Global Giving site for this Venture Strategies project in Nigeria, it says that:

"Each year twice as many women die in childbirth as people who died in the 2004 tsunami. 99% of these deaths are in developing countries and hemorrhage is the most common cause worldwide. Bleeding can be controlled in a clinic but our projects are the first to show traditional midwives can save lives in a woman's home, where most births take place, and this is where most maternal deaths occur in the developing world - - well beyond reach of hospitals and government health services."

Venture Strategies sponsors "clinical demonstration studies with traditional midwives; co-sponsor government policy meetings; organize drug approval applications; work with manufacturers of misoprostol in China, Egypt and India, and work with distributors."

It goes on to say: Nigeria [has] been unable to lower maternal deaths to meet the UN 2015 goal of 75% reduction. With this drug, traditional midwives get their first effective technology and see the first large-scale decline in mortality.

Finally there is a poignant message from the Project Leader , who states:
"My eldest daughter died of post-partum hemorrhage four years ago. In this project we are saving women's lives with misoprostol. If we had had this earlier, we would have saved her life too." - Margaum, Traditional midwife in our Tanzanian study

There is much to be done in this area; but it looks like Venture Strategies has rolled up its sleeves and is doing something about it.

Venture Strategies

Global Giving

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