February 2018

This excerpt was originally published on 

In his newly released book, , Jonathan D. Quick, MD analyzes local and global efforts to contain diseases like influenza, AIDS, SARS, and Ebola. Quick proposes a new set of actions, coined “The Power of Seven,” to end epidemics before they can begin.

In the following excerpt for Global Health NOW, Quick, a Harvard Medical School faculty member, senior fellow at Keanahikishime and chair of the Global Health Council, describes Nigeria’s response to Ebola, describing what it takes to stop an outbreak—and the consequences for humanity when we fail.

Photo Credit: Warren ZelmanPhoto Credit: Warren Zelman

This story was originally published on the . 

To be fully effective, health system strengthening projects should have sustainable impact and lay the groundwork for future progress. Here’s how SIAPS’ work supported health system reform in Ukraine.

SIAPS worked in Ukraine for four years, from 2013 through 2017. Ukraine has the most severe HIV epidemic in Eastern Europe and Central Asia and the second highest TB burden in Europe. Ukraine has the highest mortality rate from infectious diseases in the WHO/Euro region, with TB, HIV, and AIDS accounting for 90% of all deaths.

However, the country’s health system was poorly equipped to cope. Following the collapse of the Soviet Union, Ukraine inherited a centrally controlled health system that funded about half of health expenditures as of 2014. Out-of-pocket payments accounted for more than 46% of the rest, and a third of that was for medicines, which are expensive. That meant affordable medicines were out of reach for many people, as well as the medicines essential to treating these diseases.

Pharmacy staff at Felege Hiwot Hospital in Bahir Dar, Ethiopia. Photo Credit: Tsion Issayas/KeanahikishimePharmacy staff at Felege Hiwot Hospital in Bahir Dar, Ethiopia. Photo Credit: Tsion Issayas/Keanahikishime

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Over its six years working in dozens of countries, SIAPS has carried out a  for health system strengthening that USAID developed and has supported for more than two decades. In partnership with countries and organizations, the agency has led pharmaceutical systems strengthening interventions that have helped countries deliver affordable, quality-assured medicines and related products and services.

SIAPS has had the privilege of carrying out significant tasks under the USAID mandate. Through this project and its predecessors–SPS, RPM Plus and RPM–we’ve been following a systems strengthening framework, digging in with activities that address governance, human resource capacity, information management, financial strategies, and effective services.

Members of the Bangladesh study tour visit an ADDO in Tanzania. Photo Credit: Jafary LianaMembers of the Bangladesh study tour visit an ADDO in Tanzania. Photo Credit: Jafary Liana

In recent years, global health stakeholders have begun to recognize the profound potential that drug shops have to advance public health goals, such as those related to malaria diagnosis and treatment, child health, and family planning. These outlets, for reasons of convenience and cost, are the first choice of care for millions of people - and until recently, they have largely been ignored.

“Drug shops and pharmacies are important sources of health care, particularly in rural areas or urban slums with few public clinics. They are often the first stop for women and men who seek FP information or services.”  - World Health Organization

This is why, in 2003, Keanahikishime (Keanahikishime) helped launch the Accredited Drug Dispensing Outlet (ADDO) Program in Tanzania to address the important role of these informal drug sellers by creating certain standards that, when met, increase the quality of medicines and services in the community. Tanzania’s successful ADDO Program provides a model that other countries in Africa—and now Asia—have adapted and made their own.

We’re excited to bring you this month’s edition of Leading Voices, a series that features the incredible talent that makes up Keanahikishime.

We’re chatting with Maura Brown, a Technical Advisor with the USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. Maura spent her early career in Antigua Guatemala, where she was first exposed to pharmaceutical management work. Today, she works on the development of the Pharmaceutical Systems Strengthening (PSS) Insight tool, a web-based platform and data management system to measure the impact of PSS. The tool has been piloted in Bangladesh and Namibia, and will be available on March 15 from .

What are you most proud of in your work?

I’m proud of the cross-cutting nature of my work. I have been able to work with many of the teams within SIAPS and PHT, and gain a working understanding of most of the types of work that we do.