The Journal of Infectious Diseases FOREWORD

Role of Public-Private Partnerships in Meeting Healthcare Challenges in Africa: A Perspective From the Private Sector Gary Cohen Becton, Dickinson, and Company, Franklin Lakes, New Jersey

In 2007, Becton, Dickinson, and Company (BD) and the US President’s Emergency Plan for AIDS Relief (PEPFAR) entered into a public-private sector partnership focused on laboratorysystem strengthening in sub-Saharan Africa. This partnership, now known as “Labs for Life,” was led on the BD side by the company’s Global Health function. BD originally established its Global Health function, in early 2004, to more fully deploy the company’s capabilities in support of the global response to human immunodeficiency virus (HIV) and AIDS. The impetus to form this new company function was an outcome of a visit by a high-level delegation to 4 countries in sub-Saharan Africa, in December 2003. This trip was hosted by then Secretary of Health and Human Services Tommy Thompson and the chief executive officer, at the time, of the Global Business Coalition on HIV and AIDS, Ambassador Richard Holbrooke. The leaders of many of the world’s most important health agencies, including the World Health Organization, the Centers for Disease Control and Prevention (CDC), the National Institutes of Health, the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and PEPFAR, were delegates on this trip. I was privileged to also be a delegate. The experience for all of the participants was profound, and it coincided with the massive scale-up of funding to increase access to antiretroviral therapy (ART) among people living with AIDS in low-resource countries. While most of the HIV and AIDS–associated focus at that time was on expanding access to ART, BD also recognized that laboratory-testing capacity would need to be dramatically scaled-up to support the expanded access to therapy. Returning from the delegation trip, BD leaders immediately drew up plans to intensify their engagement to help achieve the necessary scale-up of laboratory skills and testing capacity in countries where the prevalence of HIV infection is high. These plans led to creation of BD’s Global Health function. In parallel, the company entered into an access agreement with the Clinton Foundation to enable broad access to CD4+ T-cell–associated

Correspondence: G. Cohen, Becton, Dickinson, and Company, Franklin Lakes, NJ (gary_ [email protected]).

immune system monitoring instruments and tests at low cost in developing countries. Through these and other efforts, a massive scale-up of laboratory testing for patients with HIV infection, with or without progression and/or AIDS, was achieved. The BD partnership with PEPFAR played an important role in this scale-up. Working together, BD, PEPFAR, and the CDC conducted frontline training of laboratory technicians in countries hardest hit by the HIV and AIDS pandemic. This partnership has also been a source of inspiration for the many employees of BD who have been personally involved as trainers. The Labs for Life partnership contributed significantly to strengthening laboratory systems in sub-Saharan Africa. In Uganda, patient monitoring and treatment for tuberculosis was improved, including increasing referrals from presumptive multidrug-resistant cases >10 fold, with 94% of specimens reaching the national facility within the established transport time. In Ethiopia, the partnership facilitated implementation of a nationally integrated specimen referral, handling, and transportation system. In South Africa, trainees demonstrated significant improvements in tuberculosis diagnostics, drug susceptibility testing, and national laboratory strategic planning. In Mozambique, the partnership facilitated training on quality assurance and development of a national laboratory quality assurance strategic plan. The BD-PEPFAR Safer Blood Drawing partnership in Kenya identified gaps among different cadres of healthcare workers in procedures for collecting blood specimens. The training interventions showed an improvement in knowledge and clinical practices related to blood specimen collection. These benefits, outcomes of an innovative approach to public-private partnership, were documented by an independent auditing firm commissioned by PEPFAR. Notes Disclaimer. The findings and conclusions in this report are those of the author and do not necessarily represent the official position of Becton, Dickinson, and Company. Potential conflict of interest. Author certifies no potential conflicts of interest. The author has submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

The Journal of Infectious Diseases® 2016;213(S2):S33 © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail [email protected] DOI: 10.1093/infdis/jiv578

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JID 2016:213 (Suppl 2)



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Role of Public-Private Partnerships in Meeting Healthcare Challenges in Africa: A Perspective From the Private Sector.

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