OUR CURRENT PROJECTS
1. Misoprostol
2. Population
3. African Voices
4. Women's Options 5. Rethinking Foreign Aid 6. Philippines' Reproductive Health Battles 7. Demographic Momentum Graphs ********************** When misoprostol came off patent in year 2000, leading African obstetrician-gynecologists from Kenya, Tanzania and Nigeria asked the fledging Venture Strategies to make misoprostol legally available in Africa to control women's hemorrhage after childbirth. It was a complex task involving policy meetings, operations research to satisfy governments, and going through governments' regulatory systems. We visited most of the pharmaceutical manufacturers around the world and attempted collaboration with a number of partners, trying to negotiate down affordable prices for the poor.
Misoprostol is a low cost, easy to use tablet that, although designed for gastric ulcers, makes the uterus contract, and it can be used in a number of ways including post-abortion care and safe abortion in addition to controlling hemorrhage. It is approved by the World Health Organization for use in preventing hemorrhage, and since year 2000 has been approved by the U.S. FDA with the abortion pill commonly known as RU486.
With the Tanzanian Ministry of Health and the Bixby Center at Berkeley, in 2003-2005 we ran a highly successful study showing that even rural, illiterate traditional birth attendants (TBAs) could successfully save lives by treating women who had hemorrhage in childbirth.
In January 2006 we achieved the first-ever legal approval anywhere in the world for importing and distributing this drug for controlling hemorrhage. Misoprostol was (and is) already commonly used this way in US and European hospitals, legally off-label, while the developing world had no such liberal rule.
Five more countries followed - we facilitated regulatory approval in Tanzania, Zambia, Bangladesh, Ghana, and Nepal. In Ethiopia, with DKT International we greatly expanded the use of misoprostol, with approval coming later. At this point we created a partner organization, Venture Strategies Innovations (VSI) which has continued the implementation of these efforts. In Ethiopia and 7 more countries, our combined organizations have facilitated approval in 14 countries - including Pakistan.
In the meantime our (Venture Strategies for Health and Development) involvement in misoprostol is high on our current list, with a special interest in making sure that women have correct information on a very large scale for the safe use of this remarkable tablet. We are increasing understanding of not only the imperative but also the feasibility of slowing population growth within a voluntary, human rights framework. We are helping the policy community to understand the importance of population growth, determinants of fertility decline, and the many unnecessary barriers to family planning. We are actively and successfully shifting public opinion in these important matters. In collaboration with the School of Public Health at the University of California, Berkeley, we published the first comprehensive review of the wide range of barriers standing between low income women around the world and the family planning methods they want.
We will provide more information about this work in the near future.
3. AFRICAN VOICES
AFIDEP is the new African Institute for Development Policy, based in Nairobi, Kenya. A registered nonprofit, it is translating high quality research into useful information for African countries' policymakers. This includes ministries of finance and planning, who welcome this information for improving development and health, including managing the challenging factor of rapid population growth. AFIDEP is the only African organization working on these matters, with purely African expertise and African voices.
AFIDEP was founded by Eliya Msiyaphazi Zulu, PhD, Malawian demographer who earned his PhD in Demography at the University of Pennsylvania. He is the elected president of UAPS, the Union for African Population Studies, with a membership of over 1,000.
In Venture Strategies we have had the privilege of providing the initial support for the establishment of AFIDEP. [See AFIDEP's web site www.afidep.org] 4. WOMEN'S OPTIONS We are determined to let women everywhere manage their childbearing. We are showing that family planning can be available at the village level - preceding health systems, which in fast-growing countries are too slow to help women. In collaboration with the Bixby Center at Berkeley, we have done a successful study in Ethiopia demonstrating that the three month DMPA can be administered safely at the community level by village level volunteers. In Ethiopia, where the unmet need for family planning is staggeringly high, DMPA is method most women prefer.
Family planning is often the most powerful and cost-effective way of changing a society and improving the status of women. We are also working to help women have correct information on the safe use of misoprostol for safe abortion and hemorrhage after childbirth. We are keenly interested in preventing unsafe abortions.
5. RETHINKING FOREIGN AID
We are pioneers in setting up and evaluating innovation voucher systems for health and reproductive health. These systems, often identified as Output Based Aid, can work more efficiently than foreign aid through country governments. Our work in this area has been supported by KfW (the German development bank), the World Bank and the UK's Department for International Development (DFID).
6. PHILIPPINES' REPRODUCTIVE HEALTH BATTLES
On request, we have been assisting with the revolutionary drive to enable women to have contraception in the Philippines. The goal is for their Congress to approve the new Reproductive Health law.
7. DEMOGRAPHIC MOMENTUM GRAPHS
This is about time and scale. The year in which a country reaches replacement level fertility has a major impact on its ultimate population size. The following 38 graphs, which we produced with AFIDEP, show the future of countries' population size depending on three scenarios of timing of fertility decline to replacement level. The technical aspects were accomplished by mathematician Matt Hamilton in Venture Strategies, working with senior demographer Carl Haub in the Population Reference Bureau. The entire collection of graphs and an explanation of the methods used can be found here: Demographic Momentum Graphs. |
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