New Lessons from Fighting an Ancient Disease

Three people die every minute from tuberculosis — a treatable and largely preventable disease. Resistant forms continue to thrive, and increased travel makes the global threat very real. We face a public health emergency.

Without adequate financing, ministries of health and even private hospitals in developing countries often don't have the resources needed to purchase diagnostic equipment, train workers, and ensure access to appropriate treatment. These obstacles make it difficult to track or report disease rates and also to purchase medications in sufficient quantity to create economies of scale.

What can the health care industry do to help fight disease, while still maintaining its commitments to shareholders?

While currently crippled by inadequate infrastructure in many countries, low- and middle-income countries will be the fastest-growing markets for pharmaceuticals and medical devices over the next decade. We at Becton Dickinson saw the opportunity to marry public health and business objectives through our Global Health Initiative, which we established to find sustainable ways to fortify over-burdened and under-resourced health care systems in Africa, Asia, and Latin America. Our teams work in partnership to provide technical assistance and training to expand lab workers' skills, secure pricing agreements to increase access to our products, and design medical technologies appropriate for resource-limited settings.

Fast and accurate diagnosis is essential in effectively treating a TB patient and preventing the further spread of the disease. Unfortunately, in sub-Saharan Africa, many labs use outdated diagnostic equipment, and the public health systems lack the infrastructure needed to ensure that patient specimens are properly transported and analyzed. Addressing systemic problems requires long-term commitment and cross-sector collaboration; a partial solution, such as donating equipment, is useless if workers are unable to use it or patients don't receive their diagnoses.

Our vision is to establish sustainable health care systems that offer high-quality care using high-quality products, whether from BD or someone else. Our motives are both idealistic and realistic: We want to improve the standards and quality of health care in areas of the world afflicted with the greatest burden of disease, and we also expect to benefit from early experience in a nascent market. That is, we are after real shared value.

In partnership with the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and the Centers for Disease Control, we designed a platform to invest in the labs for TB and HIV in Ethiopia, Uganda, and Mozambique (and eventually in other high-growth markets like India).

Public-private partnerships are not new to corporate social responsibility, but we believe the breadth and scale of our lab-strengthening partnership are rare. Through the many challenges we've faced along the way, we've gained some insights that we hope will serve us and others as we continue to try to transform health care systems in Africa, India, and beyond:

  • Set and measure ambitious goals — together. In a large, multi-country, multi-organization partnership, it's critical that all parties be equally invested in its high-level goals, not just rhetorically, or even philosophically, but because they each really have something equally ambitious to gain. Seeking to "improve the quality of laboratory diagnostics critical for the treatment of HIV/AIDS and TB," certainly aligns with the missions of the CDC and local ministries of health to dramatically improve the quality of care in developing nations. But it also aligns with BD's goal of improving our knowledge of developing markets and our understanding of specific customer challenges, so that we can adapt or develop new technologies appropriate for these diverse settings and then bring these technologies to market.
  • Redefine ROI. Rarely do public-private partnerships result in increased short-term sales, and if you measure ROI that way, your initiative will be doomed. A wiser approach recognizes benefits like improved reputation, strengthened customer relationships, and a deeper appreciation for an emerging market. While we cannot make a causal link from the initiative to BD's bottom line, we do see our business growing successfully in the markets where we've had the opportunity to collaborate with partners, and can credit these collaborations as a catalyst that has enabled our company to develop its business in these challenging yet high-potential markets.
  • Learn in order to teach. Partnerships are rarely straightforward, and determining underlying needs for program beneficiaries is often part of the process. To improve national TB programs, for example, we needed to improve not only the labs but also the tracking process of TB specimens from the patient to the lab, and we needed to learn how. To do so, we enlisted one of our NGO partners to teach our IT team how to use geographic information systems (GIS). We then, in turn, trained local lab workers, who then trained others.
  • Make a multi-year commitment. After five years, BD, PEPFAR, and our local partners have made significant progress. But we are a long way from conquering TB or transforming these markets into sustained customers. That said, we hope that in the next five years through our continued collaboration, we'll be able to show continued improvements in labs around the world.

Today's health care marketplace calls for global problem solvers, not just products, and that is something we should all strive for — together.

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