ImprovIng the health of Women & ChIldren around the World by 2015 potx

ImprovIng the health of
Women & ChIldren
around the World by 2015
6 8
10 12 14
4
2 MDG Health Alliance Pillars
3 Who We Are | Leadership
4 Improve Child Health
6 Improve Maternal Health
8 Near-Zero Malaria Deaths
10 Near-Zero Transmission of HIV from Mother-to-Child
12 Save One Million Lives from Tuberculosis
14 One Million Community Health Workers
2 | www.mdghealthalliance.org
mdg health allIanCe pIllars
IMPROVE CHILD HEALTH:
Reduce the number of children under 5
dying from 8 million per year to 4 million
per year by the end of 2015
In collaboration with UNICEF and other
partners, in countries with the largest
concentrations of child mortality, increase
access to medicines that prevent and
treat the leading causes of under 5
deaths, including oral rehydration with
zinc, pediatric antibiotics, bed nets and
malaria medicines, and interventions that
prevent the leading causes of neonatal
deaths; with a particular emphasis on
increasing private sector contributions to

achieving MDG 4.
IMPROVE MATERNAL HEALTH:
Reduce the number of women dying
in childbirth from 350,000 per year to
less than 180,000 per year and achieve
universal access to reproductive health
by the end of 2015
In collaboration with the H5 agencies
(UNFPA, UNAIDS, UNICEF, WHO and
the World Bank) the United Nations
Foundation and the United Nations
Commission on Life-Saving Commodities
for Women and Children, tap into the
vast potential of private health providers
and health businesses to deliver high
quality, aordable and accessible care
and products to women at highest
risk of maternal mortality and support
governments’ eorts to achieve MDG 5.
NEAR-ZERO MALARIA DEATHS:
Reduce the number of deaths caused
by malaria from 655,000 to near-zero
by the end of 2015
In collaboration with the Roll Back
Malaria Partnership, the African Leaders
Malaria Alliance, the Global Fund, the
World Bank, WHO, the United States and
the United Kingdom, UNICEF, and other
key partners, in countries with the largest
concentrations of malaria deaths, ensure

continued universal coverage of bednets
as well as aggressive deployment of
diagnostics and treatment integrated with
community case management in both
the public and private sectors.
NEAR-ZERO TRANSMISSION OF HIV
FROM MOTHER-TO-CHILD: Virtually
eliminate the transmission of HIV from
mother-to-child by the end of 2015
In collaboration with UNAIDS, PEPFAR, the
countries suering the greatest burden
and other partners, virtually eliminate
the transmission of HIV from mother-to-
child by 2015 worldwide. The Business
Leadership Council for a Generation Born
HIV Free, consisting of globally recognized
private sector leaders, has been formed to
bring to bear the collective resources and
acumen of the private sector to achieve
the 2015 deadline. The BLC will identify
concrete, actionable roles for businesses
to maximize their impact on vertical
transmission rates in high-burden countries.
SAVE ONE MILLION LIVES FROM
TUBERCULOSIS: Reduce the trajectory
of the number of HIV+ patients who
will die of TB, currently estimated at
1.3 million people, by the end of 2015
In collaboration with Stop TB and other
partners, increase the TB cure rate by

providing screening programs to test
for infections every three years, provide
treatment to TB-positive individuals,
provide preventive TB treatment to
all women living with HIV at risk of TB
exposure, examine all pregnant women
for signs and symptoms of TB, assess
whole-family risk, and develop new child-
friendly diagnostics.
ONE MILLION COMMUNITY HEALTH
WORKERS: Recruit, train and equip
1 million community health workers
to advance maternal and child health
by the end of 2015
In collaboration with WHO and UN
Agencies, leading telecommunications
and high-tech firms, academic institutions,
and leading NGOs and foundations,
accelerate the provision of community
health workers with training and
equipment to diagnose, prevent and
treat the leading causes of maternal
mortality and child mortality in the
highest burden countries.
www.mdghealthalliance.org | 3
Who We are
The MDG Health Alliance is convened
by MDG Advocate Ray Chambers.
The Alliance is comprised of eminent
leaders from the private, public,

and nonprofit sectors working in
conjunction with the Health and
Education Cluster of the Secretary-
General’s MDG Advocates. Together,
we seek to fulfill the vision articulated
in the UN Secretary-General’s Every
Woman Every Child movement by
mobilizing public-private partnerships.
Private Sector Leaders
+
Alan Batkin
Vice-Chairman, Eton Park Capital Management
+
Kathy Calvin
CEO, UN Foundation
+
Peter Chernin
Former President and CEO of News Corporation,
Chairman of Chernin Entertainment
+
Jack Dorsey
Founder and Executive Chairman of Twitter and
CEO of Square
+
Leith Greenslade
Private Social Investor and Partner, Acumen Fund
+
Austin Hearst
CEO and Chairman, Chestnut Holdings LLC
+

Gabriel Jamarillo
General Manager, The Global Fund for HIV/AIDS, TB,
and Malaria
+
Ellen Lambert
Merck Foundation
+
Charlie MacCormack
Formerly President and CEO, Save the Children
+
John Megrue
CEO, Apax Partners US
+
Brad Palmer
Managing Partner, Palm Ventures LLC
+
Naveen Rao, M.D.
Lead, Merck for Mothers
+
Cliord Sobel and Barbara Sobel
Former US Ambassador to Brazil
+
Diana Taylor
Managing Director, Wolfensohn Fund Management
+
Jerey C. Walker
Former Chairman of CCMP Capital Advisers, LLC
Improve Child Health
Leadership: Alan Batkin and Leith Greenslade
Improve Maternal Health

Leadership: Naveen Rao, M.D.
Near-Zero Malaria Deaths
Leadership: Suprotik Basu
Near-Zero Transmission of HIV from
Mother-to-Child
Leadership: John Megrue
Save One Million Lives from Tuberculosis
One Million Community Health Workers
Leadership: Jeff Walker
MDG Health Alliance Pillars
Six Pillars underpin the work of the Alliance, each led by a respective Chair or
Co-Chair, who is responsible for ensuring forward progress and coordination across
agendas, convening networks of new and traditional partners, raising visibility,
awareness, and resources, advocating in favor of increased public sector financing,
and assisting with logistics and in-kind resources:
4 | www.mdghealthalliance.org
Accordingly, since 2004 the public health
community has recommended ORS and
zinc for child diarrhea, however, not one
of the countries with the highest burden
of child diarrhea mortality has achieved
significant coverage of either product, as
the table below shows.
Private Sector Opportunity
An opportunity exists for the commercial
distribution of quality ORS and zinc
at aordable prices and in a variety
of formulations (tablets, syrups, food
supplements, soil fortification etc)
throughout the developing world. There

are 560 million children under 5 living
in the developing world and they each
average 3 episodes of diarrhea every
year. In addition, there are 140 million
underweight children who are at greater
risk of death from infection who would
benefit from zinc supplementation.
In most of the high child mortality
countries, consumers have already
demonstrated a willingness to pay for
diarrhea treatments, typically buying
products from local, private pharmacies
or kiosks and incurring costs up to
US$5.00 for medicines that do not treat
dehydration or strengthen a child’s
Millennium Development Goal 4 calls for
a reduction in early childhood deaths to
4 million per year in 2015. This goal will
not be met without new global eorts to
prevent and treat the leading causes of
child mortality (pneumonia, diarrhea,
preterm birth, birth asphyxia, malaria and
neonatal infection) in the countries where
deaths are concentrated, particularly
India, Nigeria, DRC, Pakistan, China and
Ethiopia. As undernutrition is the leading
risk factor for death among children in the
developing world, all strategies need to
incorporate a strong nutrition component.
ORS and zinc treat-

ment for diarrhea
should appeal to any
donor seeking a high
return on investment
and the ability to have
a rapid eect on child
mortality, and donors
who have an interest
in pursuing private
sector approaches
would be particularly
well placed to oer
initial support”.
— Clinton Health Access Initiative
GLOBAL CHALLENGE
IMPROVE CHILD HEALTH
Reduce the number of children under 5 dying from 8 million per year to
4 million per year by 2015
MDG Health Alliance Priorities
Phase 1 of the Alliance’s child health
agenda will focus on preventing child
diarrheal deaths in the two regions of the
world where they are most concentrated
— the northern states of India and Nigeria.
In Phase 2 this approach will be extended
to the other high child mortality countries
along with eorts to reduce child
pneumonia deaths and neonatal deaths.
Phase 1: Reducing Child Diarrhea Deaths
Diarrhea is the second leading cause

of death for children under 5, claiming
1.3 million every year with India and
Nigeria accounting for one third of
all deaths. Diarrhea continues to kill
millions of children every year despite
the existence of highly eective, low cost
treatment options — oral rehydration
solutions (ORS) and zinc. ORS prevents
dehydration — the leading cause of child
diarrhea deaths — and zinc boosts the
immune system, reducing the duration
and severity of a diarrheal episode and
preventing new infections for two to
three months. If used routinely ORS and
zinc could prevent 90% of child diarrhea
deaths, saving more than 1 million
children every year.
Country
Annual Number Under 5
Deaths from Diarrhea
ORS Treatment Coverage Zinc Treatment Coverage
India 237,000 26% 0.3%
Nigeria 200,000 26% 1%
DRC 100,000 31% 0%
Pakistan 74,000 41% 0%
Ethiopia 73,000 26% 0%
WHO, 2008 and UNICEF, 2009
“
www.mdghealthalliance.org | 5
Led by Alan Batkin and Leith Greenslade, the Child

Health Pillar of the MDG Health Alliance works in
partnership with UN Agencies, the private sector,
nonprofit organizations, academic institutions and
others to support country efforts to accelerate
progress toward achieving Millennium Development
Goal 4. The Pillar operates in support of
Every Woman
Every Child,
an unprecedented global movement
spearheaded by the United Nations Secretary-General
to mobilize and intensify global action to improve the
health of women and children.
n
immune system. There are also large
groups of consumers who either treat
diarrhea with home remedies or not at
all, making it one of most undertreated
illnesses in the developing world. Shifting
existing consumer and health provider
demand towards quality, aordable, child-
friendly ORS and zinc and generating new
demand from those who are currently not
seeking treatment outside the home
represents a significant opportunity for
manufacturers of ORS and zinc.
New Public-Private Partnerships
The Alliance is working in partnership with
UNICEF, the United Nations Foundation,
the Clinton Health Access Initiative, PATH
and the Bill and Melinda Gates Foundation

to mobilize new private-public
partnerships to increase the supply of,
demand for, and distribution of ORS and
zinc in countries where child diarrheal
deaths are concentrated, beginning with
India and Nigeria. Further, to build
momentum and support for new
partnerships, MDG Health Alliance
Business Councils will be established in
India and Nigeria to advocate and
mobilize resources for the diarrhea
challenge and other Alliance priorities.
Key goals of the Public-Private
Partnerships to End Child Diarrheal
Deaths in the target countries include:
1 Increase household and health
provider demand for ORS and zinc
through:
+ commercial advertising campaigns
using traditional media (particularly
radio, television and print) and mobile
communications (particularly text
messaging)
+ incentives for consumers to use ORS
and zinc and for health providers
to stock and promote their use,
particularly amongst the extensive
informal private pharmacy networks
that exist in most of the target countries
2 Ensure an adequate supply of child-

friendly ORS and zinc that meet
quality standards at prices aordable
to the poorest households by:
+ matching product design and
packaging to consumer preferences
+ supporting the regulatory changes
necessary to increase access to ORS
and zinc (e.g. achieving “over-the-
counter” status for zinc in all target
countries)
+ working with local pharmaceutical
manufacturers to stimulate local
supply, including co-packaged and/or
co-dispensed ORS and zinc products
+ training and incenting local pharmacy
networks and health workers to sell
the products
3 Mobilize local distribution networks
to maximize access to ORS and zinc
focusing on those regions within
countries where diarrheal deaths are
concentrated, by:
+ leveraging the knowledge, expertise
and assets of the leading private
sector distribution channels in target
countries so as to broaden the outlets
that will sell ORS and zinc to include
local kiosks and pharmacies
In the countdown to 2015, country-
led demand for new private sector

partnerships to increase the use of
ORS and zinc is strong creating an
opportunity for collective impact that
could save the lives of one million
children under 5.
6 | www.mdghealthalliance.org
Every day, approximately 1000 women
die due to complications of pregnancy
and childbirth — nearly all of these
deaths are preventable. Millennium
Development Goal 5 will not be met
without significant global eorts to
prevent and treat the two leading causes
of maternal mortality worldwide — post-
partum hemorrhage and hypertensive
disorders during pregnancy, such as
preeclampsia. Access to family planning
is also known to play an important role in
reducing maternal mortality.
MGD 5 is one of the
goals furthest o
track and we need to
accelerate progress
on maternal health.
Together, through
strategic public-
private partnerships
we can make the
tragedy of a woman
who dies while giving

life a memory, rather
than a crisis.
aordable and accessible care and
products to those at greatest risk of
maternal mortality.
Initially, the Alliance will work in India
and Nigeria, which together account for
one third of maternal deaths worldwide,
and Uganda where an estimated 6,000
women die each year. In Phase 2, the
Alliance will explore opportunities to
work in additional countries with a high
burden of maternal mortality.
Phase 1: Identify Sustainable and
Innovative Business Solutions
The governments of these target
countries are committed to
strengthening their health systems and
improving maternal health. And many
communities in these countries have a
strong business sector which facilitates
opportunities for innovation in public-
private partnerships at the local level.
GLOBAL CHALLENGE
IMPROVE MATERNAL HEALTH
Reduce the maternal mortality ratio by 75 percent and achieve universal access
to reproductive health by 2015
MDG Health Alliance Priorities
Governments are increasing their reliance
on private health providers and local

health businesses as an ecient way to
extend services and provide essential
medicines to hard-to-reach communities.
In all regions of the world, utilization of
private providers of health-related goods
and services is growing — across all
income levels.
Phase 1 of the Alliance’s Maternal
Health agenda will focus on helping
governments reach MDG 5 through
innovative ways of engaging private
health providers and businesses to
expand their maternal health eorts and
reach women in rural and underserved
urban communities. The Maternal Health
Pillar will tap into the vast potential
of these providers and businesses to
supplement the eorts of the public
health system to deliver high-quality,
www.mdghealthalliance.org | 7
Led by Naveen Rao, M.D., the Maternal Health Pillar
of the MDG Health Alliance works in partnership
with UN Agencies, the private sector, nonprofit
organizations, academic institutions and others to
support country efforts to accelerate progress toward
achieving Millennium Development Goal 5. The Pillar
operates in support of Every Woman Every Child, an
unprecedented global movement spearheaded by
the United Nations Secretary-General to mobilize
and intensify global action to improve the health of

women and children.
n
The business community has expertise
that could be valuable in developing and
supporting innovative business solutions
and bringing them to the public sector
in developing countries to accelerate
progress in reaching MDG 5.
Private Sector Opportunity
Approximately 80% of the population
in India and 50% in some parts of Africa
receive their health care from private
providers — and these percentages
are growing. Women in low and
middle income countries are using a
range of private clinics, fee-for-service
providers (including traditional birth
attendants and midwives), pharmacies
and health shops for their care. These
private providers and entrepreneurs
have tremendous reach into high-
need communities. They are based
in the communities they serve, have
many touch points with families and,
as businesses, have learned how to
establish trust and build customer loyalty.
They are also often owned by women.
New Public-Private Partnerships
The Alliance is working in partnership
with the H5 agencies (UNFPA, UNAIDS,

UNICEF, WHO, and the World Bank),
and the United Nations Foundation
to increase the supply of and demand
for midwifery services. The Alliance
will also work with the United Nations
Commission on Life-Saving Commodities
for Women and Children to mobilize new
partnerships to increase the supply of
and demand for life-saving medicines
to combat post-partum hemorrhage
and preeclampsia (specifically, oxytocin,
misoprostol and magnesium sulfate), and
facilitate access to key family planning
products. Further, to build momentum
and support for new partnerships, MDG
Health Alliance Business Councils will be
established to advocate for and mobilize
resources to strengthen maternal health
and other Alliance priorities, including
policy and financing eorts to encourage
an enabling environment for health
businesses to thrive.
Key goals of the Maternal Health agenda
in the target countries include:
1 Improving quality of private health
services
+ Identify and support innovative
solutions and partnerships to help
upgrade the quality of private care
2 Expanding access to goods,

services, education and referral
+ Explore opportunities to equip local
health shops and providers with
essential maternal health information
and supplies, and help them link
women to quality health services
3 Making goods and services more
aordable
+ Investigate innovative financing
mechanisms to subsidize the cost of
care for vulnerable populations and
encourage them to seek care
8 | www.mdghealthalliance.org
this overall need for commodities has
already been committed — a testament
to the increased partnership between
endemic countries and the international
community — leaving a cumulative gap
of $3.2 billion over four years. Should
this gap not be filled, we are at risk of
reversing the gains we have made.
The principal funders remain overwhelm-
ingly The Global Fund to Fight AIDS,
TB and Malaria (approximately 70% of
all external funding for malaria), The
World Bank’s International Development
Association, the United States’ President’s
Malaria Initiative, and the United Kingdom’s
DFID. While the Malaria Pillar will look to
support eorts to continue and increase

contributions from these vital partners, a
more diversified financing strategy will
provide more sustainable support for
progress towards our 2015 goal, including
domestic support from sub-Saharan
African countries given their improving
economic growth and access to conces-
sional loans. On World Malaria Day 2012,
Millennium Development Goal 6 calls
for the halting and reversal of malaria
trends by 2015. In April 2008, United
Nations Secretary-General Ban Ki-moon
issued an even bolder call: to protect all
those at risk of malaria with treatment
and prevention interventions with the
ultimate goal of reaching near zero
deaths by 2015. An estimated 655,000
persons died of malaria in 2010. 86%
of the victims were children under 5
years of age, and 91% of malaria deaths
occurred in the WHO African Region.
Rapid increases in
access to prevention
and treatment inter-
ventions have saved
over one million lives
— 85% over the past
five years alone.
GLOBAL CHALLENGE
NEAR-ZERO MALARIA DEATHS

Reduce the number of deaths caused by malaria from 665,000 to
near-zero by 2015
International funding to combat the
disease surged from US$200 million a
decade ago to US$1.8 billion in 2010, with
over US$3 billion mobilized since the
Secretary General’s call to action in 2008.
Since 2000, malaria deaths have declined
by one third. However, the current global
funding crisis threatens the achievement
of the Millennium Development Goals,
including those specifically related
to malaria. There is a risk of reduced
resources for malaria control, which
could lead to significant increases in
malaria cases, and deaths, and a serious
reversal of the gains achieved.
MDG Health Alliance Priorities
The first priority of the Malaria Pillar of
the Health Alliance will be to support
eorts to secure the necessary funding
and get to near zero deaths by 2015.
This strategy requires $6.7 billion
between 2012 and 2015 for commodity
procurement and distribution across
sub-Saharan Africa. $3.5 billion of
www.mdghealthalliance.org | 9
Led by Suprotik Basu, Managing Director of the office
of the UN Secretary-General’s Special Envoy for
Malaria, the Malaria Pillar of the MDG Health Alliance

works in partnership with UN Agencies, the private
sector, nonprofit organizations, academic institutions
and the African Leaders Malaria Alliance, to support
country efforts to accelerate progress toward
achieving Millennium Development Goal 6. The Pillar
operates in support of
Every Woman Every Child,
an
unprecedented global movement spearheaded by
the United Nations Secretary-General to mobilize
and intensify global action to improve the health of
women and children.
n
the Global Fund committed to funding
approximately $2.2 billion of the gap.
The Pillar will focus initially on 10 countries,
which comprise the majority of global
malaria mortality, and is working with the
Roll Back Malaria Partnership, World
Health Organization, the Africa Leaders
Malaria Alliance, and other partners to
set-up a “Situation Room” that will work
with countries to track progress and flag
potential bottlenecks in “real-time”.
Private Sector Opportunities
Simply calling for increased resources will
not be sucient, and the Malaria Pillar
will actively explore ways to reduce costs.
Through discussions with manufacturers
of nets, for instance, we expect to see a

significant decrease in the price of these
life-saving interventions. For instance, the
Pillar will work with industry to usher in
a generation of low-priced nets aimed at
the consumer market, while working with
manufacturers to consider developing
nets that require replacement every
5–6 years, rather than 3. The costs for
Long Lasting Insecticidal Nets (LLINs)
have already declined from an average
of US$7 in 2008, to less than US$5 today
due to increases in volumes.
We will also support the scientific
innovation crucial to sustaining the
malaria fight. In collaboration with
existing private-public partnerships,
including the Medicines for Malaria
Venture, we will support the research
and development that brought about
four new malaria drugs in just the past
three years. Supporting groundbreaking
new drugs — including OZ439 — that will
likely become available in the next 2–3
years, and in combination will help not
only stave o drug resistance, but may
also be a single-dose preventive drug
for the “traveler’s market” in wealthier
countries. The Pillar will also support
eorts to find a vaccine for malaria by
working with partners like the Bill and

Melinda Gates Foundation, who are
leading this eort. A vaccine holds the
ultimate hope for ending the disease,
and 2011 saw results from the most
promising vaccine candidate, which is
approximately 55% eective at this point
assuming net coverage is maintained.
Improved access to reliable metrics is
needed as accurate feedback is an
essential component of maintaining a
movement to end deaths from a disease.
The private sector can help track our
progress and identify areas of concern.
The Malaria Pillar will support the further
development of the African Leaders
Malaria Alliance’s (ALMA) Scorecard for
Accountability and Action. The Scorecard
tracks key malaria and tracer maternal,
newborn, and child health metrics,
identifies bottlenecks and tracks
response, allowing for a unique
mechanism in which Heads of State to
hold their peers, their partners, and
themselves accountable.
2015201420132012201120102009200820072006200520042003200220012000
500
1,000
1,500
2,000
US$ (millions)

n AMFm
n Others
n World Bank
n DFID
n PMI
n Global Fund
Dramatic Increase in Global Funding for Malaria US $200 Million in 2004; US $1.8 Billion in 2010
10 | www.mdghealthalliance.org
1
Angola, Botswana, Burundi, Cameroon, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana,
India, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, South Africa, Swaziland, Uganda, United Republic of
Tanzania, Zambia and Zimbabwe.
countries that are home to nearly
90% of pregnant women living with
HIV in need of services. Intensified eorts
are also needed to support countries with
low HIV prevalence and concentrated
epidemics to reach out to all women and
children at risk of HIV with the services
that they need. The Global Plan supports
and reinforces the development of costed
country-driven national plans.
MDG Health Alliance Priorities
The first priority of the MDG Health
Alliance is to identify concrete, actionable
roles for businesses to maximize their
Millennium Development Goal 6 calls for
the halting and reversal of the spread of
HIV by 2015. 34 million people are living
with HIV globally and 1.8 million die from

AIDS-related causes each year. In 2010,
2.7 million people were newly infected
with HIV, including 390,000 newborns
infected during labor and delivery or
during the first six months of life through
breastfeeding. 90% of new HIV infections
occur in 22 countries
1
, mostly in sub-
Saharan Africa. There is, however, strong
evidence that treatment can reduce new
HIV infections (by up to 96%). Globally,
nearly half of all pregnant women living
with HIV received drug therapy to
prevent transmission of the virus to their
children in 2010 and, as a result, new
infections in children were reduced by
30% between 2002 and 2010.
Eliminating Mother-
to-Child-Transmis-
sion of HIV is within
our grasp, but the
time is now to har-
ness the momentum
and push for 2015 as
a deadline to achieve
this goal.
GLOBAL CHALLENGE
NEAR-ZERO TRANSMISSION
OF HIV FROM MOTHER-TO-CHILD

Virtually eliminate the transmission of HIV from mother-to-child by 2015
The Global Plan towards the Elimination
of New HIV infections Among Children
by 2015 and Keeping Their Mothers
Alive: 2011-2015
This Global Plan provides the foundation
for country-led progress towards the
elimination of new HIV infections among
children and keeping their mothers
alive. The Global Plan was developed
through a consultative process by a
high level Global Task Team convened
by UNAIDS and co-chaired by UNAIDS
Executive Director Michel Sidibé and
United States Global AIDS Coordinator
Ambassador Eric Goosby. It brought
together 25 countries and 30 civil society,
private sector, networks of people living
with HIV and international organizations
to chart a roadmap to achieving this goal
by 2015. This plan covers all low- and
middle-income countries, but focuses
on the 22 countries with the highest
estimated numbers of pregnant women
living with HIV. Exceptional global and
national eorts are needed in these
yy 34 Million people living with HIV globally
yy 1.8 Million AIDS-related deaths
yy 2.7 Million new HIV infections
yy 15% of all new infections are in newborns

UNAIDS 2011 World AIDS Day Report
THE EPIDEMIC AT-A-GLANCE
www.mdghealthalliance.org | 11
Pilot process in
2-3 lead countries
Expand to other high burden countries
Recruit and match corporate partners
Accelerate achievement of virtual
elimination of MTCT worldwide
PHASE I PHASE 2 PHASE 3
Led by John Megrue, the Pillar of the MDG Health
Alliance focused on eliminating mother-to-child
transmission of HIV works in partnership with UN
Agencies, the private sector, nonprofit organizations,
academic institutions and others to support country
efforts to accelerate progress toward achieving
Millennium Development Goal 6. The Pillar
operates in support of
Every Woman Every Child,
an
unprecedented global movement spearheaded by
the United Nations Secretary-General to mobilize and
intensify global action to impose the health of women
and children.
n
n genhivfree.org

impact on vertical transmission rates in
high-burden countries. This will be
accomplished through an in-country

assessment of the PMTCT service
delivery systems in 2–3 countries from
among the 22 highest burden countries.
The focus will be on identifying the
points of entry, or “big levers” for change,
where businesses can have the biggest
impact in making the systems more
ecient and more eective, better
monitored and more responsive, scaled
and expanded, or otherwise, leveraging
the particular business or industry
sector’s expertise, network or resources.
The process identifying the actionable
roles will be conducted in close
collaboration and upon invitation from
the countries’ political and public health
leadership. The lessons from this process
will then be made available to other
countries, and replicated as needed.
Private Sector Opportunity
Identifying the areas where businesses
can most eectively leverage their
expertise, resources and network is a
process, and in some situations unique to
each country and circumstance.
Innovation will be key; truly leveraging
companies’ core competencies in
support of the elimination of MTCT goes
beyond writing a check. Some expected
areas where the private sector might

lead include: logistical and supply-chain
management; development of real-time
information systems, linking monitoring
to corrective measures and action;
increasing awareness and driving usage
of health care services; infrastructure
improvements, and others.
The Business Leadership Council for a
Generation Born HIV Free
The Business Leadership Council (BLC)
is a bold, private-sector led initiative with
one purpose: to end the transmission of
HIV from mothers to children by 2015.
BLC members are a select group of
leaders who represent media, finance,
telecommunications, health, technology
and retail. The BLC is committed to
treating 2015 as a deadline, not a goal
and bringing business acumen and
resources to the challenge.
The BLC is chaired by John F. Megrue, Jr.,
CEO of APAX Partners US. The BLC
Advisory Board is comprised of Dominic
Barton (Worldwide Managing Director,
McKinsey & Co), Steve Burke (CEO, NBC
Universal), Cynthia Carroll (CEO, Anglo
America Plc.), Jamie Cooper-Hohn
(Co-Founder & CEO, CIFF), Mary
Callahan Erdoes (CEO, J.P. Morgan Asset
Management), Nathan Kirsh (CEO, Jetro),

Norman Payson (CEO, Apria Healthcare),
Sir Martin Sorrell (CEO, WPP),
Christopher Stadler, (Managing Partner,
CVC Capital Partners), Randi Zuckerberg
(Founder & CEO R to Z Media) and
Rhonda Zygocki (EVP, Chevron).
Through its work and the voices and
networks of its members, the BLC aims
to: Increase global and local political
awareness and support; Ascertain local /
country buy-in and ownership of PMTCT
programs; Assure continuous progress
towards our goal of zero infections in
infants by 2015; Drive transparency
and accountability of all stakeholders;
Mobilize resources and expertise from
private sector.
12 | www.mdghealthalliance.org
will engage private sector partners to
scale up methods already available and
mobilize the resources to save the lives
of a million people living with HIV
who would otherwise have died of TB
by 2015. An estimated $400 million is
Millennium Development Goal 6 calls for
the halting and reversal of TB by the end
of 2015. For the 33.3 million people living
with HIV worldwide, antiretroviral therapy
(ART) has given patients the promise of
a full and fulfilling life. Now people living

with HIV can raise their families, work and
pursue their dreams. And yet, too many
patients are falling prey to another killer:
tuberculosis (TB). Every day, a thousand
people living with HIV have their lives
taken away by tuberculosis (TB). We have
made remarkable progress against both
TB and HIV in the last few years. But, TB
still kills more people with HIV than any
other disease.
TB is preventable
and curable with
inexpensive medi-
cines. It should not
be a death sentence.
Yet our eorts to stop
so many unnecessary
deaths are inad-
equate. Between 2011
and 2015, two million
people living with
HIV will die of TB if
we fail to act now.
GLOBAL CHALLENGE
SAVE ONE MILLION LIVES
FROM TUBERCULOSIS
Prevent and treat tuberculosis among people living with HIV by 2015
Social and Economic Consequences
TB and HIV form a deadly combination,
and together they are thwarting progress

in developing countries. Both diseases
are mainly striking down young adults
who should be in their most productive
years and shaping their countries’
futures. Workers who become ill with TB
are often too sick to work for weeks or
months; and they and their families may
face financial catastrophe. Children may
have to leave school and go to work or
stay at home to care for an ailing parent.
Parents who die of TB leave behind
millions of orphans (according to the
World Health Organization, there were
9.7 million children who were living as
orphans due to parental death in 2009).
Health workers, one of our most precious
resources in the response to TB and HIV,
are at especially high risk of TB.
The MDG Health Alliance Priority
Working closely with the Stop TB
Partnership and UNAIDS, the Alliance
THE EPIDEMIC AT-A-GLANCE
yy At least one out of three people in the
world has latent TB infection, which
increases the risk of becoming ill with TB.
yy People living with HIV have an estimated
20 to 30 times greater risk of developing
active TB than people without HIV infection.
yy An estimated 8.8 million people become ill
with TB worldwide in 2010, and of these

people nearly 3 million, including 1 million
people living with HIV, were in Africa.
yy Some 350,000 people died of HIV-related
TB in 2010, which makes TB responsible for
one in four AIDS deaths.
www.mdghealthalliance.org | 13
The TB Pillar of the MDG Health Alliance works
in partnership with the Stop TB Partnership and
other UN Agencies, the private sector, nonprofit
organizations, and academic institutions to support
country efforts to accelerate progress toward
achieving Millennium Development Goal 6. The Pillar
operates in support of
Every Woman Every Child,
an
unprecedented global movement spearheaded by
the United Nations Secretary-General to mobilize
and intensify global action to improve the health of
women and children.
n

needed each year to improve access to
care, preventive treatment with isoniazid,
HIV testing and TB screening across the
population every three years and TB care.
MDG Health Alliance leadership will
complement the work of partners to:
+ Make health services more widely
available. In 2010 less than a third of
people living with HIV sought care for TB

at a clinic. That needs to double by 2015.
+ Improve the quality of TB care. By
2015, the cure rate for TB among
people living with HIV should be at
least 85%, up from 70%.
+ Reach out to test for HIV and
screen for TB. In countries where
HIV and TB are prevalent, screening
programmes should provide testing
for both infections to everyone in
the population every three years. All
people who test positive for HIV and
are also found to have TB should start
TB treatment immediately. After two
weeks on TB treatment, they should
begin ART. By end 2015, 80% of TB
cases among people living with HIV
should be detected and treated.
+ Prevent TB. People living with HIV who
are routinely exposed to TB should be
protected against becoming ill with TB.
Such protection is cheap and simple —
a daily dose of isoniazid. By end 2015,
30% of people living with HIV who do
not have active TB should receive this
preventive treatment.
+ Provide ART sooner. People living with
HIV are far less likely to become ill with
and die of TB if they begin ART before
their immune systems begin serious

decline. By 2015, people living with HIV
should receive ART as soon as blood
tests show that their CD4 count has
dropped to 350.
+ Integration of HIV and TB Services.
Every country seeking to prevent
deaths from TB among people living
with HIV needs bold political leadership
to integrate HIV and TB services at
every level of the health system and
carefully developed and fully funded
plans. They also need good systems for
quickly tracking the numbers of people
living with HIV who are becoming
ill with TB, as an important step to
improving their programs. Last, they
need to take measures to reduce TB
exposure in places where people living
with HIV may be concentrated, such as
clinics, hospital wards and prisons.
There is an urgent need to rapidly support
the recruitment, training, and scale-up of
more than one million community health
workers in order to improve the health
of women and children, particularly in
areas of Africa and South Asia, where
Millennium Development Goals (MDGs)
4, 5 and 6 are most lagging. Community
Health Workers (CHWs) have been
internationally recognized for their

notable success in reducing morbidity and
averting mortality in mothers, newborns
and children. CHWs have been crucial
in settings where the overall primary
health care system is weak, particularly
in rural areas. They also represent a
strategic solution to address the growing
realization that shortages of highly
skilled health workers will not meet the
growing demand of the rural population.
All eorts to
strengthen CHW
service delivery
will be targeted to
making the biggest
contribution to
child and maternal
mortality outcomes.
14 | www.mdghealthalliance.org
process, and in some situations unique
to each country and circumstance.
Some expected areas where the private
sector can lead include: logistical and
supply-chain management; development
and distribution of diagnostics and tools
to analytics; online and in-person training
modules for CHWs; development of
real-time information systems, linking
monitoring to corrective measures and
action; increasing awareness and

driving usage of health care services;
infrastructure improvements, and others.
GLOBAL CHALLENGE
ONE MILLION COMMUNITY
HEALTH WORKERS
Recruit, train and equip one million community health workers by 2015
MDG Health Alliance Priorities
The first priority of the CHW Pillar
of the MDG Health Alliance is to
identify concrete, actionable roles for
businesses to maximize their support
and investment in Community Health
Workers in high-burden countries. The
focus will be on identifying the points of
entry, or “big levers” for change, where
networks of businesses, foundations,
academic institutions, and NGOs can
have the biggest impact in making
health systems more ecient and more
eective, better monitored and more
responsive, and leverage the particular
business or industry sector’s expertise,
network or resources. The process will
be conducted in close collaboration
and upon invitation from the countries’
political and public health leadership.
Private Sector Opportunities
Identifying the areas where businesses
can most eectively leverage their
expertise, resources and network is a

ALLIANCE GOALS AT-A-GLANCE
1 Increase public and private sector
financing of CHW efforts
2 Enhance recruitment and retention efforts
3 Leverage technology to enhance training
and effectiveness
4 Enable task-shifting where appropriate
www.mdghealthalliance.org | 15
Led by Pillar Chairman Jeff Walker and Vice-Chairs
Austin Hearst and Brad Palmer, the Community
Health Worker Pillar of the MDG Health Alliance
works in partnership with UN Agencies, the private
sector, nonprofit organizations, academic institutions
and others to support country efforts to accelerate
progress toward achieving Millennium Development
Goals 4, 5, and 6. The Pillar operates in support of
Every Woman Every Child,
an unprecedented global
movement spearheaded by the United Nations
Secretary-General to mobilize and intensify global
action to impose the health of women and children.
n
Increase Overall Public and Private
Sector Support, and Make the Case
for Investors
There is a lack of data-driven and
actionable information available to
major donors, Health and Finance
Ministries, private sector partners, and
other potential donors on the cost-

eectiveness of CHWs. It is believed that
the provision of such information would
positively impact the funding of CHWs
and CHW-related activities, and would
promote policy changes favorable to
increased CHWs in-country.
The Alliance is further underwriting the
first-ever study to calculate the Return
on Investment provided by supporting
CHWs, and will seek to articulate the
return on investment (ROI) in FHWs in
terms of the health benefits (lives saved,
cases averted, etc.), financial benefits
(from eective interventions), and
economic gains.
Understand Business Opportunities for
Increased Technology Use
A central objective is to identify
technology solutions that can be
delivered at scale and on a sustainable
basis to significantly increase the quality
and capacity of health service delivery by
CHWs. In partnership with the Barr
Foundation, Dalberg Consulting, iHeed,
and the mHealth Alliance, the Alliance
has assessed CHW training programs in
sub-Saharan Africa to identify
opportunities for business and open-
platform-solutions that support training
eorts and will increase the eectiveness

and quality of CHW service delivery.
Further work on smartphones, mHealth,
and multimedia will seek to increase the
eectiveness and quality of CHW service
delivery through the use of technology.
Enable CHW Models with Greater
Task-Shifting
Many CHWs do not have the necessary
training, equipment, or authority to
address the key causes of child or
maternal mortality. For CHWs, this will
for example mean taking on community
case management of diseases like
pneumonia and malaria. In partnership
with governments and other stakeholders
the Alliance will work on the necessary
policy changes and other prerequisites
to support the implementation of CHW
models that make the greatest dierence
to child and maternal mortality outcomes.
ENTRY POINTS FOR COLLABORATION
yy Training
yy Distance Learning
yy mHealth
yy Diagnostics
yy Analytics
yy Supply Chain
PHOTOGRAPHY CREDITS
Cover: Merck, Inside Front Cover: David Rotbard (top left), Merck (top middle), Catherine Karnow (top right), UNAIDS/AVECC/H. Vincent
(bottom left), Zoe Flood (bottom middle), Zoe Flood (bottom right), Page 5: David Rotbard, Page 6: Merck, Page 7: Merck, Page 8:

Catherine Karnow, Page 10: UNAIDS/AVECC/H. Vincent, Page 12: Zoe Flood, Page 13: Zoe Flood (left), Merck (right), Page 14: Zoe Flood,
Page 15: Zoe Flood (left), Zoe Flood (right), Inside Back Cover: Merck
16 | www.mdghealthalliance.org
For more information about the
MDG Health Alliance, please visit
us at www.mdghealthalliance.org or
email