Posted by: afedorova | 09/15/2009

Role of philanthropy in filling the gaps

GHC Policy Communications Coordinator Vince Blaser traveled to Zambia and Tanzania to visit member programs and report on policy connections. This is eighth report.

DAR ES SALAAM, Tanzania – Dr. Rowland Swazi, manager of the Tanzanian government’s National AIDS Control Programme (NACO) has seen plenty of private money flow through this country for health programs, and he believes there is a right way and a wrong way to go about it.

The wrong way: building a “luxurious facility” that the community and local leaders did not even ask for, Swazi said. The right way: the approach taken by the Abbott Fund, a GHC member and not-for-profit wing of the U.S.-based pharmaceutical company Abbott Laboratories.

The Abbott Fund has invested more than $60 million since entering in a public-private partnership with the Tanzanian government in 2001. Swazi said that the organization rather than coming in and dictating terms asked the government and other stakeholders what the biggest gaps were. He added that in the early days of the President’s Emergency Plan for AIDS Relief (PEPFAR), the Tanzanian government had requested but were denied significant investments be made in health systems in order to carry out the goals of both PEPFAR and the government. PEPFAR recently has started to make these investments, but the work of Abbott has helped fill that gap, according to Swazi.

One of the Abbott Fund’s largest projects is modernizing the 23 regional hospital laboratories across the country. Some of the labs are complete, such as the one I visited Friday at the Amana Hospital in the heart of Dar es Salaam, and all are scheduled for completion by the end of next year. Dr. Willy Sangu, medical officer in charge at Amana, told me that the new lab, which opened in May, has made a major difference in the quality and quantity of care being provided across the hospital, which treats 800 to 1,600 outpatients daily. An HIV-positive woman who asked not to be named backed up Dr. Sangu’s comments by telling me that she has received good treatment and low wait times at Amana, adding that she has brought more than 10 people in to be tested for HIV at the site.

The Abbott Fund also has made major investments at Muhimbili National Hospital, Tanzania’s national referral hospital. The organization has provided management training at the hospital, opened a new outpatient center serving hundreds daily, installed an electronic IT system and opened a new lab. They also are financing construction of a new emergency department for the hospital I toured Friday, expected to open later this year. Dr. Kenneth Lema, executive director of Abbott Fund Tanzania, said the new money invested in HIV exposed the weaknesses in the health system in Tanzania, and Abbott’s work – which also has included training health care workers voluntary counseling and testing, supporting legal services access and improving HIV/AIDS testing, access, and treatment – was a response to those weaknesses.

From government to grassroots to implementers — many people told me this week that the Abbott Fund is making great strides in improving health outcomes. The model of concentrated regional or technical efforts to fill locally identified gaps versus more spread out investments just might be the most optimal use of private philanthropy.

Let me know what you think. I am now back in Washington DC, and I look forward to continuing the conversation.

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