International Development

Global Health Projects: Worldwide

Health Finance and Governance Project (2012-2017)

Client/Agency

Abt Associates/USAID

Description

RTI is serving as a team member on the Health Finance and Governance Project (HFG), a five-year project funded by USAID and led by Abt Associates. The purpose of the HFG project is to improve the health status of partner countries' populations through improved financing and governance systems in the health sector. Partner countries' health systems are constrained by inadequate and inefficient use of existing resources, which limits their ability to deliver high quality services.

Working with Ministries of Health and partners at all levels of government will help to build country capacity in expanding access to health care, particularly for HIV/AIDS, tuberculosis, malaria, and reproductive health services.

We will provide selected technical advice on strengthening the health governance capacity of partner country systems in order to promote better health system management, greater accountability, and increased transparency.  HFG project partners will also work to achieve the following additional intermediate results through this project: 

  1. Improve financing by mobilizing domestic resources, reducing financial barriers, expanding health insurance, and implementing provider payment systems
  2. Improve country-owned health management and operations systems to improve the delivery and effectiveness of health care, for example through mobile money and public financial management
  3. Advance techniques to measure progress in health systems performance, especially around universal health coverage

Recipient Epidemiology and Donor Study (REDS) III: Data Coordinating Center (DCC) (2011-2018)

Client/Agency

U.S. National Heart, Lung, and Blood Institute

Countries

Brazil, China, India, South Africa, Thailand

Description

The goal of this highly structured, multicenter, donor-recipient epidemiology, laboratory, and clinical outcomes program is to advance public health by conducting critical research to improve transfusion practices and the safety and adequacy of the blood supply in the U.S. and in countries affected by the AIDS epidemic. The objectives of REDS-III are to ensure safe and effective blood banking and transfusion medicine practices through a comprehensive, multi-targeted strategy involving basic, translational, and clinical research. REDS-III is targeting the following blood banking and transfusion medicine areas: blood donor targeted strategies, blood banking, transfusion practices, and education and training. For this seven-year project, RTI is serving as the Data Coordinating Center (DCC) for REDS-III, for which it is responsible for the overall coordination, communications, data management, and analytical and statistical support for both domestic hubs and international program participants.

ENVISION Neglected Tropical Diseases Program (2011-2016)

Client/Agency

U.S. Agency for International Development

Background

Building on the achievements and lessons learned from the NTD Control Program (2006-2012), ENVISION is designed to continue support for integrated preventive chemotherapy (PCT) for seven NTDs targeted by U.S. Agency for International Development (USAID): lymphatic filariasis (elephantiasis), onchocerciasis (river blindness), schistosomiasis (snail fever), three soil transmitted helminthes (hookworm, roundworm, and whipworm), and blinding trachoma.

ENVISION will contribute to USAID's overall goal of reducing the burden of the seven targeted NTDs so they are no longer a public health problem. The geographic scope of the project is worldwide and includes countries in Africa, Asia, and Latin America.

Purpose

ENVISION activities will contribute to the following five objectives:

  1. Providing implementation support to countries for integrated PCT
  2. Providing technical assistance (TA) through a "TA facility or TAF" mechanism
  3. Capacity building at global and country levels
  4. Supporting global technical leadership and policy development
  5. Ensuring data management through improved monitoring and evaluation

Activities and Results

In Year 1, ENVISION is working in 10 countries (Cameroon, Haiti, Mali, Nepal, Tanzania, Uganda, Indonesia, Guinea, Mozambique, and Senegal). The ENVISION project is implemented by RTI International and partners CBM International, The Carter Center, Helen Keller International, IMA World Health, Tulane University, Sightsavers International, and World Vision.

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Health Policy Project (2010-2015)

Client/Agency

U.S. Agency for International Development

Description

The Health Policy Project aims to strengthen developing country national and subnational policy, advocacy, and governance for strategic, equitable, and sustainable health programming in more than 30 countries. The project addresses key health issues—family planning/reproductive health, HIV, and maternal health—and promotes health governance, health systems strengthening and program integration. Additionally, the project addresses cross-cutting issues such as health equity, gender, stigma and discrimination, and monitoring and evaluation.

The project builds capacity of governments and other in-country partners to direct, manage, and finance their health programs to help ensure that host countries are at the center of decision-making and leadership for their health programs as envisioned under the sustainability objectives of the Global Health Initiative and the President's Emergency Plan for AIDS Relief. As a core partner to The Futures Group, RTI's role on the team includes providing leadership and technical assistance in health governance and health systems strengthening.

Integrated Vector Management Task Order 2 (IVM2) for Improved Control of Malaria and Other Infectious Diseases (2007-2012)

Client/Agency

United States Agency for International Development

Description

Integrated Vector Management (IVM) is a rational decision-making process to optimize the use of resources to control insects and other vectors that spread human diseases, such as malaria. IVM provided a framework for countries to efficiently integrate and scale up interventions, and adapt to changing local disease environments, to either prevent or maximize the reduction of local disease transmission. The project focused on malaria, lymphatic filariasis, dengue, and leishmaniasis, among other vector-borne diseases.

As the prime contractor, RTI supported the establishment of appropriate policy and institutional frameworks for multi-sectoral action to promote cost-effectiveness and sustainability of national disease control efforts, while preventing or minimizing negative impacts on ecosystems and potential side effects on public health. Technical assistance was provided in the acquisition of commodities and strengthening the capacities of National Malaria Control Programs to plan, implement, monitor and evaluate vector control activities. These activities included providing insecticide-treated nets, managing environmental impact, and larviciding to kill mosquito eggs.

The project worked closely with the World Health Organization, as well as the Roll Back Malaria Partnership, in fostering global consensus and policy dialogue on IVM, developing critical manuals, conducting targeted training, and hosting technical meetings in priority areas.

The IVM Project covered the African countries under the President’s Malaria Initiative: Angola, Benin, Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Rwanda, Senegal, Tanzania, Uganda, and Zambia. The project has worked in Angola, Burundi, Democratic Republic of the Congo, Ghana, Liberia, Mali and Rwanda, in addition to providing support to Latin American countries in the Amazon Malaria Initiative.

The project is a task order of the Environmental Health Initiatives Indefinite Quantity Contract (IQC) (2004-2009).

AIDS Support and Technical Resources Program (AIDSTAR) Sector One (2007-2012)

Client/Agency

U.S. Agency for International Development

Description

AIDSTAR (AIDS Support and Technical Resources Program) Sector One is a multiple award Indefinite Quantity Contract with seven prime contractors providing service delivery for HIV/AIDS. The award offers USAID missions, headquarters bureaus, other U.S. government agencies, and the Global Fund access to HIV prevention, care, and treatment support in resource-constrained settings worldwide. AIDSTAR Sector One can be accessed through a fair consideration process from either headquarters or field missions. The contract office will make a competitive final award, selected among the seven prime contractors.

Contacts

For more information on utilizing technical services through AIDSTAR Sector One, please contact:

For more information on RTI and its capabilities, please contact:

  • Alison Mitchell, AIDSTAR Sector One IQC Manager
    Tel: +1-919-541-5840
    E-mail: amitchell@rti.org
  • Barbara Kennedy, Vice President
    Center for International Health
    Tel.: +1-919-316-3349
    E-mail: bkennedy@rti.org

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Venture Investment Technical Assistance in Global Health (VITA) (2007-2010)

Client/Agency

Bill & Melinda Gates Foundation

Background

Tackling the disease burden of lower-income countries requires innovation and capital to strengthen prevention, improve diagnosis, and expand treatment. Equity-based venture capital successfully builds innovative companies in medical diagnostics and devices for industrialized world markets. However, no entity has partnered with companies to commercialize these technologies for low- and middle-income countries because of the perceived market and financial risks. The unique technical and business assistance needs for global health product and market development require specialized expertise beyond that utilized for products focused solely on industrialized markets.

Purpose

To assist companies in developing and commercializing global health products for low- and middle-income markets, and provide technical assistance to help them manage the added risks of emerging markets.

Activities and Results

In collaboration with Commons Capital, a Boston-based socially responsible venture capital firm, RTI will apply its expertise in international development and technology commercialization to generate and implement sustainable global health business strategies to ensure that lifesaving products are made affordable and accessible in resource-limited countries. RTI will provide technical and business assistance for companies that qualify for a Commons Capital investment to encourage them to develop devices, diagnostics, and information technology solutions appropriately tailored for underserved markets in developing countries. Working closely with companies, RTI will define product characteristics, assess market demand and prepare regulatory strategies for target markets, assess economic and health impact of technology, identify strategic partners for product development and commercialization, and map sales and distribution channels.

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Health Systems 20/20 (HS 20/20) (2006-2012)

Client/Agency

Abt Associates/United States Agency for International Development

Description

The purpose of this subagreement was to integrate health governance, finance, operations, and capacity building in an approach that helps USAID-supported countries develop health systems and improve the quality of population, health, and nutrition services. As the health governance leader for HS 20/20, RTI supported institutional arrangements between governments, health care providers, and citizens that enhance the likelihood of positive outcomes through checks and balances, decentralization, and public-private partnerships. The project institutionalized existing tools, such as National Health Accounts (NHA) and the Health System Assessment (HSA), and developed new ones, including the HIV/AIDS Program Sustainability Analysis Tool (HAPSAT), and specific costing methodologies to generate the evidence needed to improve individual health systems.

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Population, Health, and Nutrition Technical Assistance and Support Contract 3 (TASC3) (2006-2011)

Client/Agency

United States Agency for International Development

Purpose

To establish a worldwide mechanism that supports the efforts of USAID Missions and Bureaus to improve global health in the areas of population, health, nutrition, and infectious diseases, excluding HIV/AIDS research. TASC3 continues and expands the worldwide mechanism established by the original TASC IQC and the subsequent TASC2 IQC. View TASC2 IQC task orders implemented by RTI.

Activities and Results

As requested under task orders, RTI International and its partners shall provide long- or short-term technical assistance and/or advisory services to host country institutions (both governmental and non-governmental) in the areas of population, health, infectious disease, and nutrition services, excluding HIV/AIDS research, to USAID Missions, the Global Health Bureau, other USAID Bureaus, and operating units. RTI's areas of assistance include policy reform, behavior change, monitoring and evaluation, system strengthening, capacity building, and commodity system management and development.

Neglected Tropical Disease Control Program (2006-2012)

Client/Agency

United States Agency for International Development

Background

As the lead contractor, RTI worked with 10 major sub-recipients for this project to support national Neglected Tropical Disease (NTD) control and elimination programs intended to integrate and scale up the delivery of preventative chemotherapy for seven targeted NTDs: lymphatic filariasis, schistosomiasis, trachoma, onchocerciasis, and three soil-transmitted helminths (hookworm, roundworm, and whipworm).

Leveraging the generous donations made by GlaxoSmithKline, Johnson & Johnson, Merck, and Pfizer of the proven effective treatments for NTDs—albendazole, mebendazole, Mectizan®, and Zithromax®—the program provided critical funding to allow countries receiving these donated drugs to distribute them effectively and to scale up treatment to full, national scale.

Purpose

To control and reduce the burden of seven of the most prevalent neglected tropical diseases by treating 40 million persons living in NTD endemic areas with 160 million treatments in five years.

Activities and Results

The project leveraged more than $3 billion in proven effective treatments for NTDs, which were donated through global pharmaceutical donation programs of GlaxoSmithKline, Johnson & Johnson, Merck, and Pfizer. The project also supported the distribution of more than 584 million drug treatments to 97 million individuals in 13 countries.

RTI led the NTD Control Program with support from a number of key partners and grantees including Helen Keller International, Health & Development International, IMA World Health, Malaria Consortium, the Schistosomiasis Control Initiative at Imperial College London, The Task Force for Global Health, and World Vision.

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Analysis, Information Management, and Communications (AIM) Activity (2005-2010)

Client/Agency

United States Agency for International Development

Purpose

This task order will implement the analysis, information management, and communication (AIM) activity of the Bureau for Global Health for all of its offices. RTI partners are John Snow, Inc.; ORC Macro; and Insight Systems Corporation. The purpose of the task order is to provide: (1) analysis of health, program, and financial data to support senior management decisions and investments; (2) evidence-based information and services to guide the design and management of USAID health programs; (3) knowledge management and organizational learning for USAID health programs; and (4) communication products and services to raise awareness and understanding of global health issues and activities among the informed public, both U.S. and foreign, as well as among nongovernmental organizations (NGOs), private voluntary organizations (PVOs), and decisionmakers in global health.

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Health Policy Initiative Indefinite Quantity Contract (2005-2010)

Client/Agency

United States Agency for International Development

Purpose

To improve the enabling environment for health, especially family planning/reproductive health, HIV and AIDS, and maternal health.

Activities and Results

Current task orders include the Health Policy Initiative/Greater Mekong Region and China (HPI/GMR-C) project.

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Environmental Health Initiatives Indefinite Quantity Contract (IQC) (2004-2009)

Client/Agency

United States Agency for International Development

Background

The Environmental Health IQC is the latest in a series of contracts, spanning over 20 years, offering expert technical assistance to USAID in the field of environmental health.

The Environmental Health IQC supports environmental, behavioral, and policy interventions to prevent infectious diseases, chronic diseases, and injuries caused by environmental conditions. Under the EH IQC, USAID can order support services in twelve technical areas: vector control, water supply and sanitation, solid waste management, infection control (hospital sanitation), integrated programs in population-health-environment, indoor air pollution, outdoor air pollution, injury prevention, toxic substance exposure, radiation exposure, health impacts of climate change, and emerging/reemerging infectious diseases.

Purpose

To provide services in environmental health as requested by USAID Missions, the Global Health Bureau, other USAID Bureaus and operating units. As the prime contractor, RTI will provide access to a broad range of expertise in interventions to reduce exposure to agents of disease and to hazards that exacerbate disease, by focusing on improvements in the physical environment and in key behaviors.

Population, Health and Nutrition Technical Assistance and Support Contract (TASC2) (2003-2009)

Client/Agency

United States Agency for International Development

Purpose

To establish a world-wide mechanism to support USAID Missions and Bureaus in the implementation of their Strategic Objectives pertaining to the reduction of unintended and mistimed pregnancies, maternal mortality, infant and child mortality, HIV transmission, and the threat of infectious diseases.

Activities and Results

As requested under task orders, RTI and its partners shall provide population, health and nutrition services to USAID Missions, the Global Health Bureau, other USAID Bureaus and operating units.

Current and recently completed projects include

Integrated Vector Management (IVM) for Improved Control of Malaria and Other Infectious Diseases (2004-2007)

Client/Agency

United States Agency for International Development

Activities and Results

The program provided management support for IVM activities at global and country levels and expert technical assistance to USAID missions, as well as supporting continued technical development of IVM through collaboration with international institutions, operations research, and dissemination of research and program results.

  • In Angola, Tanzania, Uganda, and Zambia, we helped ministries of health establish or expand their capacity to deliver IRS programs in areas prone to malaria epidemics.
  • In the Lira District of northern Uganda, we worked to increase the effective use of long-lasting ITNs in camps for internally displaced persons.
  • We helped established an international collaboration of research institutions to investigate the potential of larval control methods for reducing malaria transmission in urban areas, arid zones, and highlands in Africa.
  • In Eritrea, we demonstrated the efficacy of environmentally safe bacterial larvicides and then implemented a 2-year program to establish protocols for their routine use.
  • In Uganda, we supported the use of environmental management methods by local government and community teams. The project demonstrated that simple interventions such as improving drainage around kitchen gardens, filling depressions in roadway tracks, and draining borrow and brick pits reduced malaria prevalence by 11% and 36% at study sites in Kampala and Jinja.
  • RTI and its partners provided support to Eritrea’s National Malaria Control Program (NMCP) during a 7-year period, helping the NMCP refine, target, and evaluate its interventions. An analysis demonstrated that each of the vector control methods had a measurable, incremental impact on reducing malaria incidence.

Prevention of Postpartum Hemorrhage (2004-2009)

Client/Agency

United States Agency for International Development

Purpose

To decrease postpartum hemorrhage (PPH) through the use of active management of the third stage of labor (AMTSL) and community-based interventions, such as misoprostol.

Activities and Results

RTI provides project leadership for monitoring and evaluation activities, and is contributing costing and economic expertise to the project.

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Collaborative HIV/STD Prevention Trial (1999-2010)

Client/Agency

National Institute of Mental Health (NIMH)

Background

The NIMH Collaborative HIV/STD Prevention Trial is a two-arm randomized, community-level trial, which is being conducted in five countries -- China, India, Peru, Russia, and Uganda. It is an international test of a community-level prevention program -- Popular Opinion Leader—based on the theory of diffusion of innovations utilizing Community Popular Opinion Leaders (C-POLs). The NIMH Collaborative HIV/STD Prevention Trial is an opportunity to adapt this sophisticated intervention model in international sites utilizing both behavioral and biological outcomes.

The AIDS epidemic remains largely out of control in many areas of the world, and developing countries with few economic resources are being hit particularly hard, with many experiencing large increases in HIV incidence. Rapidly rising rates of sexually transmitted diseases (STD) are also a widespread concern, leading to infertility and increased risk of HIV. Effective individual prevention approaches are not rapid enough to avert the epidemic, and they are too resource intensive. Community-level behavior change interventions, on the other hand, have the potential to reach large numbers of people, to be cost effective, and to be feasible for implementation even in areas with limited resources.

In all areas, intervention such as this engages C-POLs to serve as behavior-change agents for friends and neighbors in their venue. The intervention is expected to strengthen norms about safer sexual behavior and to encourage risk reduction among populations in the venues.

Purpose

To examine the efficacy of a community-level intervention to reduce HIV/STD incidence and high-risk behaviors in international populations imminently threatened by the disease. The intervention seeks to modify social norms at the community level in order to effect mass changes in HIV/STD risk behaviors.

Activities and Results

RTI serves as the Data Coordinating Center (DCC).

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