In the developing world
As well as the availability of appropriate medicines, access to healthcare depends on having a functional healthcare system, trained healthcare staff and effective supply and distribution mechanisms in place to ensure that medicines are used to their full effect as part of overall healthcare management. In some parts of the developing world, this is a particular challenge.
We believe that sustainable improvement in healthcare in these countries can only be achieved through the commitment of all related stakeholders, including governments, non-governmental organisations (NGOs) and the international community, as well as the private sector. AstraZeneca nevertheless remains committed to making a contribution. The medicines in our range today are not relevant to the treatment of HIV, TB and malaria, the most significant healthcare problems that the developing world is currently facing, but we are applying our skills and resources to helping in other ways. Our approach is two-fold.
We have a dedicated scientific resource in Bangalore, India that focuses on finding a new, improved treatment for TB and further information about this commitment can be found in the Infection therapy area review section.
Alongside this ongoing research programme, we partner with NGOs and other organisations working with local communities to strengthen their frameworks for managing healthcare in a sustainable way. In particular, we focus on community-based projects that can be scaled up to improve outcomes for the greatest number of people.
Strengthening healthcare capabilities
TB and HIV form a potentially lethal combination, each speeding the other’s progress and TB is the biggest killer of people living with HIV. Over the last five years, we have supported the British Red Cross in their community-based efforts to combat the growing threat of TB and TB/HIV in Central Asia. Work in Kyrgyzstan and Turkmenistan has focused on improving patient compliance, encouraging early diagnosis, raising awareness of TB, fighting the stigma associated with the disease and building local capabilities in prevention and control. To date, over 6,000 patients have successfully completed their TB treatment and community awareness campaigns and health education sessions in schools and public places have reached over 750,000 people. In Kazakhstan, where TB/HIV co-infection is a rising threat, the local Red Crescent Society is working to establish effective, sustainable and replicable models of community based social support for patients with TB and HIV, and their families. The programme brings together people with a range of skills, such as social workers, psychologists and employment lawyers, who work with volunteers – many of them former patients – to offer a range of support to those on treatment and those who have recently completed treatment. To date, this project has helped to reduce the rate of patients giving up on treatment from 33% in 2006 to 13% in 2007. Overall, with our funding, the work of the Red Crescent Societies in Kyrgyzstan, Turkmenistan and Kazakhstan is contributing to the implementation of national TB programmes that are leading to a stabilisation and reduction in the incidence of TB in these countries. In 2007, to help the British Red Cross to broaden its approach to the co-infection challenge, we further expanded our partnership and are supporting the charity over the next three years in their work to help local communities combat the co-infection threat in South Africa and Lesotho where HIV is the single most important factor determining the increasing incidence of TB.
We also further increased the geographic footprint of our support activity through a new partnership in 2007 with the African Medical and Research Foundation (AMREF) that focuses on helping to strengthen healthcare systems and integrated delivery of TB/HIV/malaria programmes in Uganda, where there is a high burden of all three diseases. During the year, AMREF and AstraZeneca worked together with the Ministry of Health in Uganda to develop a model for managing HIV/AIDS, malaria and TB collectively that will provide a framework for effective and efficient healthcare at both local and national levels. The first programme is now underway. Those initially targeted to benefit are the poor and remote communities in the Luwero and Kiboga districts of central Uganda, particularly women of child-bearing age, people living with HIV/AIDS and children under the age of five.
In the developing world, the incidence of cancer is on the increase. It is predicted that 20 million more people will be diagnosed by 2010, and 70% will live in countries that between them will have fewer than 5% of the resources for cancer control. In 2005 AstraZeneca began a pilot project in Ethiopia, designed to build local capability in managing breast cancer – the second most common cancer among young women in that country. We are partnering with Axios, an organisation experienced in working with the private sector to advance healthcare in developing countries, with a focus on integrating local resources and priorities in chronic disease management and drug delivery.
At the outset of our Ethiopia Breast Cancer Project, the country had only one cancer specialist for the entire population, there was no mammography, no easy access to chemotherapy or hormonal agents, no cancer screening and no national treatment protocols. Our programme has focused on strengthening diagnosis and treatment capabilities at Tikur Anbessa University Hospital in Addis Ababa, where the country’s only cancer specialist was based. In the last three years, with our help, the hospital has become a centre of reference for breast cancer treatment across Ethiopia. Activities have included developing treatment guidelines, strengthening the referral system, setting up an institutional-based cancer registry, raising awareness of the facilities amongst healthcare professionals and providing training for other physicians in Ethiopia. AstraZeneca’s breast cancer medicines are also being donated.
The impact of the programme has been much broader than we anticipated for what was originally intended as a small, targeted pilot. By focusing on the creation of treatment protocols and standardised reporting guidelines, by collaborating with the Ministry of Health and other health institutions on the guideline development and national distribution, and by working with the Ethiopian Cancer Association to help strengthen awareness- and fund-raising capabilities, the benefits have been far wider reaching than just the Tikur Anbessa Hospital. We believe that this pilot is delivering a sustainable model that can be successfully replicated in other countries and other disease areas.
We also partner with Voluntary Service Overseas (VSO), an international development charity that works through volunteers to strengthen core capabilities in the developing world. The charity focuses on six strategic goals: education, disability, secure livelihoods, participation/governance, HIV/AIDS and health. Our partnership includes financial support and the engagement of AstraZeneca people in a range of different support activities.
As the VSO’s exclusive Health Champion, we have committed funds and a senior manager secondment to the organisation to help them further develop their strategy and framework for delivering their health goal. We are also providing funding for VSO volunteers to work in underserved communities, helping to build local healthcare capabilities, including essential health programme research. During 2006 and 2007, we funded 17 volunteers working mainly on two-year placements across Indonesia, Cambodia and Sri Lanka.
Alongside this, AstraZeneca is also enabling its own people to volunteer for up to 12-month placements, primarily across Africa and Asia, that draw on the broad range of skills they can offer in human resources, finance, IT and communications, as well as health and medicine. The placements seek to build professional capabilities in the government, non-governmental and community-based organisations that play a key role in establishing and improving important infrastructures in developing countries. For our employees, it provides the opportunity to make a personal contribution whilst developing their skills in leadership, collaboration and project management as part of their career development. To date, we have had one employee working as a Human Resources advisor for a food security NGO in India, another working in a capacity advisory role for a democracy and human rights NGO in Sierra Leone and a third working in Nigeria in an organisational development capacity for a youth charity.
Engaging at an international level
As part of our focus on TB, we actively engage in international efforts to help in the fight against this devastating disease.
In 2007, through our involvement with the Stop TB Partnership for Europe, we participated in ‘All Against Tuberculosis’, a WHO European Ministerial Forum, hosted by the German government. The Forum’s purpose was to accelerate progress towards achieving the global targets for TB control in the WHO European Region and Target 8 of the United Nations’ Millennium Development Goal 6: “to have halted and begun to reverse the incidence of TB by 2015.” Over 300 delegates at the Forum adopted the Berlin Declaration on Tuberculosis, which describes the disease as “an increasing threat to health security in the WHO European Region”. The Declaration calls for urgent action to halt and reverse the high levels of TB, including its multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains. In the Declaration, Member States and international partners, including AstraZeneca, commit themselves to providing more support and resources to control and, eventually, eliminate the disease.
More information about our community activities around the world is available on our website, astrazeneca.com/responsibility.
