Advocacy at every step

Advocacy at every step

Navigate challenges

Advocates help pave the way so that health solutions can be broadly used, marketed, and financed

Getting the right tools into the right hands to save lives. With PATH support, advocates in Malawi raised awareness of gaps in access to lifesaving medicines and tools—influencing national leaders to take action.

Protecting global access to vaccines. When a global treaty threatened to restrict access to lifesaving vaccines, PATH advocates—and partners around the world—intervened.

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Health worker giving an infant an injection in a group of waiting mothers and children.
Photo: PATH/Doune Porter

Malawi

Raising awareness to get the right tools into the right hands to save lives

The opportunity

Over the past decade, leaders in Malawi have significantly reduced deaths among women and children. Still, the country struggles with the highest premature birth rate in the world, high rates of maternal mortality, and a lack of access to safe, effective family planning methods.

Too often, women and babies die from causes that are preventable and treatable. Many of these deaths could be averted if Malawi’s health workers, especially those in the rural areas where 85 percent of the country’s people live, had access to lifesaving medicines and technologies.

Getting the right tools in the right hands could save millions of lives. But first, someone had to put the issue in the public spotlight. PATH helped local advocates succeed.

The challenge

In 2012, recognizing the need to improve access to key health supplies, Malawi’s government signed on to a global initiative called the United Nations Commission on Life-Saving Commodities (UNCoLSC) for Women, Children, and Newborns. The initiative provides a blueprint for increasing access to and use of critical health supplies. In particular, it recommends the adoption and distribution of 13 key health commodities.

Two years later, however, many of these commodities still remained unavailable to Malawi’s women and children.

Illustration of 13 lifesaving commodities for reproductive, maternal, newborn, and child health.
The United Nations Commission on Life-Saving Commodities for Women, Children, and Newborns recommends the adoption and distribution of 13 key health commodities.

How advocacy unlocked innovation

To tackle this delay, PATH supported a civil society organization in Malawi called the Health and Rights Education Program (HREP) to coordinate a group of local advocacy partners.

Beginning in 2014, the group developed a strategy to persuade the Ministry of Health to make key revisions to the country’s Essential Medicines List (EML). The EML guides national drug policy, details safe and cost-effective medicines that should be widely available, and helps the government identify funding and support for those commodities.

The advocates noted that the EML was missing 4 of the 13 UNCoLSC-recommended commodities:

  • Newborn resuscitation devices, which deliver oxygen when a baby’s first breath fails.
  • Antenatal corticosteroids, which are crucial for premature babies whose lungs need more time to develop.
  • Injectable antibiotics to treat deadly newborn sepsis infections.
  • Contraceptive implants to help women choose when and whether to become pregnant.

Without these products, too many babies and women faced unnecessary risks.

To get the commodities on the list, HREP gathered 15 partner organizations to present a civil-society petition to the government. They also caught the public’s attention by educating journalists and broadcasters about their goals—sparking newspaper and radio coverage that increased momentum and brought more attention to the issue. In addition, they met with government decision-makers to remind them of their commitments and ensure they understood recent evidence on the value of the missing commodities.

The outcome

As a result of HREP’s efforts, the Ministry of Health included the four missing commodities in the EML update in January 2015. Even more, the Secretary of Health committed to training health workers to put the tools to work.

Although there is still much to be done, the changes are a crucial first step to empowering health workers and ensuring that they have the tools they need to protect women and babies.

Now, the Ministry of Health is working with partners to establish the funding, training guidelines, and other resources and policies necessary to put the changes into practice. As they do so, HREP and its partners will continue their efforts and ensure that government leaders remain accountable for their commitment to Malawi’s women and newborns.

Project partners: The Malawi Ministry of Health, United Nations Population Fund, the Health and Rights Education Program, and the United Nations Commission on Life-Saving Commodities

Vials with heat-sensitive vaccine vial monitor stickers.
Photo: Umit Kartoglu

United Nations Environment Programme Treaty

Protecting global access to lifesaving vaccines

In January 2013, government delegates finalized a global environmental treaty on mercury. Notably, the treaty excluded vaccines containing the safe, effective preservative thimerosal (also called thiomersal) from further regulation.

That decision, crucial to the health of millions of children, was the direct result of PATH’s global advocacy. We put the best of our expertise to work to ensure that vaccines retained the approval necessary to continue saving lives around the globe.

The opportunity

The United Nations Environment Programme (UNEP) treaty focuses on restricting products and pollutants that are major sources of mercury released into the environment and that pose serious health risks. Some vaccines contain a preservative called thimerosal, which contains a small amount of ethylmercury. Although studies have demonstrated thimerosal’s safety in vaccines for children and adults, inaccurate scientific information led to discussions during treaty negotiations on restricting use of thimerosal-containing vaccines.

The challenge

PATH and our partners knew the devastating implications of restricting access to thimerosal-containing vaccines. At the time, vaccines helped save between 2 and 3 million lives annually; roughly half of those lives saved were due to vaccines containing thimerosal. Restricted access would endanger the immense health gains achieved during the last century.

How advocacy unlocked innovation

Fortunately, we also knew that the right advocacy and policy efforts during the UNEP mercury treaty negotiations could successfully educate delegates and protect vaccines. Drawing on our credibility as a health leader with the technical and scientific expertise to understand the issues at hand, we spearheaded a successful advocacy strategy.

PATH mobilized a broad network of global and local partners. Together, we drew on relevant technical and national-level evidence about vaccine safety, supply chains, and immunization costs to educate country treaty delegates about thimerosal in terms that resonated with them. We connected delegates with experts and national-level advocacy networks. To coordinate a single consensus position across a range of health stakeholders, we invited advocates and supporters to sign a statement letter. Finally, we worked to correct misinformation by providing robust evidence on the safety and value of thimerosal.

The outcome

As a result of our efforts, the final language in the treaty expressly protected the use of thimerosal in vaccines. In addition, country delegates gained a powerful understanding of the safety and value of vaccines.

Most importantly, we protected global access to lifesaving vaccines, ensuring that immunization—one of the world’s most powerful, effective, and efficient allies in the fight against disease—continues to protect millions of families and communities around the globe.

Project partners: World Health Organization; United Nations Children’s Fund; Gavi, the Vaccine Alliance; community-supported organizations; International Pediatric Association; American Academy of Pediatrics; International Federation of Animal Health; Médecins Sans Frontières, and the World Organisation for Animal Health