It’s estimated that more than 300 thousand lives could be saved each year by applying a simple, inexpensive, and effective antiseptic drug on the umbilical cords of newborns. Leading the charge to bring this drug to scale is senior commercialization officer Mutsumi Metzler. PATH communications officer Tracy Romoser caught up with Mutsumi during a recent break in her busy schedule to find out what drives her as she works to establish connections with partners and collaborators around the world.
Q: Mutsumi, you’re one of the most frequently traveled employees at PATH. How much do you travel?
A: I can’t recall (she laughs). But at PATH there’s a tracker whenever I make a travel request… and it shows I’ve gone on over 70 different work trips. Fortunately, as a commercialization officer, traveling to meet with stakeholders is one of the more interesting parts of the job.
Q: You’ve been at PATH now for nearly 10 years, most of that time on the chlorhexidine project. How did this work begin?
A: It’s interesting to see how chlorhexidine grew from a small project to what it is today. We got involved after the development stage, first by reviewing data from clinical trials that showed chlorhexidine has a significant impact as a tool for preventing newborn sepsis, and then by guiding the product’s introduction and global scale up. I still remember the initial funding was so modest that our team wondered if we even had sufficient funds to travel to Nepal where our first work began. And now we are managing a global introduction project funded by UNICEF and USAID.
“… The main reason I am passionate about my work is that I love babies. I believe each newborn is precious.”— Mutsumi Metzler
Q: Chlorhexidine has been around for years and years. Why are you working to scale it up if it’s already a product?
A: Yes, it’s been widely used as an antiseptic, however its specific use for cord care is novel, especially in developing countries—therefore, significant effort is required to introduce and scale it up. My work at PATH is to help develop and promote global policies and guidelines for this new use. I also work with ministries of health and key stakeholders at the country level to incorporate chlorhexidine in their essential newborn care programs and in their clinical and training guidelines.
Chlorhexidine is relatively easy to make, but making sure that it is high-quality is much more difficult. We partner with pharmaceutical manufacturers in developing countries to ensure the product will meet local needs. Furthermore, working with local manufacturers leads to local industry capacity development. Even when a quality-assured product is made, delivering it to every mother who needs it is another daunting task since many countries do not have functioning distribution systems.
It is easy to understand the impact that chlorhexidine can have in saving lives of newborns, but the challenge is how to successfully introduce and scale it in developing countries. That is why PATH is involved—we have broad capabilities to meet this challenge.
Mutsumi met this mother and her newborn in Kamrangirchar slum during one of her trips to Bangladesh to observe how antenatal and postnatal care were being provided. Photo: Mutsumi Metzler.
Q: What other activities are you involved in to bring this drug to communities around the world?
A: Our focus now is global scale-up and to increase the availability of high-quality chlorhexidine. I’m working with a partner to assess manufacturers (primarily in Africa) that are capable of making this level of quality. Now chlorhexidine manufactured in Kenya and Nigeria is available on the market.
I also support ministries of health with their efforts to nationally scale up. In Kenya, we are assisting the ministry of health’s efforts to implement chlorhexidine into two regions by leveraging the USAID-funded APHIAplus Western project that PATH leads and develop a national scale-up strategy. The market research we did as well as the data from the introduction will be used to develop this strategy.
A variety of chlorhexidine products for umbilical cord care that are currently available in developing countries. Photo: PATH/Patrick McKern.
Q: That sounds like an incredible amount of work. How many countries have you helped introduce this special formulation of chlorhexidine into?
A: It’s already been introduced into 10 countries and more than 15 others have expressed interest. Each country is different and faces its own unique set of challenges. But, in order to accelerate global scale-up of chlorhexidine, we continue to provide technical assistance to ministries of health and private sector partners, and to ensure the exchange of knowledge and experience between them.
Q: What excites you most each day as you prepare for work?
A: Although I am an American citizen, I am originally from Japan. PATH has a diverse culture, and the diversity here sometimes makes me forget about this difference. Each one of us working here is committed to making an impact in global health.
But the main reason I am passionate about my work is that I love babies and I believe each newborn is precious. That’s why I champion this drug. Seeing it through, from introduction to scale-up, is something I would like to experience during my career at PATH.