Publications

    Talbot JR, Cole C, May M, Weintraub R. Voluntary Medical Male Circumcision in Nyanza Province, Kenya. Harvard Business Publishing. 2012.Abstract

    This case traces the development of the voluntary medical male circumcision (VMMC) campaign in Nyanza Province, Kenya as it transformed from the subject of a randomized clinical trial into national policy. After providing some background on the cultural, political, and scientific context surrounding male circumcision, the case traces the PEPFAR-funded implementers' advances in delivering male circumcision in Nyanza. It examines the various delivery models used in Nyanza and the evolution of the relationship between implementers as well as on the development of the national strategic plan for VMMC released in 2009. The case ends with the implementers having come together successfully for two rapid, aggressive, 30-day implementation campaigns and the head of Kenya's National AIDS and Sexually Transmitted Infections Control Programme wrestling with how to make such campaigns sustainable and what lessons from the campaign to pass on to the national program.

    Teaching Note available through Harvard Business Publishing.

    Mobile Service Delivery Model
    (A) Group counseling on male circumcision; (B) mobile circumcision counseling site; and (C) circumcision being conducted in tented delivery site. Source: Nyanza Reproductive Health Society.

    Learning Objectives: To understand how a randomized controlled trial may be translated into a large-scale public health program; how a surgical campaign was designed and implemented for rapid impact; the role of national and international collaboration in large-scale health delivery; and the ethical tradeoffs that arise in large-scale public health programs.

    Supporting Content: There is a shorter version of this case titled Voluntary Medical Male Circumcision in Nyanza Province, Kenya (Condensed Version).

    Keywords: Project management, AIDS, policy, supply and demand, partnerships, strategy, innovation

    Arnquist S, Weintraub R. HIV/AIDS in Indonesia: Building a Coordinated National Response. Harvard Business Publishing. 2011.Abstract

    This case documents Indonesia’s progress in developing a coordinated national HIV/AIDS response. Within the context of a new democratic government, a weak civil society sector, a newly decentralized and underfunded public health system, and a religiously conservative environment, the case describes how international donors financed and directed HIV/AIDS-related efforts for the first 15 years of the epidemic. In 2006 the National AIDS Commission (NAC) was restructured and awarded funding from the United Kingdom’s Department for International Development (DFID). The case documents how DFID’s flexible financing enabled the NAC to develop a single national strategy, a national monitoring and evaluation framework, and a system of local AIDS commissions. The case ends in 2009 with the NAC preparing to assume a new role as one of three Principal Recipients of the Global Fund to Fight, AIDS, Tuberculosis and Malaria. The NAC leadership must contemplate how to sustain and further the progress made in scaling up HIV prevention services while taking on new responsibilities as a Global Fund Principal Recipient.

    Teaching Note available through Harvard Business Publishing.

    Map of Indonesia Showing HIV Program Implementers, 2005
    Map of Indonesia Showing HIV Program Implementers, 2005. Source: Indonesia National AIDS Commission. (Exhibit 1 "HIV/AIDS in Indonesia: Building a Coordinated National Response" case.)

    Learning Objectives: To understand the impact of external financing, donor-driven agendas, and a national champion in creating a multisectoral response to HIV in a religiously conservative, lower middle-income country.

    Keywords: National strategy, sustainability, HIV prevention, flexible donor financing

    Cole C, May M, Talbot JR, Weintraub R, Porter ME. The Avahan India AIDS Initiative: Managing Targeted HIV Prevention at Scale. Harvard Business Publishing. 2011.Abstract

    This case is the second in a two-part series describing the Avahan Indian AIDS Initiative (Avahan), a large-scale HIV prevention delivery program of the Bill & Melinda Gates Foundation (Gates Foundation). The case examines Avahan's choice of intervention strategies in the face of the HIV epidemic of India in 2002. It describes Avahan's structure, operations, and execution style, as well as how Avahan's management system for its seven "state lead partners" and 137 district-level nongovernmental organizations was applied initially to scale and later to sustain the delivery model. The case ends with Avahan's director planning to transfer program ownership to the Government of India.

    Teaching Note available through Harvard Business Publishing.

    Examples of Microplanning Tools Developed by Avahan SLPs
    Examples of Microplanning Tools Developed by Avahan SLPs. Source: Created by case writers. (Exhibit 10 "The Avahan India AIDS Initiative: Managing Targeted HIV Prevention at Scale" case.)

    Learning Objectives: To understand the strategies needed to deliver HIV prevention services at scale; how the configuration of management activities can enable rapid scale up of HIV prevention programming; and how these management activities must evolve to sustain delivery at scale.

    Keywords: Management and operations, HIV prevention, transferring large-scale programs to government ownership, scaling up, sustainability, strategy

    Kleinman S, Talbot JR, Harris J, Ellner A. The AIDS Support Organization (TASO) of Uganda. Harvard Business Publishing. 2011.Abstract

    This case traces the development of The AIDS Support Organization (TASO), a Ugandan non-governmental organization, from 2001 to 2006. One of the first organizations to become involved in HIV/AIDS in the late 1980s, TASO began as a meeting place for people infected and affected by HIV/AIDS, helping people to live positively. The organization provided free counselling, social support, limited medical care, community mobilizing, advocacy and networking. TASO worked alongside government facilities and trained government medical personnel in HIV counselling. After many years, TASO got a new director who brought management skills, a commitment to professionalizing the organization, and a drive to expand services. TASO began incorporating antiretroviral therapy (ART) into its offerings. The ART delivery model combined home and clinic-based care in order to maximize patient adherence. The case follows the development of the organization and scale up of services and raises the question of how to deliver care most cost effectively while maintaining its values and meeting the changing needs of the population and clients.

    Teaching Note available through Harvard Business Publishing.

    Training health workers to care for HIV/AIDS patients in Uganda. Credit: Sarah Kleinman; TASO
    Training health workers to care for HIV/AIDS patients in Uganda. Credit: Sarah Kleinman; TASO

    Learning Objectives: Students should learn how a healthcare delivery organization can expand and evolve over time in response to changes in external context and the needs of its clients; how public and private organizations can coordinate to meet the varied needs of a population; and the importance of leadership, management, and strategic vision in creating successful global health programs.

    Keywords: Service expansion, Home- and clinic-based care, HIV prevention and treatment.