Publications

    Rosenberg J, Weintraub R. Chasing Polio Eradication: Vaccine Development. Harvard Business Publishing. 2019.Abstract

     

    This case describes the development and rollout of bivalent oral polio vaccine (bOPV), starting in 2007, to support the Global Polio Eradication Initiative (GPEI) in eliminating poliovirus. After providing background on the global polio eradication program, the case explores the policy decisions behind the development of bOPV, progression through clinical trials, licensure, and distribution of the vaccine. In particular, the case examines the role of the World Health Organization (WHO) in accelerating the progression through these stages. The case study ends with Steve Cochi and Roland Sutter of WHO reflecting on the successes of bOPV and its impact on the eradication program at a global level.


    Teaching Note available through Harvard Business Publishing.

    Learning objectives: A productive class discussion will allow readers to understand the importance of product development to respond rapidly to the needs of a global health initiative as well as the complexities of ensuring the engagement of stakeholders involved in vaccine development, and the potential role of the public sector in facilitating product development.

    Supporting content: The case entitled Polio Elimination in Uttar Pradesh, India may provide helpful background information.

    Keywords: randomized controlled trial, global health, public health, vaccine development, supply chain management, disease eradication, public-private partnership, collaboration, product development

     

    Hashimoto K, Rhatigan J. Chagas Disease Vector Control in Honduras. Harvard Business Publishing. 2017.Abstract

    This case describes how the Honduran Ministry of Health developed and implemented a Chagas disease control program with the assistance of the Japan International Cooperation Agency (JICA) and others from 2003 to 2012. After providing background information about Honduras and Chagas disease, the case examines the work of the Guatemalan Ministry of Health and JICA to implement a Chagas disease control program that provided the template for the program in Honduras. The case then describes the adaptation of this model for the Honduran context, including details of the surveillance model and vector control interventions. The case concludes with the program considering how it would maintain its success in spite of decreased funding and changes in leadership.

    Teaching Note available through Harvard Business Publishing.

    Chagas vector chart
    Main vector species of Chagas disease in Central America. Source: Biblioteca Virtual en Salud de Honduras.

    Indoor residual spraying
    Training community members for indoor residual spraying in the first trial in Intibucá 2004. Source: Case writers.

    Learning Objectives: A productive class discussion will allow students to appreciate strategies in control of neglected tropical diseases; Chagas disease vector control and surveillance; the role of bilateral cooperation to strengthen health systems management; and how regional disease control initiatives are implemented locally.

    Keywords: Information management, scale-up, health care policy, public administration, government policy, resource-limited settings, data-collection

    Madore A, Yousif H, Rosenberg J, Desmond C, Weintraub R. Political Leadership in South Africa: HIV. Harvard Business Publishing. 2015.Abstract

    This case describes the rapid scale-up of South Africa’s national HIV/AIDS response from 2009 until 2015. After providing background on apartheid, the impact of HIV/AIDS denialism, and an overview of the health system in South Africa, the case follows Minster of Health Aaron Motsoaledi’s leadership of the national department of health’s HIV/AIDS program. The response included four key components: a countrywide counseling and testing campaign, capacity building to increase access to treatment, an overhaul of the ARV bidding and procurement processes, and promotion of voluntary male medical circumcision. The case highlights how Motsoaledi and his team leveraged expertise and resources from domestic and international organizations to support ambitious testing and treatment goals. It focuses on Motsoaledi’s communication strategies and the factors that influenced his planning and implementation decisions. The case ends with Motsoaledi considering how to advance the national HIV/AIDS program amid larger health system issues, including overcrowding and limited monitoring capacity.

    Teaching Note available through Harvard Business Publishing.

    Promotion of prevention of mother-to-child transmission (PMTCT) of HIV
    Promotion of prevention of mother-to-child transmission (PMTCT) of HIV (source: Global Health Delivery Project case writers)

    Learning Objectives: A productive class discussion will allow students to appreciate how politics can shape the trajectory of an epidemic; the importance of leveraging existing resources to scale services in a public health system; the challenges of transitioning from an emergency response to a sustainable public program; and the competing interests of a vertical intervention program and the complex health system within which it operates.

    Keywords: Political leadership, data and health policy, counseling and testing, adherence, advocacy, HIV treatment, health care delivery, cross-sector collaboration, vertical programs, value creation, drug procurement, civil society, strategy

     

    Madore A, Rosenberg J, Weintraub R. “Sin Taxes” and Health Financing in the Philippines. Harvard Business Publishing. 2015.Abstract

    This case traces the implementation of tobacco tax policy and health system reforms in the Philippines from 2009 to 2015 in the context of the global tobacco control movement, the economic and political influence of the Philippine tobacco industry, and the Philippine health system. After providing background on the prevalence and costs of smoking in the Philippines, the case follows the steps taken by a diverse group of actors to design, promote, and implement higher taxes on tobacco and alcohol products, the primary goals of which were to reduce smoking and raise funds to achieve universal health care. The case highlights the strategies used to counter opposition from the tobacco industry and allied politicians. It focuses on Health Secretary Enrique Ona’s efforts to support sin tax reform and how the country used the resulting revenues to try to improve health care and health insurance coverage. It ends with Ona contemplating the impact of his investments in national health insurance and public health infrastructure as a new health secretary takes his place.

    Teaching Note available through Harvard Business Publishing.

    From left to right: House of Representatives; Woman selling cigarettes
    From left to right: House of Representatives; Woman selling cigarettes. Source: Global Health Delivery Project case writers.

    Learning Objectives: A productive class discussion will allow students to appreciate the complexity and trade-offs governments may face in stimulating their economy, regulating industry, and improving public health; the importance of data in driving and sustaining policy reform; the role of financing policies and funding as tools for health system strengthening and value creation when leveraged strategically; and the potential for health to unify different actors and sectors to generate new policy and restructure fiscal and financial systems.

    Keywords: Health insurance, health care financing, tobacco control, smoking, universal health care implementation, policy, cross sector collaboration, health system reform, political leadership, management

    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

    Talbot JR, Rhatigan J. Multidrug-Resistant Tuberculosis Treatment in Peru. Harvard Business Publishing. 2011.Abstract

    This case traces the development of a multidrug-resistant tuberculosis (MDR-TB) treatment program in Peru between 1994 and 1999 by Socios en Salud (SES), a community-based nonprofit organization, in a shantytown of Northern Lima called Carabayllo. After providing some background on existing TB treatment services and the organizational history of SES, it follows the organization up to 1999 and frames its work within the context of international MDR-TB policy. The case presents background information on the epidemiology of TB and MDR-TB in Peru as well as the shantytown of Carabayllo. It describes how SES implemented community-based treatment for cadre of patients with MDR-TB and achieved cure rates comparable with those obtained in the US. The case begins with a vignette that illuminates the problem of MDR-TB from a patient’s perspective and ends with the program needing to strategize about how to scale-up and expand its reach to more patients.

    Teaching Note available through Harvard Business Publishing.

    Outdoor sputum collection booth to prevent TB transmission in (MOH) national hospital in northern shantytown of Peru
    Outdoor sputum collection booth to prevent TB transmission in (MOH) national hospital in northern shantytown of Peru; Credit: Julie Rosenberg Talbot

    Learning Objectives: To understand strategies that innovative programs use to improve access to health care and to explore ways that community health workers can deliver complex medical interventions within well-designed public health programs.

    Keywords: Community health workers, multi-drug resistant tuberculosis treatment, policy change, advocacy

    Blumenthal D, Ellner A, Jain S, Rhatigan J. Polio Elimination in Uttar Pradesh. Harvard Business Publishing. 2011.Abstract

    This case describes key elements of the Global Polio Eradication Initiative’s (GPEI) campaign in India and explores the challenges faced in eliminating polio from the northern state of Uttar Pradesh. Throughout the 1990s, India began implementing coordinated national polio immunization days to supplement routine immunization in health clinics in an effort to eliminate polio from the nation. The case provides contextual information about India and Uttar Pradesh as well as polio and polio vaccines. It then examines the roles of key partners in the GPEI, including Rotary International, the World Health Organization (WHO), the US Centers for Disease Control (CDC) and UNICEF, and it describes the local operational challenges of the mass immunization campaign in Uttar Pradesh. The campaign has been unable to eliminate polio from this state, and the program leaders grapple with ways to improve the campaign’s performance there.

    Teaching Note available through Harvard Business Publishing.

    Comic Book, Crusade Against Polio, Front Cover
    Comic Book, Crusade Against Polio, Front Cover. Source: Rotary International.

    Learning Objectives: To understand the political and operational challenges of implementing a nation-wide disease elimination program and to appreciate how local, contextual factors influence the delivery of health interventions.

    Keywords: Polio elimination and immunization campaigns, supply chain management, global collaboration