Publications

    Brooks P, Rosenberg J, Weintraub R. The Global Trachoma Mapping Project. Harvard Business Publishing. 2016.Abstract

    This case explores what it took to map the prevalence of trachoma infection in 1,531 districts across 26 countries by directly examining 2.39 million individuals in just three years. Dozens of organizations worked together on the largest standardized mapping project in the world as part of an effort to eliminate blinding trachoma globally by the year 2020. After providing some background on trachoma, early control efforts, and the formation of a global coalition, the case explores the events, strategies, technology, and stakeholders that enabled the mapping project. It describes how the stakeholders worked together, the coordination and management mechanisms used, and the investments required. Given that disease elimination had been achieved only once before, in the case of smallpox, the case asks students to consider how the project’s leaders, Tom Millar and Anthony Solomon, could help maximize returns from trachoma mapping so that the campaign could achieve its ultimate goal of global trachoma elimination within the next five years. Were there ways in which they could leverage efforts to map this neglected tropical disease to inform other disease control programs?

    Teaching Note available through Harvard Business Publishing.

    Life cycle of Trachoma
    Life Cycle of Trachoma. Source: The Carter Center/Al Granberg, International Trachoma Initiative. Available at http://www.neglecteddiseases.gov/target_diseases/trachoma/.

    Learning Objectives: A productive class discussion will allow students to appreciate what contributes to the development of a productive coalition; what it takes to collect quality data at scale; the challenges and benefits of identifying your target population for public health programming; and the tradeoffs between a targeted campaign addressing one disease and bundling efforts for multiple diseases.

    Keywords: Disease mapping, disease elimination, multi-sectoral collaboration, electronic data capture

     

    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

    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

    ole‐MoiYoi K, Rodriguez W. Building Local Capacity for Health Commodity Manufacturing: A to Z Textile Mills Ltd. Harvard Business Publishing. 2011.Abstract

    This case focuses on the establishment of the Olyset® Consortium—a public-private partnership that was created to facilitate the manufacture of long-lasting insecticidal bed nets to prevent malaria infection in sub-Saharan Africa—and A to Z Textile Mills (“A to Z”), the manufacturer of the nets in Arusha, Tanzania. The case examines how the public-private partnership was developed, its use of an incentive-based supply chain, A to Z’s business model and impact, and the sustainability of the venture. The case reveals that despite significant success in attaining objectives, the misaligned incentives of the many partners presented major obstacles to the overall sustainability of A to Z’s Olyset® production line.

    Teaching Note available through Harvard Business Publishing.

    Long Lasting Insecticide Nets and Olyset Production Process
    Long Lasting Insecticide Nets and Olyset Production Process. Source: A to Z Textile Mills Ltd., Arusha, Tanzania (Case Exhibit 9).

    Learning Objectives: To understand the potential for public-private partnerships to leverage innovation and scalability from the private sector and quality and equitable access from the public sector and to examine the costs and benefits of local manufacturing of technologically complex global health commodities in resource-limited settings.

    Keywords: Public-private partnerships, incentive-based supply chain, global health commodity manufacturing, malaria prevention

    Talbot JR, Rhatigan J, Kim JY. The Peruvian National Tuberculosis Control Program. Harvard Business Publishing. 2011.Abstract

    This case examines effective public health management strategies by examining the turnaround of National Tuberculosis (TB) Control Program (NTP) in Peru during the 1990s under Director Dr. Pedro Suarez. The case presents background information on the NTP before 1990 and situates its underperformance within the political and economic context of Peru at this time. It describes how Suarez transformed the NTP from an essentially bankrupt program in August 1990 to a model program, using effective management techniques. It concludes with the program struggling to improve outcomes among a group of patients failing its standardized protocols.

    Teaching Note available through Harvard Business Publishing.

    Health Center in Peru
    Health center in Peru; Credit: Julie Rosenberg Talbot

    Learning Objectives: To understand the operations of a national tuberculosis control program and to learn how effective management techniques can be employed in public health programs to improve performance with an emphasis on basic principles of quality improvement.

    Keywords: Program management, leadership, vertical programming, public health, tuberculosis control

    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