A Mission to Addis Ababa to Improve Diagnostic Aid

All aboard: Aligning stakeholders to improve diagnostic aid for pneumonia

Jonathan Howard Brand
Emebet Felke waiting to vaccinate her child at Selam Health Center.
UNICEF/UNI189013/Ayene
09 November 2016

With the challenges children face evolving at a faster rate, UNICEF continues to use innovation to improve UNICEF programmes, integrate technologies and develop effective life-saving tools and products.  The biggest challenges that face the world are not solved by one organization or one group of people in just one country. They are overcome by an interdisciplinary group of individuals working across industries, countries, and cultures. Since UNICEF often works with so many different stakeholders, it’s important to ensure stakeholders are aligned, their concerns are addressed, and together we achieve results for children.

Launched by UNICEF, the Acute Respiratory Infection Diagnostic Aid (ARIDA) project aims to find improved products to diagnose pneumonia. UNICEF, therefore developed a Target Product Profile that specifies the performance characteristics of an improved diagnostic tool, that once available, will first be tested in Ethiopia.

Community health volunteer Mariam Diarra uses a device to time the breathing of eight-month-old Gimbala Keita, who suffers from pneumonia, during a home visit in the village of Kabe, Mali on Monday August 30, 2010.
UNICEF/UNI100818/Asselin
Community health volunteer Mariam Diarra uses a device to time the breathing of eight-month-old Gimbala Keita, who suffers from pneumonia, during a home visit in the village of Kabe, Mali on Monday August 30, 2010.

As field tests help validate the effectiveness of products to UNICEF’s end-users, it is important that these tests take place. Conducting field trials also requires substantial planning including engaging and collaborating with governments, UNICEF colleagues in country offices and implementing partners. To safeguard that this project runs smoothly, I was sent on a mission to Addis Ababa with a single, simple, outcome goal: to ensure all stakeholders and partners are on board with activities and proposed next steps of the ARIDA project. Moreover, to manage and align the goals of the ARIDA project with our stakeholders’ expectations.

During this mission, I was able to meet all our stakeholders listed below, informing them on the progress of the project and advising them on the limitations and challenges we are facing. As a result, we were able to make sure our stakeholders were aware, aligned and involved every step of the way.

Mother Zinabe holds her baby boy, Abinet, at the Hamido health post in Ethiopia. Abinet has pneumonia.
UNICEF/Ethiopia/Jason Chute
Mother Zinabe holds her baby boy, Abinet, at the Hamido health post in Ethiopia. Abinet has pneumonia.

Despite successful meetings with stakeholders, the project is still delayed, since we cannot commence a field trial until the products are available. We can only start field trials when products are:

  1. Commercially available (not prototypes)
  2. Clinically trialed and proven accurate in counting respiration rates
  3. Approved by a recognized regulatory body (e.g. CE and FDA)

For example, UNICEF released a Request for Proposal (RFP) for the supply of products that we can include in our field trials. With the help of the Health Technology Centre which drafted an innovative contracting mechanism, companies who have responded to our RFP, have 24 months to offer products that meet our specifications and be included in our field trials. We are continuing to collaborate with those companies and soon we can communicate the approved products we will be testing, where, and when.

This is an exciting time, as we finally know the pneumonia products we will be trialing and the future timelines of other devices as they enter into commercialization. Partnering with Malaria Consortium (Long Term Arrangement) has enabled us to develop and conduct the required protocols during our field trials. Lastly, with the support of funding partner, “la Caixa” Foundation, we are moving faster – so plans are now being finalized to start delivering results.

Community health worker using the ARI timer to diagnose pneumonia
UNICEF/Ethiopia
Community health worker using the ARI timer to diagnose pneumonia

After this mission, I strongly emphasize the importance of communicating regularly with stakeholders in any project delivery. In the case of our planned trial in Ethiopia, stakeholders there had been hearing mixed messages about the status of the ARIDA project, product development and availability, plus potential confusion of how the new Oxygen Strategy intersects with ARIDA. This mission helped us keep everyone involved aware of the status of the project and excited of the upcoming field trials.

So there we have it, a quick overview of my mission to meet our Ethiopia-based stakeholders who are involved in our project. Now to do the same with Bolivia, Philippines, Ivory Coast and Nepal.

Stay tuned.

 


 

Various stakeholders and the detailed outcome of the meeting:

Ethiopia Federal Ministry of Health (FMOH)

The FMOH are updated and aligned with the development of the field trial plans and timelines and had some input on locations, as well as their interest in participating in the workshop to develop the field trial protocols.

Armaurer Hansen Research Institute (AHRI)

AHRI is a Biomedical research Institute in Ethiopia,  working very closely with the FMOH. They have a great deal of interest in our project and will be assisting in the protocol development and ethical approvals needed for the field trials to take place. We will discuss how we can collaborate in terms of quality control of the field trials as well as monitoring and evaluating the (potential) scale up.

Clinton Health Access Initiative (CHAI)

Updated and aligned with the ARIDA project and how our work compliments the oxygen work they are doing in Ethiopia. They are particularly interested in devices which do both respiratory rate and pulse oximetry as this is more in line with their work then respiratory rate alone.

UNICEF Country Office

The UNICEF Ethiopia Country Office are key to the success of this project as they are the interceptor and intervener with the above stakeholders. In addition, to ensure internal processes do not add to any potential delays, conversations with supply and logistics teams were held so items such as customs clearance etc. are planned for so all of our paperwork is in place before starting the field trials.