TY 2019 Form 990 Schedule O

efile Public Visual Render ObjectId: 202033179349305453 - Submission: 2020-11-12 TIN: 91-1157127

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

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Form 990 or 990-EZ or to provide any additional information.
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OMB No. 1545-0047

2019

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FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:	PATH IS A GLOBAL ORGANIZATION THAT WORKS TO ACCELERATE HEALTH EQUITY BY BRINGING TOGETHER PUBLIC INSTITUTIONS, BUSINESSES, SOCIAL ENTERPRISES, AND INVESTORS TO SOLVE THE WORLD'S MOST PRESSING HEALTH CHALLENGES. WITH EXPERTISE IN SCIENCE, HEALTH, ECONOMICS, TECHNOLOGY, ADVOCACY, AND DOZENS OF OTHER SPECIALTIES, PATH DEVELOPS AND SCALES UP SOLUTIONS-INCLUDING VACCINES, DRUGS, DEVICES, DIAGNOSTICS, AND INNOVATIVE APPROACHES TO STRENGTHENING HEALTH SYSTEMS WORLDWIDE. SINCE 2011, PATH AND OUR PARTNERS AND SUPPORTERS HAVE IMPROVED HEALTH FOR MORE THAN 150 MILLION PEOPLE ON AVERAGE EACH YEAR. THE LARGEST INVESTMENTS IN PATH'S PROGRAMMATIC WORK IN 2019 WERE ORGANIZED INTO THREE PRIMARY PORTFOLIOS: GLOBAL HEALTH PROGRAMS; ESSENTIAL MEDICINES; AND TECHNOLOGY, ANALYTICS, AND MARKET INNOVATION. SEE BELOW FOR DESCRIPTIONS OF THESE PROGRAMS.
FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE:	IN UKRAINE, PATH LEADS THE USAID-FUNDED SERVING LIFE PROJECT, WHICH REDUCES TB, HIV, AND HEPATITIS C TRANSMISSION IN PRETRIAL DETENTION CENTERS, PRISONS, POST-PRISON SETTINGS, AND THE COMMUNITY. STRATEGIES INCLUDE INCREASING CASE DETECTION, STRENGTHENING LINKAGES TO CARE, AND EMPLOYING A CASE-MANAGEMENT APPROACH TO ENSURE TREATMENT COMPLETION. IN 2019, WE WORKED IN 12 REGIONS IN 75 PRETRIAL DETENTION CENTERS, PRISON COLONIES, AND CORRECTIONAL CENTERS, AND 12 PROBATION CENTERS. WE TESTED APPROXIMATELY 30,000 PEOPLE FOR HIV, LINKED AROUND 3,000 NEWLY IDENTIFIED PLHIV TO TREATMENT, AND SUPPORTED ABOUT 2,500 PEOPLE IN PRISON ON HIV TREATMENT. IN 2019, WE ALSO PARTNERED WITH THE MINISTRY OF JUSTICE TO LAUNCH A PILOT PROGRAM TO PROVIDE OPIOID-SUBSTITUTION THERAPY TO PEOPLE WHO INJECT DRUGS, THE FIRST TIME THIS INTERVENTION HAS BEEN PROVIDED IN A PRISON IN UKRAINE. IN ANOTHER ADVANCEMENT, WE ROLLED OUT THE USE OF A SMART PILL BOX THAT REMINDS PATIENTS TO TAKE THEIR TB MEDICATION AND NOTIFIES PROVIDERS IF DOSES ARE MISSED, RESULTING IN 90% TREATMENT COMPLETION AMONG PATIENTS USING THIS TECHNOLOGY. WE WILL CONTINUE TO BUILD ON THESE SUCCESSES AS A PARTNER UNDER THE UNITAID-FUNDED ADHERENCE SUPPORT COALITION TO END TB PROJECT, LAUNCHED IN 2019. FOR MORE INFORMATION ON OUR WORK IN UKRAINE, SEE THE COUNTRY PROGRAMS SECTION. IN VIETNAM, PATH CONTINUED TO PILOT INNOVATIONS IN HIV. IN 2019, WE EQUIPPED SOCIAL ENTERPRISES AND PRIVATE CLINICS LED BY KEY POPULATIONS TO GENERATE DEMAND FOR AND PROVIDE HIV SERVICES. INNOVATIVE ONLINE CHAT BOTS OFFERED INFORMATION ON HIV SELF TESTING (HIVST) AND PRE-EXPOSURE PROPHYLAXIS (PREP); CARE PROVIDERS THEN SERVED THESE CLIENTS OFFLINE IN COMMUNITIES OR AT CLINICS. PATH ALSO ENGAGED THE GOVERNMENT OF VIETNAM TO SCALE UP NEW MODELS OF HIV TESTING, INCLUDING EXPANDING ACCESS TO HIV LAY- AND SELF-TESTING AND PARTNER NOTIFICATION SERVICES. THE PROJECT TESTED APPROXIMATELY 50,000 PEOPLE IN 2019. WORKING AGAIN WITH THE GOVERNMENT AND KEY POPULATION SERVICE PROVIDERS, PATH INTRODUCED A VARIETY OF SERVICE MODELS TO RAPIDLY SCALE UP PREP NATIONWIDE; IN 2019 ALONE, WE DOUBLED THE NUMBER OF PEOPLE ON PREP. PATH ALSO FOCUSED ON TB CONTROL. IN 2019, THE BREATH FOR LIFE PROJECT WORKED WITH VIETNAM'S NATIONAL TUBERCULOSIS PROGRAM TO DEVELOP AND TEST STANDARD OPERATING PROCEDURES TO ADDRESS THE SPECIMEN COLLECTION CHALLENGES THAT CONTRIBUTE TO LOW DETECTION OF TB IN CHILDREN. OUR EFFORTS RESULTED IN UPDATED NATIONAL GUIDELINES THAT FACILITATED COUNTRYWIDE SCALE-UP OF STOOL XPERT TESTING FOR TB DIAGNOSIS AMONG CHILDREN. IN INDIA, PATH DEVELOPED TOOLS AND APPLICATIONS TO ENHANCE MONITORING OF HIV SERVICE DELIVERY THROUGH IMPROVED DATA QUALITY AND AUTOMATED DATA COMPILATION. TO IMPROVE TB SERVICES, WE PILOTED ARTIFICIAL INTELLIGENCE TO STREAMLINE CHEST X-RAY READINGS, ENABLING QUICKER DIAGNOSIS AND INITIATION ON TB TREATMENT. FURTHER, WE WORKED CLOSELY WITH THE NATIONAL TB PROGRAM TO DEVELOP PUBLIC-PRIVATE PARTNERSHIP GUIDELINES, AND WE CONTINUED ENGAGING THE PRIVATE SECTOR TO LINK DRUG-RESISTANT TB PATIENTS TO PUBLIC-SECTOR CARE. IN TANZANIA, PATH AND OUR PARTNERS DEVELOPED A MOBILE PHONE APPLICATION THAT ENABLED ALMOST 229,900 PEOPLE TO SELF-SCREEN FOR TB. IN ZAMBIA, PATH CONTINUED TO IMPLEMENT THE ERADICATE TB PROJECT, SUPPORTING 249 HEALTH FACILITIES ACROSS SIX PROVINCES. THE PROJECT TESTED MORE THAN 125,000 PEOPLE FOR TB AND INITIATED MORE THAN 8,000 PEOPLE ON TREATMENT. FOR MORE INFORMATION, SEE THE COUNTRY PROGRAMS SECTION. ALSO IN 2019, PATH BEGAN WORK ON A NEW TB PROJECT IN CENTRAL ASIA THAT PROVIDES CLINICAL TECHNICAL SUPPORT AND DRUG SAFETY MONITORING TO NATIONAL TB PROGRAMS IN TAJIKISTAN, KAZAKHSTAN, AND UZBEKISTAN. MATERNAL, NEWBORN, AND CHILD HEALTH AND NUTRITION: PATH WORKS WITH PARTNERS TO IMPROVE MATERNAL, NEWBORN, AND CHILD HEALTH AND NUTRITION AROUND THE WORLD. TOGETHER WE DEVELOP, ADAPT, AND SCALE TECHNOLOGIES AND APPROACHES TO REDUCE ILLNESS AND DEATH AND GIVE CHILDREN THE BEST POSSIBLE START IN LIFE. IN 2019, PATH CONTINUED TO EXPAND OUR GLOBAL AND NATIONAL LEADERSHIP IN EARLY CHILDHOOD DEVELOPMENT (ECD). WITH PATH SUPPORT, THE GOVERNMENTS OF ETHIOPIA, KENYA, MOZAMBIQUE, AND ZAMBIA CONTINUED TO INCORPORATE ECD SERVICES INTO BASIC HEALTH CARE. THIS PIONEERING WORK FOCUSES ON BUILDING AN ENABLING LEADERSHIP AND POLICY ENVIRONMENT WHILE SUPPORTING AND STRENGTHENING THE CAPACITY OF HEALTH SYSTEMS AND HEALTH SERVICE PROVIDERS. ALONG WITH WHO, UNICEF, THE WORLD BANK, AND OTHERS, PATH HELPED ADVANCE THE NURTURING CARE FOR ECD FRAMEWORK, WHICH OFFERS A STRUCTURE FOR COUNTRIES TO ADOPT, ADAPT, AND SCALE ECD SERVICES. IN PARTNERSHIP WITH THE AFRICAN POPULATION AND HEALTH RESEARCH CENTER, WE LAUNCHED A RANDOMIZED CONTROL TRIAL OF ECD INTERVENTIONS IN KENYA. WITH HARVARD UNIVERSITY, WE DESIGNED A LARGE-SCALE EVALUATION IN MOZAMBIQUE. PATH CONTINUED EFFORTS TO ENSURE THAT ALL INFANTS RECEIVE HUMAN MILK. OUR WORK CENTERS AROUND BREASTFEEDING PROMOTION, INCLUDING THE PROVISION OF SAFE DONOR MILK THROUGH HUMAN MILK BANKS. IN 2019, PATH LAUNCHED STRENGTHENING HUMAN MILK BANKING: A RESOURCE TOOLKIT FOR ESTABLISHING AND OPERATING HUMAN MILK BANK PROGRAMS, THE FIRST-EVER STANDARD TO ENSURE QUALITY AND SAFETY. AMONG OTHER EFFORTS, PATH WORKED WITH THE MINISTRY OF HEALTH (MOH) IN KENYA TO LAUNCH THE FIRST HUMAN MILK BANK IN THE EAST AFRICAN REGION AND CONDUCTED AN EVALUATION TO ASSESS OUTCOMES. IN GHANA, THE MAKING EVERY BABY COUNT INITIATIVE STRENGTHENED LEADERSHIP AND CAPACITY AT THE NATIONAL AND LOCAL LEVELS TO MANAGE AND SUSTAIN BEST PRACTICES IN NEWBORN CARE. BY 2019, PATH HAD TRAINED MORE THAN 3,600 FRONTLINE HEALTH WORKERS IN IMPROVED NEWBORN CARE, HELPED DRIVE ADVOCACY AND POLICY THROUGH THE GHANA NATIONAL NEWBORN SUBCOMMITTEE, AND PARTNERED WITH THE GHANA HEALTH SERVICE ON ITS NEWBORN ACTION PLAN TO REDUCE NEONATAL MORTALITY RATES. RECOGNIZING THAT NUTRITION IS AFFECTED BY A VARIETY OF ECONOMIC AND ENVIRONMENTAL FACTORS, PATH'S NUTRITION TEAM CONTINUED TO DRIVE NOVEL APPROACHES TO ADDRESS THE MASSIVE BURDEN OF MALNUTRITION IN COMMUNITIES AROUND THE WORLD. WE ENGAGED STAKEHOLDERS WITH EXPERTISE SPANNING GLOBAL HEALTH, DEVELOPMENT, AND THE ENVIRONMENT, FROM BOTH THE PUBLIC AND PRIVATE SECTORS. PATH CONTINUED TO LEAD A CONSORTIUM OF FIVE ORGANIZATIONS IN A PROJECT KNOWN AS MAXIMISING THE QUALITY OF SCALING UP NUTRITION PLUS (MQSUN+). IN 2019, MQSUN+ SUPPORTED THE DEVELOPMENT OF A MULTISECTORAL NUTRITION PLAN FOR TAJIKISTAN AND COSTED MULTISECTORAL NUTRITION PLANS FOR AFGHANISTAN, GUINEA, SOMALIA, TOGO, AND YEMEN. MQSUN+ ALSO SUPPORTED EFFORTS TO PROVIDE STRATEGIC DIRECTION TOWARD THE NEXT PHASE OF THE "SCALING UP NUTRITION" MOVEMENT AND CONTINUED TO ADVANCE AND SUPPORT THE TRACKING OF FINANCIAL AND NONFINANCIAL COMMITMENTS TO NUTRITION. OTHER ACTIVITIES IN 2019 INCLUDED PARTNERING WITH THE NATURE CONSERVANCY, DUKE UNIVERSITY, AND THE INTERNATIONAL FOOD POLICY RESEARCH INSTITUTE ON USE OF ALTERNATIVE PROTEINS; THIS WORK WAS FUNDED BY THE ROCKEFELLER FOUNDATION. WE ALSO WORKED WITH HARVEST PLUS TO EXPAND THE REACH OF BIOFORTIFIED CROPS. WE CONTINUED TO DRIVE MULTISECTORAL COLLABORATION IN 2019 THROUGH THE BRIDGE COLLABORATIVE, A TRAILBLAZING, CROSS-DISCIPLINARY EFFORT TO ENGAGE MORE THAN 150 LEADING TECHNICAL EXPERTS FROM THE HEALTH, DEVELOPMENT, AND ENVIRONMENTAL SECTORS TO ADDRESS HUMAN AND PLANETARY HEALTH. IN CONJUNCTION WITH THE WILDLIFE CONSERVATION SOCIETY AND THE NATURE CONSERVANCY, THE BRIDGE COLLABORATIVE PUBLISHED SEVERAL NEW PAPERS AND HELD SEVERAL MEETINGS ON FOOD SYSTEMS AND THE INTERSECTION OF HUMAN AND PLANETARY HEALTH. IN 2019, PATH STAFF MEMBERS PRESENTED AT KEY GLOBAL AND NATIONAL MEETINGS AND AUTHORED, EDITED, AND CONTRIBUTED TO VARIOUS HIGH-PROFILE PEER-REVIEWED JOURNAL ARTICLES, BOOK CHAPTERS, GLOBAL REPORTS, AND SYSTEMATIC REVIEWS. THESE EFFORTS ADVANCED THINKING ON BROAD, EFFECTIVE SOLUTIONS TO THE MOST PRESSING CHALLENGES IN MATERNAL, NEWBORN, AND CHILD HEALTH AND NUTRITION. SEXUAL AND REPRODUCTIVE HEALTH: PATH'S WORK IN SEXUAL AND REPRODUCTIVE HEALTH IS GUIDED BY THE KEY PRINCIPLES OF CHOICE, EQUITY, AND DIGNITY FOR ALL WOMEN. BECAUSE WE UNDERSTAND THE COMPLEX SOCIAL, BEHAVIORAL, AND GENDER DIMENSIONS OF WOMEN'S REPRODUCTIVE HEALTH, WE BUILD EVIDENCE AROUND TOOLS AND SERVICES THAT ARE BEST SUITED TO ADDRESS WOMEN'S DIVERSE NEEDS AND CIRCUMSTANCES. WE SPECIALIZE IN REDUCING BARRIERS TO ACCESS.
FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE:	IN 2019, PATH CONTINUED TO CHAMPION THE RIGHT OF WOMEN TO MANAGE THEIR OWN SEXUAL AND REPRODUCTIVE HEALTH BY CREATING AND ADVANCING IMPROVED TOOLS AND PRACTICES THAT MAKE WOMEN'S SELF-CARE POSSIBLE. AN INTEGRATED APPROACH TO WOMEN'S HEALTH INCLUDES ATTENTION TO CONTRACEPTION, CERVICAL AND BREAST CANCER, SEXUALLY TRANSMITTED INFECTIONS, AND A WOMAN'S RIGHT TO DECIDE WHETHER AND WHEN TO BECOME A MOTHER. AMONG THE RECENT WOMAN-INITIATED PRODUCTS INTRODUCED BY PATH ARE AN ALL-IN-ONE INJECTABLE CONTRACEPTIVE THAT CAN BE SELF-ADMINISTERED AND A VAGINAL SELF-SAMPLING KIT FOR HUMAN PAPILLOMAVIRUS (HPV) TESTING IN CERVICAL CANCER SCREENING PROGRAMS, AS DESCRIBED BELOW. PATH'S RESEARCH AND COORDINATION TO EXPAND ACCESS TO THE INJECTABLE CONTRACEPTIVE SUBCUTANEOUS DMPA (DMPA-SC, OR SAYANA PRESS) CONTINUED IN 2019, PRIMARILY THROUGH THE SELF-INJECTION BEST PRACTICES AND DMPA-SC ACCESS COLLABORATIVE PROJECTS. OUR SELF-INJECTION PROJECT IN UGANDA TOOK A USER-CENTERED APPROACH TO DEVELOP AND INTRODUCE MODELS FOR CONTRACEPTIVE SELF-INJECTION AND DISSEMINATED INFORMATION ON HOW THE PRACTICE CAN BE IMPLEMENTED AT SCALE. MORE THAN 7,000 WOMEN SELF-INJECTED DMPA-SC ACROSS FOUR DISTRICTS THROUGH THIS PROGRAM. THE DMPA-SC ACCESS COLLABORATIVE CONTINUED WORKING WITH MINISTRIES OF HEALTH AND PARTNERS ACROSS SECTORS IN SEVEN COUNTRIES TO FACILITATE DMPA-SC INTRODUCTION AS WELL AS SCALE-UP PLANNING FOR A RANGE OF CONTRACEPTIVE OPTIONS. IN 2019, THE COLLABORATIVE PROVIDED TECHNICAL ASSISTANCE TO ENSURE IMPLEMENTATION OF EACH COUNTRY'S TOTAL MARKET PLAN. THE COLLABORATIVE FACILITATED LEARNING ACROSS COUNTRIES BY EXCHANGING INFORMATION, RESULTS, AND LESSONS LEARNED; TROUBLESHOOTING CHALLENGES; AND ACCELERATING THE ADOPTION OF BEST PRACTICES. PATH WORKED WITH GLOBAL AND COUNTRY PARTNERS TO IMPROVE THE PREVENTION, DETECTION, AND TREATMENT OF CERVICAL PRECANCER, WHICH IS CAUSED BY INFECTION WITH HPV. WE CONTINUED OUR PARTNERSHIP WITH THE MINISTRIES OF HEALTH IN GUATEMALA AND HONDURAS TO SUPPORT THE SCALE-UP OF HPV TESTING IN THE PUBLIC SECTOR. WE PROVIDED TECHNICAL SUPPORT FOR PROCUREMENT OF TESTS, SUPPORTED ADVOCACY AND DISSEMINATION EVENTS, AND MADE PROGRESS TOWARD TRANSITIONING LEADERSHIP OF THE PROGRAM TO THE MINISTRIES AS THE PROJECT WAS IN ITS FINAL YEAR. WE ALSO EVALUATED FOLLOW-UP AND TREATMENT STRATEGIES TO ENSURE WOMEN RECEIVE APPROPRIATE, COMPREHENSIVE CARE. PATH PARTICIPATED IN WHO'S CALL FOR GLOBAL CERVICAL CANCER ELIMINATION BY HELPING SHAPE STRATEGIES FOR LOW- AND MIDDLE-INCOME COUNTRIES. IN MYANMAR, WE ENGAGED WITH THE MOH AND OTHER STAKEHOLDERS TO DESIGN A CERVICAL CANCER CONTROL PLAN. A PATH-LED CONSORTIUM ALSO WORKED CLOSELY WITH THE MOH TO STRENGTHEN THE KNOWLEDGE, CAPACITY, AND COORDINATION OF DECISION-MAKERS, SERVICE PROVIDERS, AND COMMUNITY MEMBERS TO UNDERSTAND SEXUAL AND REPRODUCTIVE HEALTH SERVICES AND RIGHTS AND TO INFLUENCE THE DEVELOPMENT AND IMPLEMENTATION OF RELATED POLICIES. TO COMBAT BREAST CANCER, WE WORKED IN PERU WITH THE NATIONAL AND REGIONAL CANCER INSTITUTES AND OTHER STAKEHOLDERS TO IMPLEMENT A MODEL FOR EARLY DETECTION OF BREAST CANCER APPROPRIATE AND FEASIBLE FOR LOW- AND MIDDLE-RESOURCE SETTINGS. WE BUILT THE CAPACITY OF HEALTH PROFESSIONALS TO IMPLEMENT THIS MODEL AND SHARED EVIDENCE WITH MOH REPRESENTATIVES FROM EL SALVADOR, GUATEMALA, HONDURAS, AND NICARAGUA. WE ALSO CONDUCTED ADVOCACY AMONG HEALTH OFFICIALS TO ENSURE BREAST CANCER REMAINS ON THE AGENDA AND WOMEN RECEIVE SCREENING AND TREATMENT EVEN IN THE ABSENCE OF MAMMOGRAPHY SERVICES. PATH CONTINUED TO SERVE AS THE SECRETARIAT FOR THE REPRODUCTIVE HEALTH SUPPLIES COALITION, A GLOBAL PARTNERSHIP OF MORE THAN 400 PUBLIC AND PRIVATE ENTITIES AND NGOS WORKING TO EXPAND ACCESS TO CRITICAL SEXUAL AND REPRODUCTIVE HEALTH AND FAMILY PLANNING SUPPLIES AND SERVICES. NONCOMMUNICABLE DISEASES: PATH IS AT THE FOREFRONT OF THE FIGHT AGAINST NONCOMMUNICABLE DISEASES (NCDS), INCLUDING DIABETES AND CARDIOVASCULAR DISEASE, IN LOW-RESOURCE SETTINGS WORLDWIDE. THE BURDEN OF THESE DISEASES IS RISING DISPROPORTIONATELY AMONG LOW- AND MIDDLE-INCOME COUNTRIES AND POPULATIONS. IN 2019, PATH CONTINUED TO SERVE AS THE SECRETARIAT OF THE COALITION FOR ACCESS TO NCD MEDICINES AND PRODUCTS. THIS GLOBAL, MULTISECTORAL COALITION IS DEDICATED TO INCREASING ACCESS TO NCD MEDICINES AND HEALTH PRODUCTS IN LOW- AND MIDDLE-INCOME COUNTRIES. IN ADDITION TO GLOBAL ADVOCACY EFFORTS, THE COALITION FOCUSED ON EAST AFRICA. AMONG OTHER ACTIVITIES, PATH CO-LED A MEETING WITH THE EAST AFRICA COMMUNITY SECRETARIAT TO BEGIN DEVELOPING A REGIONAL FRAMEWORK FOR NCDS. IN COLLABORATION WITH THE KENYA MOH AND LOCAL STAKEHOLDERS, PATH CONTINUED TO REFINE THE NCD NAVIGATOR, A FIRST-OF-ITS-KIND DIGITAL MANAGEMENT INFORMATION SYSTEM THAT PROVIDES REAL-TIME DATA ON NCD PROGRAMMING. OTHER ACHIEVEMENTS INCLUDED AN END-TO-END NCD SUPPLY CHAIN ASSESSMENT IN KENYA THAT WILL INFORM SUPPLY CHAIN STRENGTHENING EFFORTS. IN 2019, PATH BEGAN ADDRESSING THE GROWING NCD BURDEN IN GHANA BY LEVERAGING THE WORK DONE IN KENYA AND APPLYING THE NCD NAVIGATOR TO THE LOCAL CONTEXT. WE CONDUCTED A SITUATIONAL ANALYSIS AND DEVELOPED A PROTOCOL FOR A SUPPLY CHAIN ASSESSMENT (TO BE IMPLEMENTED IN 2020). ALSO IN GHANA, PATH LAUNCHED THE HEALTHY HEART AFRICA PROJECT. IN PARTNERSHIP WITH THE GHANA HEALTH SERVICE, THE PROJECT WORKS IN THE ASHANTI REGION TO SUPPORT HYPERTENSION SCREENING AND LINKAGES TO CARE. IN 2019, THE PROGRAM CONDUCTED MORE THAN 20,000 BLOOD PRESSURE SCREENINGS AND DIAGNOSED MORE THAN 1,200 PEOPLE WITH HYPERTENSION, CONTRIBUTING TO NATIONAL TESTING EFFORTS. IN VIETNAM, PATH BUILT ON THE PREVIOUS COMMUNITIES FOR HEALTHY HEARTS PROJECT AND ADAPTED THE MODEL IN 2019 TO INCLUDE DIABETES AND HYPERTENSION. USING LESSONS LEARNED AND CAPACITY STRENGTHENING ACTIVITIES, THE MODEL WAS SCALED UP NATIONALLY. WORKING CLOSELY WITH THE MOH AND A PROVINCIAL GOVERNMENT, WE SCREENED 10,000 PEOPLE AND LINKED 6,000 PEOPLE TO CARE. PATH ALSO COLLABORATED WITH THE MOH TO CREATE A DIGITAL ROAD MAP FOR MANAGING NCDS IN VIETNAM. IN SENEGAL, PATH IMPLEMENTED THE BETTER HEARTS BETTER CITIES PROJECT TO IMPROVE THE HYPERTENSION CONTROL RATE IN DAKAR. MORE INFORMATION CAN BE FOUND IN THE COUNTRY PROGRAMS SECTION. PATH ALSO IMPLEMENTED A HYPERTENSION SCREENING PROJECT IN MUMBAI, INDIA, IN PARTNERSHIP WITH RESOLVE TO SAVE LIVES. THE PROJECT USES A PRIVATE-SECTOR ENGAGEMENT MODEL. FINALLY, PATH LED AND CONTRIBUTED TO CONVENINGS TO RAISE AWARENESS OF NCDS AND ORCHESTRATE ACTION TO IMPROVE ACCESS TO PREVENTION AND CARE. HEALTH SYSTEMS INNOVATION AND DELIVERY: PATH'S HEALTH SYSTEMS INNOVATION AND DELIVERY PROGRAM STRENGTHENS HEALTH SYSTEMS AND ENHANCES COUNTRY CAPACITY FOR DATA-DRIVEN DECISION-MAKING. OUR PORTFOLIO SERVES AS AN ORGANIZING MECHANISM FOR PATH PROJECTS, INITIATIVES, AND UNITS THAT STRENGTHEN HEALTH SYSTEMS. THE HEALTH SYSTEMS ANALYTICS UNIT PROMOTES SYSTEMS THINKING; WITHIN AND OUTSIDE OF PATH, THIS UNIT LEADS COMPLEX EVALUATIONS OF HEALTH PROGRAMS, ENGAGES IN IMPLEMENTATION SCIENCE RESEARCH, FACILITATES HEALTH TECHNOLOGY INTRODUCTION AND SCALE-UP, AND WORKS TO IMPROVE DATA QUALITY AND USE FOR DECISION-MAKING. IN 2019, AS PART OF THE GLOBAL FUND'S PROSPECTIVE COUNTRY EVALUATIONS, THE UNIT EVALUATED THE GLOBAL FUND'S BUSINESS MODEL IN THE DRC, GUATEMALA, AND UGANDA. STAFF ENGAGED IN NETWORK ANALYSES TO INFORM THE OPTIMAL STRUCTURE AND FUNCTION OF VARIOUS COALITIONS AND INFORMAL AND FORMAL NETWORKS. THE HEALTH SYSTEMS STRENGTHENING IMPACT TEAM CONTINUED TO SERVE AS A HUB FOR STAFF WORKING IN HEALTH SYSTEMS. THE TEAM PLANNED FUTURE WORK IN STRENGTHENING URBAN HEALTH SYSTEMS, IMPROVING COMMUNITY-LEVEL DATA USE, AND DEVELOPING RESOURCES FOR SUCCESSFUL INTRODUCTION AND SCALE-UP OF INTERVENTIONS AND TECHNOLOGIES. THIS TEAM ALSO DEVELOPED PATH'S PRIMARY HEALTH CARE STRATEGY. THE GLOBAL HEALTH SECURITY TEAM CONTINUED TO INNOVATE FOR THE PREVENTION, DETECTION, AND CONTROL OF INFECTIOUS DISEASE OUTBREAKS. WITH SUPPORT FROM THE US CENTERS FOR DISEASE CONTROL AND PREVENTION, THE TEAM WORKED WITH NATIONAL LEADERS IN THE DRC, SENEGAL, TANZANIA, AND VIETNAM TO STRENGTHEN THEIR PUBLIC HEALTH SYSTEMS AND BUILD THEIR CAPACITY IN EPIDEMIC PREPAREDNESS AND RESPONSE. THE TEAM ALSO WORKED AS A MAJOR SUBGRANTEE ON THE USAID-SUPPORTED INFECTIOUS DISEASE DETECTION & SURVEILLANCE PROJECT. THIS PROJECT WORKS TO IMPROVE THE DETECTION OF HIGH-PRIORITY INFECTIOUS DISEASES AND IDENTIFICATION OF ANTIMICROBIAL RESISTANCE THROUGH IMPROVED DIAGNOSTIC AND SURVEILLANCE SYSTEMS. OUR CROSS-ORGANIZATIONAL IMPACT TEAM FOR EPIDEMIC PREPAREDNESS AND RESPONSE CONTINUED TO BE AT THE FOREFRONT OF THE EBOLA RESPONSE IN THE DRC, ENHANCING SURVEILLANCE, DETECTION, AND RESOURCE MOBILIZATION. OTHER EFFORTS INCLUDED STRENGTHENING ELECTRONIC HEALTH INFORMATION SYSTEMS, ADVANCING NOVEL VACCINE PLATFORMS, PREPARING MEDICAL COUNTERMEASURES FOR PANDEMIC INFLUENZA, AND DEFINING PATH'S ROLE IN COMBATING ANTIMICROBIAL RESISTANCE.
FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE:	COUNTRY PROGRAMS: PATH'S COUNTRY PROGRAMS SUPPORT WORK RANGING FROM SMALL-SCALE PILOTS TO LARGE, MULTICOUNTRY EFFORTS. IN 2019, WE OPERATED FULL-SCALE "COUNTRY" OFFICES IN THE DRC, ETHIOPIA, INDIA, KENYA, MYANMAR, SENEGAL, TANZANIA, UGANDA, UKRAINE, VIETNAM, AND ZAMBIA, AS WELL AS SMALLER "PROJECT" OFFICES IN MANY OTHER COUNTRIES. EXAMPLES THIS YEAR FOCUS ON SENEGAL, UKRAINE, AND ZAMBIA. IN SENEGAL, PATH WORKS CLOSELY WITH THE GOVERNMENT TO ACCELERATE PROGRESS TOWARD HEALTH SYSTEM MILESTONES. WE DO THIS IN PART BY BUILDING A CULTURE OF DATA USE. THE MACEPA PROGRAM, DESCRIBED EARLIER, HAS WORKED WITH SENEGAL'S MINISTRY OF HEALTH AND SOCIAL ACTION (MOHSA) AND NATIONAL MALARIA CONTROL PROGRAM SINCE 2010. IN 2019, MACEPA PROVIDED TECHNICAL ASSISTANCE IN DATA QUALITY AND DATA-DRIVEN DECISION-MAKING, OPERATIONAL RESEARCH, DEVELOPMENT OF NATIONAL POLICIES, AND COLLABORATION ON CROSS-BORDER ISSUES WITH NEIGHBORING COUNTRIES; FOR INSTANCE, PATH SUPPORTED COORDINATED PLANNING BETWEEN SENEGAL AND THE GAMBIA FOR THE DEVELOPMENT OF A SHARED DATA PLATFORM AND THE MASS DISTRIBUTION OF LONG-LASTING INSECTICIDE-TREATED BEDNETS. DURING 2019, PATH'S GLOBAL HEALTH SECURITY TEAM, ALSO DESCRIBED EARLIER, FOCUSED IN SENEGAL ON STRENGTHENING LABORATORY, SURVEILLANCE, AND INFORMATION SYSTEMS, AND ON PREVENTING ANTIMICROBIAL RESISTANCE. IN 2019, PATH SUPPORTED THE MOHSA TO IMPROVE ELECTRONIC REPORTING FROM HOSPITALS. WE ALSO SUPPORTED PUBLICATION OF KEY POLICY DOCUMENTS RELATED TO THE NATIONAL LABORATORY SYSTEM, INCLUDING A QUALITY ASSURANCE ACTION PLAN AND FIVE-YEAR STRATEGIC PLAN. WE ALSO STRENGTHENED REAL-TIME, COMMUNITY-BASED SURVEILLANCE FOR PRIORITY HUMAN AND ZOONOTIC DISEASES WITH EPIDEMIC POTENTIAL. AS PART OF THE DOSE PER CONTAINER PARTNERSHIP, PATH CONDUCTED FORMATIVE RESEARCH THAT CONTRIBUTED TO THE VACCINE INNOVATION PRIORITIZATION STRATEGY WORK LED BY GAVI. PATH ALSO CONDUCTED A REFRIGERATOR TEMPERATURE MONITORING STUDY IN PRIVATE PHARMACIES IN TWO URBAN DISTRICTS AND ORGANIZED COLD CHAIN MANAGEMENT TRAINING WORKSHOPS FOR THE CHIEF REGIONAL SUPPLY PHARMACISTS IN ALL 14 REGIONS OF THE COUNTRY. IN 2019, PATH PROVIDED TECHNICAL ASSISTANCE TO THE GOVERNMENT OF SENEGAL TO SCALE UP SAFE OXYGEN DELIVERY. ACTIVITIES INCLUDED QUANTIFYING THE DEMAND FOR, AND THE EXISTING IN-COUNTRY SUPPLY OF, OXYGEN. IN ADDITION, WE PROVIDED TECHNICAL ASSISTANCE TO A COALITION OF PARTNERS LED BY THE MOHSA TO COLLECT DATA ON THE AVAILABILITY OF MEDICAL DEVICES, INCLUDING OXYGEN AND PULSE OXIMETERS, WITHIN ALL PUBLIC HEALTH FACILITIES. THROUGH THE BETTER HEARTS BETTER CITIES PROJECT, PATH PUT IN PLACE AN ACTION PLAN FOR THE MOHSA AND NATIONAL SUPPLY PHARMACY TO IMPROVE THE AVAILABILITY AND ACCESSIBILITY OF HYPERTENSION MEDICATIONS. WE ALSO ESTABLISHED A COALITION OF PRIVATE COMPANIES TO RAISE AWARENESS AND INCREASE HEALTH LITERACY AROUND NONCOMMUNICABLE DISEASES. THE GOAL WAS TO CHANGE THE MINDSET FROM TREATMENT TO PREVENTION, WITH A BUSINESS CASE DEVELOPED TO DEMONSTRATE THE GAIN FOR BOTH COMPANIES AND EMPLOYEES. PATH HAS BEEN A KEY PARTNER TO THE GOVERNMENT OF SENEGAL SINCE THE INCEPTION OF ITS HPV VACCINATION DEMONSTRATION PROGRAM IN 2013. PROVIDING SUPPORT EACH YEAR, ACTIVITIES IN 2019 INCLUDED MULTI-AGE COHORT VACCINATIONS OF 9- TO 14-YEAR-OLD GIRLS. PER THE GOVERNMENT'S REQUEST, PATH CONTINUED TO ASSIST WITH PROGRAM PLANNING AND PREPARATION, SOCIAL MOBILIZATION, VACCINE DELIVERY, MONITORING AND EVALUATION, AND GRANT RENEWALS. FINALLY, AS PART OF A PROJECT FUNDED BY THE CLINTON HEALTH ACCESS INITIATIVE, PATH AND THE MOHSA WORKED TOGETHER TO TRAIN 1,672 PROVIDERS (ABOUT 200 MORE THAN ANTICIPATED) ON SELF-INJECTION OF THE CONTRACEPTIVE DMPA-SC. THE PROJECT EXCEEDED TRAINING TARGETS ACROSS ALL CADRES OF HEALTH WORKERS AND SIGNIFICANTLY CONTRIBUTED TO THE MOHSA'S OBJECTIVE OF SCALING UP DMPA-SC SELF-INJECTION NATIONWIDE. PATH IN UKRAINE ENGAGES DIRECTLY WITH KEY MOH AND NATIONAL CENTER FOR PUBLIC HEALTH (NCPH) STAKEHOLDERS TO ENSURE THAT THE PROGRAMS WE IMPLEMENT ARE ADAPTED TO THE CONTEXT OF THE COUNTRY'S ONGOING HEALTH SYSTEM REFORM. WE PROVIDE TECHNICAL ASSISTANCE TO CENTRAL-, OBLAST-, AND MUNICIPAL-LEVEL INSTITUTIONS IN DEVELOPING TB AND TB/HIV PLANS, PROTOCOLS, AND OTHER GUIDING DOCUMENTS. THE AIM IS TO ENSURE RAPID AND EFFECTIVE UPTAKE OF SUSTAINABLE, COMPREHENSIVE, HIGH-QUALITY CARE FOR ALL PATIENTS. PATH ALSO MAINTAINS STRONG RELATIONSHIPS WITH UKRAINE'S NGO AND CIVIL-SOCIETY SECTOR, ESSENTIAL PARTNERS IN REACHING MARGINALIZED GROUPS. WE WORK ACROSS THE COUNTRY, BUILDING THIS SECTOR'S CAPACITY TO PROVIDE PREVENTION, SCREENING, AND TREATMENT SUPPORT SERVICES TO TB PATIENTS, PLHIV, AND OTHER KEY POPULATIONS. NGOS AND CIVIL-SOCIETY ORGANIZATIONS FILL IMPORTANT GAPS IN THE CONTINUUM OF CARE FOR A RANGE OF CONDITIONS AND ARE OFTEN MORE TRUSTED THAN FORMAL HEALTH SERVICES. UNDER THE USAID-FUNDED SERVING LIFE PROJECT, PATH COLLABORATES WITH THE MINISTRY OF JUSTICE, MOH, AND A BROAD RANGE OF HIV, TB, AND PENITENTIARY HEALTH STAKEHOLDERS TO STRENGTHEN HIV, TB, AND HEPATITIS C SCREENING, DIAGNOSIS, TREATMENT, AND LINKAGES TO CARE (POST-RELEASE), AS DESCRIBED IN THE HIV AND TUBERCULOSIS SECTION. THIS WORK BUILDS ON A PREVIOUS PROGRAM FUNDED THROUGH TB REACH THAT LED TO A TEN-FOLD INCREASE IN TB CASE DETECTION AMONG PRETRIAL DETAINEES AND PRISONERS OVER TWO YEARS. IN 2019, PATH CLOSED OUT CHALLENGE TB (CTB) AND BEGAN A NEW PROJECT: SUPPORT TB CONTROL EFFORTS IN UKRAINE (STBCEU). CTB'S ACTIVITIES IMPROVED CASE DETECTION AND ADHERENCE TO TREATMENT AND CONTRIBUTED TOWARD NATIONWIDE CONTROL OF THE DRUG-RESISTANT TB EPIDEMIC. AMONG OTHER ACHIEVEMENTS, CTB HELPED UKRAINE INTRODUCE NEW DRUG REGIMENS THAT DRAMATICALLY IMPROVED CARE AND OUTCOMES FOR THESE PATIENTS. STBCEU PICKED UP WHERE CTB LEFT OFF AND WILL CONTINUE TO IMPROVE SERVICES AND INTRODUCE INNOVATIONS FOR TB CONTROL. THE UNITAID-FUNDED ADHERENCE SUPPORT COALITION TO END TB (ASCENT) PROJECT, FOR WHICH PATH IS A LEAD PARTNER IN UKRAINE, USES DIGITAL INNOVATIONS SUCH AS MOBILE COMMUNICATION TECHNOLOGIES TO HELP PATIENTS SUCCEED IN TREATMENT. THE ASCENT PROJECT IS GENERATING CRUCIAL EVIDENCE FOR OPTIMAL USE AND SCALE. THE LONG-TERM VISION IS A WORLD WHERE THESE DIGITAL TOOLS CAN BE AVAILABLE TO ALL TB PATIENTS, NO MATTER WHERE THEY LIVE. OVER THE LAST DECADE AND A HALF, PATH HAS ESTABLISHED ITSELF IN ZAMBIA AS A KEY AND ALL-WEATHER PARTNER FOR THE MOH. THROUGH MACEPA AND PAMO (SEE THE MALARIA AND NEGLECTED TROPICAL DISEASES SECTION), PATH SUPPORTS THE EXPANSION OF MALARIA SURVEILLANCE AND TREATMENT SERVICES. AMONG OTHER ACTIVITIES, THESE PROGRAMS STRENGTHEN IN-COUNTRY CAPACITY FOR EFFECTIVE ANALYSIS AND USE OF DATA FOR EVIDENCE-BASED DECISION-MAKING. PATH'S MALARIA WORK IN ZAMBIA SPANS SIX PROVINCES; IN 2019, EASTERN PROVINCE REACHED A NEW THRESHOLD OF LOW MALARIA PREVALENCE. IN RESPONSE, PATH, WITH ADDITIONAL FUNDING, TRAINED 1,401 COMMUNITY HEALTH WORKERS AND SET UP INTENSIFIED SURVEILLANCE SYSTEMS IN AN EFFORT TO REDUCE MALARIA INCIDENCE TO ITS LOWEST POSSIBLE LEVEL AND ACHIEVE PRE-ELIMINATION STATUS. MACEPA ALSO INTRODUCED THE CONCEPT OF COMMUNITY-BASED REACTIVE INDOOR RESIDUAL SPRAYING TO EXTEND VECTOR CONTROL COVERAGE THROUGHOUT THE YEAR IN PERENNIAL MALARIA TRANSMISSION AREAS OF SOUTHERN PROVINCE. VECTOR CONTROL IS A PROVEN AND PRIORITY INTERVENTION OF THE GOVERNMENT OF ZAMBIA TO REDUCE MALARIA. TO THIS END, PAMO SUPPORTED DEVELOPMENT OF GUIDELINES FOR EFFECTIVE AND CONTINUOUS DISTRIBUTION OF LONG-LASTING INSECTICIDE-TREATED NETS. IN 2019, PAMO DISTRIBUTED 115,416 OF THESE NETS ACROSS THE COUNTRY; 63% THROUGH A "MOP-UP" CAMPAIGN AND 37% THROUGH SCHOOLS. PATH'S EFFORTS TO ELIMINATE MALARIA EXPANDED IN 2019 TO INCLUDE RESEARCH ON A NOVEL TOOL: ATTRACTIVE TARGETED SUGAR BAITS, WHICH ARE DEPLOYED OUTSIDE OF HOMES TO ATTRACT MOSQUITOES AND PROVIDE THEM WITH A LETHAL DOSE OF INSECTICIDE. ACHIEVEMENTS IN ZAMBIA INCLUDED PRODUCT TESTING AND OPTIMIZATION BOTH IN THE LAB AND IN SEMI-FIELD SETTINGS. PATH ALSO SUPPORTED THE INTRODUCTION, TESTING, AND DOCUMENTATION OF DIGITAL TOOLS TO IMPROVE OPERATIONAL PERFORMANCE OF MASS DRUG ADMINISTRATION AND INDOOR RESIDUAL SPRAYING CAMPAIGNS IN SOUTHERN AND WESTERN PROVINCES. TB IS ANOTHER MAJOR CHALLENGE IN ZAMBIA. FOR THE PAST THREE YEARS, PATH HAS BEEN IMPLEMENTING USAID'S FLAGSHIP TB PROJECT, ERADICATE TB. OVER THE LIFE OF THE PROJECT, THE TB CURE RATE IN ZAMBIA HAS IMPROVED FROM 65% TO 70%, AND THE PROPORTION OF TB/HIV PATIENTS ON ANTIRETROVIRAL TREATMENT HAS INCREASED FROM 84% TO 93%. ALSO IN ZAMBIA, PATH CONTINUED TO ADVANCE THE AVAILABILITY OF DMPA-SC, AN INJECTABLE CONTRACEPTIVE. (SEE THE SEXUAL AND REPRODUCTIVE HEALTH SECTION.) IN 2019, PATH ROLLED OUT TRAININGS ON SELF-INJECTION TO SEVEN OUT OF TEN PROVINCES. THE TRAININGS REACHED 1,790 HEALTH CARE PROVIDERS FROM 625 HEALTH FACILITIES IN 62 DISTRICTS WHO ARE NOW ABLE TO OFFER SELF-INJECTION AS PART OF THE FAMILY PLANNING PACKAGE.
FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE:	PATH ALSO BUILT UPON THE BETTER IMMUNIZATION DATA PROJECT BY BRINGING TOGETHER A CONSORTIUM OF TECHNICAL EXPERTS AND PARTNERS WORKING WITH THE GOVERNMENT OF ZAMBIA TOWARD A COMMON GOAL: ACCURATE, IMPROVED, AND EQUITABLE VACCINE COVERAGE RATES. THIS WORK IS FUNDED BY GAVI. KEY ACHIEVEMENTS IN 2019 INCLUDED REFRESHER TRAININGS FOR 562 HEALTH CARE WORKERS IN 320 HEALTH FACILITIES.
FORM 990, PART III, LINE 4B, DESCRIPTION OF PROGRAM SERVICE:	DRUG DEVELOPMENT: THROUGH OUR WORK ON DRUG DEVELOPMENT AND INTRODUCTION, PATH HELPS ENSURE THAT PEOPLE AROUND THE WORLD, ESPECIALLY CHILDREN IN LOW-RESOURCE SETTINGS, HAVE RELIABLE ACCESS TO LIFESAVING MEDICINES. OVER THE YEARS, OUR WORK HAS ADVANCED SOLUTIONS FOR A RANGE OF URGENT GLOBAL HEALTH CHALLENGES, INCLUDING ENTERIC AND DIARRHEAL DISEASES, NEGLECTED TROPICAL DISEASES, HIV/AIDS, AND MALARIA. DRAWING ON AN ENDURING COMMITMENT TO HEALTH EQUITY AND A UNIQUE PARTNERSHIP APPROACH THAT SPANS THE ACADEMIC, PRIVATE, NONPROFIT, AND GOVERNMENT SECTORS, OUR WORK OVERTURNS BARRIERS TO HEALTH AT EVERY STAGE OF DRUG DEVELOPMENT AND USE-FROM EARLY RESEARCH TO POLICY INTRODUCTION. IN 2019, THE DIARRHEA INNOVATIONS GROUP, AN INTERNATIONAL NETWORK OF CHILD HEALTH STAKEHOLDERS HOUSED WITHIN AND CO-CHAIRED BY PATH, MOVED FORWARD A CRITICAL GUIDANCE FOR DIARRHEA MANAGEMENT AMONG CHILDREN: THE ADDITION OF CO-PACKAGED ORS AND ZINC TO THE WHO ESSENTIAL MEDICINES LISTS. CO-PACKAGED ADMINISTRATION, NOW RECOGNIZED AS ESSENTIAL, COULD INCREASE ACCESS TO THIS LIFESAVING TREATMENT AND ACCELERATE PROGRESS TOWARD CHILD HEALTH GOALS. ALSO IN 2019, WE CONTINUED OUR WORK ON DEVELOPING NEW THERAPEUTICS FOR CRYPTOSPORIDIUM, A DEADLY DIARRHEA-CAUSING PARASITE FOR WHICH NO HIGHLY EFFECTIVE TREATMENT IS AVAILABLE. ADDITIONALLY, WE BEGAN ENROLLMENT IN A PHASE 2 PROOF-OF-CONCEPT CLINICAL TRIAL OF IOWH032, A NOVEL ANTISECRETORY DRUG FOR THE TREATMENT OF CHOLERA. WE ALSO CONTINUED TO ADVANCE OUR WORK ON A NEW ASSESSMENT TOOL FOR ENVIRONMENTAL ENTERIC DYSFUNCTION (EED)-AN INTESTINAL DISORDER RESPONSIBLE FOR A SIGNIFICANT PORTION OF THE GROWTH STUNTING OF APPROXIMATELY 140 MILLION CHILDREN WORLDWIDE. KNOWN AS THE "MICRONUTRIENT AND ENVIRONMENTAL ENTERIC DYSFUNCTION ASSESSMENT TOOL" (MEEDAT), THE TOOL IS DESIGNED TO MEASURE MULTIPLE BIOMARKERS, INCLUDING THOSE OF EED, SYSTEMIC INFLAMMATION, GROWTH HORMONE RESISTANCE, AND MICRONUTRIENTS.
FORM 990, PART III, LINE 4C, DESCRIPTION OF PROGRAM SERVICE:	MARKET DYNAMICS: PATH'S MARKET DYNAMICS PROGRAM ENCOMPASSES EFFORTS TO EVALUATE MARKETS, ASSESS SHORTCOMINGS, AND DESIGN MARKET-BASED INTERVENTIONS TO IMPROVE HEALTH OUTCOMES. THIS WORK COMPLEMENTS PATH'S OTHER EFFORTS, SUCH AS PRODUCT DEVELOPMENT AND INTRODUCTION. IT BUILDS UPON OUR EXISTING STRENGTH IN COMMERCIALIZATION, ALIGNS EXPERTISE ACROSS TEAMS, AND EXPANDS OUR CAPACITY TO ADDRESS MARKET-BASED ISSUES. IN 2019, OUR WORK FOCUSED ON ASSESSING MARKETS AND IMPROVING MARKET FUNCTIONING FOR MALARIA DRUGS AND DRUG INTERMEDIATES, MALARIA DIAGNOSTICS, AND OXYGEN THERAPY DEVICES. CENTER OF DIGITAL AND DATA EXCELLENCE: PATH USES DIGITAL TECHNOLOGIES AND DATA-LED ACTION TO IMPROVE HEALTH AND SAVE LIVES. IN 2019, THE CENTER OF DIGITAL AND DATA EXCELLENCE APPLIED ITS EXPERTISE TO SEVERAL PROJECTS. KEY ACCOMPLISHMENTS INCLUDED THE WHO-PATH STRATEGIC COLLABORATION ON INNOVATION AND GLOBAL DIGITAL HEALTH. THIS COLLABORATION BRINGS TOGETHER A CROSS-SECTOR NETWORK OF DIGITAL HEALTH EXPERTS AND INVESTORS TO SUPPORT WHO IN DEVELOPING A GLOBAL DIGITAL HEALTH DEPARTMENT AND PORTFOLIO. WORK CONTINUED UNDER DIGITAL SQUARE, A PATH-LED INITIATIVE. THIS INITIATIVE BRINGS DONORS AND PARTNERS TOGETHER TO IMPROVE HOW THE GLOBAL COMMUNITY DESIGNS, USES, AND PAYS FOR DIGITAL HEALTH TOOLS AND APPROACHES. PATH ALSO CONTINUED IMPLEMENTATION OF THE TANZANIA DATA USE PARTNERSHIP, WHICH SUPPORTS THE GOVERNMENT OF TANZANIA TO IMPROVE COUNTRYWIDE HEALTH INFORMATION SYSTEMS AND IMPLEMENT THE TANZANIA DIGITAL HEALTH INVESTMENT ROAD MAP. IN 2019, THE PARTNERSHIP SUPPORTED LAUNCH OF THE COUNTRY'S 2019-2024 NATIONAL DIGITAL HEALTH STRATEGY. THE BID INITIATIVE, A COLLABORATION BETWEEN PATH AND THE GOVERNMENTS OF TANZANIA AND ZAMBIA, HAS EMPOWERED THESE COUNTRY GOVERNMENTS TO ENHANCE IMMUNIZATION THROUGH IMPROVED DATA COLLECTION, QUALITY, AND USE. PATH CONTINUED TO SUPPORT THE SCALE-UP AND SUSTAINABILITY OF ELECTRONIC IMMUNIZATION REGISTRIES IN BOTH COUNTRIES WHILE PROVIDING MENTORSHIP AND PEER LEARNING OPPORTUNITIES TO OTHER COUNTRIES PURSUING SIMILAR DIGITAL HEALTH SOLUTIONS. IN ADDITION, PATH COLLABORATED WITH THE JOINT LEARNING NETWORK FOR UNIVERSAL HEALTH COVERAGE TO CONTINUE A PEER LEARNING MODEL THAT INCLUDES PROFESSIONALS FROM MINISTRIES OF HEALTH AND NATIONAL HEALTH INSURANCE AGENCIES IN TEN COUNTRIES. PATH ALSO INCREASED PARTICIPATION IN HIGH-LEVEL COALITIONS, INCLUDING THE DIGITAL TRANSFORMATION FOR UHC 2030 COALITION, THE LANCET/FINANCIAL TIMES JOINT COMMISSION ON GOVERNING HEALTH FUTURES 2030, AND THE DIGITAL CONNECTED CARE COALITION.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 WAS PREPARED BY AN OUTSIDE ACCOUNTING FIRM USING INFORMATION PROVIDED BY PATH ACCOUNTING SERVICES STAFF. PATH SENIOR MANAGEMENT REVIEWED THE DRAFT FORM. A COPY OF THE DRAFT WAS SENT TO THE BOARD OF DIRECTORS FOR COMMENT. AFTER THE COMMENT PERIOD, THE CHIEF OF ACCOUNTING SIGNED THE FORM.
FORM 990, PART VI, SECTION B, LINE 12C	PATH HAS POLICIES AND PROCEDURES TO ADDRESS CONFLICTS OF INTEREST. PATH MANAGEMENT AND ALL STAFF AT A DESIGNATED LEVEL OR HIGHER WITHIN THE ORGANIZATION MUST COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM EACH YEAR. ALL FORMS ARE REVIEWED AND KEPT ON FILE. A CONFLICT MANAGEMENT PLAN IS DEVELOPED FOR ANY EMPLOYEE WITH A SIGNIFICANT ACTUAL OR PERCEIVED CONFLICT OF INTEREST. PATH ALSO HAS A WELL-DEFINED PROCEDURE FOR IDENTIFYING AND REPORTING ACTUAL AND POTENTIAL CONFLICTS OF INTEREST AMONG BOARD MEMBERS. NEW BOARD MEMBERS ARE ASKED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM WITHIN 30 DAYS OF JOINING THE BOARD AND TO COMPLETE A NEW FORM ANNUALLY THEREAFTER. IN ADDITION, MEMBERS ARE REMINDED TO REPORT ANY NEW ISSUES THAT ARISE OUTSIDE OF THE ANNUAL DISCLOSURE PERIOD. THE DISCLOSURE FORMS ARE REVIEWED BY PATH'S GENERAL COUNSEL, AND IF ANY ACTUAL OR POTENTIAL CONFLICTS ARE IDENTIFIED, GENERAL COUNSEL MAKES A RECOMMENDATION TO THE CHAIR OF THE GOVERNANCE COMMITTEE AND THE CHAIR OF THE BOARD FOR A MANAGEMENT PLAN TO PROPERLY MANAGE ANY CONFLICTS. A FORMAL MANAGEMENT PLAN IS THEN AGREED UPON WITH THE BOARD MEMBER, AND THE ENTIRE BOARD OF DIRECTORS IS INFORMED AT THE NEXT REGULARLY SCHEDULED BOARD MEETING.
FORM 990, PART VI, SECTION B, LINE 15	THE BOARD'S EXECUTIVE COMPENSATION COMMITTEE ANNUALLY REVIEWS SALARIES AND BENEFITS FOR EXECUTIVE EMPLOYEE POSITIONS AND PROVIDES GUIDANCE TO THE PRESIDENT/CHIEF EXECUTIVE OFFICER (CEO) ON COMPENSATION DECISIONS FOR EXECUTIVE POSITIONS. THE COMPENSATION AND BENEFITS FOR PATH'S PRESIDENT/CEO ARE REVIEWED AND APPROVED BY THE ENTIRE BOARD OF DIRECTORS EACH YEAR. PATH ROUTINELY USES THE SERVICES OF EXTERNAL FIRMS TO ASSESS AND BENCHMARK EXECUTIVE COMPENSATION (PRESIDENT/CEO, VICE PRESIDENTS, AND EXECUTIVE TEAM MEMBERS). THE MOST RECENT MAJOR REVIEW WAS COMPLETED BY THE BOARD COMPENSATION COMMITTEE IN 2017. AT THE REQUEST OF THE BOARD, PATH ENGAGED MERCER (A COMPENSATION, BENEFITS, AND HUMAN RESOURCES CONSULTING FIRM) TO REVIEW CURRENT AND PROPOSED BASE SALARIES OF PATH'S PRESIDENT/CEO, VICE PRESIDENTS, AND EXECUTIVE TEAM MEMBERS. MERCER USED DATA FROM MULTIPLE SOURCES TO EVALUATE CURRENT AND PROPOSED BASE SALARIES FOR THESE POSITIONS. THE BOARD'S EXECUTIVE COMPENSATION COMMITTEE REVIEWED THE MERCER REPORT AND APPROVED THE USE OF THE REPORT TO ESTABLISH A FRAMEWORK WITHIN WHICH THE PRESIDENT/CEO IS DELEGATED AUTHORITY TO ESTABLISH THE TOTAL COMPENSATION PACKAGES OF THE VICE PRESIDENTS AND EXECUTIVE TEAM MEMBERS. ADDITIONALLY, MERCER REVIEWED THE PROPOSED TOTAL COMPENSATION AND BENEFITS PACKAGE FOR THE PRESIDENT/CEO POSITION AND OBTAINED A SIGNIFICANT NUMBER OF DATA POINTS TO ASCERTAIN ITS REASONABLENESS AND APPROPRIATENESS. THE BOARD APPROVED THE COMMITTEE'S RECOMMENDATION FOR THE PRESIDENT/CEO'S TOTAL COMPENSATION PACKAGE.
FORM 990, PART VI, SECTION C, LINE 19	PATH GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST; MOST DOCUMENTS ARE ALSO AVAILABLE ONLINE.

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Explanation

FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:

PATH IS A GLOBAL ORGANIZATION THAT WORKS TO ACCELERATE HEALTH EQUITY BY BRINGING TOGETHER PUBLIC INSTITUTIONS, BUSINESSES, SOCIAL ENTERPRISES, AND INVESTORS TO SOLVE THE WORLD'S MOST PRESSING HEALTH CHALLENGES. WITH EXPERTISE IN SCIENCE, HEALTH, ECONOMICS, TECHNOLOGY, ADVOCACY, AND DOZENS OF OTHER SPECIALTIES, PATH DEVELOPS AND SCALES UP SOLUTIONS-INCLUDING VACCINES, DRUGS, DEVICES, DIAGNOSTICS, AND INNOVATIVE APPROACHES TO STRENGTHENING HEALTH SYSTEMS WORLDWIDE. SINCE 2011, PATH AND OUR PARTNERS AND SUPPORTERS HAVE IMPROVED HEALTH FOR MORE THAN 150 MILLION PEOPLE ON AVERAGE EACH YEAR. THE LARGEST INVESTMENTS IN PATH'S PROGRAMMATIC WORK IN 2019 WERE ORGANIZED INTO THREE PRIMARY PORTFOLIOS: GLOBAL HEALTH PROGRAMS; ESSENTIAL MEDICINES; AND TECHNOLOGY, ANALYTICS, AND MARKET INNOVATION. SEE BELOW FOR DESCRIPTIONS OF THESE PROGRAMS.

FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE:

IN UKRAINE, PATH LEADS THE USAID-FUNDED SERVING LIFE PROJECT, WHICH REDUCES TB, HIV, AND HEPATITIS C TRANSMISSION IN PRETRIAL DETENTION CENTERS, PRISONS, POST-PRISON SETTINGS, AND THE COMMUNITY. STRATEGIES INCLUDE INCREASING CASE DETECTION, STRENGTHENING LINKAGES TO CARE, AND EMPLOYING A CASE-MANAGEMENT APPROACH TO ENSURE TREATMENT COMPLETION. IN 2019, WE WORKED IN 12 REGIONS IN 75 PRETRIAL DETENTION CENTERS, PRISON COLONIES, AND CORRECTIONAL CENTERS, AND 12 PROBATION CENTERS. WE TESTED APPROXIMATELY 30,000 PEOPLE FOR HIV, LINKED AROUND 3,000 NEWLY IDENTIFIED PLHIV TO TREATMENT, AND SUPPORTED ABOUT 2,500 PEOPLE IN PRISON ON HIV TREATMENT. IN 2019, WE ALSO PARTNERED WITH THE MINISTRY OF JUSTICE TO LAUNCH A PILOT PROGRAM TO PROVIDE OPIOID-SUBSTITUTION THERAPY TO PEOPLE WHO INJECT DRUGS, THE FIRST TIME THIS INTERVENTION HAS BEEN PROVIDED IN A PRISON IN UKRAINE. IN ANOTHER ADVANCEMENT, WE ROLLED OUT THE USE OF A SMART PILL BOX THAT REMINDS PATIENTS TO TAKE THEIR TB MEDICATION AND NOTIFIES PROVIDERS IF DOSES ARE MISSED, RESULTING IN 90% TREATMENT COMPLETION AMONG PATIENTS USING THIS TECHNOLOGY. WE WILL CONTINUE TO BUILD ON THESE SUCCESSES AS A PARTNER UNDER THE UNITAID-FUNDED ADHERENCE SUPPORT COALITION TO END TB PROJECT, LAUNCHED IN 2019. FOR MORE INFORMATION ON OUR WORK IN UKRAINE, SEE THE COUNTRY PROGRAMS SECTION. IN VIETNAM, PATH CONTINUED TO PILOT INNOVATIONS IN HIV. IN 2019, WE EQUIPPED SOCIAL ENTERPRISES AND PRIVATE CLINICS LED BY KEY POPULATIONS TO GENERATE DEMAND FOR AND PROVIDE HIV SERVICES. INNOVATIVE ONLINE CHAT BOTS OFFERED INFORMATION ON HIV SELF TESTING (HIVST) AND PRE-EXPOSURE PROPHYLAXIS (PREP); CARE PROVIDERS THEN SERVED THESE CLIENTS OFFLINE IN COMMUNITIES OR AT CLINICS. PATH ALSO ENGAGED THE GOVERNMENT OF VIETNAM TO SCALE UP NEW MODELS OF HIV TESTING, INCLUDING EXPANDING ACCESS TO HIV LAY- AND SELF-TESTING AND PARTNER NOTIFICATION SERVICES. THE PROJECT TESTED APPROXIMATELY 50,000 PEOPLE IN 2019. WORKING AGAIN WITH THE GOVERNMENT AND KEY POPULATION SERVICE PROVIDERS, PATH INTRODUCED A VARIETY OF SERVICE MODELS TO RAPIDLY SCALE UP PREP NATIONWIDE; IN 2019 ALONE, WE DOUBLED THE NUMBER OF PEOPLE ON PREP. PATH ALSO FOCUSED ON TB CONTROL. IN 2019, THE BREATH FOR LIFE PROJECT WORKED WITH VIETNAM'S NATIONAL TUBERCULOSIS PROGRAM TO DEVELOP AND TEST STANDARD OPERATING PROCEDURES TO ADDRESS THE SPECIMEN COLLECTION CHALLENGES THAT CONTRIBUTE TO LOW DETECTION OF TB IN CHILDREN. OUR EFFORTS RESULTED IN UPDATED NATIONAL GUIDELINES THAT FACILITATED COUNTRYWIDE SCALE-UP OF STOOL XPERT TESTING FOR TB DIAGNOSIS AMONG CHILDREN. IN INDIA, PATH DEVELOPED TOOLS AND APPLICATIONS TO ENHANCE MONITORING OF HIV SERVICE DELIVERY THROUGH IMPROVED DATA QUALITY AND AUTOMATED DATA COMPILATION. TO IMPROVE TB SERVICES, WE PILOTED ARTIFICIAL INTELLIGENCE TO STREAMLINE CHEST X-RAY READINGS, ENABLING QUICKER DIAGNOSIS AND INITIATION ON TB TREATMENT. FURTHER, WE WORKED CLOSELY WITH THE NATIONAL TB PROGRAM TO DEVELOP PUBLIC-PRIVATE PARTNERSHIP GUIDELINES, AND WE CONTINUED ENGAGING THE PRIVATE SECTOR TO LINK DRUG-RESISTANT TB PATIENTS TO PUBLIC-SECTOR CARE. IN TANZANIA, PATH AND OUR PARTNERS DEVELOPED A MOBILE PHONE APPLICATION THAT ENABLED ALMOST 229,900 PEOPLE TO SELF-SCREEN FOR TB. IN ZAMBIA, PATH CONTINUED TO IMPLEMENT THE ERADICATE TB PROJECT, SUPPORTING 249 HEALTH FACILITIES ACROSS SIX PROVINCES. THE PROJECT TESTED MORE THAN 125,000 PEOPLE FOR TB AND INITIATED MORE THAN 8,000 PEOPLE ON TREATMENT. FOR MORE INFORMATION, SEE THE COUNTRY PROGRAMS SECTION. ALSO IN 2019, PATH BEGAN WORK ON A NEW TB PROJECT IN CENTRAL ASIA THAT PROVIDES CLINICAL TECHNICAL SUPPORT AND DRUG SAFETY MONITORING TO NATIONAL TB PROGRAMS IN TAJIKISTAN, KAZAKHSTAN, AND UZBEKISTAN. MATERNAL, NEWBORN, AND CHILD HEALTH AND NUTRITION: PATH WORKS WITH PARTNERS TO IMPROVE MATERNAL, NEWBORN, AND CHILD HEALTH AND NUTRITION AROUND THE WORLD. TOGETHER WE DEVELOP, ADAPT, AND SCALE TECHNOLOGIES AND APPROACHES TO REDUCE ILLNESS AND DEATH AND GIVE CHILDREN THE BEST POSSIBLE START IN LIFE. IN 2019, PATH CONTINUED TO EXPAND OUR GLOBAL AND NATIONAL LEADERSHIP IN EARLY CHILDHOOD DEVELOPMENT (ECD). WITH PATH SUPPORT, THE GOVERNMENTS OF ETHIOPIA, KENYA, MOZAMBIQUE, AND ZAMBIA CONTINUED TO INCORPORATE ECD SERVICES INTO BASIC HEALTH CARE. THIS PIONEERING WORK FOCUSES ON BUILDING AN ENABLING LEADERSHIP AND POLICY ENVIRONMENT WHILE SUPPORTING AND STRENGTHENING THE CAPACITY OF HEALTH SYSTEMS AND HEALTH SERVICE PROVIDERS. ALONG WITH WHO, UNICEF, THE WORLD BANK, AND OTHERS, PATH HELPED ADVANCE THE NURTURING CARE FOR ECD FRAMEWORK, WHICH OFFERS A STRUCTURE FOR COUNTRIES TO ADOPT, ADAPT, AND SCALE ECD SERVICES. IN PARTNERSHIP WITH THE AFRICAN POPULATION AND HEALTH RESEARCH CENTER, WE LAUNCHED A RANDOMIZED CONTROL TRIAL OF ECD INTERVENTIONS IN KENYA. WITH HARVARD UNIVERSITY, WE DESIGNED A LARGE-SCALE EVALUATION IN MOZAMBIQUE. PATH CONTINUED EFFORTS TO ENSURE THAT ALL INFANTS RECEIVE HUMAN MILK. OUR WORK CENTERS AROUND BREASTFEEDING PROMOTION, INCLUDING THE PROVISION OF SAFE DONOR MILK THROUGH HUMAN MILK BANKS. IN 2019, PATH LAUNCHED STRENGTHENING HUMAN MILK BANKING: A RESOURCE TOOLKIT FOR ESTABLISHING AND OPERATING HUMAN MILK BANK PROGRAMS, THE FIRST-EVER STANDARD TO ENSURE QUALITY AND SAFETY. AMONG OTHER EFFORTS, PATH WORKED WITH THE MINISTRY OF HEALTH (MOH) IN KENYA TO LAUNCH THE FIRST HUMAN MILK BANK IN THE EAST AFRICAN REGION AND CONDUCTED AN EVALUATION TO ASSESS OUTCOMES. IN GHANA, THE MAKING EVERY BABY COUNT INITIATIVE STRENGTHENED LEADERSHIP AND CAPACITY AT THE NATIONAL AND LOCAL LEVELS TO MANAGE AND SUSTAIN BEST PRACTICES IN NEWBORN CARE. BY 2019, PATH HAD TRAINED MORE THAN 3,600 FRONTLINE HEALTH WORKERS IN IMPROVED NEWBORN CARE, HELPED DRIVE ADVOCACY AND POLICY THROUGH THE GHANA NATIONAL NEWBORN SUBCOMMITTEE, AND PARTNERED WITH THE GHANA HEALTH SERVICE ON ITS NEWBORN ACTION PLAN TO REDUCE NEONATAL MORTALITY RATES. RECOGNIZING THAT NUTRITION IS AFFECTED BY A VARIETY OF ECONOMIC AND ENVIRONMENTAL FACTORS, PATH'S NUTRITION TEAM CONTINUED TO DRIVE NOVEL APPROACHES TO ADDRESS THE MASSIVE BURDEN OF MALNUTRITION IN COMMUNITIES AROUND THE WORLD. WE ENGAGED STAKEHOLDERS WITH EXPERTISE SPANNING GLOBAL HEALTH, DEVELOPMENT, AND THE ENVIRONMENT, FROM BOTH THE PUBLIC AND PRIVATE SECTORS. PATH CONTINUED TO LEAD A CONSORTIUM OF FIVE ORGANIZATIONS IN A PROJECT KNOWN AS MAXIMISING THE QUALITY OF SCALING UP NUTRITION PLUS (MQSUN+). IN 2019, MQSUN+ SUPPORTED THE DEVELOPMENT OF A MULTISECTORAL NUTRITION PLAN FOR TAJIKISTAN AND COSTED MULTISECTORAL NUTRITION PLANS FOR AFGHANISTAN, GUINEA, SOMALIA, TOGO, AND YEMEN. MQSUN+ ALSO SUPPORTED EFFORTS TO PROVIDE STRATEGIC DIRECTION TOWARD THE NEXT PHASE OF THE "SCALING UP NUTRITION" MOVEMENT AND CONTINUED TO ADVANCE AND SUPPORT THE TRACKING OF FINANCIAL AND NONFINANCIAL COMMITMENTS TO NUTRITION. OTHER ACTIVITIES IN 2019 INCLUDED PARTNERING WITH THE NATURE CONSERVANCY, DUKE UNIVERSITY, AND THE INTERNATIONAL FOOD POLICY RESEARCH INSTITUTE ON USE OF ALTERNATIVE PROTEINS; THIS WORK WAS FUNDED BY THE ROCKEFELLER FOUNDATION. WE ALSO WORKED WITH HARVEST PLUS TO EXPAND THE REACH OF BIOFORTIFIED CROPS. WE CONTINUED TO DRIVE MULTISECTORAL COLLABORATION IN 2019 THROUGH THE BRIDGE COLLABORATIVE, A TRAILBLAZING, CROSS-DISCIPLINARY EFFORT TO ENGAGE MORE THAN 150 LEADING TECHNICAL EXPERTS FROM THE HEALTH, DEVELOPMENT, AND ENVIRONMENTAL SECTORS TO ADDRESS HUMAN AND PLANETARY HEALTH. IN CONJUNCTION WITH THE WILDLIFE CONSERVATION SOCIETY AND THE NATURE CONSERVANCY, THE BRIDGE COLLABORATIVE PUBLISHED SEVERAL NEW PAPERS AND HELD SEVERAL MEETINGS ON FOOD SYSTEMS AND THE INTERSECTION OF HUMAN AND PLANETARY HEALTH. IN 2019, PATH STAFF MEMBERS PRESENTED AT KEY GLOBAL AND NATIONAL MEETINGS AND AUTHORED, EDITED, AND CONTRIBUTED TO VARIOUS HIGH-PROFILE PEER-REVIEWED JOURNAL ARTICLES, BOOK CHAPTERS, GLOBAL REPORTS, AND SYSTEMATIC REVIEWS. THESE EFFORTS ADVANCED THINKING ON BROAD, EFFECTIVE SOLUTIONS TO THE MOST PRESSING CHALLENGES IN MATERNAL, NEWBORN, AND CHILD HEALTH AND NUTRITION. SEXUAL AND REPRODUCTIVE HEALTH: PATH'S WORK IN SEXUAL AND REPRODUCTIVE HEALTH IS GUIDED BY THE KEY PRINCIPLES OF CHOICE, EQUITY, AND DIGNITY FOR ALL WOMEN. BECAUSE WE UNDERSTAND THE COMPLEX SOCIAL, BEHAVIORAL, AND GENDER DIMENSIONS OF WOMEN'S REPRODUCTIVE HEALTH, WE BUILD EVIDENCE AROUND TOOLS AND SERVICES THAT ARE BEST SUITED TO ADDRESS WOMEN'S DIVERSE NEEDS AND CIRCUMSTANCES. WE SPECIALIZE IN REDUCING BARRIERS TO ACCESS.

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IN 2019, PATH CONTINUED TO CHAMPION THE RIGHT OF WOMEN TO MANAGE THEIR OWN SEXUAL AND REPRODUCTIVE HEALTH BY CREATING AND ADVANCING IMPROVED TOOLS AND PRACTICES THAT MAKE WOMEN'S SELF-CARE POSSIBLE. AN INTEGRATED APPROACH TO WOMEN'S HEALTH INCLUDES ATTENTION TO CONTRACEPTION, CERVICAL AND BREAST CANCER, SEXUALLY TRANSMITTED INFECTIONS, AND A WOMAN'S RIGHT TO DECIDE WHETHER AND WHEN TO BECOME A MOTHER. AMONG THE RECENT WOMAN-INITIATED PRODUCTS INTRODUCED BY PATH ARE AN ALL-IN-ONE INJECTABLE CONTRACEPTIVE THAT CAN BE SELF-ADMINISTERED AND A VAGINAL SELF-SAMPLING KIT FOR HUMAN PAPILLOMAVIRUS (HPV) TESTING IN CERVICAL CANCER SCREENING PROGRAMS, AS DESCRIBED BELOW. PATH'S RESEARCH AND COORDINATION TO EXPAND ACCESS TO THE INJECTABLE CONTRACEPTIVE SUBCUTANEOUS DMPA (DMPA-SC, OR SAYANA PRESS) CONTINUED IN 2019, PRIMARILY THROUGH THE SELF-INJECTION BEST PRACTICES AND DMPA-SC ACCESS COLLABORATIVE PROJECTS. OUR SELF-INJECTION PROJECT IN UGANDA TOOK A USER-CENTERED APPROACH TO DEVELOP AND INTRODUCE MODELS FOR CONTRACEPTIVE SELF-INJECTION AND DISSEMINATED INFORMATION ON HOW THE PRACTICE CAN BE IMPLEMENTED AT SCALE. MORE THAN 7,000 WOMEN SELF-INJECTED DMPA-SC ACROSS FOUR DISTRICTS THROUGH THIS PROGRAM. THE DMPA-SC ACCESS COLLABORATIVE CONTINUED WORKING WITH MINISTRIES OF HEALTH AND PARTNERS ACROSS SECTORS IN SEVEN COUNTRIES TO FACILITATE DMPA-SC INTRODUCTION AS WELL AS SCALE-UP PLANNING FOR A RANGE OF CONTRACEPTIVE OPTIONS. IN 2019, THE COLLABORATIVE PROVIDED TECHNICAL ASSISTANCE TO ENSURE IMPLEMENTATION OF EACH COUNTRY'S TOTAL MARKET PLAN. THE COLLABORATIVE FACILITATED LEARNING ACROSS COUNTRIES BY EXCHANGING INFORMATION, RESULTS, AND LESSONS LEARNED; TROUBLESHOOTING CHALLENGES; AND ACCELERATING THE ADOPTION OF BEST PRACTICES. PATH WORKED WITH GLOBAL AND COUNTRY PARTNERS TO IMPROVE THE PREVENTION, DETECTION, AND TREATMENT OF CERVICAL PRECANCER, WHICH IS CAUSED BY INFECTION WITH HPV. WE CONTINUED OUR PARTNERSHIP WITH THE MINISTRIES OF HEALTH IN GUATEMALA AND HONDURAS TO SUPPORT THE SCALE-UP OF HPV TESTING IN THE PUBLIC SECTOR. WE PROVIDED TECHNICAL SUPPORT FOR PROCUREMENT OF TESTS, SUPPORTED ADVOCACY AND DISSEMINATION EVENTS, AND MADE PROGRESS TOWARD TRANSITIONING LEADERSHIP OF THE PROGRAM TO THE MINISTRIES AS THE PROJECT WAS IN ITS FINAL YEAR. WE ALSO EVALUATED FOLLOW-UP AND TREATMENT STRATEGIES TO ENSURE WOMEN RECEIVE APPROPRIATE, COMPREHENSIVE CARE. PATH PARTICIPATED IN WHO'S CALL FOR GLOBAL CERVICAL CANCER ELIMINATION BY HELPING SHAPE STRATEGIES FOR LOW- AND MIDDLE-INCOME COUNTRIES. IN MYANMAR, WE ENGAGED WITH THE MOH AND OTHER STAKEHOLDERS TO DESIGN A CERVICAL CANCER CONTROL PLAN. A PATH-LED CONSORTIUM ALSO WORKED CLOSELY WITH THE MOH TO STRENGTHEN THE KNOWLEDGE, CAPACITY, AND COORDINATION OF DECISION-MAKERS, SERVICE PROVIDERS, AND COMMUNITY MEMBERS TO UNDERSTAND SEXUAL AND REPRODUCTIVE HEALTH SERVICES AND RIGHTS AND TO INFLUENCE THE DEVELOPMENT AND IMPLEMENTATION OF RELATED POLICIES. TO COMBAT BREAST CANCER, WE WORKED IN PERU WITH THE NATIONAL AND REGIONAL CANCER INSTITUTES AND OTHER STAKEHOLDERS TO IMPLEMENT A MODEL FOR EARLY DETECTION OF BREAST CANCER APPROPRIATE AND FEASIBLE FOR LOW- AND MIDDLE-RESOURCE SETTINGS. WE BUILT THE CAPACITY OF HEALTH PROFESSIONALS TO IMPLEMENT THIS MODEL AND SHARED EVIDENCE WITH MOH REPRESENTATIVES FROM EL SALVADOR, GUATEMALA, HONDURAS, AND NICARAGUA. WE ALSO CONDUCTED ADVOCACY AMONG HEALTH OFFICIALS TO ENSURE BREAST CANCER REMAINS ON THE AGENDA AND WOMEN RECEIVE SCREENING AND TREATMENT EVEN IN THE ABSENCE OF MAMMOGRAPHY SERVICES. PATH CONTINUED TO SERVE AS THE SECRETARIAT FOR THE REPRODUCTIVE HEALTH SUPPLIES COALITION, A GLOBAL PARTNERSHIP OF MORE THAN 400 PUBLIC AND PRIVATE ENTITIES AND NGOS WORKING TO EXPAND ACCESS TO CRITICAL SEXUAL AND REPRODUCTIVE HEALTH AND FAMILY PLANNING SUPPLIES AND SERVICES. NONCOMMUNICABLE DISEASES: PATH IS AT THE FOREFRONT OF THE FIGHT AGAINST NONCOMMUNICABLE DISEASES (NCDS), INCLUDING DIABETES AND CARDIOVASCULAR DISEASE, IN LOW-RESOURCE SETTINGS WORLDWIDE. THE BURDEN OF THESE DISEASES IS RISING DISPROPORTIONATELY AMONG LOW- AND MIDDLE-INCOME COUNTRIES AND POPULATIONS. IN 2019, PATH CONTINUED TO SERVE AS THE SECRETARIAT OF THE COALITION FOR ACCESS TO NCD MEDICINES AND PRODUCTS. THIS GLOBAL, MULTISECTORAL COALITION IS DEDICATED TO INCREASING ACCESS TO NCD MEDICINES AND HEALTH PRODUCTS IN LOW- AND MIDDLE-INCOME COUNTRIES. IN ADDITION TO GLOBAL ADVOCACY EFFORTS, THE COALITION FOCUSED ON EAST AFRICA. AMONG OTHER ACTIVITIES, PATH CO-LED A MEETING WITH THE EAST AFRICA COMMUNITY SECRETARIAT TO BEGIN DEVELOPING A REGIONAL FRAMEWORK FOR NCDS. IN COLLABORATION WITH THE KENYA MOH AND LOCAL STAKEHOLDERS, PATH CONTINUED TO REFINE THE NCD NAVIGATOR, A FIRST-OF-ITS-KIND DIGITAL MANAGEMENT INFORMATION SYSTEM THAT PROVIDES REAL-TIME DATA ON NCD PROGRAMMING. OTHER ACHIEVEMENTS INCLUDED AN END-TO-END NCD SUPPLY CHAIN ASSESSMENT IN KENYA THAT WILL INFORM SUPPLY CHAIN STRENGTHENING EFFORTS. IN 2019, PATH BEGAN ADDRESSING THE GROWING NCD BURDEN IN GHANA BY LEVERAGING THE WORK DONE IN KENYA AND APPLYING THE NCD NAVIGATOR TO THE LOCAL CONTEXT. WE CONDUCTED A SITUATIONAL ANALYSIS AND DEVELOPED A PROTOCOL FOR A SUPPLY CHAIN ASSESSMENT (TO BE IMPLEMENTED IN 2020). ALSO IN GHANA, PATH LAUNCHED THE HEALTHY HEART AFRICA PROJECT. IN PARTNERSHIP WITH THE GHANA HEALTH SERVICE, THE PROJECT WORKS IN THE ASHANTI REGION TO SUPPORT HYPERTENSION SCREENING AND LINKAGES TO CARE. IN 2019, THE PROGRAM CONDUCTED MORE THAN 20,000 BLOOD PRESSURE SCREENINGS AND DIAGNOSED MORE THAN 1,200 PEOPLE WITH HYPERTENSION, CONTRIBUTING TO NATIONAL TESTING EFFORTS. IN VIETNAM, PATH BUILT ON THE PREVIOUS COMMUNITIES FOR HEALTHY HEARTS PROJECT AND ADAPTED THE MODEL IN 2019 TO INCLUDE DIABETES AND HYPERTENSION. USING LESSONS LEARNED AND CAPACITY STRENGTHENING ACTIVITIES, THE MODEL WAS SCALED UP NATIONALLY. WORKING CLOSELY WITH THE MOH AND A PROVINCIAL GOVERNMENT, WE SCREENED 10,000 PEOPLE AND LINKED 6,000 PEOPLE TO CARE. PATH ALSO COLLABORATED WITH THE MOH TO CREATE A DIGITAL ROAD MAP FOR MANAGING NCDS IN VIETNAM. IN SENEGAL, PATH IMPLEMENTED THE BETTER HEARTS BETTER CITIES PROJECT TO IMPROVE THE HYPERTENSION CONTROL RATE IN DAKAR. MORE INFORMATION CAN BE FOUND IN THE COUNTRY PROGRAMS SECTION. PATH ALSO IMPLEMENTED A HYPERTENSION SCREENING PROJECT IN MUMBAI, INDIA, IN PARTNERSHIP WITH RESOLVE TO SAVE LIVES. THE PROJECT USES A PRIVATE-SECTOR ENGAGEMENT MODEL. FINALLY, PATH LED AND CONTRIBUTED TO CONVENINGS TO RAISE AWARENESS OF NCDS AND ORCHESTRATE ACTION TO IMPROVE ACCESS TO PREVENTION AND CARE. HEALTH SYSTEMS INNOVATION AND DELIVERY: PATH'S HEALTH SYSTEMS INNOVATION AND DELIVERY PROGRAM STRENGTHENS HEALTH SYSTEMS AND ENHANCES COUNTRY CAPACITY FOR DATA-DRIVEN DECISION-MAKING. OUR PORTFOLIO SERVES AS AN ORGANIZING MECHANISM FOR PATH PROJECTS, INITIATIVES, AND UNITS THAT STRENGTHEN HEALTH SYSTEMS. THE HEALTH SYSTEMS ANALYTICS UNIT PROMOTES SYSTEMS THINKING; WITHIN AND OUTSIDE OF PATH, THIS UNIT LEADS COMPLEX EVALUATIONS OF HEALTH PROGRAMS, ENGAGES IN IMPLEMENTATION SCIENCE RESEARCH, FACILITATES HEALTH TECHNOLOGY INTRODUCTION AND SCALE-UP, AND WORKS TO IMPROVE DATA QUALITY AND USE FOR DECISION-MAKING. IN 2019, AS PART OF THE GLOBAL FUND'S PROSPECTIVE COUNTRY EVALUATIONS, THE UNIT EVALUATED THE GLOBAL FUND'S BUSINESS MODEL IN THE DRC, GUATEMALA, AND UGANDA. STAFF ENGAGED IN NETWORK ANALYSES TO INFORM THE OPTIMAL STRUCTURE AND FUNCTION OF VARIOUS COALITIONS AND INFORMAL AND FORMAL NETWORKS. THE HEALTH SYSTEMS STRENGTHENING IMPACT TEAM CONTINUED TO SERVE AS A HUB FOR STAFF WORKING IN HEALTH SYSTEMS. THE TEAM PLANNED FUTURE WORK IN STRENGTHENING URBAN HEALTH SYSTEMS, IMPROVING COMMUNITY-LEVEL DATA USE, AND DEVELOPING RESOURCES FOR SUCCESSFUL INTRODUCTION AND SCALE-UP OF INTERVENTIONS AND TECHNOLOGIES. THIS TEAM ALSO DEVELOPED PATH'S PRIMARY HEALTH CARE STRATEGY. THE GLOBAL HEALTH SECURITY TEAM CONTINUED TO INNOVATE FOR THE PREVENTION, DETECTION, AND CONTROL OF INFECTIOUS DISEASE OUTBREAKS. WITH SUPPORT FROM THE US CENTERS FOR DISEASE CONTROL AND PREVENTION, THE TEAM WORKED WITH NATIONAL LEADERS IN THE DRC, SENEGAL, TANZANIA, AND VIETNAM TO STRENGTHEN THEIR PUBLIC HEALTH SYSTEMS AND BUILD THEIR CAPACITY IN EPIDEMIC PREPAREDNESS AND RESPONSE. THE TEAM ALSO WORKED AS A MAJOR SUBGRANTEE ON THE USAID-SUPPORTED INFECTIOUS DISEASE DETECTION & SURVEILLANCE PROJECT. THIS PROJECT WORKS TO IMPROVE THE DETECTION OF HIGH-PRIORITY INFECTIOUS DISEASES AND IDENTIFICATION OF ANTIMICROBIAL RESISTANCE THROUGH IMPROVED DIAGNOSTIC AND SURVEILLANCE SYSTEMS. OUR CROSS-ORGANIZATIONAL IMPACT TEAM FOR EPIDEMIC PREPAREDNESS AND RESPONSE CONTINUED TO BE AT THE FOREFRONT OF THE EBOLA RESPONSE IN THE DRC, ENHANCING SURVEILLANCE, DETECTION, AND RESOURCE MOBILIZATION. OTHER EFFORTS INCLUDED STRENGTHENING ELECTRONIC HEALTH INFORMATION SYSTEMS, ADVANCING NOVEL VACCINE PLATFORMS, PREPARING MEDICAL COUNTERMEASURES FOR PANDEMIC INFLUENZA, AND DEFINING PATH'S ROLE IN COMBATING ANTIMICROBIAL RESISTANCE.

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COUNTRY PROGRAMS: PATH'S COUNTRY PROGRAMS SUPPORT WORK RANGING FROM SMALL-SCALE PILOTS TO LARGE, MULTICOUNTRY EFFORTS. IN 2019, WE OPERATED FULL-SCALE "COUNTRY" OFFICES IN THE DRC, ETHIOPIA, INDIA, KENYA, MYANMAR, SENEGAL, TANZANIA, UGANDA, UKRAINE, VIETNAM, AND ZAMBIA, AS WELL AS SMALLER "PROJECT" OFFICES IN MANY OTHER COUNTRIES. EXAMPLES THIS YEAR FOCUS ON SENEGAL, UKRAINE, AND ZAMBIA. IN SENEGAL, PATH WORKS CLOSELY WITH THE GOVERNMENT TO ACCELERATE PROGRESS TOWARD HEALTH SYSTEM MILESTONES. WE DO THIS IN PART BY BUILDING A CULTURE OF DATA USE. THE MACEPA PROGRAM, DESCRIBED EARLIER, HAS WORKED WITH SENEGAL'S MINISTRY OF HEALTH AND SOCIAL ACTION (MOHSA) AND NATIONAL MALARIA CONTROL PROGRAM SINCE 2010. IN 2019, MACEPA PROVIDED TECHNICAL ASSISTANCE IN DATA QUALITY AND DATA-DRIVEN DECISION-MAKING, OPERATIONAL RESEARCH, DEVELOPMENT OF NATIONAL POLICIES, AND COLLABORATION ON CROSS-BORDER ISSUES WITH NEIGHBORING COUNTRIES; FOR INSTANCE, PATH SUPPORTED COORDINATED PLANNING BETWEEN SENEGAL AND THE GAMBIA FOR THE DEVELOPMENT OF A SHARED DATA PLATFORM AND THE MASS DISTRIBUTION OF LONG-LASTING INSECTICIDE-TREATED BEDNETS. DURING 2019, PATH'S GLOBAL HEALTH SECURITY TEAM, ALSO DESCRIBED EARLIER, FOCUSED IN SENEGAL ON STRENGTHENING LABORATORY, SURVEILLANCE, AND INFORMATION SYSTEMS, AND ON PREVENTING ANTIMICROBIAL RESISTANCE. IN 2019, PATH SUPPORTED THE MOHSA TO IMPROVE ELECTRONIC REPORTING FROM HOSPITALS. WE ALSO SUPPORTED PUBLICATION OF KEY POLICY DOCUMENTS RELATED TO THE NATIONAL LABORATORY SYSTEM, INCLUDING A QUALITY ASSURANCE ACTION PLAN AND FIVE-YEAR STRATEGIC PLAN. WE ALSO STRENGTHENED REAL-TIME, COMMUNITY-BASED SURVEILLANCE FOR PRIORITY HUMAN AND ZOONOTIC DISEASES WITH EPIDEMIC POTENTIAL. AS PART OF THE DOSE PER CONTAINER PARTNERSHIP, PATH CONDUCTED FORMATIVE RESEARCH THAT CONTRIBUTED TO THE VACCINE INNOVATION PRIORITIZATION STRATEGY WORK LED BY GAVI. PATH ALSO CONDUCTED A REFRIGERATOR TEMPERATURE MONITORING STUDY IN PRIVATE PHARMACIES IN TWO URBAN DISTRICTS AND ORGANIZED COLD CHAIN MANAGEMENT TRAINING WORKSHOPS FOR THE CHIEF REGIONAL SUPPLY PHARMACISTS IN ALL 14 REGIONS OF THE COUNTRY. IN 2019, PATH PROVIDED TECHNICAL ASSISTANCE TO THE GOVERNMENT OF SENEGAL TO SCALE UP SAFE OXYGEN DELIVERY. ACTIVITIES INCLUDED QUANTIFYING THE DEMAND FOR, AND THE EXISTING IN-COUNTRY SUPPLY OF, OXYGEN. IN ADDITION, WE PROVIDED TECHNICAL ASSISTANCE TO A COALITION OF PARTNERS LED BY THE MOHSA TO COLLECT DATA ON THE AVAILABILITY OF MEDICAL DEVICES, INCLUDING OXYGEN AND PULSE OXIMETERS, WITHIN ALL PUBLIC HEALTH FACILITIES. THROUGH THE BETTER HEARTS BETTER CITIES PROJECT, PATH PUT IN PLACE AN ACTION PLAN FOR THE MOHSA AND NATIONAL SUPPLY PHARMACY TO IMPROVE THE AVAILABILITY AND ACCESSIBILITY OF HYPERTENSION MEDICATIONS. WE ALSO ESTABLISHED A COALITION OF PRIVATE COMPANIES TO RAISE AWARENESS AND INCREASE HEALTH LITERACY AROUND NONCOMMUNICABLE DISEASES. THE GOAL WAS TO CHANGE THE MINDSET FROM TREATMENT TO PREVENTION, WITH A BUSINESS CASE DEVELOPED TO DEMONSTRATE THE GAIN FOR BOTH COMPANIES AND EMPLOYEES. PATH HAS BEEN A KEY PARTNER TO THE GOVERNMENT OF SENEGAL SINCE THE INCEPTION OF ITS HPV VACCINATION DEMONSTRATION PROGRAM IN 2013. PROVIDING SUPPORT EACH YEAR, ACTIVITIES IN 2019 INCLUDED MULTI-AGE COHORT VACCINATIONS OF 9- TO 14-YEAR-OLD GIRLS. PER THE GOVERNMENT'S REQUEST, PATH CONTINUED TO ASSIST WITH PROGRAM PLANNING AND PREPARATION, SOCIAL MOBILIZATION, VACCINE DELIVERY, MONITORING AND EVALUATION, AND GRANT RENEWALS. FINALLY, AS PART OF A PROJECT FUNDED BY THE CLINTON HEALTH ACCESS INITIATIVE, PATH AND THE MOHSA WORKED TOGETHER TO TRAIN 1,672 PROVIDERS (ABOUT 200 MORE THAN ANTICIPATED) ON SELF-INJECTION OF THE CONTRACEPTIVE DMPA-SC. THE PROJECT EXCEEDED TRAINING TARGETS ACROSS ALL CADRES OF HEALTH WORKERS AND SIGNIFICANTLY CONTRIBUTED TO THE MOHSA'S OBJECTIVE OF SCALING UP DMPA-SC SELF-INJECTION NATIONWIDE. PATH IN UKRAINE ENGAGES DIRECTLY WITH KEY MOH AND NATIONAL CENTER FOR PUBLIC HEALTH (NCPH) STAKEHOLDERS TO ENSURE THAT THE PROGRAMS WE IMPLEMENT ARE ADAPTED TO THE CONTEXT OF THE COUNTRY'S ONGOING HEALTH SYSTEM REFORM. WE PROVIDE TECHNICAL ASSISTANCE TO CENTRAL-, OBLAST-, AND MUNICIPAL-LEVEL INSTITUTIONS IN DEVELOPING TB AND TB/HIV PLANS, PROTOCOLS, AND OTHER GUIDING DOCUMENTS. THE AIM IS TO ENSURE RAPID AND EFFECTIVE UPTAKE OF SUSTAINABLE, COMPREHENSIVE, HIGH-QUALITY CARE FOR ALL PATIENTS. PATH ALSO MAINTAINS STRONG RELATIONSHIPS WITH UKRAINE'S NGO AND CIVIL-SOCIETY SECTOR, ESSENTIAL PARTNERS IN REACHING MARGINALIZED GROUPS. WE WORK ACROSS THE COUNTRY, BUILDING THIS SECTOR'S CAPACITY TO PROVIDE PREVENTION, SCREENING, AND TREATMENT SUPPORT SERVICES TO TB PATIENTS, PLHIV, AND OTHER KEY POPULATIONS. NGOS AND CIVIL-SOCIETY ORGANIZATIONS FILL IMPORTANT GAPS IN THE CONTINUUM OF CARE FOR A RANGE OF CONDITIONS AND ARE OFTEN MORE TRUSTED THAN FORMAL HEALTH SERVICES. UNDER THE USAID-FUNDED SERVING LIFE PROJECT, PATH COLLABORATES WITH THE MINISTRY OF JUSTICE, MOH, AND A BROAD RANGE OF HIV, TB, AND PENITENTIARY HEALTH STAKEHOLDERS TO STRENGTHEN HIV, TB, AND HEPATITIS C SCREENING, DIAGNOSIS, TREATMENT, AND LINKAGES TO CARE (POST-RELEASE), AS DESCRIBED IN THE HIV AND TUBERCULOSIS SECTION. THIS WORK BUILDS ON A PREVIOUS PROGRAM FUNDED THROUGH TB REACH THAT LED TO A TEN-FOLD INCREASE IN TB CASE DETECTION AMONG PRETRIAL DETAINEES AND PRISONERS OVER TWO YEARS. IN 2019, PATH CLOSED OUT CHALLENGE TB (CTB) AND BEGAN A NEW PROJECT: SUPPORT TB CONTROL EFFORTS IN UKRAINE (STBCEU). CTB'S ACTIVITIES IMPROVED CASE DETECTION AND ADHERENCE TO TREATMENT AND CONTRIBUTED TOWARD NATIONWIDE CONTROL OF THE DRUG-RESISTANT TB EPIDEMIC. AMONG OTHER ACHIEVEMENTS, CTB HELPED UKRAINE INTRODUCE NEW DRUG REGIMENS THAT DRAMATICALLY IMPROVED CARE AND OUTCOMES FOR THESE PATIENTS. STBCEU PICKED UP WHERE CTB LEFT OFF AND WILL CONTINUE TO IMPROVE SERVICES AND INTRODUCE INNOVATIONS FOR TB CONTROL. THE UNITAID-FUNDED ADHERENCE SUPPORT COALITION TO END TB (ASCENT) PROJECT, FOR WHICH PATH IS A LEAD PARTNER IN UKRAINE, USES DIGITAL INNOVATIONS SUCH AS MOBILE COMMUNICATION TECHNOLOGIES TO HELP PATIENTS SUCCEED IN TREATMENT. THE ASCENT PROJECT IS GENERATING CRUCIAL EVIDENCE FOR OPTIMAL USE AND SCALE. THE LONG-TERM VISION IS A WORLD WHERE THESE DIGITAL TOOLS CAN BE AVAILABLE TO ALL TB PATIENTS, NO MATTER WHERE THEY LIVE. OVER THE LAST DECADE AND A HALF, PATH HAS ESTABLISHED ITSELF IN ZAMBIA AS A KEY AND ALL-WEATHER PARTNER FOR THE MOH. THROUGH MACEPA AND PAMO (SEE THE MALARIA AND NEGLECTED TROPICAL DISEASES SECTION), PATH SUPPORTS THE EXPANSION OF MALARIA SURVEILLANCE AND TREATMENT SERVICES. AMONG OTHER ACTIVITIES, THESE PROGRAMS STRENGTHEN IN-COUNTRY CAPACITY FOR EFFECTIVE ANALYSIS AND USE OF DATA FOR EVIDENCE-BASED DECISION-MAKING. PATH'S MALARIA WORK IN ZAMBIA SPANS SIX PROVINCES; IN 2019, EASTERN PROVINCE REACHED A NEW THRESHOLD OF LOW MALARIA PREVALENCE. IN RESPONSE, PATH, WITH ADDITIONAL FUNDING, TRAINED 1,401 COMMUNITY HEALTH WORKERS AND SET UP INTENSIFIED SURVEILLANCE SYSTEMS IN AN EFFORT TO REDUCE MALARIA INCIDENCE TO ITS LOWEST POSSIBLE LEVEL AND ACHIEVE PRE-ELIMINATION STATUS. MACEPA ALSO INTRODUCED THE CONCEPT OF COMMUNITY-BASED REACTIVE INDOOR RESIDUAL SPRAYING TO EXTEND VECTOR CONTROL COVERAGE THROUGHOUT THE YEAR IN PERENNIAL MALARIA TRANSMISSION AREAS OF SOUTHERN PROVINCE. VECTOR CONTROL IS A PROVEN AND PRIORITY INTERVENTION OF THE GOVERNMENT OF ZAMBIA TO REDUCE MALARIA. TO THIS END, PAMO SUPPORTED DEVELOPMENT OF GUIDELINES FOR EFFECTIVE AND CONTINUOUS DISTRIBUTION OF LONG-LASTING INSECTICIDE-TREATED NETS. IN 2019, PAMO DISTRIBUTED 115,416 OF THESE NETS ACROSS THE COUNTRY; 63% THROUGH A "MOP-UP" CAMPAIGN AND 37% THROUGH SCHOOLS. PATH'S EFFORTS TO ELIMINATE MALARIA EXPANDED IN 2019 TO INCLUDE RESEARCH ON A NOVEL TOOL: ATTRACTIVE TARGETED SUGAR BAITS, WHICH ARE DEPLOYED OUTSIDE OF HOMES TO ATTRACT MOSQUITOES AND PROVIDE THEM WITH A LETHAL DOSE OF INSECTICIDE. ACHIEVEMENTS IN ZAMBIA INCLUDED PRODUCT TESTING AND OPTIMIZATION BOTH IN THE LAB AND IN SEMI-FIELD SETTINGS. PATH ALSO SUPPORTED THE INTRODUCTION, TESTING, AND DOCUMENTATION OF DIGITAL TOOLS TO IMPROVE OPERATIONAL PERFORMANCE OF MASS DRUG ADMINISTRATION AND INDOOR RESIDUAL SPRAYING CAMPAIGNS IN SOUTHERN AND WESTERN PROVINCES. TB IS ANOTHER MAJOR CHALLENGE IN ZAMBIA. FOR THE PAST THREE YEARS, PATH HAS BEEN IMPLEMENTING USAID'S FLAGSHIP TB PROJECT, ERADICATE TB. OVER THE LIFE OF THE PROJECT, THE TB CURE RATE IN ZAMBIA HAS IMPROVED FROM 65% TO 70%, AND THE PROPORTION OF TB/HIV PATIENTS ON ANTIRETROVIRAL TREATMENT HAS INCREASED FROM 84% TO 93%. ALSO IN ZAMBIA, PATH CONTINUED TO ADVANCE THE AVAILABILITY OF DMPA-SC, AN INJECTABLE CONTRACEPTIVE. (SEE THE SEXUAL AND REPRODUCTIVE HEALTH SECTION.) IN 2019, PATH ROLLED OUT TRAININGS ON SELF-INJECTION TO SEVEN OUT OF TEN PROVINCES. THE TRAININGS REACHED 1,790 HEALTH CARE PROVIDERS FROM 625 HEALTH FACILITIES IN 62 DISTRICTS WHO ARE NOW ABLE TO OFFER SELF-INJECTION AS PART OF THE FAMILY PLANNING PACKAGE.

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PATH ALSO BUILT UPON THE BETTER IMMUNIZATION DATA PROJECT BY BRINGING TOGETHER A CONSORTIUM OF TECHNICAL EXPERTS AND PARTNERS WORKING WITH THE GOVERNMENT OF ZAMBIA TOWARD A COMMON GOAL: ACCURATE, IMPROVED, AND EQUITABLE VACCINE COVERAGE RATES. THIS WORK IS FUNDED BY GAVI. KEY ACHIEVEMENTS IN 2019 INCLUDED REFRESHER TRAININGS FOR 562 HEALTH CARE WORKERS IN 320 HEALTH FACILITIES.

FORM 990, PART III, LINE 4B, DESCRIPTION OF PROGRAM SERVICE:

DRUG DEVELOPMENT: THROUGH OUR WORK ON DRUG DEVELOPMENT AND INTRODUCTION, PATH HELPS ENSURE THAT PEOPLE AROUND THE WORLD, ESPECIALLY CHILDREN IN LOW-RESOURCE SETTINGS, HAVE RELIABLE ACCESS TO LIFESAVING MEDICINES. OVER THE YEARS, OUR WORK HAS ADVANCED SOLUTIONS FOR A RANGE OF URGENT GLOBAL HEALTH CHALLENGES, INCLUDING ENTERIC AND DIARRHEAL DISEASES, NEGLECTED TROPICAL DISEASES, HIV/AIDS, AND MALARIA. DRAWING ON AN ENDURING COMMITMENT TO HEALTH EQUITY AND A UNIQUE PARTNERSHIP APPROACH THAT SPANS THE ACADEMIC, PRIVATE, NONPROFIT, AND GOVERNMENT SECTORS, OUR WORK OVERTURNS BARRIERS TO HEALTH AT EVERY STAGE OF DRUG DEVELOPMENT AND USE-FROM EARLY RESEARCH TO POLICY INTRODUCTION. IN 2019, THE DIARRHEA INNOVATIONS GROUP, AN INTERNATIONAL NETWORK OF CHILD HEALTH STAKEHOLDERS HOUSED WITHIN AND CO-CHAIRED BY PATH, MOVED FORWARD A CRITICAL GUIDANCE FOR DIARRHEA MANAGEMENT AMONG CHILDREN: THE ADDITION OF CO-PACKAGED ORS AND ZINC TO THE WHO ESSENTIAL MEDICINES LISTS. CO-PACKAGED ADMINISTRATION, NOW RECOGNIZED AS ESSENTIAL, COULD INCREASE ACCESS TO THIS LIFESAVING TREATMENT AND ACCELERATE PROGRESS TOWARD CHILD HEALTH GOALS. ALSO IN 2019, WE CONTINUED OUR WORK ON DEVELOPING NEW THERAPEUTICS FOR CRYPTOSPORIDIUM, A DEADLY DIARRHEA-CAUSING PARASITE FOR WHICH NO HIGHLY EFFECTIVE TREATMENT IS AVAILABLE. ADDITIONALLY, WE BEGAN ENROLLMENT IN A PHASE 2 PROOF-OF-CONCEPT CLINICAL TRIAL OF IOWH032, A NOVEL ANTISECRETORY DRUG FOR THE TREATMENT OF CHOLERA. WE ALSO CONTINUED TO ADVANCE OUR WORK ON A NEW ASSESSMENT TOOL FOR ENVIRONMENTAL ENTERIC DYSFUNCTION (EED)-AN INTESTINAL DISORDER RESPONSIBLE FOR A SIGNIFICANT PORTION OF THE GROWTH STUNTING OF APPROXIMATELY 140 MILLION CHILDREN WORLDWIDE. KNOWN AS THE "MICRONUTRIENT AND ENVIRONMENTAL ENTERIC DYSFUNCTION ASSESSMENT TOOL" (MEEDAT), THE TOOL IS DESIGNED TO MEASURE MULTIPLE BIOMARKERS, INCLUDING THOSE OF EED, SYSTEMIC INFLAMMATION, GROWTH HORMONE RESISTANCE, AND MICRONUTRIENTS.

FORM 990, PART III, LINE 4C, DESCRIPTION OF PROGRAM SERVICE:

MARKET DYNAMICS: PATH'S MARKET DYNAMICS PROGRAM ENCOMPASSES EFFORTS TO EVALUATE MARKETS, ASSESS SHORTCOMINGS, AND DESIGN MARKET-BASED INTERVENTIONS TO IMPROVE HEALTH OUTCOMES. THIS WORK COMPLEMENTS PATH'S OTHER EFFORTS, SUCH AS PRODUCT DEVELOPMENT AND INTRODUCTION. IT BUILDS UPON OUR EXISTING STRENGTH IN COMMERCIALIZATION, ALIGNS EXPERTISE ACROSS TEAMS, AND EXPANDS OUR CAPACITY TO ADDRESS MARKET-BASED ISSUES. IN 2019, OUR WORK FOCUSED ON ASSESSING MARKETS AND IMPROVING MARKET FUNCTIONING FOR MALARIA DRUGS AND DRUG INTERMEDIATES, MALARIA DIAGNOSTICS, AND OXYGEN THERAPY DEVICES. CENTER OF DIGITAL AND DATA EXCELLENCE: PATH USES DIGITAL TECHNOLOGIES AND DATA-LED ACTION TO IMPROVE HEALTH AND SAVE LIVES. IN 2019, THE CENTER OF DIGITAL AND DATA EXCELLENCE APPLIED ITS EXPERTISE TO SEVERAL PROJECTS. KEY ACCOMPLISHMENTS INCLUDED THE WHO-PATH STRATEGIC COLLABORATION ON INNOVATION AND GLOBAL DIGITAL HEALTH. THIS COLLABORATION BRINGS TOGETHER A CROSS-SECTOR NETWORK OF DIGITAL HEALTH EXPERTS AND INVESTORS TO SUPPORT WHO IN DEVELOPING A GLOBAL DIGITAL HEALTH DEPARTMENT AND PORTFOLIO. WORK CONTINUED UNDER DIGITAL SQUARE, A PATH-LED INITIATIVE. THIS INITIATIVE BRINGS DONORS AND PARTNERS TOGETHER TO IMPROVE HOW THE GLOBAL COMMUNITY DESIGNS, USES, AND PAYS FOR DIGITAL HEALTH TOOLS AND APPROACHES. PATH ALSO CONTINUED IMPLEMENTATION OF THE TANZANIA DATA USE PARTNERSHIP, WHICH SUPPORTS THE GOVERNMENT OF TANZANIA TO IMPROVE COUNTRYWIDE HEALTH INFORMATION SYSTEMS AND IMPLEMENT THE TANZANIA DIGITAL HEALTH INVESTMENT ROAD MAP. IN 2019, THE PARTNERSHIP SUPPORTED LAUNCH OF THE COUNTRY'S 2019-2024 NATIONAL DIGITAL HEALTH STRATEGY. THE BID INITIATIVE, A COLLABORATION BETWEEN PATH AND THE GOVERNMENTS OF TANZANIA AND ZAMBIA, HAS EMPOWERED THESE COUNTRY GOVERNMENTS TO ENHANCE IMMUNIZATION THROUGH IMPROVED DATA COLLECTION, QUALITY, AND USE. PATH CONTINUED TO SUPPORT THE SCALE-UP AND SUSTAINABILITY OF ELECTRONIC IMMUNIZATION REGISTRIES IN BOTH COUNTRIES WHILE PROVIDING MENTORSHIP AND PEER LEARNING OPPORTUNITIES TO OTHER COUNTRIES PURSUING SIMILAR DIGITAL HEALTH SOLUTIONS. IN ADDITION, PATH COLLABORATED WITH THE JOINT LEARNING NETWORK FOR UNIVERSAL HEALTH COVERAGE TO CONTINUE A PEER LEARNING MODEL THAT INCLUDES PROFESSIONALS FROM MINISTRIES OF HEALTH AND NATIONAL HEALTH INSURANCE AGENCIES IN TEN COUNTRIES. PATH ALSO INCREASED PARTICIPATION IN HIGH-LEVEL COALITIONS, INCLUDING THE DIGITAL TRANSFORMATION FOR UHC 2030 COALITION, THE LANCET/FINANCIAL TIMES JOINT COMMISSION ON GOVERNING HEALTH FUTURES 2030, AND THE DIGITAL CONNECTED CARE COALITION.

FORM 990, PART VI, SECTION B, LINE 11B

THE FORM 990 WAS PREPARED BY AN OUTSIDE ACCOUNTING FIRM USING INFORMATION PROVIDED BY PATH ACCOUNTING SERVICES STAFF. PATH SENIOR MANAGEMENT REVIEWED THE DRAFT FORM. A COPY OF THE DRAFT WAS SENT TO THE BOARD OF DIRECTORS FOR COMMENT. AFTER THE COMMENT PERIOD, THE CHIEF OF ACCOUNTING SIGNED THE FORM.

FORM 990, PART VI, SECTION B, LINE 12C

PATH HAS POLICIES AND PROCEDURES TO ADDRESS CONFLICTS OF INTEREST. PATH MANAGEMENT AND ALL STAFF AT A DESIGNATED LEVEL OR HIGHER WITHIN THE ORGANIZATION MUST COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM EACH YEAR. ALL FORMS ARE REVIEWED AND KEPT ON FILE. A CONFLICT MANAGEMENT PLAN IS DEVELOPED FOR ANY EMPLOYEE WITH A SIGNIFICANT ACTUAL OR PERCEIVED CONFLICT OF INTEREST. PATH ALSO HAS A WELL-DEFINED PROCEDURE FOR IDENTIFYING AND REPORTING ACTUAL AND POTENTIAL CONFLICTS OF INTEREST AMONG BOARD MEMBERS. NEW BOARD MEMBERS ARE ASKED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM WITHIN 30 DAYS OF JOINING THE BOARD AND TO COMPLETE A NEW FORM ANNUALLY THEREAFTER. IN ADDITION, MEMBERS ARE REMINDED TO REPORT ANY NEW ISSUES THAT ARISE OUTSIDE OF THE ANNUAL DISCLOSURE PERIOD. THE DISCLOSURE FORMS ARE REVIEWED BY PATH'S GENERAL COUNSEL, AND IF ANY ACTUAL OR POTENTIAL CONFLICTS ARE IDENTIFIED, GENERAL COUNSEL MAKES A RECOMMENDATION TO THE CHAIR OF THE GOVERNANCE COMMITTEE AND THE CHAIR OF THE BOARD FOR A MANAGEMENT PLAN TO PROPERLY MANAGE ANY CONFLICTS. A FORMAL MANAGEMENT PLAN IS THEN AGREED UPON WITH THE BOARD MEMBER, AND THE ENTIRE BOARD OF DIRECTORS IS INFORMED AT THE NEXT REGULARLY SCHEDULED BOARD MEETING.

FORM 990, PART VI, SECTION B, LINE 15

THE BOARD'S EXECUTIVE COMPENSATION COMMITTEE ANNUALLY REVIEWS SALARIES AND BENEFITS FOR EXECUTIVE EMPLOYEE POSITIONS AND PROVIDES GUIDANCE TO THE PRESIDENT/CHIEF EXECUTIVE OFFICER (CEO) ON COMPENSATION DECISIONS FOR EXECUTIVE POSITIONS. THE COMPENSATION AND BENEFITS FOR PATH'S PRESIDENT/CEO ARE REVIEWED AND APPROVED BY THE ENTIRE BOARD OF DIRECTORS EACH YEAR. PATH ROUTINELY USES THE SERVICES OF EXTERNAL FIRMS TO ASSESS AND BENCHMARK EXECUTIVE COMPENSATION (PRESIDENT/CEO, VICE PRESIDENTS, AND EXECUTIVE TEAM MEMBERS). THE MOST RECENT MAJOR REVIEW WAS COMPLETED BY THE BOARD COMPENSATION COMMITTEE IN 2017. AT THE REQUEST OF THE BOARD, PATH ENGAGED MERCER (A COMPENSATION, BENEFITS, AND HUMAN RESOURCES CONSULTING FIRM) TO REVIEW CURRENT AND PROPOSED BASE SALARIES OF PATH'S PRESIDENT/CEO, VICE PRESIDENTS, AND EXECUTIVE TEAM MEMBERS. MERCER USED DATA FROM MULTIPLE SOURCES TO EVALUATE CURRENT AND PROPOSED BASE SALARIES FOR THESE POSITIONS. THE BOARD'S EXECUTIVE COMPENSATION COMMITTEE REVIEWED THE MERCER REPORT AND APPROVED THE USE OF THE REPORT TO ESTABLISH A FRAMEWORK WITHIN WHICH THE PRESIDENT/CEO IS DELEGATED AUTHORITY TO ESTABLISH THE TOTAL COMPENSATION PACKAGES OF THE VICE PRESIDENTS AND EXECUTIVE TEAM MEMBERS. ADDITIONALLY, MERCER REVIEWED THE PROPOSED TOTAL COMPENSATION AND BENEFITS PACKAGE FOR THE PRESIDENT/CEO POSITION AND OBTAINED A SIGNIFICANT NUMBER OF DATA POINTS TO ASCERTAIN ITS REASONABLENESS AND APPROPRIATENESS. THE BOARD APPROVED THE COMMITTEE'S RECOMMENDATION FOR THE PRESIDENT/CEO'S TOTAL COMPENSATION PACKAGE.

FORM 990, PART VI, SECTION C, LINE 19

PATH GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST; MOST DOCUMENTS ARE ALSO AVAILABLE ONLINE.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

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