Increasing Access to Critical Technologies

In the developing world, BD’s multi-dimensional approach to tackling HIV/AIDS positions us to make a significant impact in the fight against this disease and its deadly companion, TB. Recognizing that no single technology or company will defeat these diseases, BD is calling on its leading technology, expertise, experience, global presence and strong relationships with nongovernmental organizations to address problems that limit access to healthcare services in the developing world. We are working to help increase access to critical technologies through public-private sector collaborations including:

Bill and Melinda Gates Foundation: Collaboration to identify barriers to the use of diagnostics in the developing world and solutions to overcoming them.

The Global Partnership to Stop TB: BD is an Organizational Partner of this entity which works to realize the goal of eliminating TB as a public health problem.

Stop TB program of the Global Drug Facility: BD developed an innovative, unique new injection device to safely inject streptomycin for TB patients in developing countries, most of whom are HIV-positive.

The William J. Clinton Foundation: BD is working with the Foundation to expand the accessibility of our advanced CD4 cell-counting technology for immune system monitoring of people living with HIV/AIDS. Our agreement with the Foundation resulted in deeply discounted pricing – approximately 75 percent – for some developing world countries, compared with developed world pricing. We also provide training and equipment servicing.

Foundation for Innovative New Diagnostics (FIND): BD works with FIND to improve the diagnosis of pulmonary tuberculosis in developing countries. TB is the leading cause of death for people living with AIDS. Demonstration sites in Africa, Eastern Europe and Asia benefit from advanced culture technology for rapid diagnosis and drug sensitivity testing of TB. In 2007, we expanded our agreement to include funding for laboratory strengthening and a pricing agreement for the BD BACTEC^TM MGIT^TM 960 system and reagents. The system uses liquid culture, which can dramatically shorten mycobacterial culture recovery time and improve patient management.

Improving Clinical and Laboratory Services

Limited access to clinical and laboratory health services is one of the largest constraints to battling disease in developing countries. The majority of the disease burden exists in non-urban locations (districts and rural villages), and access to health services in these locations is often poor to non-existent. BD is committed to helping improve the fundamental capacity to deliver healthcare, including training healthcare workers and improving access to clinical and laboratory products and services.

For nearly a decade, since BD co-developed a training manual with the Program for Appropriate Technology in Healthcare (PATH) in 2000, BD has focused on training healthcare workers to safely administer vaccines without harming the patient or the healthcare worker. BD healthcare professionals continue to engage with local Ministries of Health, national organizations and international agencies to train thousands of healthcare workers each year. Since 2000, BD has conducted over 250 Immunization Injection Safety Trainings in 49 countries throughout Asia, Africa, Eastern Europe, the Middle East and Latin America.

We are also committed to laboratory practice training. Laboratories in more than 120 developing countries use BD FACSCount™ and BD FACSCalibur™ flow cytometers for CD4 monitoring. To improve the effectiveness of these technologies, our Good Laboratory Practice (GLP) workshops have trained more than 3,400 laboratory workers in 57 countries. The training, which focuses on implementing Standard Operating Procedures (SOPs) for immune system monitoring of HIV/AIDS patients via CD4 testing, teaches fundamental laboratory practices such as quality control and blood sampling and is being expanded to cover TB testing procedures.

BD collaborations in this area include:

• Hindustan Latex, Ltd. (India): The purpose of this collaboration is to help prevent the reuse of syringes in India through the introduction of auto-disable syringes, as well as education and training of healthcare workers and the implementation of advocacy programs with the Government of India. According to a WHO report, unsafe injections are the second leading cause of HIV spread in India.

• Kenyan Medical Research Institute (Kenya) and Stellenbosch University (South Africa): BD collaborated to open training centers at both entities. Originally targeted at training for CD4 applications, training has been extended to cover other basic laboratory procedures such as blood collection and quality control. These centers have fully outfitted laboratories with equipment donated by BD, and when not in use for training purposes, the laboratories are available for actual patient monitoring and HIV/AIDS research. This model is working well and similar sites are being reviewed for Uganda, Mali and Russia. BD has also established training centers in China and India. 

• University of Virginia (U.S.): Through this collaboration, BD is able to deploy the EPINet™ occupational injury surveillance system at no charge to healthcare facilities. EPINet was developed by Janine Jagger, M.P.H., Ph.D., and colleagues in the International Healthcare Worker Safety Center at the University of Virginia. The intent of EPINet is to provide healthcare facilities with a standardized method for recording percutaneous injuries and contacts with blood and other body fluids. This system, in use in 27 countries, protects clinicians through precise tracking of the sources of sharps injury and other blood exposures, facilitating data collection and planning of appropriate exposure prevention policies. (EPINet is a trademark of the University of Virginia Patent Foundation.)

• World Economic Forum (WEF): BD has provided funding to and is engaged with the WEF Global Health Initiative to contribute to the strengthening of health systems in sub-Saharan Africa. A pilot program in Ghana focusing on management and leadership development will seek to leverage the untapped knowledge and skills of the private sector in this area to benefit the public sector.

Unique Healthcare Needs Require Investments in New Technologies

BD recognizes that existing developed world technologies do not always meet the unique healthcare demands of developing areas. As such, BD is committed to investing in new technologies that can address these specific healthcare challenges:

• Reuse of Syringes and Needles: To help prevent inappropriate reuse of disposable syringes and needles, BD developed auto-disable syringes in close collaboration with the World Health Organization (WHO) and several other international agencies. BD has shipped over five billion auto-disable syringes to 90 countries in Asia, Africa, the Middle East, Eastern Europe and South Latin America.  Some product examples include:
  
  
• The BD SoloShot^TM range of injection devices are widely used by ministries of health and donor agencies to vaccinate children in the developing world. These syringes are designed to automatically lock after single-use. This prevents injection reuse from patient-to-patient which could result in the spread of unnecessary disease and death such as Hepatitis B, hepatitis C and HIV/AIDS among other infections.
  
  
• In the summer of 2006, we launched the BD Vacutainer^® CD4 Stabilization Blood Collection Tube, which is currently available only in Africa. The tube stabilizes CD4 cells for longer time periods and at higher temperatures, enabling more samples to be taken in remote areas and transported to central labs for testing.
  

Providing Healthcare to Africa’s Healthcare Providers

To help those who help others, BD and the International Council of Nurses (ICN) teamed up in November 2006 for a multi-year initiative to provide health and wellness services to healthcare providers working in several African nations. The program offers a range of services, including testing, counseling and treatment for HIV and TB; antenatal services, including Prevention of Mother to Child Transmission (PMTC); stress management; post-exposure prophylaxis; screening for chronic conditions and a training and resource/knowledge center for continuous professional development.

In sub-Saharan Africa, healthcare systems are experiencing a severe scarcity of healthcare workers, due to the HIV/AIDS pandemic, migration and very difficult working conditions. Together, BD and ICN are working with national nurses associations in sub-Saharan Africa to help strengthen and revitalize these systems through wellness centers providing care for healthcare workers who, in turn, will be able to better care for their patients and communities. The goal is to provide the necessary materials to sustain a healthy, motivated and productive healthcare work force, leading to a strengthened healthcare delivery system in sub-Saharan Africa. It is estimated that the program will reach 40,000 healthcare workers and their immediate families.

The first-ever Wellness Centre for Healthcare Workers was officially opened in September 2006 in Manzini, Swaziland, and is run by the Swaziland Nurses Association. It has been held up as a model of good practice by many global organizations, including the World Health Organization and Physicians for Human Rights.

As part of this initiative, BD will:

• Commit $120,000 in cash support to the ICN to help fund local wellness centers;
• Include ICN in its awareness and advocacy efforts as part of BD’s Trusted Partners campaign and provide ICN with promotional materials, journal ads and general awareness materials; and
• Work with ICN to promote Good Clinical Practices training at the wellness centers.

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