The Little Engine That Could

The uphill battle has been won, now we begin to roll over the top of the mountain and cascade down the other side. The number of lives lost already is incomprehensible. Even more incredible is the number of lives that can be saved in the next 5-10 years. Join us in this history-making effort.

Once workable vaccines existed, an even larger problem appeared: distribution. The practical contributions of Rotarians and other in creating National Immunization Days, NIDs, solve many of issues. Solutions continue to evolve on how to get vaccines and vaccine-like goods to market. Most recently, in December the Red Cross (with many partners) distributed Insecticide Treated Nets to essentially every child and pregnant woman in an entire country, Togo. At the end of the week, they had met the Abuja Target for coverage of nets – years in advance. For far less money than anyone thought.

The train is starting down the hill. The Delivery Machine is picking up speed. Along with speed, the train picks up capacity, as it now distributes Vitamin A, deworming medicines and more lifesaving, life-enhancing goods.

What makes the difference?

Dovetail solutions

Put a water well at a school and have girls able to safely get safe water, someone there to manage and maintain the well.

Incentivize one solution with another

Offer nets and more women take their kids to get vaccinated—which can up the rates of attendance to beyond the zone of interrupting transmission.

Seek high payoff, low cost solutions

Hand washing is low cost at about $.02 per person and lower with donations in kind of soap and promotions, with a high impact of 40% reduction in water-related diseases. Part of expense can also be paid by country's development fund and World Bank fund.

Need Champions more than Money

Many major projects need only small amount of money to tip into action. More than money, they need champions.

Transparency

With net projects money was tracked so transparently that we knew where $5 went and knew it pretty much real time.

Local

Use local knowledge, local talent, and local labor to reduce costs and increase success—both because locals often know things, like best places to dig for water, and also because doing so empowers locals to care for themselves.

Strategic Partnerships

Certain partners have to work with governments or bureaucracies. Work flexibly to get governments to cover certain costs so NGOs pays for goods. Use goods as incentives. Also, use unique ability of each org such as exemplified by Measles Initiative.

Combine for added value

Measles and Malaria combine to make the delivery of each cheaper and also encourage higher participation. Also with net distribution, add spraying houses to further reduce transmission, add water and increase health too, which then reduces disease rates.

Look for Economic Impact

For every dollar put into nets, at least $20-$100 are generated in the economy. That number is considered very conservative. For every dollar put into water projects, very conservatively speaking, at least $37 or $38 goes into the economy.

Certain inputs have higher impact than others. Do these first to start upward spiral and free up energy in the system.

Safe water solves several problems—safety of women, water-related diseases, etc to free up the systems

• Healthcare System--nets for malaria frees up hospital beds (>40%) and medicinal costs
• Economic System-- healthy people work and contribute to economy
• Personal/Physical Systems--dehydrated people are grouchy and poor functioning. People without safe water are often sick.

Addressing symptoms is more costly that addressing cause

Cheaper to distribute nets than to provide anti-malarial medicine, develop new meds as disease develops resistance, build more hospitals/add more beds, etc.

Watch for seemingly indirect links

Malaria increases risk of HIV transplacental transmission. Reduce malaria to reduce transplacental HIV transmission. Relatively cheap preventative technique.

Saving Kids

We want to save kids. The next disease to address? Disease perpetuates a vicious cycle of poverty, illness, and overwhelmed hospitals. We have inputs that can change the cycle.

Child survival began with Rotary addressing Polio throughout the world. They created a model for mass immunization that the Red Cross continued with the Measles Initiative. Already millions of children have been spared from Polio and Measles.

There are many solutions and much to be hopeful about. The inputs described here create virtuous cycles. The virtuous cycles may be strong enough to break the vicious cycles currently at work. We hope you become part of the solution. Our combined strengths can solve many of the problems of the world.

How? Expanding the Rotary Model to include non-vaccine goods sets the stage for other treatments. As the systems get built up through each rollout of vaccines and non-vaccines, the platform for child survival strengthens. Already other inputs help. While vaccinating for Measles, the Red Cross also distibutes deworming medicine and Vitamin A. The next round adds nets. Strong drops in diseases accompanied by building the local health care system leads to local empowerment. To aid local empowerment, see the leave behinds for child survival. Next steps: Rotavirus, Rubella (vaccines for various subtypes of developing countries under development), Pneumonia (Pneumococcus) vaccines exist (vaccines for various subtypes of developing countries under development). The more inputs in each distribution, the more the cost of distribution for each goes down. And preventative measures like IMCI cost less than 80 cents per child yet yield huge benefits.