RPCV Theresa Gruber-Tapsoba tackles Worldwide Health Concerns with Innovation, Education
Healthy Planet
T-birds Tackle Worldwide Health Concerns with Innovation, Education
Volume 56, No. 2, 2004
* President's Message
- by Jessica McCann
As the cover artwork suggests, physical activity plays a key role in improving worldwide health. But, according to T-bird alumni, joint public and private efforts - coupled with creativity - also play an integral role. Using innovative low-and h-tech solutions. T-birds are addressing health concerns such as AIDS, obesity and diseases resulting from unsafe water supplies.
Image by: Illustration © Laura Tedeschi/Images.com, Inc. A decade ago, in the small African country of Guinea, Muslim extremists made common practice of smashing the stands of any vendor who dared to sell condoms. This, in a region of the world where 28 million people are infected with HIV and nearly half a million have died from AIDS.
To overcome the barriers of accepted condom use in this traditional Islamic culture, Population Services International (PSI) applied an innovative strategy called social marketing. The multifaceted plan began with reaching out to and educating the area's religious leaders. With a better understanding of the disease, those leaders, in turn, began to support the idea of condom use in their communities.
It's a fascinating concept - one that proves innovative health care solutions need not be high-tech or complicated. Such innovative approaches are critical to addressing many of the world's most critical health concerns, not just AIDS.
In one of its largest research projects ever, the World Health Organization (WHO) announced in 2003 the 10 leading health risk factors globally in its World Health Report. The list includes what the authors aptly named "familiar enemies of health and allies of poverty," such as unsafe sex, polluted water, poor sanitation and hygiene, low body weight, iron deficiency and indoor smoke from solid fuels. It also includes risks more commonly associated with wealthy societies, such as high blood pressure, tobacco consumption and obesity.
The ultimate goal of the report, according to the WHO, is to help governments around the globe lower these risks and raise the healthy life expectancy of their populations. Yet, many health industry professionals are of the opinion that, while government support is critical, it also takes involvement from the private sector to make a real and lasting impact.
Many T-birds, such as Theresa Gruber-Tapsoba '85, are making that meaningful and lasting impact. As director of the Cameroonian Association for Social Marketing, a PSI affiliate, Tapsoba has seen the positive effects of social marketing on one of the world's deadliest diseases, AIDS. The once-taboo condoms of Guinea are now accessible and affordable. In fact, they are sold at thousands of pharmacies, boutiques, mobile vendors, bars and nightclubs throughout the region. As a result of PSI's social marketing efforts worldwide, approximately 2.4 million cases of HIV have been prevented.
"It's an awareness of the community that causes people and employers to take a more proactive stand regarding these health risks," said Thunderbird Professor Emeritus Robert Tancer. "And that could be as simple as having exercise facilities in the workplace to help deal with obesity or, especially in South Africa, having educational programs about safe sex and how AIDS is transmitted. But you need both government support and you need private sector support to really be successful."
An attorney by profession, Tancer had worked both for a private law firm and for the U.S. State Department before coming to Thunderbird as a professor of international studies in the late 1960s. During the 10 years prior to his retirement in 2001, the bulk of Tancer's research and teaching activities centered on the health industry. His case study "AIDS in South Africa," for example, explores the issue of balancing private rights, pharmaceutical patents and the public interest in controlling the AIDS epidemic in that region. Today, Tancer continues to teach a Thunderbird Winterim course on mergers and acquisitions, and a law class for the School's EMBA program.
PSI's success certainly supports Tancer's assertion that joint public and private effort is needed to impact critical health concerns. A nonprofit group based in Washington, D.C., PSI is the leading social marketing organization in the world with programs in more than 70 countries, specializing in AIDS prevention, family planning, and maternal and child health.
"Social marketing is based on simple marketing precepts: product, place, price, promotion," said Gruber-Tapsoba. "But when social marketing for health impact, you also have to understand the culture and the disease, and you have to be willing to put in the time. Most importantly, you have to be willing to subsidize products such as condoms, so that people who really need them can afford them."
Gruber-Tapsoba's career history is a varied and unique blend of global experiences - from Peace Corps work as a fish farmer in Central America and working as a director of medical education in the pharmaceutical industry in the United States, to a technical officer addressing chronic respiratory diseases for the WHO in Geneva and a director of social marketing for PSI in Cameroon.
"When I came to PSI, I felt like I had come home," she said. "I had the advantage of the kind of bottom-line health impact, the bottom-line measurement I had grown accustomed to in the private sector, along with the pleasure of actually serving populations in need that I had grown accustomed to in the Peace Corps."
To make a bottom-line health impact on the AIDS epidemic, PSI began with a series of public health workshops for Muslim religious leaders, first in Guinea, then in Cameroon, Chad, Mali and Niger. A PSI director - a practicing Muslim - introduced the facts about the disease and how it is transmitted. Throughout the presentation, he quoted passages from the Koran to justify preventive health practices. Meanwhile, a comprehensive mass-media campaign reached out to the community with messages of safe sex, and PSI employees forged relationships with private-sector sponsors and vendors to help make low-cost condoms available to the masses.
The strategy worked.
Within a few years, PSI had made a breakthrough. With a greater understanding of the disease, the region's leaders have taken a position that allows them to remain faithful to their religious beliefs, while protecting the health of their community.
TRIMMING THE FAT
Another serious health risk listed in the World Health Report is obesity. More than one billion adults worldwide are overweight and at least 300 million are clinically obese. According to the WHO, about half a million people in North America and Western Europe died last year from obesity-related diseases such as diabetes, high blood pressure and stroke.
In fact, the rate of obesity in the United States has increased to the point that more Americans are expected to die from obesity than from smoking by the end of the decade, according to a recent report in the American Journal of Health Promotion.
Besides the obvious tragedy of loss of life, the cost of obesity is immense. A Web exclusive article in the journal Health Affairs, published in May 2003, estimated that obesity- and overweight-related conditions are contributing as much as $93 billion to the yearly medical bill in the United States alone. For employers, obesity-related costs add up in the form of health care and disability insurance, lowered productivity and increased absenteeism.
To reduce that financial impact, many of the world's largest employers are stepping up their efforts to reduce obesity and weight-related health complications among their workers. According to the Washington Business Group on Health, some have gone so far as to offer financial incentives to employees for exercising, dieting and other healthy behavior. Others have taken steps as simple as adding healthier food alternatives to their vending machines and employee cafeterias, swapping out sugary sodas for bottled water, for example.
At the same time, the U.S. Centers for Disease Control (CDC) is working to stem obesity in America's children - ostensibly, tomorrow's workforce. According to data from the CDC's National Center for Health Statistics, the percentage of overweight children is on the rise. Among children and teens ages 6 to 19 years old, 15 percent (almost 9 million) are overweight. That's three times the number in 1980.
The CDC's innovative VERBTM campaign, which inspires children to choose a verb each day and act on it - walk, swim, skate, pogo - has raised the bar for social marketing to children. Sporting the catchphrase "VERB. It's what you do," the program uses multimedia venues to get kids engaged and helps them appreciate physical activity for the fun of it - as well as for the health benefits.
Typically, government public service announcements and campaigns are focused primarily on getting the facts out to people. Rarely do they strive to create any sort of branding in their execution or in their messaging, said Kirsten Meyer '91, a senior vice president with Saatchi & Saatchi Advertising in New York who was part of the original creative team that developed VERB two years ago. With kids as the target audience, she explained, the VERB campaign was different and required more than just "getting the facts out."
"Social messaging to kids is a really difficult sell," said Meyer. "Kids are told what to do by adults all day long." For the VERB campaign to be effective, she explained, it was critical that a brand be created that kids could respond to on their own level, rather than one in which yet another adult voice was telling them what to do.
"With VERB, we created a brand that would be from the voice and from the minds of kids, so that kids would be responsive to it in a way that they generally aren't in social marketing," said Meyer, who has more than 10 years of advertising experience with leading global companies and brands including Tylenol, Nescafé, Olay and General Mills.
VERB ads are fast-paced, colorful and splashy, with simple messages such as, "Get out and go play." They feature everyday kids engaging in fun physical activities - from swimming and bike-riding to pingpong and hip-hop dancing.
The brand also extends beyond advertisements. Parental and community involvement, corporate partnerships, events and promotions all play an important role in the effectiveness of the campaign. In its first year, VERB sponsored Nickelodeon's "Wild and Crazy Kids" television program, as well as MTV's "Made" program, both aimed at encouraging kids to try something new. Organizations such as the YMCA, National Parks and Recreation, and Boys & Girls Clubs also have been important partners. An interactive Web site (www.verbnow.com) features videos, quizzes and lots of ideas about "stuff 2 do."
ACCELERATING INNOVATION
Social marketing often can take years before measurable success is realized - perhaps a necessary burden to bear when striving to make a long-term community health impact. Yet, many companies in the private sector are applying equally creative approaches to speed up health care innovation and bring new products to market.
Take, for instance, Applied Biotech, a health care and life-sciences corporate development company led by T-bird Jordi Argente '83. From main offices in Hong Kong and Vancouver, the company identifies Asian expansion, partnership and funding opportunities for Canadian and U.S. health technology companies.
"We put together projects," explained CEO Argente, a native of Spain and a 20-year veteran in technology and management consulting across Asia, the United States and Europe. "We identify the science, which originates mostly from Canada and the United States, and the funding, which originates mostly from Hong Kong and China. Then we get them together. By bringing East and West together in this way, we're combining the strengths of both and getting more from the project."
Applied Biotech works primarily with groups of scientists or companies that are mid- to late-stage start-ups. The groups often either already have a product in the market or are about to launch one. In such cases, the new product or company typically would grow slowly in its own country or region, and only when it reached significant size would it start to venture globally.
"Our value to a new initiative is that by going global early, you can grow much faster than if you just stay in your own country," explained Argente. "For example, when bringing to market a new health treatment developed by Canadian scientists, we can conduct trials at much lower costs and typically find more patients for those trials in Asia than in the West." As a result, companies that combine the strengths of both countries can potentially bring life-altering health products to market quicker - products that address some of the WHO's most pressing concerns.
One example is a British Columbia-based company that has designed a water risk control device to identify biohazards in public drinking systems. Applied Biotech is currently working to secure funding to develop and launch the technology in Asia. Another is a project that Argente and his team completed last year, involving a group of scientists and doctors at Chinese University's Prince of Wales Hospital in Hong Kong. The company helped facilitate funding to launch the new initiative - a specialist clinic with a breakthrough approach in the treatment of diabetes.
So, in the time it took to read this article, a middle-aged man in Hong Kong consulted with a physician about a new treatment for his diabetes; a young man in Cameroon safely purchased condoms from a street vendor; and a child in the United States decided to turn off the television and go for a bike ride - tasks ultimately made possible through the work of T-bird alumni.
As the WHO's World Health Report clearly shows, a relatively small number of health risks cause an enormous number of premature deaths worldwide each year. Yet, as T-birds around the globe also demonstrate, small doses of creativity are going a long way in creating a healthier planet.
