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The Global Health Initiative (GHI) is a tripartite collaboration among Northwestern University, non-profit donors, and commercial diagnostics companies. GHI attempts to bridge the gap between the market for sophisticated medical diagnostics equipment in wealthy nations and the need for point-of-care diagnostics in resource limited settings. In 2006 GHI narrowed its focus to HIV diagnostics for underserved nations. The case examines the accuracy-access tradeoff related to the roll-out of infant HIV diagnostics in Tanzania. Tanzania has a prevalent HIV/AIDS problem, particularly in children. As of 2007, Tanzania had an estimated 140,000 children infected with HIV. Existing lab-based diagnostic equipment was either inaccurate for use in infants or required highly skilled health workers. Tanzania's limited infrastructure also forced healthcare providers to choose between providing advanced care to a minority of the population and offering minimal care to the majority with poor access. A Kellogg MBA student research team performed more than thirty in-country interviews to collect data on stakeholder perceptions of three infant test concepts: the strip test, the squeeze test, and the filter paper test. Across the three tests, access decreased as accuracy increased---rural labs could not find or afford health workers skilled enough to conduct the test. In general, interviewees closely affiliated with the government preferred accuracy over access. In contrast, private health facilities had to follow fewer regulations and preferred access over accuracy. The case focuses on the decisions facing Kara Palamountain, the executive director of GHI, in her roll-out recommendations for infant HIV tests in Tanzania. It examines key factors of working in a developing country, including the need to operate in the absence of sufficient market research, balance the competing agendas of different stakeholders, and mitigate external risks such as major international funding dry

This case was written to be used as a teaching case for students unfamiliar with how to approach and analyze a typical business school case. Unlike many cases used in specific classroom settings, this case is intended to be broad enough that any single student will not have a significant advantage because of his or her background. Moreover, the case is designed to guide students' thinking in a certain direction, using open-ended and more focused discussion questions provided at the case's end.

The Global Health Initiative (GHI) is a tripartite collaboration among Northwestern University, non-profit donors, and commercial diagnostics companies. GHI attempts to bridge the gap between the market for sophisticated medical diagnostics equipment in wealthy nations and the need for point-of-care diagnostics in resource limited settings. In 2006 GHI narrowed its focus to HIV diagnostics for underserved nations. The case examines the accuracy-access tradeoff related to the roll-out of infant HIV diagnostics in Tanzania. Tanzania has a prevalent HIV/AIDS problem, particularly in children. As of 2007, Tanzania had an estimated 140,000 children infected with HIV. Existing lab-based diagnostic equipment was either inaccurate for use in infants or required highly skilled health workers. Tanzania's limited infrastructure also forced healthcare providers to choose between providing advanced care to a minority of the population and offering minimal care to the majority with poor access. A Kellogg MBA student research team performed more than thirty in-country interviews to collect data on stakeholder perceptions of three infant test concepts: the strip test, the squeeze test, and the filter paper test. Across the three tests, access decreased as accuracy increased---rural labs could not find or afford health workers skilled enough to conduct the test. In general, interviewees closely affiliated with the government preferred accuracy over access. In contrast, private health facilities had to follow fewer regulations and preferred access over accuracy. The case focuses on the decisions facing Kara Palamountain, the executive director of GHI, in her roll-out recommendations for infant HIV tests in Tanzania. It examines key factors of working in a developing country, including the need to operate in the absence of sufficient market research, balance the competing agendas of different stakeholders, and mitigate external risks such as major international funding.

This case was written to be used as a teaching case for students unfamiliar with how to approach and analyze a typical business school case. Unlike many cases used in specific classroom settings, this case is intended to be broad enough that any single student will not have a significant advantage because of his or her background. Moreover, the case is designed to guide students' thinking in a certain direction, using open-ended and more focused discussion questions provided at the case's end.

It is January 2017, and Nikki Tyler, market access advisor at the U.S. Agency for International Development's Center for Accelerating Innovation and Impact, must recommend an actionable strategy for how to use the $10 million contributed by global donors and foundations to scale up the use of chlorhexidine in Nigeria. It was clear that chlorhexidine, a substance applied to newborns' umbilical cord stumps to prevent infection, could reduce infant mortality significantly. However, changing behavior would be an enormous challenge. This case gives students an appreciation for the importance and complexity of global health issues, along with an understanding of key analytic techniques for approaching a complex market situation. Students quickly learn that there are no easy answers to encouraging chlorhexidine's greater use. To develop a plan, it is essential to complete detailed analyses, study insights and motivations, and ultimately compare different possible solutions, considering efficiency and efficacy.

It is January 2014, and the case protagonist, David Milestone (senior advisor at the Center for Accelerating Innovation and Impact at the U.S. Agency for International Development's Global Health Bureau), is preparing for a meeting of global stakeholders and pharmaceutical manufacturers who are interested in reducing mortality caused by childhood pneumonia and are prepared to donate $10 million to support this effort.

Milestone's goal is to propose a strategy to address childhood pneumonia in Uganda, toward which the $10 million donation would go. In addition to effectively and sustainably reducing childhood pneumonia deaths, the plan must align the interests of various stakeholders behind the problem. A successful strategy in Uganda could be a model for interventions elsewhere. The United Nations Commission on Lifesaving Commodities for Women and Children recently identified Uganda as a “pathfinder” country, meaning it could serve as the example for other countries wrestling with the same issues. This is a remarkable opportunity to change the lives of children in Uganda—and all around the world.

After reading and analyzing the case, students will be able to:

• Perform a stakeholder analysis

• Appreciate the challenges involved in improving public health, especially in developing countries

• Create a patient journey and use it to identify potential impact points

Perform a stakeholder analysis

Appreciate the challenges involved in improving public health, especially in developing countries

Create a patient journey and use it to identify potential impact points