News Article | July 20, 2017
Murphy brings over 25 years of experience within the public and private sectors, including international development firms, nongovernmental organizations and nonprofit organizations within the U.S. government contracting, international and commercial arenas. "These are uncertain times in global health and development," Murphy says. "IntraHealth is preparing by becoming even more nimble in today's evolving marketplace and forging powerful new partnerships. This will not only further IntraHealth's mission, but also make us a stronger organization in the long run." Murphy's broad and diverse experience includes managing financial systems, corporate structures/strategy, human resources, program oversight, contracts/legal, facilities, mergers and acquisitions, and information technology within foreign assistance environments. Before joining IntraHealth, Murphy served as chief financial officer/chief compliance officer at FHI 360. He also served in senior roles, including as chief financial officer, at Deloitte Emerging Markets Group, the United Nations Office for Project Services in Denmark, Counterpart International, Development Alternatives, Inc. and the Academy for Educational Development.
News Article | July 19, 2017
The new report and case studies complement existing findings The GovLab has published on its open data website, ODimpact.org, a multi-faceted platform of information about how open data can improve peoples' lives. The "Open Data in Developing Economies" report is also the result of a months-long collaboration between The GovLab and several partners, including the U.S. Agency for International Development, FHI 360, and the World Wide Web Foundation. "We're very excited to share key lessons and takeaways from this project," said Stefaan G. Verhulst, co-founder and chief research and development officer at The GovLab. "Together with our partners, we set out to learn if and how a broader use of open data could improve lives and spur opportunity in developing economies. Our findings show that open data provides unique opportunities for developing economies to become more data-driven; and the framework and insights provided in the report allow the development community to become more evidence-based in how to leverage open data for good." HOW TO CAPTURE EVIDENCE? While the use of open data is on the rise in developing economies, a common (and comprehensive) framework for evaluating what works and how was missing. The "Open Data in Developing Economies" report sought to fill this gap and provide a way to analyze and assess existing open data initiatives. In developing this part of the framework, The GovLab focused on all the elements that comprise the open data value chain: supply, demand, action, output, use, indicators, impact, and stakeholder feedback. WHAT CAN WE LEARN FROM THE FIELD? Capturing the stories behind the data is another critical factor in leveraging open data in developing economies. The repository of case studies that was launched simultaneously with the report features 12 case studies from 12 countries: Burundi, Cambodia, Colombia, Ghana, India, Jamaica, Kenya, Nepal, Paraguay, South Africa, Tanzania, and Uganda. From its analysis of these case studies — which represented a variety of sectors such as health, poverty alleviation, and energy — The GovLab identified four ways people's lives can be improved in developing countries: For example, in Colombia, The GovLab case study showed how the Colombian government is using open data to better understand and address the way climate is affecting the country's potential to grow its own food — a particularly serious challenge for small farmers, who represent the majority of crop growers in the country. WHAT MAKES A DIFFERENCE? The GovLab subsequently organized the variables that determine impact into a new Periodic Table of Open Data, containing 27 elements that can play an important role in determining whether an open data project succeeds or fails, within five overarching categories: (1) Problem and Demand Definition, (2) Capacity and Culture, (3) Governance, (4) Partnerships, and (5) Risks. The Periodic Table of Open Data also provides a unique checklist for open data providers and users. Providing a set of actionable recommendations for practitioners as well as decision-makers was another important element of the report. Recommendations for practitioners included articulating the issue to be addressed with as much granularity as possible, and clearly defining why the use of data for addressing a given problem matters. For decision-makers, recommendations included developing and integrating regular exercises that identify how open data can help to address problems. "Our work at The GovLab is ultimately meant to help us get smarter about what works in practice," said Andrew Young, knowledge director at The GovLab. "We believe 'Open Data in Developing Economies' provides tools that practitioners, governments, donors, and several others in the development community can use to unlock the power of open data to benefit people in developing economies around the world." The full report, "Open Data in Developing Economies: Toward Building an Evidence Base on What Works and How," along with the 12 new case studies, is available at ODimpact.org, and thegovlab.org. About The Governance Lab The Governance Lab's mission is to improve people's lives by changing the way we govern. Our goal at The GovLab is to strengthen the ability of institutions — including but not limited to governments — and people to work more openly, collaboratively, effectively, and legitimately to make better decisions and solve public problems. We believe that increased availability and use of data, new ways to leverage the capacity, intelligence, and expertise of people in the problem-solving process, combined with new advances in technology and science, can transform governance. We approach each challenge and opportunity in an interdisciplinary, collaborative way, irrespective of the problem, sector, geography, and level of government. For more information, visit thegovlab.org. About the New York University Tandon School of Engineering The NYU Tandon School of Engineering dates to 1854, the founding date for both the New York University School of Civil Engineering and Architecture and the Brooklyn Collegiate and Polytechnic Institute (widely known as Brooklyn Poly). A January 2014 merger created a comprehensive school of education and research in engineering and applied sciences, rooted in a tradition of invention and entrepreneurship and dedicated to furthering technology in service to society. In addition to its main location in Brooklyn, NYU Tandon collaborates with other schools within NYU, the country's largest private research university, and is closely connected to engineering programs at NYU Abu Dhabi and NYU Shanghai. It operates Future Labs focused on start-up businesses in downtown Manhattan and Brooklyn and an award-winning online graduate program. For more information, visit engineering.nyu.edu.
News Article | September 19, 2017
Prior to the switch to Foxit and Phantom PDF Business, the organization used Adobe Acrobat for its PDF needs. When Adobe required that the organization move to one of its cloud-based subscription options at a price point that was not feasible for the nonprofit, it became evident that it was time for a change. "When it was clear that we needed to make a transition, I was tasked with identifying a replacement software with the powerful features employees needed while meeting our strict and highly regulated budget constraints," said Len Curry, IT Project Manager with FHI 360. "After reviewing the solutions available in the market, it was clear that only Foxit would be able to deliver the features that our staff need and rely on at the right price." Foxit's PhantomPDF Business successfully brought many benefits to the FHI 360 organization and it's staff, including: "I was so pleased with how the transition from Adobe to Foxit went for our organization," said Len. "My experience with vendors in the past has seen them quickly disappear once we have a deal in place. But with Foxit, this has absolutely not been the case, as they are incredibly responsive, answering every question we have right away and we couldn't be happier." About Foxit Software Foxit is a leading software provider of fast, affordable, and secure PDF solutions. Foxit addresses the needs of three distinct market segments. For End-User Productivity, Foxit delivers easy to use desktop software, mobile apps, and cloud services to make knowledge workers more productive. ConnectedPDF leading edge technology that powers document management, security, and collaboration services for PDF files. For Enterprise Automation, Foxit provides server software for large scale PDF document management and data capture. Foxit's Developer Solutions enable developers to incorporate powerful PDF technology into their applications. Foxit has over 475 million users and has sold to over 100,000 customers located in more than 200 countries. The company has offices all over the world, including locations in the US, Asia, Europe, and Australia. For more information, please visit https://www.foxitsoftware.com
News Article | September 25, 2017
The creators of a male birth control gel designed to inhibit sperm production—while maintaining healthy testosterone levels in the bloodstream—will soon start recruiting 420 couples from around the world to enroll in a new clinical trial. Male participants will apply the hormonal gel to both shoulders once a day. Then, after lab testing indicates their sperm counts have been suppressed to extremely low levels (which could take two to three months), the couples will be tracked for a year while they use the gel as their lone form of contraception. The project, led by the U.S. National Institutes of Health and the Population Council, is expected to begin signing up couples in early 2018, along with collaborating partners at nine locations in the U.K., Sweden, Italy, Chile, Kenya and several medical centers in the U.S. Once these sites get institutional and national review board sign-offs, the study will test whether the latest version of a hormonal birth control system for men can overcome the myriad obstacles that have sidelined earlier efforts. Just last year a clinical trial of a hormonal male contraceptive shot was shut down after some participants suffered concerning side effects. Right now, options for male birth control are few—condoms, vasectomy and withdrawal—and there is no equivalent of “the Pill,” a hormonal contraceptive used by women, that would limit sperm production. Yet vasectomy requires surgery and is not always reversible, condoms are often used inconsistently and withdrawal is unreliable. That’s why the NIH team has turned to its new experimental gel. It introduces into the bloodstream a combination of the hormones progestin—which suppresses sperm creation in the body—and testosterone. An earlier version of this approach appeared promising in a small, six-month pilot trial, in which gel application reduced sperm production while maintaining healthy testosterone levels. In about 89 percent of users, sperm counts were reduced to one million per milliliter or less (a point typically considered to indicate successful sperm suppression). “That number—89 percent—may sound low, but we suspect that there was some level of noncompliance, since the men in that pilot trial were not using this for contraceptive purposes,” says Diana Blithe, who is leading the gel trial as chief of the contraceptive development program at the NIH’s National Institute of Child Health and Human Development. By way of comparison, among women the typical failure rate for oral contraceptives hovers around 9 percent due to noncompliance and imperfect use, putting it in striking distance of the male gel sperm-suppression numbers. Researchers have been trying for decades to deliver on male hormonal birth control. Theoretically this would inhibit sperm production in men, much as the Pill blocks women’s ovaries from releasing eggs. But in practice it is far more complex. In women the Pill essentially tricks the body into acting as though it already is pregnant, making it temporarily infertile. Among men a hormonal contraceptive could inhibit testosterone production in the testes, reducing sperm levels. It would, however, simultaneously decrease testosterone in the blood—which would cause intolerable side effects that include impeded ejaculation as well as altered libido and muscle mass. So the biggest hurdle to developing a male contraceptive pill has been the difficulty of providing replacement testosterone in oral form, Blithe says. The hormone would leave the body too quickly, rendering such a pill impractical because men would have to take it too many times a day. Blithe’s contraceptive gel aims to get around those problems by steadily adding testosterone back into the bloodstream through the skin—at levels low enough to avoid promoting sperm production in the testes but high enough to prevent problematic side effects. “The amount of testosterone needed for sperm production in the testes is believed to be about 50 to 100 times greater than what is needed in the blood for other functions,” she notes. Her team’s effort comes on the heels of a troubled, high-profile male contraceptive trial. Last year a study headed by the World Health Organization and a reproductive health institute called CONRAD reported a hormone injection suppressing sperm production in men was about 96 percent effective. (The NIH had no role in that project.) The shot—which men needed to receive every two months—included testosterone and progestin. Despite the injection’s effectiveness, the study was halted early when male volunteers experienced side effects including depression, acne and mood swings. Twenty of the 320 participants in that trial dropped out citing problems such as mood changes, erectile dysfunction or pain. One participant’s sperm levels had not returned to normal four years after an injection and remain at levels considered subfertile, says Douglas Colvard, a reproductive expert at CONRAD and one of the lead investigators of the hormonal shot effort. Yet even with those side effects there was still a lot of interest in the product. The remaining trial participants mostly praised the injections and said they were still interested in continuing to use them, even after the scientists brought the test to a halt. Blithe and her team expect their approach to be largely free of the side effects seen with the injection, because the daily gel applications would release the hormones more consistently. The most common side effect would likely be acne, according to Blithe. In the pilot work a small number of men reported acne, increased appetite, decreased libido, mood swings, headaches or insomnia—side effects also seen among women who take oral contraception. Unlike the gel, Blithe notes, the shots contained large levels of hormones that were introduced every eight weeks and then decreased in the body at varying rates until the next injection, likely contributing to the negative side effects. Colvard, who is not involved with the gel effort, says it seems promising. “We don’t know for a fact that the fluctuating hormones in [our] study were the only cause of the side effects that occurred, but it’s plausible, given that behavioral changes occur during different hormonal cycles in men—like when teenagers hit puberty,” he says. For now his group is analyzing links between some of the mood swings seen in its study and hormonal fluctuations in the weeks following the injections, he says. Aaron Hamlin, executive director of the Male Contraception Initiative—a nonprofit organization that funds and advocates for nonhormonal male birth control—says a gel that continuously delivers a hormone makes sense. “If you are able to spread the dosage out over more time, intuitively it seems like a better approach than having spikes that occur every so often, like with the shot,” he says. But he cautions that reversible nonhormonal methods—those that block sperm from fertilizing eggs without introducing hormones into the body—would still be preferable, because any hormone-based intervention would be subject to months-long delays between when a man starts using it and when his sperm production is sufficiently suppressed. The body, Hamlin notes, must also clear a reserve of sperm that existed before the treatment began. He is also concerned about the side effects of hormonal birth control, and the consideration that it may not adequately suppress sperm count in all men. Yet nonhormonal methods (beyond vasectomies and condoms) that seek to impede egg fertilization have yet to reach the same level of testing in men. Animal tests have been performed with a couple of products including a compound called H2-gamendazole, which keeps sperm from reaching maturity so they are not fully developed when they are ejaculated—causing men to essentially “shoot blanks.” Another nonhormonal product, called Vasalgel, is a polymer hydrogel that physically blocks sperm in the vas deferens so they cannot reach an egg. Researchers published promising results with Vasalgel in rabbits and monkeys earlier this year but its maker says it has no timeline for human clinical trials. Yet another product, Gendarussa, was created by researchers at Airlangga University in Indonesia. It prevents sperm from fertilizing an egg via a mechanism that remains unclear—and the Indonesian team has not published results from its phase I human trials—so it is hard for outsiders to assess the product’s success or science, Blithe and Colvard say. Gendarussa has, however, received clearance from the Indonesian equivalent of the U.S. Food and Drug Administration to proceed with phase II trials, says Paul Feldblum, a senior epidemiologist in global health research at FHI 360, a human development organization that helped develop some protocols for the trial’s next phase. Gendarussa’s creators did not respond to a request for comment. Despite their different methods, all these products have one thing in common: They are designed to fill the massive need for more contraceptive options. In 2012, 40 percent of all pregnancies worldwide were unintended, according to the Guttmacher Institute. New forms of birth control, reproductive specialists hope, could help slash those numbers.
Avery M.,FHI 360
Current Opinion in HIV and AIDS | Year: 2017
PURPOSE OF REVIEW: Controlling the HIV epidemic requires strong linkages across a ‘cascade’ of prevention, testing, and treatment services. Information and communications technology (ICT) offers the potential to monitor and improve the performance of this HIV cascade in real time. We assessed recent (<18 months) peer-reviewed publications regarding uses of ICT to improve performance through expanded and targeted reach, improved clinical service delivery, and reduced loss to follow-up. RECENT FINDINGS: Research on ICT has tended to focus on a specific ‘silo’ of the HIV cascade rather than on tracking individuals or program performance across the cascade. Numerous innovations have been described, including use of social media to expand reach and improve programmatic targeting; technology in healthcare settings to strengthen coordination, guide clinical decision-making and improve clinical interactions; and telephone-based follow-up to improve treatment retention and adherence. With exceptions, publications have tended to be descriptive rather than evaluative, and the evidence-base for the effectiveness of ICT-driven interventions remains mixed. SUMMARY: There is widespread recognition of the potential for ICT to improve HIV cascade performance, but with significant challenges. Successful implementation of real-time cascade monitoring will depend upon stakeholder engagement, compatibility with existing workflows, appropriate resource allocation, and managing expectations.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
Aral S.O.,Centers for Disease Control and Prevention |
Cates Jr. W.,FHI 360
Sexually Transmitted Infections | Year: 2013
Development of efficacious interventions is only the first step in achieving population level impact. Efficacious interventions impact infection levels in the population only if they are implemented at the right scale. Coverage must be prioritised across subpopulations based on the diversity and clustering of infections and risk in society, and expanded rapidly without delay. It is important to prioritise those who are most likely to transmit infection first.
Van Der Straten A.,University of California at San Francisco |
Van Damme L.,FHI 360 |
Haberer J.E.,Massachusetts General Hospital |
Bangsberg D.R.,Harvard University
AIDS | Year: 2012
Although the balance of recent evidence supports the efficacy of antiretroviral (ARV)-based pre-exposure prophylaxis (PrEP) against HIV-1 infection, recent negative trial results are perplexing. Of seven trials with available HIV endpoints, three different products have been tested: tenofovir 1% vaginal gel, oral tenofovir disoproxil fumarate (TDF) tablets, and TDF/emtricitabine tablets. Six of these trials were conducted exclusively in sub-Saharan Africa; all found the products to be well tolerated, and four demonstrated effectiveness. Furthermore, the HIV Prevention Trial Network (HPTN) 052 trial recently confirmed that antiretroviral treatment leads to 96% reduction in transmission to HIV-negative partners in HIV-serodiscordant couples. These results, along with human and animal data, provide substantial evidence for the efficacy of antiretroviral-based HIV prevention. Yet assessment of oral TDF/emtricitabine in the FEM-PrEP study and of oral and vaginal tenofovir in the Microbicide Trial Network (MTN)-003 trial (VOICE) was stopped for futility. How do we make sense of these discrepant results? We believe that adherence is a key factor, although it cannot be the only factor. Expanding upon a recent editorial in the Lancet, we discuss the impact of suboptimal product adherence on PrEP efficacy in the context of variable drug concentration at the exposure site, integrity of the vaginal epithelium, and the role of acute infection. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Grimes D.A.,CB No 7570 |
Schulz K.F.,FHI 360
Obstetrics and Gynecology | Year: 2012
Most reported associations in observational clinical research are false, and the minority of associations that are true are often exaggerated. This credibility problem has many causes, including the failure of authors, reviewers, and editors to recognize the inherent limitations of these studies. This issue is especially problematic for weak associations, variably defined as relative risks (RRs) or odds ratios (ORs) less than 4. Such associations, commonly reported in the medical literature, are more likely to be attributable to bias than to causal association. All observational research has bias (which can include selection, information, and confounding bias). Hence, detection of small associations falls below the discriminatory ability of observational studies. In general, unless RRs in cohort studies exceed 2 to 3 or ORs in case-control studies exceed 3 or 4, associations in observational research findings should not be considered credible. However, these guidelines are not foolproof: strong (yet spurious) associations can result when large amounts of bias are present. Only in a properly performed randomized controlled trial, free of bias, should small associations merit attention. Better training and more circumspection on the part of investigators, tougher editorial standards on the part of journals, and hefty skepticism on the part of referees and readers are necessary to avoid the dangers of false alarms, pseudo-epidemics, and their unfortunate consequences. © 2012 by The American College of Obstetricians and Gynecologists. Published by Lippincott Williams & Wilkins.
Bratt J.H.,FHI 360 |
Zyambo Z.,FHI 360 Zambia
Journal of Acquired Immune Deficiency Syndromes | Year: 2013
Background: Rapid scale-up of voluntary medical male circumcision (VMMC) is needed to realize potential reductions in HIV incidence in sub-Saharan Africa. New disposable VMMC devices such as the Shang Ring may offer several advantages over standard surgery, including lower costs. Methods: We compared direct costs of the Shang Ring and dorsal slit techniques for delivery of VMMC in the context of a randomizedcontrolled trial carried out in Zambia in 2011. Information on direct costs of clinician time, disposable supplies, and reusable medical instruments were collected by study staff. Results: During the trial, the direct cost of 1 VMMC procedure using the Shang Ring device was US $18.21, whereas the direct cost of using dorsal slit was US $17.67. Higher costs of clinician time related to dorsal slit VMMC were offset by higher costs of disposable supplies with the Shang Ring approach. Discussion: Although direct costs were roughly equivalent during this small-scale trial, with the increased demand from scaling up VMMC, a Shang Ring team could provide services at a substantially lower average total cost due to the potential for more intensive use of staff and other fixed resources. Copyright © 2013 by Lippincott Williams & Wilkins.
Jariseta Z.R.,FHI 360
Food and nutrition bulletin | Year: 2012
Individual dietary intake data are important for informing national nutrition policy but are rarely available. National Household Consumption and Expenditures Surveys (HCES) may be an alternative method, but there is no evidence to assess their relative performance. To compare HCES-based estimates of the nutrient density of foods consumed by Ugandan women (15 to 49 years of age) and children (24 to 59 months of age) with estimates based on 24-hour recall. The 52 food items of the Uganda 2006 HCES were matched with nutrient content of foods in a 2008 24-hour recall survey, which were used to refine the HCES-based estimates of nutrient intakes. Two methods were used to match the surveys'food items. Model 1 identified the four or five most commonly consumed foods from the 24-hour recall survey and calculated their unweighted average nutrient contents. Model 2 used the nutrient contents of the single most consumed food from the 24-hour recall. For each model, 14 estimates of nutrient densities of the diet were made and 84 differences were compared. Models 1 and 2 were not significantly different. Of the model 2 HCES-24-hour recall comparisons, 67 (80%) did not find a significant difference. No significant differences were found for protein, fat, fiber, iron, thiamin, riboflavin, and vitamin B6 intakes. HCES overestimated intakes of vitamins C and B12 and underestimated intakes of vitamin A,folate, niacin, calcium, and zinc in at least one of the groups. The HCES-based estimates are a relatively good proxy for 24-hour recall measures of nutrient density of the diet. Further work is needed to ascertain nutrient adequacy using this method in several countries.