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Good Health

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OUR WORK

Conducting Critical COVID-19 Research

The global COVID-19 pandemic has been disastrous for the world’s health and economies. To date, more than 164 million people have been infected with the novel coronavirus, or SARS-CoV-2, and 3.4 million people have died from its associated disease, COVID-19. In the U.S., the Centers for Disease Control and Prevention (CDC) plays a critical role in combatting the pandemic and conducting research on critical questions around COVID-19 risk factors, transmissibility, and vaccine effectiveness.

Abt has played a key—and rapidly evolving—role in CDC’s response. When CDC awarded Abt a contract in May 2020 to support COVID-19 research efforts, we mobilized an infrastructure of clinical health organizations we set up in 2013 to conduct studies of influenza or other novel respiratory viruses among different population cohorts—from which we built a response tailored to the evolving pandemic.

This enabled us to efficiently launch COVID-19 studies of five priority populations: healthcare personnel, first responders, and essential workers; pregnant women and infants; individuals 50 years and older; older adults in retirement communities; and households. In these studies, our infectious diseases and clinical research experts are collecting and analyzing data from 16 sites to understand how COVID-19 spreads.

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In addition, when vaccines were produced with unprecedented speed, Abt pivoted and led a swift, behind-the-scenes effort to gear up a massive and unanticipated data collection platform to determine their effectiveness. The pivot required prompt alterations to study protocols and data collection practices to adapt to new challenges.

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Interim data from one of the studies, RECOVER, showed that for 3,950 healthcare personnel, first responders, and other essential front-line workers in six states, Pfizer and Moderna vaccines were 81 percent effective for partial immunization (one shot) and 91 percent effective for full immunization. That translates into only three infections and no severe infections or deaths among 2,264 fully vaccinated workers. For those vaccinated, the risk of self-reported fevers was 58 percent lower, and they spent 2.3 fewer days sick in bed than those who were not vaccinated.

A forthcoming article in the New England Journal of Medicine focuses on the study’s results. The data showed COVID-19 vaccines are highly effective under real-world conditions. Data like these are used daily by CDC to make important decisions about public health practices, such as declaring that fully vaccinated individuals no longer need to wear masks. Consequently, state and local leaders have largely lifted COVID-19 restrictions, with an ensuing boost to the economy.

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Our ongoing studies of the other four cohorts will yield important additional insights to further inform CDC’s policy response to the pandemic. Continuing vaccine effectiveness studies, including with children, will help determine the duration of protection offered by COVID-19 vaccines, including their effectiveness against variants, and measure the effectiveness of newer COVID-19 vaccines, including single-shot vaccines and boosters as they are introduced.

UN Sustainable Development Goals

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UN Global Compact Principles

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Impact

Questions We Addressed

Client & Project

  • U.S. Centers for Disease Control and Prevention (CDC)

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    Research on the Epidemiology of SARS-CoV-2 in Essential Response Personnel (RECOVER)

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Integrating Cervical Cancer Prevention into the HIV Response in Mozambique

Mozambique has one of the highest HIV prevalence rates in the world, with 12.6 percent of the nation’s adults testing positive for the virus. 

This disease burden is exacerbated by other related illnesses that further strain the health system and already vulnerable lives. Cervical cancer is one such disease, as women living with HIV who become infected with the HPV virus often quickly progress to high-mortality, invasive cervical cancer. Integrating cervical cancer prevention and treatment services into the HIV response saves lives—and that is exactly what the Abt team did across four provinces in Mozambique.

In our first year of leading USAID’s Efficiencies for Clinical HIV Outcomes (ECHO) project, we put in place interventions to maximize synergies between responding to HIV and preventing cervical cancer. In October 2019, only 856 eligible women living with HIV were screened for cervical cancer in the four provinces. We mobilized to train nearly 300 clinicians to identify eligible women and reinforce cervical cancer treatment protocols, referred women from routine checkups or pharmacies, and even escorted women to testing sites. As a result, within just one year, ECHO had screened 49,387 women for cervical cancer—a huge step toward addressing one of the primary health threats to women living with HIV.

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UN Sustainable Development Goals

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UN Global Compact Principles

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Impact

Results We Generated
  • 49,387 women screened for cervical cancer (in 1 year)

  • 1-month retention on anti-retroviral therapy (ART) increased from 58% to 93%

  • 3-month retention on anti-retroviral therapy (ART) increased from 74% to 92%

Client & Project

  • U.S. Agency for International Development (USAID)

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    Efficiencies for Clinical HIV/AIDS Outcomes (ECHO)

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Strengthening Supply Chain Management in DRC

Without a functional medical supply chain, health systems cannot get the right drugs to the right people at the right time. This is an issue faced by numerous under-resourced countries. 

In the Democratic Republic of the Congo (DRC), supply chains are often broken. Stockouts of vital drugs and commodities are common, as it may take weeks to reach remote communities by vehicle and many pharmacists lack training to properly manage stocks. Sometimes supplies that do get to pharmacies and clinics end up sitting on shelves because they are ordered by someone who does not understand the community’s health needs.

Abt is addressing this problem in nine provinces in southeastern DRC, where many people live in vulnerable conditions at the “last mile” of supply chains. To connect supplies to service delivery, Abt uses an integrated structure, leveraging relationships, local knowledge, and training at multiple levels. Medical personnel are trained in national guidelines, first-line treatment, and diagnostic and treatment protocols in tuberculosis, malaria, and family planning, among other health areas. This in turn builds demand for appropriate drugs and commodities. Abt also teams with local transit operators—often on motorbikes—to get medications to remote clinics and community care sites and is piloting a mobile money system to incentivize swift transport. 

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Local data ownership is another key part of the strategy. Starting in late 2019, Abt trained hundreds of data managers, stock managers, and executives to enter accurate data into the national drug supply platform, InfoMED. The following year, Abt introduced monthly health zone distribution plans and quarterly meetings hosted by provincial health districts. These meetings build the skills of pharmacists to analyze data and coordinate with counterparts in neighboring zones to reallocate surplus stocks. As a result of these efforts, over the past two years, reported stockouts of key medicines and medical supplies have plunged from 72 percent to 46 percent. The results validate Abt’s strategy to empower providers at all levels to manage supply chains—particularly at the last mile.

UN Sustainable Development Goals

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UN Global Compact Principles

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Impact

Results We Generated
  • Reduced medical supply stockouts from 72% to 46%

Client & Project

  • U.S. Agency for International Development (USAID)

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    USAID Integrated Health Program

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Fighting Malaria in the Age of COVID-19

The COVID-19 pandemic is creating massive strains on health systems worldwide and threatening to undo hard-fought progress made in battling other debilitating diseases. In early 2020, the World Health Organization (WHO) declared that if essential malaria interventions were greatly disrupted due to the pandemic, the number of malaria cases would significantly increase, and death rates could double.

Abt has battled malaria on the front lines of the most afflicted regions of the world since 2012. Leading the U.S. President’s Malaria Initiative’s (PMI) flagship project, Abt has managed indoor residual spraying (IRS) campaigns, distributed insecticide-treated nets (ITNs), spearheaded entomological research, and conducted ITN durability monitoring in over two dozen countries over the last decade.

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But as COVID-19 hit, that progress came under threat. Leading the PMI VectorLink Project, Abt mobilized a response across 26 countries on three continents. We navigated reduced commodity availability, unreliable logistics systems, and increased lead time for procurements—achieving a 100 percent track record for on-time delivery of commodities. We pivoted to virtual formats for key regional activities on environmental compliance and entomological data management training. And we ensured that the more than 100,000 staff we employ to implement these complex operations were safe and protected from the pandemic.

Even as we ensured our own operations adapted to COVID-19, our PMI VectorLink team played a key role in drafting global guidelines on how to safely implement vector control activities during the pandemic. The World Health Organization and numerous countries have adopted these guidelines for their vector control activities.

Throughout this unprecedented year, we—together with our partners—protected more than 31 million people from malaria and ensured continuity of services, despite disruptions and challenges posed by COVID-19. Our team conducted successful IRS campaigns in 16 countries, including Cote d’Ivoire, where we had never done a spray campaign before. We restarted PMI-supported entomology activities in Angola and distributed ITNs in Tanzania and Malawi. Technical assistance was provided to local government ITN efforts in Cameroon, Ghana, Senegal, and Zambia, and net durability monitoring studies were conducted in nine countries across Africa, from Liberia to Madagascar.

DATA FOR REAL-TIME DECISION MAKING IN MALARIA CONTROL

The project continues to expand the use of VectorLink Collect, a system based on District Health Information Software2 (DHIS-2), that manages entomological and spray data into a single, integrated platform. This allows for near real-time program monitoring, quality assurance, and analysis. VectorLink Collect was used in all 16 PMI-supported IRS countries this year for spray data and in 17 countries for entomological data.

Indoor residual spraying requires high-quality data to plan, implement, and track progress during a spray campaign. The PMI VectorLink Project expanded its mobile data collection strategy to allow spray teams to make quick and informed decisions to improve spray performance.

UN Sustainable Development Goals

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UN Global Compact Principles

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Impact

Results We Generated
  • 21.3 million people protected from malaria by indoor residual spraying (IRS)

  • 3.49 million children and 636,527 pregnant women protected

  • >58,000 seasonal workers hired to support IRS (33% female)

  • >5.8 million insecticide treated nets (ITNs) distributed

  • 5 peer-reviewed journal articles published on studies that assessed malaria risks and increased trust in new vector control approaches

Questions WE Addressed

Client & Project

  • U.S. Agency for International Development (USAID)

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    U.S. President’s Malaria Initiative (PMI) VectorLink

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OUR PEOPLE AND OPERATIONS

Prioritizing Employee Health and Safety

The COVID-19 pandemic forced us to make swift adjustments, guided by a single overriding priority: the health and safety of our staff. Early on, Abt convened a Global Preparedness Taskforce to understand risks, design a coordinated and comprehensive response, and disseminate guidance quickly. 

We began implementing cleaning protocols in February and March that exceeded CDC guidelines, suspended non-essential travel by March 4 to maximize staff safety, and because of our investments in technology, every employee capable of working from home was doing so by March 16. To safeguard staff who were still using our facilities, Abt worked closely with landlords to improve ventilation by increasing HVAC flow, upgrading to micron-stye filters, and maximizing the circulation of outdoor air.

In the months that followed, we held biweekly all-staff meetings, offered crisis care to help with costs of in-home caregivers, distributed stipends to U.S.-based staff for office-related purchases, instituted two-week flexible-timecard periods so employees could better balance their work and at-home priorities, and provided resources to address challenges such as social isolation and talking with children about COVID-19.

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More than half of our staff live overseas. All third-country nationals and expats were given the choice of staying or returning to their home country of record to work virtually. Some decided to return home; however, many remained at their post and continued to work virtually or in the offices on a limited occupancy basis, strictly following COVID-19 mitigation procedures. Abt offices worldwide operated based on local conditions and following national and international health guidance.

Soliciting transparent feedback and hearing directly from our staff is central to how we manage the company—this was especially important as we navigated the COVID-19 response. In August 2020, Abt’s Australia and Britain offices conducted an anonymous all-staff survey to gauge how effective our pandemic response had been. Results indicated a high degree of trust, clarity in communication, and goodwill from staff across offices.

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UN Sustainable Development Goals

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UN Global Compact Principles

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Global Reporting Initiative Index

OUR COMMUNITIES

Supporting Communities Through COVID-19

The COVID-19 pandemic has devastated the communities in which we live and work, and Abt made an early commitment to helping those whose lives had been upended. In March 2020, we announced that Abt would match all staff donations made through May 2020 to pandemic-related causes. We chose to make targeted matches, reflective of staff donations, to maximize our shared impact.

Abt employees donated $31,000 to COVID-19-relief efforts in the U.S. alone. Staff also donated to international COVID-19 charities in countries where they work. In total, Abt and its employees donated $76,000 to health-related charities. A quarter of the corporate match went to the COVID-19 Solidarity Response Fund for the World Health Organization. 

Compassion in Action

Our community service in 2020 was not just about COVID-19. During an indoor residual spraying campaign in Ghana, district IRS coordinator Grace Ayijunu found a young girl named Latifa, who had suffered second-degree burns. Latifa’s family was keeping her home, hoping that the burns would heal on their own. After Grace’s team summoned health personnel, Grace went to the hospital and stayed in touch with doctors throughout the girl’s one-month stay.

Learning that Latifa’s family could not afford the cost of her treatment, Grace settled the bill with support from colleagues and provided money for relatives who helped care for Latifa during her hospital stay. Today, Latifa is healthy and strong, and Grace has been given the name ‘Mma’ (“mother” in the Mampruli language) by Latifa’s grandmother.

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UN Sustainable Development Goals

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Impact

  • $76K donated to COVID-19 relief efforts

Virtual Athletes for a Cause

Our Abt athletes continued to support efforts to fight HIV/AIDS and food insecurity and participated in virtual activities benefiting children’s hospitals and domestic violence prevention programs. Despite having to walk, run, or bike solo, they raised thousands of dollars and found ways to make a difference—at a distance.

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UN Sustainable Development Goals

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Impact

  • 40 athletes went virtual to support their causes