IMA World Health: The Good Drug Runners
Distribution
Written by John Zorabedian   
Thursday, 01 May 2008
IMA World Health: The Good Drug Runners - American Executive - RedCoat Publishing
Paul Derstine leads this nonprofit health organization's global efforts to combat crisis and disease.
Premier Business Partners:

Merck & Co, Inc.
Protestant church agencies fanned out across the Third World in the last century to help underserved and remote villages gain access to healthcare, sanitation, and rural aid. IMA World Health, a nonprofit established in 1960 to distribute pharmaceuticals and medical supplies to church-run hospitals abroad, is still working in Africa and the Caribbean to fulfill its founding mission, but many US Protestant churches no longer control healthcare institutions in the countries the nonprofit is assisting.

IMA World Health: The Good Drug Runners - American Executive - RedCoat Publishing
Paul Derstine , President
Over the last decade, IMA World Health (IMA), based in New Windsor, Md., has transformed from a distributor of donated medicines and medical supplies to a support agency that establishes networks for healthcare delivery, including the drugs that are crucial in battling tropical diseases such as river blindness, HIV/AIDS, and elephantiasis. Paul Derstine, IMA’s president, said the organization works closely with international agencies and host-country health ministries to reach underserved villages in places like Tanzania, the Democratic Republic of the Congo, and Haiti.

In 1994, IMA signed on with pharmaceutical manufacturer Merck to distribute its river blindness control drug, Mectizan, in Tanzania. In 2001, it received a $25 million government grant from the US Agency for International Development (USAID) that allowed the organization to establish health networks in the DRCongo. These two health programs have propelled IMA into a more enhanced role in supporting healthcare delivery, rather than solely shipping donated medicines and medical supplies from a warehouse as it did in the 1960s.

“With the great transition in the way pharmaceutical and medical supplies are manufactured globally, we’ve made the transition into global health work,” Derstine said. “We still handle some gifts-in-kind, but a lot of the work we do now is in systems strengthening and building the capacity of those local partners.”

Along with church relief groups, pharmaceutical companies, and the US government, IMA partners with international groups such as the World Health Organization of the United Nations and philanthropies such as the Bill and Melinda Gates Foundation. Each of these stakeholders places demands on IMA to demonstrate the effectiveness of their work in the host countries. “We need to be much clearer now in terms of the intended outcomes, how many people we’re treating, and how we’re reducing the health issue we said we would,” Derstine said.

Derstine said this type of accountability is important to IMA’s work. The organization’s biggest challenge is helping to rebuild disrupted or nonexistent health networks in countries wracked by poverty and civil strife.

Broken chain
Civil wars and violence in countries like the Sudan and the Congo, where a level of civil unrest is ongoing; Kenya, after its recent disputed elections; and Haiti, after a military coup in 1991, make the work of delivering healthcare dangerous and unstable. Strengthening health systems already under constant stress from poor funding and inadequate technology is that much more difficult with political disruptions and refugee crises caused by war.

Derstine, who formerly worked in banking and as an industry consultant in the coffee trade, was in Haiti when the country’s president was ousted by a coup in 1991. “I was out in a remote mountain village in the country when the government fell and all the roads were blocked, and I was stuck there for a week,” Derstine said. “It finally hit me what it’s like to be a villager.”

IMA’s continuing work in places like Haiti, Tanzania, and the Congo is for naught if the health systems it supports cannot sustain themselves after IMA is no longer in the country. “We cannot plan to always be out there doing this work for years,” Derstine said. “We need to build the systems with the local ministry of health to sustain this work for a much longer period of time.”

In Tanzania, IMA established field operations in 1995 to support the distribution of the drug Mectizan, manufactured and dontated by Merck to control river blindness. Merck had originally agreed to provide its support for a period of five years but has extended its support to the Tanzanian Ministry of Health through 2008. Research into the disease has found that the parasites that cause river blindness can live in the hosts’ bodies for up to 25 years, meaning the hope of eradicating the disease depends upon ministries of health continuing to distribute the drugs to control the disease for years to come.

IMA sets up training programs for community volunteers who distribute the drugs in their villages and reports back to the agency on the names of people who are taking the drug. “It takes so many of us working in different countries to ultimately have hope that we can control this disease,” Derstine said. “The same mechanism can be applied to a number of other diseases that have been identified—neglected tropical diseases—that need the same approach. We need these mechanisms to bring the private and public institutions together.”

Although Merck has pledged to continue distributing Mectizan until the disease is brought under control, IMA’s support for the program in Tanzania will end after 2008. IMA’s distribution network must be able to continue functioning after IMA is gone. “The philosophy we operate under here is not only to get the drug out every year but to also think about long-term sustainability and what systems need to be in place,” Derstine said.

And without funding to continue its work in a specific location, IMA necessarily needs to end its operations there. “It’s important for any organization like ours to raise its own funding,” Derstine said. “What we don’t do as well yet is raise unrestricted funding from individual donors that would allow us to expand in a given country or region.”

IMA seeks financial support for the type of work it does well, he said, rather than simply following the money and trying to provide a service to meet eligible funding. “Our objective is to see what services we deliver well and find opportunities to do that,” Derstine said.
 
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