The Global Health Delivery Project is producing a series of in-depth global health field case studies as a key tool in developing frameworks to diagnose and improve care delivery in multiple settings. The cases, which follow the Harvard Business School model, also form the core of a new global health delivery curriculum for a wide range of students. The cases document the experiences of actual global health programs and examine the impact of diverse factors on program strategy, design and implementation. Following are sample descriptions of completed cases.

The Academic Model for the Prevention and Treatment of HIV/AIDS
The Academic Model for the Prevention and Treatment of HIV (AMPATH) cares for more than 55,000 HIV-infected adults and children in Kenya, making it the country’s larg­est provider of HIV care. AMPATH developed in 2001 out of a partnership between two academic institutions: the In­diana University School of Medicine and the Moi Universi­ty School of Medicine, based in Eldoret, Kenya. This case examines the role of academic institutions in global health delivery and AMPATH’s progression from a primary health and education center to a program focused on HIV care.

HIV Care in Rwanda
In 2005, the Government of Rwanda, the Clinton HIV/AIDS Initiative, and Partners In Health formed a unique collaboration to deliver HIV care in two rural districts with a population of 450,000 where there had previously not been a single physician. As a result of the program’s suc­cess, the partners have been asked to assist the government as it expands the HIV care model throughout the country. This case follows the development of the partnership and its efforts to deliver and scale HIV care services integrated with primary care in a rural setting.

HIV in Thailand: The 100% Condom Program
Confronted with a rapidly intensifying HIV epidemic in 1991, the National AIDS Committee of Thailand imple­mented the “100% condom program”. Pioneered two years earlier by public health officials working with the com­mercial sex worker industry in the Ratchaburi province, the program required clients of sex workers to use condoms. This successful partnership and its expansion into a nation­al program are detailed in this case.

Botswana's Program in Preventing Mother-to-Child HIV Transmission
Prevention of mother-to-child transmission (PMTCT) of HIV is a critical challenge in global health. By 2008, Botswana’s PMTCT program was well known as a PMTCT success story. Over the program’s nine years, its operations have been significantly affected by changes in political leadership and policy. This case examines the impact of these political changes and the development of the program as it became tightly integrated with broader maternal and child care services.

A to Z Textile Mills Ltd
In 2003, the World Health Organization and Sumitomo Chemical Company in Japan joined forces to begin manufacturing the Olyset long-lasting insecticidal bed net (LLIN) to prevent malaria infection in sub-Saharan Africa. The Olyset net, the most effective LLIN available, was impregnated with insecticides that killed and repelled mos­quitoes for up to five years. The public-private partnership developed, manufactured, and distributed the nets using an incentive-based supply chain that simultaneously addressed underlying poverty through job creation and income gener­ating activities. The case explores both the use of incentive-based supply chain development for commodities and the way in which health care delivery can act as a driver of sustainable economic development.

Multi-Drug Resistant Tuberculosis Treatment in Peru
In 1990, the Peruvian government set out to create a stan­dardized national treatment program to address a growing tuberculosis epidemic. The Peruvian National Tuberculosis Control Program was able to bring the epidemic under con­trol, and its successful approach was adopted by the World Health Organization as a model tuberculosis treatment strategy in 1994. The case examines the successful imple­mentation of the national program and demonstration of the DOTS (directly observed therapy short-course) strategy, as well as the experience of treating the small percentage of patients who did not respond to standard treatment.

BRAC's Tuberculosis Program: Pioneering DOT Treatment for TB in Rural Bangladesh
In the early 1980s, BRAC, a Bengali non-governmental organization focused on rural development, undertook the development and expansion of a rural tuberculosis pro­gram. Working closely with the government, BRAC rapidly expanded the program from a pilot in one sub-district to a full-scale program covering a catchment area of 83 mil­lion in 2006. The case explores how BRAC developed and expanded its program to face the challenges of tuberculosis service delivery in rural Bangladesh and how the organiza­tion evaluates its compatibility for future challenges (e.g. new contexts and diseases) and its partnership with the National Tuberculosis Programme.

Tuberculosis in Dhaka: BRAC's Urban TB Program
In 2002, building on the successes of its Rural Tuberculosis Programme, BRAC, a Bengali non-governmental organiza­tion focused on rural development, expanded tuberculosis services to the capital city of Dhaka. The move from a rural to an urban setting required BRAC to modify its strategy significantly and form partnerships with a host of new constituencies, including private practitioners, garment fac­tory owners, and public hospitals, which housed testing and referral centers. The case focuses on both the added value and challenges in adapting BRAC’s Rural Tuberculosis Programme in the urban context of Dhaka.

Iran’s Triangular Clinic
Iran’s Triangular Clinic was established by Iranian medical professors in 1999 to combat the problem of HIV/AIDS that had emerged in Iran during the late 1980s due to high rates of injection drug use. Using a comprehensive Harm Reduction model that included needle exchange, condom distribution, and counseling, the clinic was successful in reducing the transmission of HIV and decreasing stigma. This case examines the complexity of working with a marginalized population and scaling up Harm Reduction in Iran’s challenging social and cultural environment.

Polio Elimination in Uttar Pradesh
In 2002, there was an unexpected polio outbreak in India, a country where the disease had been thought to be largely under control, with infection levels dropping to a low of 265 cases in 2000. This case examines the polio elimination program in the northern state of Uttar Pradesh, an economi­cally disadvantaged region whose minority Muslim popula­tion was disproportionately affected by the disease.

Additional Completed and Planned Cases
• Partners In Health: The PACT Project (Harvard Business School Press)
• Multi-drug Resistant Tuberculosis/Directly Observed Therapy Short-course Plus in Peru
• Zambia’s National Malaria Control Program
• CIDRZ Operations & Care Delivery Model in Zambia
• Thailand and Quality Improvement
• HIV Voluntary Counseling and Testing in Hinche, Haiti
• Human Resources & Task Shifting in Swaziland: Male Circumcision
• Information Technology in Low Resource Settings: Open Medical Record System
• Tobacco Control in South Africa
• Community-Based Health Insurance in Rwanda (Mutuelles)
• HIV Care Delivery in Uganda: The AIDS Support Organization (TASO)
• The Anti-Malarial Supply Chain: Advanced Bio-Extracts
• Ready-to-Use Therapeutic Food

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