Photo Credit: Gurmeet Sapal
Aug 11
August 11, 2015

Karl Hofmann

President and CEO, Population Services International (PSI)

The New Frontier of Non-Communicable Diseases


Population Services International (PSI) has been a member of the Clinton Global Initiative (CGI) since 2006, partnering on more than 15 Commitments to Action. In July, Karl Hofmann, president and CEO of PSI, participated in a session focused on non-communicable diseases held during the CGI Week of Action. Here he shares a behind the scenes look at PSI’s cervical cancer prevention commitment and the role that the CGI community plays in helping to drive this work forward.

There was a time when non-communicable diseases (NCDs) seemed too exotic to matter in slum areas like Kibera, Nairobi; Dharavi, Mumbai; or Cité Soleil, Port-au-Prince. Until recently, the global health community has focused on immediate threats, lifting millions out of poverty and preventing deaths throughout the world. It’s worth celebrating.

But the progress we’ve seen in global health presents a new challenge. The NCD burden is rapidly rising, as developing countries experience increased rates of diabetes, hypertension, cancer, and other non-infectious diseases. We now realize these concerns matter too.

At Population Services International (PSI), we make it easier for people in the developing world to lead healthy lives, and plan the families they desire in more than 65 countries by employing proven business practices—such as the franchising of health facilities and the marketing of health products and services. While PSI began 45 years ago with a mission to increase access to family planning, for the last 15 years we have focused on infectious diseases including malaria, HIV, and tuberculosis.

Unfortunately, we at PSI, along with the global health community, struggle to determine exactly how to attack the new frontier of NCDs. One solution—expanded through a 2014 CGI Commitment to Action in partnership with the Indian Society of Healthcare Professionals—is our cervical cancer detection and treatment initiative in Uttar Pradesh, India.  

Above, A community outreach worker speaks to a woman about her health in uttar Pradesh, india. Photo Credit: Gurmeet Sapal.

Cervical cancer can be prevented by population-based screening, which aims to detect the disease at a pre-cancer stage when it can easily be treated. Our commitment will enlist more than 80 franchised clinics to provide screening services—including pharmacies and other outlets offering health services—across three districts within Uttar Pradesh. Operational research will also be conducted to better understand drivers and barriers to cervical cancer screening among women in this region.

Despite a challenging start, we are working through headwinds to:

  • Create demand for cervical cancer detection and treatment, and facilitate the transition between these two steps.
  • Make it affordable.
  • Connect private sector engagement with public sector involvement, such as the integration of cervical cancer screening into the Indian public health system.
  • Break down social barriers and the gatekeeping of women’s health by men and mothers-in-law.

Above, A doctor works in a clinic in india where women can receive health services. Photo Credit: Gurmeet Sapal.

During CGI’s recent Week of Action, I had the opportunity to discuss the challenges of this commitment among my peers in a session exclusively dedicated to NCDs. Leaders from across sectors shared insightful feedback and recommended next steps for moving forward with our commitment, including:

  • To engage with other cervical cancer treatment and prevention programs in order to learn from their best practices.
  • To design special outreach efforts that address the concerns of women’s health gatekeepers, like mothers-in-law and men.
  • To borrow from peer education in HIV management, for example using women who have previously undergone screening and/or treatment to empower others in proactively managing their own health.
  • To tie our work to Indian government national plans through cross-sector collaboration and integration.

It is our hope that, by leveraging the PSI global network and incorporating feedback from other CGI members, we will strategically improve the way NCDs are treated around the world and build upon the tremendous progress we've already seen in the global health community.