Johnson & Johnson commits to donating sutures to support approximately 15,000 fistula surgeries each year over three years, potentially enabling thousands of women to receive the proper surgical treatment of fistula. These sutures will be provided to trusted partners who have a long history with J&J, as well as with providers of fistula surgeries. Johnson & Johnson will work with Direct Relief International (DRI) and others to reach the surgeons in DRI's network. In addition, the company plans to work with the UNFPA fistula kits. By supporting surgeons in the UNFPA network, who have not been reached by Johnson & Johnson's previous suture donations, the company aims to reduce their cost of materials and therefore their overall costs. Through this cost reduction, Johnson & Johnson aims to enable doctors to perform more surgeries, and therefore impact a greater number of women and girls.
The provision of sutures to partners is due to start in January 2014, with subsequent shipments on a quarterly basis, as they are distributed. The donation to UNFPA based on demand is expected to total 500 consumable kits per year, which can support to the treatment of 10,000 women (each kit is designed to provide consumable materials for 20 surgeries). With the addition of other partners, additional sutures will be provided for up for an additional 5,000 surgeries. This will help with a substantial amount of surgeries performed annually and potentially make affordable surgeries available to more women.
Johnson & Johnson will also conduct measurement and evaluation activities that will be completed with all partners on an annual basis, in 1Q of each year. Metrics captured will include the number of sutures donated, the number of kits distributed, the number of surgeries performed per kit, and the number of doctors served. Other information to be gathered includes awareness of the kit program and tracking of the patients and surgeons who benefit from the kits. In addition, complete site visits and partner reviews will be conducted annually to ensure the health of the partnership.
An estimated 2 to 3 million women and girls in developing countries are living with obstetric fistula; a devastating childbirth injury resulting from prolonged labor which causes women to leak urine or fecal matter uncontrollably. Fistula is most common in sub-Saharan Africa and Asia, where there is persistent poverty (approximately 50% of the population is living on less than .25 per day) and a lack of equity for women and girls. The World Health Organization estimates that at least 50,000 new cases of fistula occur each year, but due to limited surgical capacity and resources, only approximately 18,500 women annually are able to receive corrective surgery. The average cost of fistula treatment, including the surgery and post-operative and preoperative care, is .
Fistula is an unfortunate consequence of prolonged labor, and an estimated 85-100% of such labors result in unviable pregnancies, creating emotional guilt and grieving for mothers. In addition, many women affected by fistula are abandoned by their husbands and ostracized by their communities. Often, they are not able to gather water when others are present, and are unable to make a living. In addition to the incontinence brought on by this condition, women may also have nerve damage to their ankles and feet. An additional complication can arise when a woman lies on her mat for prolonged periods, waiting for the urine to dry. In this situation, she may also develop contracture of the joints in her legs, making it impossible to walk.
Despite the relative ease and success of the surgery, around a 90% treatment rate, most women afflicted with this condition cannot afford or do not have access to the surgery. This commitment aims to address the availability of sutures for such surgeries, to not only increase access to this critical surgical tool but to also help make the procedure more affordable, and perhaps even free. In doing so, Johnson & Johnson aims to help these women receive help, gain hope, and to renew their lives. The WHO estimates 18,000-20,000 fistula repair surgeries are performed annually, and Johnson & Johnson can potentially support sutures for up to 80% of these procedures.
J&J seeks partners to help with the implementation of the project, particularly the logistics of delivering the sutures to an expansive group of surgeons. Additionally, they seek other groups offering financial or surgical resources which can help offset other related costs of the surgeries, decreasing the burden on the women, surgeons, and communities.