5) Description of health product/service offering: In India and Africa, despite national healthcare programs, the poor are frequently unable to access primary care services in order to receive treatment for tuberculosis, malaria, diarrhea, river blindness, HIV-AIDS and other debilitating diseases. Progressive Health Worldwide’s goal is to supplement (1) the pharmaceutical supply and (2) home health care available to the poor offered through primary care clinics managed by governments or nonprofit organizations. Our primary beneficiaries in Pavagada, India, will be children of low-income families served by PHWW’s Pediatric Tuberculosis Clinic, which provides home health care through a physician and nurse. The TB treatment will be delivered daily along with a nutritional supplement. In Rungwe District of Mbeya Province, Southwest Tanzania, PHWW is delivering pharmaceutical supplies to primary care clinics which only have 50% of the medication needed to serve the villages of the district.

6) Description of innovation: The home health delivery care program in Pavagada, India, (a free Pediatric Tuberculosis Clinic) is being financed by ProgressiveRx, LLC, a U.S.-based company which provides low-cost prescription medication and over-the-counter (OTC) drugs to some of the 46 million Americans without healthcare insurance and to low-income families who cannot afford the high deductibles and co-pay associated with their medication. This financing and donations pay for the home health services of a doctor and nurse and the monthly rental of a vehicle. The program is coordinated through the Swami Vivekananda Integrated Rural Health Centre which provides office space for the doctor and nurse and the rental vehicle at the hospital which they operate. Likewise, in Rungwe District, Tanzania, PHWW is collaborating with an existing educational, agricultural, community development, and micro-credit financing program for women which includes eight villages working with the nonprofit U.S. organization Africa Bridge. PHWW is supporting an existing clinic through donated pharmaceuticals provided by ProgressiveRx to supplement those provided two-weeks each month by the Tanzanian Ministry of Health. Thus, in both India and Tanzania, the primary care programs link relatively small organizations that are community based with small U.S. nonprofit organizations which are not controlling the healthcare services being offered to low-income and marginalized families, but rather supporting and strengthening indigenous ones.

7) Operational model: Progressive Health Worldwide’s mission is to help low- income families in India and Africa get access to essential and primary healthcare, including pharmaceutical supplies. Financially, PHWW relies extensively upon the monthly contribution of ProgressiveRx, LLC in the form of cash and pharmaceutical supplies which it purchases from FDA-approved pharmaceutical firms in India. The Bangalore, India, staff of ProgressiveRx provides staff and logistical support for both the Pavagada, India, and Southwest Tanzania programs. In both India and Tanzania, PHWW works with and through other relatively small nonprofit community based organizations—rather than International Nongovernmental Organizations—in order to maximize the financial contributions of ProgressiveRx and other donors and grantors.

8) Human resources: Progressive Health Worldwide (PHWW) has an executive director based in Portland, Oregon. However, as described above, the nonprofit’s work is only possible at this time because of the links it enjoys with ProgressiveRx, LLC and its founder, both of whom are in the U.S.; the ProgressiveRx office in Bangalore, India, which employs four college-educated women who process orders; the Swami Vivekananda Integrated Rural Health Center in Pavagada, India; Africa Bridge, based in Marylhurst, Oregon, but linked to eight villages in Rungwe District, Southwest Tanzania. The founder of both ProgressiveRx and PHWW has a B.A. in political science and international economics from Pitzer College (Claremont, California) and an MBA from Oxford College, England. He received a Freeman Foundation research grant to study Sherpa and other montaine Asian communities (1999-2000), another grant to attend Oxford, and worked for Ford Motor (England) for 18 months before deciding to undertake entrepreneural work in healthcare that would allow him to fund nonprofit healthcare for the poor. The executive director of PHWW has a B.A. in history (Westminster College, 1965) and a Ph.D. in African history and anthropology (Northwestern University, 1978), experience with Africa dating back to 1965, as well as private sector and academic employment since 1977. He also is a board member or advisor to eight other African advocacy programs.

9) Key operational partnerships: In India and Africa, ProgressiveRx, LLC (www.progressiverx.com) funds the work of its nonprofit sister organization, Progressive Health Worldwide (www.phww.org). PHWW oversees the recently launched free Pediatric Tuberculosis Clinic in Pavagada, India, and the work of one physician and one nurse who daily distribute TB treatment and a nutritional supplement to 50 children. In Rungwe District, Mbeya Province, of Southwest Tanzania, PHWW has just begun working with a nonprofit organization, Africa Bridge, to supplement the pharmaceutical supplies given by the Tanzanian Ministry of Health, but which only cover 50% of the demand of the district.

10) Financial Sustainability

          • Fees charged to clients?: No

          • How do you assure affordability?: Currently, we are not charging low-income families in either India or Tanzania for the pharmaceutical supplies they are receiving.

          • Earned incomes as a percentage of operating costs: 0

          • Other funding sources: Currently ProgressiveRx is paying for the free services and medication being offered through Progressive Health Worldwide (PHWW). However, PHWW, which has submitted its application for nonprofit tax status with the Internal Revenue Service, has also begun appealing for and receiving donations.

          • Strategy for long-term sustainability: Long-term, we hope that universal primary health programs in the U.S., India, and Africa will eliminate the need for both ProgressiveRx as well as Progressive Health Worldwide. Until then, the owner of ProgressiveRx will continue to keep overhead and administrative costs low, use profits to fund the nonprofit work of Progressive Health Worldwide, and PHWW will appeal to other potential donors (individuals and foundations) to contribute to the elimination of tuberculosis in children in India and the well-being of families in Africa.

11) Current and Future Impact

          • Total number of clients: About 200

          • Clients in the past year: About 200

          • Percentage of low-income clients: 100

          • Impact: In India, we do not know. In Tanzania, our partners have worked with the postal system to assure delivery

          • Overall "market": ProgressiveRx is looking at a market in the U.S. which is 46-50 million people--those without healthcare insurance and those with insurance but on fixed incomes who cannot afford prescription medication. The nonprofit Progressive Health Worldwide (PHWW)is currently providing daily TB treatment and nutritional supplements to 50 children in India and would like to raise that to 200 children by 2009 for a cost of approximately $50,000 annually; and provide $50,000 annually of pharmaceutical supplies to Africa by 2009. PHWW will be able to purchase pharmaceutical supplies at cost from ProgressiveRx.

12) Scaling up strategy

          • Stage of the initiative: Scaling Up stage.

          • Expansion plan: ProgressiveRx's revenues depend upon the number of American customers who purchase prescription medication. Since the firm has no plans to pay for advertising, its expansion will depend upon the number of referrals made by existing customers and the number of articles which appear in the print media and at Internet sites. ProgressiveRx's ability to contribute to the nonprofit work of Progressive Health Worldwide will be determined, therefore, by its own cash flow and expenditure needs. The owner of ProgressiveRx is also owner of another for-profit venture now in the research and development phase which, if successful, may be a more significant source of funding in two-three years. But, PHWW is also planning to undertake fundraising activity on its own behalf and to apply for foundation grants available to nonprofit organizations.

13) Policy change: In the United States, the federal and state governments could openly permit and encourage the use of the Indian pharmaceutical market rather than opposing it as a source of low-cost prescription medication. That would significantly enhance the annual revenues of ProgressiveRx, which would provide larger contributions to the work of Progressive Health Worldwide in India and Africa.

14) Origin of the initiative: The initiative was the result of the founder's return trip to Asia in 2004 to assist an Oxford University classmate undergo treatment for a recently diagnosed condition of multiple sclerosis. While there, the founder, whose entire family lacked healthcare insurance, purchased low- cost prescription medication. After opening the ProgressiveRx office in Bangalore and establishing a Web site, the founder, Hayden Hamilton, asked his father, Robert Hamilton, to manage the nonprofit Progressive Health Worldwide and its programs in India and Africa. A short biography of each man was included in the answer to Question 8. Articles about the ProgressiveRx and PHWW ventures have appeared in Business Week On-line, Oregon Business, and The Oregonian.

Contact Information:
Robert  Hamilton
Executive Director
Progressive Health Worldwide (PHWW)
(nonprofit healthcare for India and Africa)
319 SW Washington Street; Suite 1175; Portland, Oregon 97204
United States
Tel: 503-320-5994
Fax: 866-400-6441
Email: robert@phww.org
Website: www.phww.org