The 2014 Atlanta Summit - - The Art of Alignment: Nonprofit Strategies for Improving Public Health

Strategic Alignment Principles:

• Nonprofits and government agencies share similar constraints regarding limited resources and the necessity of partnerships to achieve broad national impact.
• Successful collaboration requires identifying shared goals despite differing core missions and respecting the time needed to align large, complex organizations.
• Silos subvert solutions; overcoming them requires stakeholders to have "skin in the game," share intellectual capabilities, and commit to long-term network constructs.
• Effective alignment often involves ceding institutional identity to broader, inclusive partnerships to encourage participation from diverse sectors.

Sector-Specific Case Studies:

• Robert Wood Johnson Foundation & YMCA:
  • The Foundation partnered with the YMCA to expand from facility-based wellness to local and state policy advocacy regarding childhood obesity.
  • This partnership leveraged the YMCA's presence in 2,700 communities, reaching more children daily than McDonald's.
  • The collaboration resulted in the YMCA adopting policy change as a central agenda item and reporting tangible community impacts.
• ASU & Precision Medicine Biomarkers:
  • A new nonprofit network was established to address the failure rate in translating genomic discoveries into FDA-approved biomarkers.
  • Current statistics highlight that only 1.2 biomarkers are approved per year at the FDA, a rate unchanged since 1993.
  • Less than 100 biomarkers are utilized in current clinical practice despite their foundational role in precision medicine.
  • The initiative aims to create a transparent pathway for biomarkers to prevent the failure of phase three clinical trials.
• Measles & Rubella Initiative (Global Scale):
  • The initiative (launched 2001) aligned the American Red Cross, CDC, UN Foundation, UNICEF, and WHO to pool resources and expertise.
  • Vaccination efforts have reached over one billion children, driving an 84% reduction in measles mortality in Africa.
  • One in five child deaths prevented globally since 1990 is attributed to this specific vaccination campaign.
• George Washington University & Community Health:
  • HIV/AIDS: Embedded epidemiology professors within DC health departments to build surveillance and prevention systems with CDC and nonprofits.
  • Obesity: Partnered with Santa Fe Institute to create the "Stop Obesity Alliance," involving government, industry, and healthcare providers.
  • Community Health Assessment: Developed a web-based tool with the Robert Wood Johnson Foundation to help hospitals assess and report the health impact of their community activities.
  • Smoking Cessation: Deployed the "text quit" app in partnership with software and healthcare providers, achieving a 32% success rate among 75,000 users.
• University of Pennsylvania & Behavioral Health:
  • Focuses on the 5,000 hours patients spend outside clinical settings to improve health outcomes.
  • Community health worker programs have reduced hospital readmissions for high-risk patients by 15–50%.
  • The "Way to Health" center utilizes behavioral economics and IT to improve medication adherence, raising rates from 40–50% to 90% via lottery incentives.
  • The program integrates Wharton School behavioral economics, engineering skills, and Robert Wood Johnson scholars.

Nonprofit Sector Advantages:

• The sector offers flexibility, the ability to pivot quickly, and the capacity to target specific issues without the constraints of bureaucratic mandates.
• Nonprofits can partner flexibly across for-profit, nonprofit, and public sectors to address long-term health outcomes defined as overall quality of life.
• Academic institutions must revise promotion and tenure models to reward collaborative work rather than individual achievement.

CDC Partnership Dynamics:

• Strengths:
  • CDC is recognized as unparalleled in building community partnerships, offering unique technical expertise, laboratory surveillance, and convening power.
  • Global CDC operations, such as those in Nigeria (130+ staff) and Botswana, excel at working directly with Ministries of Health and understanding local economic and cultural contexts.
  • CDC demonstrated rapid innovation during the SARS crisis by sequencing the virus before other agencies.
  • The agency successfully catalyzed national screening laws for breast and cervical cancer through collaboration with advocates.
• Challenges:
  • Severe budget constraints frequently limit CDC's ability to attend partnership tables or provide sufficient leverage for collaborative resources.
  • Budget cuts often restrict the agency to "bare minimum" activities focused only on immediate threats, hindering efforts to address chronic issues like obesity.
  • Resource limitations at CDC challenge the ability to scale successful interventions.
• Future Outlook:
  • Experts advocate for increased funding for CDC to fully leverage its convening capabilities for complex problems like drug-resistant tuberculosis.
  • The "post-2015 framework" under debate at the UN is expected to prioritize universal health coverage, guiding future development assistance.
  • Aligning with CDC is viewed as essential for public health success, with CDC acting as the central hub around which other sectors must organize.