| FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: |
PATH IS A GLOBAL ORGANIZATION THAT WORKS TO ACCELERATE HEALTH EQUITY BY BRINGING TOGETHER PUBLIC INSTITUTIONS, BUSINESSES, SOCIAL ENTERPRISES, AND INVESTORS TO SOLVE THE WORLD'S MOST PRESSING HEALTH CHALLENGES. WITH EXPERTISE IN SCIENCE, HEALTH, ECONOMICS, TECHNOLOGY, ADVOCACY, AND DOZENS OF OTHER SPECIALTIES, PATH DEVELOPS AND SCALES UP SOLUTIONS-INCLUDING VACCINES, DRUGS, DEVICES, DIAGNOSTICS, AND INNOVATIVE APPROACHES TO STRENGTHENING HEALTH SYSTEMS WORLDWIDE. SINCE 2011, PATH AND OUR PARTNERS AND SUPPORTERS HAVE IMPROVED HEALTH FOR MORE THAN 150 MILLION PEOPLE ON AVERAGE EACH YEAR. |
| FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE: |
IN UKRAINE, PATH CONTINUED TO LEAD THE USAID-FUNDED SERVING LIFE PROJECT, WHICH REDUCES TB, HIV, AND HEPATITIS C VIRUS (HCV) TRANSMISSION IN THE PENAL SYSTEM AND COMMUNITIES ACROSS 12 REGIONS. RESPONDING TO COVID-19, WE OFFERED MULTIPLE OPTIONS FOR HIVST KIT DELIVERY AND ADVOCATED FOR VIRTUAL ART INITIATION AND MONITORING; WITHIN TWO MONTHS OF ENACTMENT OF A NEW POLICY, ALMOST 400 VIRTUAL CONSULTATIONS WERE HELD. IN ADDITION, WITH PATH'S TECHNICAL SUPPORT AND SUCCESSFUL ADVOCACY, THE MINISTRY OF JUSTICE PROCURED 60,000 HCV RAPID TESTS AND THE DRUGS REQUIRED TO TREAT NEARLY 500 PRISONERS WITH HCV. AS A PARTNER IN THE UNITAID-FUNDED ADHERENCE SUPPORT COALITION TO END TB PROJECT, PATH BEGAN A STUDY IN UKRAINE ON IMPLEMENTATION OF DIGITAL ADHERENCE TECHNOLOGIES (DATS) AND WORKED TO ESTABLISH A GLOBAL MARKET FOR DATS; FOR EXAMPLE, THE WISEPILL DIGITAL PILLBOX. BY THE END OF 2020, WISEPILL WAS THE FIRST-EVER DAT INCLUDED IN THE GLOBAL DRUG FACILITY CATALOGUE. PATH ALSO CONTINUED TO IMPLEMENT THE USAID-FUNDED SUPPORT TB CONTROL EFFORTS IN UKRAINE (STBCEU) PROJECT, WHICH FOCUSES ON PREVENTION, DETECTION, AND TREATMENT OF TB, DRUG-RESISTANT TB, AND TB/HIV. IN 2020, STBCEU RAPIDLY ADAPTED PROJECT ACTIVITIES TO A REMOTE MODEL. WE ALSO BEGAN SCALE-UP OF A SUCCESSFUL NEW APPROACH FOR TRANSPORTING DIAGNOSTIC SPECIMENS AND DELIVERING DRUGS TO TREAT TB AND HIV. WHEN USAID PROVIDED ADDITIONAL FUNDING FOR EMERGENCY RESPONSE TO COVID-19, PATH PROCURED DNA EXTRACTORS AND CONDUCTED ON-THE-JOB TRAINING TO DRAMATICALLY INCREASE THE NUMBER OF SAMPLES FOR COVID-19 (AND OTHER DISEASES) THAT COULD BE TESTED IN A DAY. THE NUMBER OF UNPROCESSED SAMPLES AT ONE LABORATORY WENT FROM 800 TO ZERO IN LESS THAN A MONTH AND REMAINED AT ZERO THROUGH THE END OF 2020. IN INDIA, PATH ENHANCED HIV SERVICE DELIVERY THROUGH AUTOMATION OF DATA AND DEVELOPMENT OF A MACHINE-LEARNING-ENABLED TOOL TO REDUCE LOSS OF PATIENTS FROM TREATMENT. TO IMPROVE TB SERVICES, WE PILOTED ARTIFICIAL INTELLIGENCE TO STREAMLINE CHEST X-RAY READINGS, ENABLING QUICKER DIAGNOSIS AND INITIATION ON TREATMENT. IN TAJIKISTAN, KAZAKHSTAN, AND UZBEKISTAN, PATH DEVELOPED DRUG-RESISTANT TB CASE MANAGEMENT GUIDELINES, SET UP A DIGITAL TB PREVENTION PLATFORM, PROVIDED TECHNICAL EXPERTISE ON LATENT TB INFECTION, AND MORE FOR THE USAID ELIMINATING TB IN CENTRAL ASIA PROJECT. IN TANZANIA, THE USAID-FUNDED INFECTIOUS DISEASE DETECTION AND SURVEILLANCE (IDDS) PROJECT SUPPORTED KEY FUNCTIONS AT THE CENTRAL TB REFERENCE LABORATORY, FACILITATED REPORTING FROM GENEXPERT TESTING SITES, AND ASSESSED THE TB DIAGNOSTIC NETWORK. IN VIETNAM, PATH CONTINUED TO PIONEER DIFFERENTIATED AND INTEGRATED SERVICE DELIVERY THROUGH THE USAID HEALTHY MARKETS PROJECT. IN 2020, HEALTHY MARKETS ADDED NEW MODES OF DELIVERY FOR PRE-EXPOSURE PROPHYLAXIS AND HIVST. THE PROJECT ALSO CREATED ONE-STOP SHOPS OFFERING PREVENTION, TESTING, AND TREATMENT FOR HIV AND SEXUALLY TRANSMITTED INFECTIONS; MENTAL HEALTH SCREENING AND REFERRALS; GENDER-AFFIRMING SERVICES; AND HEPATITIS B AND C SCREENING AND TREATMENT FOR PLHIV. THE PROJECT USED SOCIAL MEDIA, WEBSITES, AND TELEPHONE HOTLINES TO PROMOTE AND SUPPORT THESE SERVICES AND RAISE AWARENESS OF COVID-19. THESE ADAPTATIONS WERE CRITICAL TO NOT ONLY CONTINUING BUT ACTUALLY INCREASING SERVICES DURING THE PANDEMIC; FOR EXAMPLE, THE PROJECT'S ONLINE HIVST 3.0 ORDERING PLATFORM AND HOME DELIVERY RESULTED IN A 93 PERCENT INCREASE IN THE NUMBER OF HIVST KITS DISTRIBUTED TO KEY POPULATIONS. THROUGH THE IDDS PROJECT IN VIETNAM, PATH CONTINUED TO SUPPORT THE NATIONAL TUBERCULOSIS PROGRAM (NTP). IDDS ASSESSED PROGRESS ON THE "DOUBLE X" STRATEGY (CHEST X-RAY AND GENEXPERT TEST) AND PUT FORTH EVIDENCE-BASED RECOMMENDATIONS TO IMPROVE IMPLEMENTATION. THE BREATH FOR LIFE (B4L) PROJECT 2.0 IN VIETNAM IMPROVED AND SCALED UP THE B4L MODEL DEVELOPED IN PRIOR YEARS. B4L 2.0 INCREASED ACCURATE DIAGNOSIS OF PEDIATRIC TB, TREATMENT OF TB AND LATENT TB, AND TB PREVENTION. FOLLOWING A STOOL-BASED GENEXPERT TESTING PILOT, B4L 2.0 AND IDDS PAIRED UP TO SUPPORT THE NTP IN THE USE OF STOOL SAMPLES TO INCREASE TB DETECTION AMONG CHILDREN. IMPORTANTLY, THE VIETNAM NTP INCLUDED PEDIATRIC TB ACTIVITIES INFORMED BY B4L IN ITS STRATEGIC PLAN 2021-2025. IN ZAMBIA, PATH CONTINUED TO IMPLEMENT THE USAID-FUNDED ERADICATE TB PROJECT, WHICH TESTED NEARLY 150,000 PEOPLE AND DIAGNOSED APPROXIMATELY 21,000 WITH TB. OF THE NEARLY 9,000 BACTERIOLOGICALLY CONFIRMED INDIVIDUALS, 95 PERCENT WERE INITIATED ON TREATMENT. TO MITIGATE COVID-19, THE PROJECT CONDUCTED INFECTION PREVENTION AND CONTROL TRAININGS FOR MORE THAN 500 HEALTH CARE WORKERS, COMPLETED FOLLOW-UP FACILITY ASSESSMENTS, ACTIVATED THREE TESTING SITES, AND ORIENTED 500 COMMUNITY-BASED VOLUNTEERS. MATERNAL, NEWBORN, AND CHILD HEALTH AND NUTRITION MATERNAL, NEWBORN, AND CHILD HEALTH AND NUTRITION (MNCHN) IS PART OF PATH'S COMPREHENSIVE, ONE HEALTH, PEOPLE- AND COMMUNITY-CENTERED PRIMARY HEALTH CARE MODEL, WHICH ADDRESSES BROADER DETERMINANTS OF HEALTH (E.G., SOCIAL, ECONOMIC, ENVIRONMENTAL). WE FOCUS ON INNOVATIVE, EVIDENCE-BASED TOOLS AND APPROACHES TO MEET PEOPLE'S NEEDS AND PREFERENCES ACROSS THEIR LIFETIME. TOGETHER WITH PARTNERS AROUND THE WORLD, WE DEVELOP, ADAPT, AND SCALE UP TECHNOLOGIES AND SYSTEMS TO REDUCE ILLNESS AND DEATH AND GIVE CHILDREN THE BEST POSSIBLE START IN LIFE. IN 2020, PATH CONTINUED TO EXPAND OUR GLOBAL AND NATIONAL LEADERSHIP IN EARLY CHILDHOOD DEVELOPMENT (ECD); FOR INSTANCE, WITH PATH SUPPORT, THE GOVERNMENTS OF ETHIOPIA, KENYA, AND MOZAMBIQUE CONTINUED TO INCORPORATE ECD SERVICES INTO BASIC HEALTH CARE. THIS PIONEERING WORK CENTERS AROUND BUILDING AN ENABLING LEADERSHIP AND POLICY ENVIRONMENT WHILE STRENGTHENING THE CAPACITY OF HEALTH SYSTEMS AND HEALTH SERVICE PROVIDERS. ALONG WITH WHO, UNICEF, THE WORLD BANK, AND OTHERS, PATH PROMOTED THE NURTURING CARE FOR ECD FRAMEWORK-A STRUCTURE FOR COUNTRIES TO ADOPT, ADAPT, AND SCALE UP ECD SERVICES. TO ENSURE THAT ALL INFANTS HAVE ACCESS TO HUMAN MILK, PATH FOCUSES ON BREASTFEEDING PROMOTION, INCLUDING PROVISION OF SAFE DONOR MILK THROUGH LOCAL HUMAN MILK BANKS. IN 2020, WE CONTINUED TO ADVOCATE FOR UPTAKE AND USE OF GLOBAL STANDARDS FOR STRENGTHENING HUMAN MILK BANKING. WE ALSO BEGAN CO-DEVELOPING A DIGITAL KIT TO OPTIMIZE NEWBORN FEEDING AND THE PROVISION OF LACTATION SUPPORT. IN GHANA, PATH IS LEADING A FOUR-YEAR (2020-2024) INITIATIVE, ADVANCED NEWBORN CARE IN GHANA: BEYOND MAKING EVERY BABY COUNT INITIATIVE (MEBCI 2.0), TO REDUCE PERINATAL MORTALITY IN FOUR HIGH-VOLUME REFERRAL HOSPITALS. IN 2020, MEBCI 2.0 ENGAGED WITH THE GHANA HEALTH SERVICE TO DESIGN ITS NEWBORN ACTION PLAN, MOBILIZE REGIONAL STAKEHOLDERS AND RESOURCES, AND DRIVE ADVOCACY AND POLICY ACTION. IN FOUR FOCUS COUNTRIES, PATH EMBARKED ON LESSONS LEARNED IN ESTABLISHING IN-PATIENT NEWBORN CARE, A PLATFORM FOR UNDERSTANDING AND SHOWCASING COUNTRY-LEVEL JOURNEYS TO PROVIDING CRITICAL CARE FOR SMALL AND SICK NEWBORNS. PATH ALSO LED THE ASSET TRACKER PROJECT TO DOCUMENT UPTAKE OF 14 KEY MNCHN ASSETS IN 81 COUNTDOWN TO 2030 COUNTRIES ACROSS AFRICA AND SOUTH ASIA. THROUGH KEY INFORMANT INTERVIEWS AND POLICY REVIEWS IN SEVEN TARGET COUNTRIES, PATH IDENTIFIED BARRIERS AND ENABLERS TO SCALE-UP AND PRESENTED AN INTERACTIVE DASHBOARD TO GUIDE STRATEGIES TO ACCELERATE COVERAGE. RECOGNIZING THAT NUTRITION IS AFFECTED BY A VARIETY OF ECONOMIC AND ENVIRONMENTAL FACTORS, PATH'S NUTRITION TEAM DRIVES NOVEL APPROACHES TO ADDRESS THE MASSIVE BURDEN OF MALNUTRITION IN COMMUNITIES AROUND THE WORLD. IN 2020, PATH COMPLETED A SEVEN-YEAR PROJECT, MAXIMISING THE QUALITY OF SCALING UP NUTRITION PLUS (MQSUN+), WHICH ENGAGED MORE THAN 50 COUNTRIES AND THE GLOBAL SUN MOVEMENT SECRETARIAT IN DEMAND-DRIVEN, ADAPTIVE COLLABORATIONS. MQSUN+ EMPHASIZED COUNTRY-LED MULTISECTOR PLANNING, OFTEN IN FRAGILE CONTEXTS. IN THE LAST YEAR, SIX MQSUN+ COUNTRIES PRODUCED ENDORSED, COSTED PLANS TO REDUCE FOOD INSECURITY AND IMPROVE NUTRITION. OTHER ACTIVITIES IN 2020 INCLUDED PARTNERING WITH THE NATURE CONSERVANCY, DUKE UNIVERSITY, AND THE INTERNATIONAL FOOD POLICY RESEARCH INSTITUTE ON USE OF ALTERNATIVE PROTEINS. WE ALSO PARTNERED WITH HARVESTPLUS TO EXPAND THE REACH OF BIOFORTIFIED CROPS. PATH CONTINUED OUR WORK ON THE BRIDGE COLLABORATIVE, A TRAILBLAZING, CROSS-DISCIPLINARY EFFORT OF MORE THAN 150 LEADING TECHNICAL EXPERTS FROM THE HEALTH, DEVELOPMENT, AND ENVIRONMENTAL SECTORS TO ADDRESS HUMAN AND PLANETARY HEALTH. IN CONJUNCTION WITH THE WILDLIFE CONSERVATION SOCIETY AND THE NATURE CONSERVANCY, THE BRIDGE COLLABORATIVE FOCUSED ATTENTION ON FOOD SYSTEMS AND THE INTERSECTION OF HUMAN AND PLANETARY HEALTH. |
| FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE: |
IN 2020, MNCHN STAFF SERVED GLOBALLY IN LEADERSHIP ROLES RELATED TO COVID-19 AND THE PROTECTION OF WOMEN AND CHILDREN. WE PRESENTED (MOSTLY VIRTUALLY) AT KEY GLOBAL AND NATIONAL MEETINGS AND AUTHORED AND CONTRIBUTED TO HIGH-PROFILE PEER-REVIEWED JOURNAL ARTICLES, BOOK CHAPTERS, GLOBAL REPORTS, AND SYSTEMATIC REVIEWS. THESE EFFORTS ADVANCED THINKING ON BROAD, EFFECTIVE SOLUTIONS TO THE MOST PRESSING CHALLENGES IN MNCHN. SEXUAL AND REPRODUCTIVE HEALTH PATH'S WORK IN SEXUAL AND REPRODUCTIVE HEALTH (SRH) IS GUIDED BY THE KEY PRINCIPLES OF CHOICE, EQUITY, AND DIGNITY FOR ALL PEOPLE. AND BECAUSE WE UNDERSTAND THE COMPLEX SOCIAL, BEHAVIORAL, AND GENDER DIMENSIONS OF WOMEN'S REPRODUCTIVE HEALTH, WE BUILD EVIDENCE AROUND TOOLS AND SERVICES THAT ARE BEST SUITED TO ADDRESS THEIR DIVERSE NEEDS AND CIRCUMSTANCES. WE SPECIALIZE IN REDUCING BARRIERS TO ACCESS AND INTRODUCING WOMAN-INITIATED PRODUCTS. PATH CHAMPIONS PEOPLE'S RIGHT TO MANAGE THEIR OWN SRH BY CREATING AND ADVANCING IMPROVED TOOLS AND PRACTICES THAT MAKE SELF-CARE FOR SRH POSSIBLE. IN 2020, WE CO-CREATED WITH THE GOVERNMENTS OF NIGERIA, SENEGAL, AND UGANDA THEIR FIRST-EVER NATIONAL SELF-CARE GUIDELINES. OUR INTEGRATED APPROACH INCLUDES ATTENTION TO CONTRACEPTION, CERVICAL AND BREAST CANCER, SEXUALLY TRANSMITTED INFECTIONS, AND A WOMAN'S RIGHT TO DECIDE WHETHER AND WHEN TO BECOME A MOTHER. OUR EFFORTS TO EXPAND ACCESS TO THE SELF-INJECTABLE CONTRACEPTIVE SUBCUTANEOUS DMPA (DMPA-SC, OR SAYANA PRESS) CONTINUED IN 2020. THE DMPA-SC ACCESS COLLABORATIVE WORKED WITH MINISTRIES OF HEALTH AND MULTISECTOR PARTNERS IN SIX COUNTRIES TO FACILITATE SELF-INJECTION INTRODUCTION AND SCALE-UP PLANNING FOR A RANGE OF CONTRACEPTIVES. DATA FROM 11 COUNTRIES SHOWED NEARLY 300,000 CLIENT VISITS FOR CONTRACEPTIVE SELF-INJECTION IN 2020; THE ACCESS COLLABORATIVE ALSO LAUNCHED AND SUPPORTED A CADRE OF "SELF-INJECTION AMBASSADORS" TO ADVANCE CONTRACEPTIVE SELF-INJECTION AND SELF-CARE OPTIONS MORE BROADLY. PATH ALSO WORKED TO IMPROVE THE PREVENTION, DETECTION, AND TREATMENT OF CERVICAL PRECANCER CAUSED BY INFECTION WITH HUMAN PAPILLOMAVIRUS (HPV). WE CONTINUED OUR PARTNERSHIP WITH THE MINISTRIES OF HEALTH IN GUATEMALA, HONDURAS, AND NICARAGUA TO SCALE UP HPV TESTING IN THE PUBLIC SECTOR. WE ALSO EVALUATED FOLLOW-UP AND TREATMENT STRATEGIES TO ENSURE WOMEN RECEIVE APPROPRIATE, COMPREHENSIVE CARE. AS THE PROJECT NEARED CLOSEOUT, WE WORKED TO TRANSITION ACTIVITIES TO THE MINISTRIES. GLOBALLY, PATH HELPED SHAPE STRATEGIES FOR LOW- AND MIDDLE-INCOME COUNTRIES AS PART OF WHO'S CALL FOR GLOBAL CERVICAL CANCER ELIMINATION. IN PERU, PATH CONTINUED TO IMPLEMENT A MODEL FOR EARLY DETECTION OF BREAST CANCER APPROPRIATE AND FEASIBLE FOR LOW- AND MIDDLE-RESOURCE SETTINGS. WE PARTNERED WITH THE MOH TO DESIGN AND IMPLEMENT A REAL-TIME DIGITAL PATIENT TRACKING SYSTEM FOR BREAST CANCER DETECTION. IN MYANMAR, PATH SUPPORTED THE CREATION OF THE NATIONAL STRATEGIC PLAN FOR REPRODUCTIVE, MATERNAL, NEWBORN, CHILD, AND ADOLESCENT HEALTH; DRAFTED A NATIONAL OPERATIONAL PLAN FOR CERVICAL PRECANCER SCREENING AND TREATMENT; CREATED A TRAINING CURRICULUM FOR HEALTH WORKERS ON SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS (SRHR), INCLUDING SELF-CARE INTERVENTIONS; HELD ADVOCACY WORKSHOPS; DEVELOPED SRHR AWARENESS TOOLKITS FOR PEOPLE LIVING WITH DISABILITIES; AND RESPONDED TO COVID-19 BY PARTNERING WITH LOCAL CIVIL-SOCIETY ORGANIZATIONS TO DISTRIBUTE INFECTION PREVENTION INFORMATION AND SUPPLIES IN REFUGEE CAMPS AND HARD-TO-REACH AREAS OF TWO STATES. IN INDIA, WE WORKED WITH THE ODISHA STATE GOVERNMENT TO LEVERAGE THE NATION'S POSTAL SERVICE TO DELIVER CONTRACEPTIVES BY MAIL-AND SO MAINTAIN ACCESS THROUGHOUT COVID-19. PATH CONTINUED TO SERVE AS THE SECRETARIAT FOR THE REPRODUCTIVE HEALTH SUPPLIES COALITION, A GLOBAL PARTNERSHIP OF MORE THAN 540 PUBLIC AND PRIVATE ENTITIES AND NONGOVERNMENTAL ORGANIZATIONS WORKING TO EXPAND ACCESS TO CRITICAL SRH AND FAMILY PLANNING SUPPLIES AND SERVICES. NONCOMMUNICABLE DISEASES PATH IS AT THE FOREFRONT OF THE FIGHT AGAINST NONCOMMUNICABLE DISEASES (NCDS), INCLUDING DIABETES AND CARDIOVASCULAR DISEASE, IN LOW-RESOURCE SETTINGS WORLDWIDE, WHERE THE BURDEN OF THESE DISEASES IS RISING DISPROPORTIONATELY. IN 2020, PATH CONTINUED TO SERVE AS THE SECRETARIAT OF THE COALITION FOR ACCESS TO NCD MEDICINES AND PRODUCTS. THIS GLOBAL, MULTISECTORAL COLLABORATION WORKS TO INCREASE ACCESS TO NCD MEDICINES AND HEALTH PRODUCTS IN LOW- AND MIDDLE-INCOME COUNTRIES. IN ADDITION TO GLOBAL ADVOCACY, THE COALITION LED THE DEVELOPMENT OF A FORECASTING TOOL FOR NCD MEDICINES AND PRODUCTS, PILOTED THE TOOL IN KENYA, AND LAID THE GROUNDWORK FOR ITS INTRODUCTION IN UGANDA. PATH IMPLEMENTED NCD PROJECTS IN GHANA, KENYA, AND VIETNAM THAT BUILD STRONGER PRIMARY HEALTH CARE SYSTEMS, SUPPLY CHAINS, AND DATA-DRIVEN DECISION-MAKING-ALL CRITICAL COMPONENTS OF HEALTH SYSTEM RESILIENCY: OUR EFFORTS IN GHANA INCLUDED SUPPLY CHAIN STRENGTHENING, MESSAGING TO SUPPORT THE COVID-19 RESPONSE, AND INTRODUCTION OF THE NCD NAVIGATOR-A FIRST-OF-ITS-KIND, LOCALLY MANAGED, NCD DIGITAL INFORMATION SYSTEM FOR RESOURCE PLANNING AND ALLOCATION. IN PARTNERSHIP WITH THE GHANA HEALTH SERVICE, PATH'S HEALTHY HEART AFRICA PROJECT CONDUCTED MORE THAN 500,000 BLOOD PRESSURE SCREENINGS AND LINKED THOSE DIAGNOSED TO TREATMENT. IN KENYA, PATH DEPLOYED A CUTTING-EDGE PROGRAM THAT ENABLES COMMUNITY AND HOUSEHOLD SCREENINGS FOR HYPERTENSION, REMOTE BLOOD PRESSURE AND BLOOD SUGAR MONITORING, TELEMEDICINE, COMMUNITY-BASED DRUG DELIVERY, AND ENHANCED DATA MANAGEMENT. WE TRAINED 2,815 HEALTH CARE WORKERS ON COVID-19 INFECTION PREVENTION AND CONTROL, WITH AN EMPHASIS ON PEOPLE LIVING WITH NCDS. AS THE MOH SEEKS TO IMPROVE THE NCD SUPPLY CHAIN IN PREPARATION FOR UNIVERSAL HEALTH COVERAGE, WE TRANSITIONED OWNERSHIP OF THE NCD NAVIGATOR TO THE MOH AND FINALIZED OUR KENYA NCD SUPPLY CHAIN REPORT. RECOMMENDATIONS FROM THE REPORT WERE ADOPTED IN THE KENYA NCD STRATEGY 2021-2025. OUR FOCUS IN VIETNAM WAS ON A PRIMARY HEALTH CARE MODEL THAT USES PUBLIC-PRIVATE PARTNERSHIPS, DIGITAL TOOLS, AND COMMUNITY HEALTH WORKERS TO SUPPORT SCREENING AND LINKAGES TO CARE; FOR EXAMPLE, WE BROKERED A PARTNERSHIP BETWEEN THE MOH, CO.OPMART (A LARGE, PRIVATE-SECTOR SUPERMARKET CHAIN), AND PATH TO LAUNCH THE FIRST-EVER SUPERMARKET BLOOD PRESSURE CHECKPOINT IN HO CHI MINH CITY. THE CHECKPOINT SCREENED ALMOST 1,000 PEOPLE BY THE END OF 2020, DEMONSTRATING THE FEASIBILITY OF THE APPROACH. FINALLY, PATH LED AND CONTRIBUTED TO CONVENINGS TO RAISE AWARENESS OF NCDS AND ORCHESTRATE ACTION TO IMPROVE ACCESS TO NCD PREVENTION AND CARE. HEALTH SYSTEMS INNOVATION AND DELIVERY PATH'S HEALTH SYSTEMS INNOVATION AND DELIVERY (HSID) PROGRAM STRENGTHENS HEALTH SYSTEMS AND ENHANCES COUNTRY CAPACITY FOR DATA-DRIVEN DECISION-MAKING. OUR PORTFOLIO SERVES AS AN ORGANIZING MECHANISM FOR PATH PROJECTS AND INITIATIVES THAT STRENGTHEN HEALTH SYSTEMS. HSID'S HEALTH SYSTEMS ANALYTICS UNIT PROMOTES SYSTEMS THINKING. WITHIN AND OUTSIDE OF PATH, THE UNIT LEADS COMPLEX EVALUATIONS OF HEALTH PROGRAMS, ENGAGES IN IMPLEMENTATION SCIENCE RESEARCH, FACILITATES HEALTH TECHNOLOGY INTRODUCTION AND SCALE-UP, AND IMPROVES DATA QUALITY AND USE FOR DECISION-MAKING. IN 2020, AS PART OF THE GLOBAL FUND'S PROSPECTIVE COUNTRY EVALUATIONS, THE UNIT EVALUATED THE GLOBAL FUND'S BUSINESS MODEL IN THE DRC, GUATEMALA, SENEGAL, AND UGANDA-EXAMINING BARRIERS AND FACILITATORS TO IMPACT. THE GLOBAL HEALTH SECURITY TEAM CONTINUED TO INNOVATE FOR THE PREVENTION, DETECTION, AND CONTROL OF INFECTIOUS DISEASE OUTBREAKS. WITH SUPPORT FROM THE US CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC), THE TEAM WORKED WITH NATIONAL LEADERS IN THE DRC, SENEGAL, TANZANIA, AND VIETNAM TO BUILD THEIR CAPACITY FOR EPIDEMIC PREPAREDNESS AND RESPONSE. THE TEAM ALSO WORKED AS A MAJOR SUBGRANTEE ON THE USAID IDDS PROJECT. OUR CROSS-ORGANIZATIONAL IMPACT TEAM FOR EPIDEMIC PREPAREDNESS AND RESPONSE REMAINED AT THE FOREFRONT OF THE EBOLA RESPONSE IN THE DRC-ENHANCING SURVEILLANCE, DETECTION, AND RESOURCE MOBILIZATION. OTHER EFFORTS INCLUDED STRENGTHENING ELECTRONIC HEALTH INFORMATION SYSTEMS, ADVANCING DIAGNOSTIC NETWORK CAPABILITIES, AND LINKING THIS WORK WITH DEVELOPMENT OF NEW DIAGNOSTICS, VACCINES, AND DATA TOOLS. COUNTRY PROGRAMS PATH'S COUNTRY PROGRAMS SUPPORT WORK RANGING FROM SMALL-SCALE PILOTS TO LARGE, MULTI-COUNTRY EFFORTS. IN 2020, WE OPERATED FULL-SCALE "COUNTRY" OFFICES IN THE DRC, CHINA, ETHIOPIA, INDIA, KENYA, MYANMAR, SENEGAL, TANZANIA, UGANDA, UKRAINE, VIETNAM, AND ZAMBIA, AS WELL AS SMALLER "PROJECT" OFFICES IN MANY OTHER COUNTRIES. OUR EXAMPLES THIS YEAR FOCUS ON INDIA, UGANDA, AND VIETNAM. |
| FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE: |
INDIA: PATH HAS WORKED IN INDIA FOR MORE THAN 20 YEARS TO IMPROVE HEALTH AND SAVE LIVES THROUGH INNOVATION AND COLLABORATION WITH LOCAL PARTNERS. PATH'S PROJECTS IN INDIA FOCUS ON TB, HIV, NEGLECTED TROPICAL DISEASES, VACCINES (BOTH DEVELOPMENT AND DELIVERY), AND REPRODUCTIVE, MATERNAL, NEWBORN, CHILD, AND ADOLESCENT HEALTH. IN 2020, PATH PROVIDED TECHNICAL SUPPORT TO THE GOVERNMENT OF INDIA TO EXPAND OUR AWARD-WINNING PUBLIC-PRIVATE MODEL FOR TB DIAGNOSIS AND TREATMENT TO 15 STATES ACROSS THE COUNTRY. OUR PIONEERING WORK IN RICE FORTIFICATION CONTINUED AS WELL, BRINGING LIFESAVING NUTRITION TO NEARLY 1 MILLION PEOPLE, INCLUDING MORE THAN 650,000 SCHOOLCHILDREN. WITH THE ONSET OF COVID-19, PATH IMMEDIATELY LEVERAGED OUR PROGRAMMATIC EXPERTISE AND WORKING RELATIONSHIPS WITH THE GOVERNMENT TO PREPARE HEALTH FACILITIES TO RESPOND TO THE DISEASE. WITH FUNDING FROM THE ROCKEFELLER FOUNDATION, PATH AND OUR PARTNERS WORKED WITH THE STATE GOVERNMENTS OF MAHARASHTRA AND PUNJAB TO IMPROVE ACCESS TO HIGH-QUALITY, AFFORDABLE TESTING FOR COVID-19 BY IMPLEMENTING NEWER DIAGNOSTIC TECHNOLOGIES AND NOVEL TESTING ALGORITHMS, AUTOMATING DATA ENTRY AND ANALYSIS, AND INCREASING HUMAN RESOURCE CAPACITY IN LABORATORIES. WE ALSO BEGAN IMPLEMENTING DECENTRALIZED GENE SEQUENCING PLATFORMS AT THE STATE LEVEL TO ACCELERATE IDENTIFICATION OF NEW VIRAL MUTATIONS AND VARIANTS. PATH'S INDIA TEAM IN 2020 CONTINUED OUR COLLABORATION WITH OTHER SOUTH ASIAN COUNTRIES; FOR EXAMPLE, WE SUPPORTED DEVELOPMENT OF A POINT-OF-CARE "SUITCASE LABORATORY" BASED ON RECOMBINASE POLYMERASE AMPLIFICATION FOR RAPID AND ACCURATE DIAGNOSIS OF KALA-AZAR AND POST-KALA-AZAR DERMAL LEISHMANIASIS IN BANGLADESH AND NEPAL. UGANDA: PATH'S UGANDA COUNTRY PROGRAM HAS BEEN PARTNERING CLOSELY WITH THE UGANDA MOH FOR MORE THAN 15 YEARS, IMPLEMENTING AN EVER-WIDER RANGE OF PROJECTS AIMED AT IMPROVING HEALTH. BELOW ARE A FEW HIGHLIGHTS FROM 2020. AS THE IDDS PROJECT LEAD IN UGANDA, PATH WORKED WITH THE UGANDA GOVERNMENT TO REVIEW EXISTING SURVEILLANCE SYSTEMS IN HUMAN AND ANIMAL HEALTH; SUPPORTED DEVELOPMENT OF NEW TESTING ALGORITHMS FOR PRIORITY ZOONOTIC DISEASES; DEVELOPED A STANDARDIZED QUALITY-CONTROL TOOLKIT; ASSESSED ANIMAL AND HUMAN SPECIMEN REFERRAL SYSTEMS; AND SUPPORTED LABORATORY TRAININGS. PATH'S LARGEST ADVOCACY AND PUBLIC POLICY PROJECT-OPERATING WORLDWIDE AND FUNDED BY THE BILL & MELINDA GATES FOUNDATION-CONTINUED TO FOCUS IN UGANDA ON IMMUNIZATION, PRIMARY HEALTH CARE, AND REPRODUCTIVE, MATERNAL, NEWBORN, CHILD, AND ADOLESCENT HEALTH. WITH COVID-19 DISRUPTING HEALTH SYSTEMS, PATH SUPPORTED THE MOH TO DEVELOP AND BROADLY DISSEMINATE MESSAGES ON COVID-19 PREVENTION AND THE CONTINUITY OF ESSENTIAL HEALTH SERVICES. PATH ALSO HELPED DRAFT THE UGANDA EXPANDED PROGRAM ON IMMUNIZATION RECOVERY PLAN FOR IMMUNIZATION SERVICES DURING COVID-19. OUR ADVOCACY FOR MEDICAL OXYGEN SCALE-UP IN UGANDA, LAUNCHED PRE-COVID-19, GAINED ADDED TRACTION IN THE PANDEMIC. PATH WORKED WITH THE KAMPALA CITY AUTHORITY AND TWO LEADING TELEVISION STATIONS TO AMPLIFY COVID-19 INFECTION PREVENTION AND CONTROL (IPC) MESSAGES; WE RECORDED A TALK SHOW THAT WAS HIGHLY PROMOTED AND FEATURED ON ONE OF THE TELEVISION STATIONS' TWITTER ACCOUNTS, WITH 1.2 MILLION FOLLOWERS. WITH FUNDING FROM THE HILTON FOUNDATION, PATH INTRODUCED ONSITE CHLORINE GENERATION FOR IPC AT HEALTH FACILITIES AND DONATED PERSONAL PROTECTIVE EQUIPMENT AND IPC MATERIALS TO 48 FACILITIES IN 11 DISTRICTS. WE PARTICIPATED IN A WATER FOR PEOPLE WORKING GROUP WITH INTERNATIONAL RESCUE COMMITTEE, WORLD VISION, AND THE US CDC TO IMPROVE WATER, SANITATION, AND HYGIENE IN HEALTH FACILITIES. AS PART OF A SUPPLY SYSTEMS INNOVATIONS GRANT, PATH COORDINATED THE SUCCESSFUL DISTRIBUTION AND INSTALLATION OF UPDATED COLD CHAIN EQUIPMENT IN TEN REGIONS OF UGANDA AND WORKED WITH THE MOH ON HPV VACCINE ACCESS AND COVERAGE. WE SUPPORTED WHO'S EFFECTIVE VACCINE MANAGEMENT INITIATIVE TO REVIEW STOCK STATUS, FORECASTING, COLD CHAIN EQUIPMENT MAINTENANCE, AND LOGISTICS PLANNING FOR COVID-19 AND OTHER VACCINES. TO PREPARE FOR COVID-19 VACCINE INTRODUCTION, PATH (WITH SUPPORT FROM GAVI, THE VACCINE ALLIANCE) DEVELOPED AN ADVOCACY AND ENGAGEMENT PLAN TO INCREASE STAKEHOLDER BUY-IN AND COMMUNITY ACCEPTANCE. WE THEN SUPPORTED THE SUCCESSFUL NATIONAL VACCINATION LAUNCH. THE BILL & MELINDA GATES FOUNDATION FAMILY PLANNING PROJECT AIMS TO IMPROVE THE HEALTH OF WOMEN AND GIRLS BY EXPANDING ACCESS TO RIGHTS-BASED FAMILY PLANNING, INCLUDING DMPA-SC, AN INJECTABLE CONTRACEPTIVE. IN UGANDA, PATH MOBILIZED FUNDING THAT LED TO THE CONTINUATION AND EVEN ACCELERATION OF FAMILY PLANNING EFFORTS, DESPITE CHALLENGES RELATED TO COVID-19. PATH WORKED WITH PARTNERS TO ENSURE DMPA-SC (INCLUDING SELF-INJECTION, WHERE APPROVED) WAS ACCEPTABLE TO USERS AND AVAILABLE AT AN AFFORDABLE PRICE AND AT A VARIETY OF SERVICE DELIVERY POINTS. FINALLY, THE HIV SELF-TESTING AFRICA (STAR) INITIATIVE (PHASE III) WORKED TO ESTABLISH THE STRUCTURES, SYSTEMS, AND OVERSIGHT NECESSARY FOR LONG-TERM SUSTAINABILITY OF THE HIVST MARKET IN UGANDA. COLLABORATING WITH THE MOH AND OTHER STAKEHOLDERS, THE STAR III TEAM DEVELOPED A FOUR-YEAR NATIONAL SCALE-UP PLAN FOR HIVST (2021-2024) AND MOBILIZED AND SUPPORTED A WHO PREQUALIFICATION TRAINING. THE TEAM MAPPED HIVST PARTNERS, TRAINED PEERS AND PROVIDERS, ASSESSED CURRENT REGULATIONS AND POLICIES, AND WORKING WITH THE NATIONAL DRUG AUTHORITY, DEVELOPED A POST-MARKET SURVEILLANCE PLAN. THE PROJECT REACHED NEARLY 16,000 CLIENTS, MAINLY THROUGH COMMUNITY DISTRIBUTION. VIETNAM: IN 2020, PATH CELEBRATED OUR 40TH ANNIVERSARY IN VIETNAM. THROUGH THE GLOBAL HEALTH SECURITY PARTNERSHIP FUNDED BY THE US CDC, PATH UPGRADED THE MOH'S ONLINE INFECTION SURVEILLANCE PORTAL, LAUNCHED A NEW ANTIMICROBIAL RESISTANCE (AMR) PORTAL, SUPPORTED DEVELOPMENT OF COVID-19 TRACKING AND SENTINEL SURVEILLANCE SYSTEMS, AND SUPPORTED TWO HOSPITALS IN QUALITY IMPROVEMENT IMPLEMENTATION. PATH ALSO ASSESSED VIETNAM'S ANIMAL HEALTH INFORMATION SYSTEM AS WELL AS THE LABORATORY CAPACITY, SPECIMEN REFERRAL, AND SURVEILLANCE SYSTEMS FOR ANIMAL AND HUMAN HEALTH. THROUGH THE FLEMING FUND, WE HELPED STRENGTHEN LABORATORY INFORMATION SYSTEMS AND BIOREPOSITORY MANAGEMENT, SUPPORTED HOSPITALS TO SUBMIT AMR REPORTS, DEVELOPED THE DEPARTMENT OF ANIMAL HEALTH'S AMR E-REPORTING PORTAL, AND ORGANIZED A WHONET WORKSHOP FOR THE DEPARTMENT AND THREE ANIMAL LABORATORIES. FOR COVID-19, PATH AND THE US CDC CONTRIBUTED TO THE NATIONAL GUIDELINES, DEVELOPED AN ONLINE SELF-ASSESSMENT FORM, AND SUPPORTED TRAINING FOR HOSPITALS AND 3,300 HEALTH CARE PROVIDERS. PATH ASSISTED THE MOH WITH COVID-19 VACCINE DEVELOPMENT AND INTRODUCTION EFFORTS AND SUPPORTED THE INTERNATIONAL VACCINE ACCESS CENTER TO PRODUCE COVID-19 VACCINE LOTS FOR USE IN CLINICAL TRIALS. THE USAID HEALTHY MARKETS PROJECT SCALED UP ACCESS TO HIVST AND HIV PREVENTION SERVICES, ENROLLING 6,177 NEW CLIENTS IN PRE-EXPOSURE PROPHYLAXIS AND REACHING MORE THAN 40,700 WITH HIV TESTING. PATH SUPPORTED A $2.5M+ PRIVATE-SECTOR INVESTMENT IN HIV RESPONSE AND BUILT THE CAPACITY AND SUSTAINABILITY OF KEY POPULATION ORGANIZATIONS. PATH ALSO SUPPORTED THE NATIONAL TB PROGRAM TO PILOT STOOL-BASED DIAGNOSIS OF PEDIATRIC TB AND CONSEQUENTLY UPDATE THE NATIONAL PEDIATRIC TB GUIDELINES. (SEE ALSO THE HIV AND TUBERCULOSIS SECTION.) THE INTRODUCING DIGITAL IMMUNIZATION INFORMATION SYSTEMS-EXCHANGE AND LEARNING PROJECT, FUNDED BY THE BILL & MELINDA GATES FOUNDATION, LAUNCHED AN E-LEARNING PLATFORM AND E-IMMUNIZATION CARD SYSTEM IN HANOI AND SON LA AND HELPED THE NATIONAL EXPANDED PROGRAM ON IMMUNIZATION TRANSITION TO PAPERLESS IN FOUR PROVINCES. FINALLY, TO COMBAT MALARIA, PATH CONDUCTED OPERATIONAL RESEARCH IN VIETNAM THAT PROVIDED EVIDENCE FOR ADOPTION OF G6PD TESTING. |
| FORM 990, PART III, LINE 4C, DESCRIPTION OF PROGRAM SERVICE: |
WORK CONTINUED ON THE DATA USE PARTNERSHIP (DUP), WHICH SUPPORTS THE GOVERNMENT OF TANZANIA TO IMPROVE ITS HEALTH INFORMATION SYSTEMS. IN 2020, DUP REFRESHED THE TANZANIA DIGITAL HEALTH INVESTMENT ROAD MAP AND RECEIVED APPROVAL FOR THE COUNTRY'S NEW CENTRE FOR DIGITAL HEALTH. DUP ALSO FINALIZED THE TANZANIA HEALTH ENTERPRISE ARCHITECTURE, A BLUEPRINT FOR IDENTIFYING AND ALIGNING IMPORTANT INTERRELATIONSHIPS BETWEEN THE COUNTRY'S DIGITAL SYSTEMS TO AVOID FRAGMENTATION, DUPLICATION, AND LACK OF INTEROPERABILITY. PATH BEGAN A NEW PROJECT, DATA USE ACCELERATION AND LEARNING, TO DOCUMENT AND AMPLIFY LEARNINGS FROM FIVE FOCAL COUNTRIES DIGITALIZING THEIR HEALTH SYSTEMS. THE INFORMATION WILL SUPPORT GOVERNMENTS, IMPLEMENTERS, POLICYMAKERS, AND FUNDERS AS THEY SHIFT THEIR FINANCING, GUIDANCE, AND PROGRAMMATIC APPROACHES TO IMPROVE THE USE OF DATA. PATH ALSO LAUNCHED THE HEALTH INSIGHT PLATFORM, A NEW DATA ANALYTICS AND VISUALIZATION SERVICE THAT USES BEST-IN-CLASS TOOLS TO ADVANCE DATA USE. LAST, PATH INCREASED PARTICIPATION IN HIGH-LEVEL COALITIONS, INCLUDING TRANSFORM HEALTH, THE LANCET/FINANCIAL TIMES JOINT COMMISSION ON GOVERNING HEALTH FUTURES 2030, AND THE DIGITAL CONNECTED CARE COALITION. |
| FORM 990, PART VI, SECTION B, LINE 11B |
THE FORM 990 WAS PREPARED BY AN OUTSIDE ACCOUNTING FIRM USING INFORMATION PROVIDED BY PATH ACCOUNTING SERVICES STAFF. PATH SENIOR MANAGEMENT REVIEWED THE DRAFT FORM. A COPY OF THE DRAFT WAS SENT TO THE BOARD OF DIRECTORS FOR COMMENT. AFTER THE COMMENT PERIOD, THE PRINCIPAL FINANCIAL OFFICER SIGNED THE FORM. |
| FORM 990, PART VI, SECTION B, LINE 12C |
PATH HAS POLICIES AND PROCEDURES TO ADDRESS CONFLICTS OF INTEREST. PATH MANAGEMENT AND ALL STAFF AT A DESIGNATED LEVEL OR HIGHER WITHIN THE ORGANIZATION MUST COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM EACH YEAR. ALL FORMS ARE REVIEWED AND KEPT ON FILE. A CONFLICT MANAGEMENT PLAN IS DEVELOPED FOR ANY EMPLOYEE WITH A SIGNIFICANT ACTUAL OR PERCEIVED CONFLICT OF INTEREST. PATH ALSO HAS A WELL-DEFINED PROCEDURE FOR IDENTIFYING AND REPORTING ACTUAL AND POTENTIAL CONFLICTS OF INTEREST AMONG BOARD MEMBERS. NEW BOARD MEMBERS ARE ASKED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM WITHIN 30 DAYS OF JOINING THE BOARD AND TO COMPLETE A NEW FORM ANNUALLY THEREAFTER. IN ADDITION, MEMBERS ARE REMINDED TO REPORT ANY NEW ISSUES THAT ARISE OUTSIDE OF THE ANNUAL DISCLOSURE PERIOD. THE DISCLOSURE FORMS ARE REVIEWED BY PATH'S GENERAL COUNSEL, AND IF ANY ACTUAL OR POTENTIAL CONFLICTS ARE IDENTIFIED, GENERAL COUNSEL MAKES A RECOMMENDATION TO THE CHAIR OF THE GOVERNANCE COMMITTEE AND THE CHAIR OF THE BOARD FOR A MANAGEMENT PLAN TO PROPERLY MANAGE ANY CONFLICTS. A FORMAL MANAGEMENT PLAN IS THEN AGREED UPON WITH THE BOARD MEMBER, AND THE ENTIRE BOARD OF DIRECTORS IS INFORMED AT THE NEXT REGULARLY SCHEDULED BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 15 |
THE BOARD'S EXECUTIVE COMPENSATION COMMITTEE ANNUALLY REVIEWS SALARIES AND BENEFITS FOR EXECUTIVE EMPLOYEE POSITIONS AND PROVIDES GUIDANCE TO THE PRESIDENT/CHIEF EXECUTIVE OFFICER (CEO) ON COMPENSATION DECISIONS FOR EXECUTIVE POSITIONS. THE COMPENSATION AND BENEFITS FOR PATH'S PRESIDENT/CEO ARE REVIEWED AND APPROVED BY THE ENTIRE BOARD OF DIRECTORS EACH YEAR. PATH ROUTINELY USES THE SERVICES OF EXTERNAL FIRMS TO ASSESS AND BENCHMARK EXECUTIVE COMPENSATION (PRESIDENT/CEO, VICE PRESIDENTS, AND EXECUTIVE TEAM MEMBERS). THE MOST RECENT MAJOR REVIEW WAS COMPLETED BY THE BOARD COMPENSATION COMMITTEE IN 2020. AT THE REQUEST OF THE BOARD, PATH ENGAGED MERCER (A COMPENSATION, BENEFITS, AND HUMAN RESOURCES CONSULTING FIRM) TO REVIEW CURRENT AND PROPOSED BASE SALARIES OF PATH'S PRESIDENT/CEO AND EXECUTIVE TEAM MEMBERS. MERCER USED DATA FROM MULTIPLE SOURCES TO EVALUATE CURRENT AND PROPOSED BASE SALARIES FOR THESE POSITIONS. THE BOARD'S EXECUTIVE COMPENSATION COMMITTEE REVIEWED THE MERCER REPORT AND APPROVED THE USE OF THE REPORT TO ESTABLISH A FRAMEWORK WITHIN WHICH THE PRESIDENT/CEO IS DELEGATED AUTHORITY TO ESTABLISH THE TOTAL COMPENSATION PACKAGES OF THE EXECUTIVE TEAM MEMBERS. ADDITIONALLY, MERCER REVIEWED THE PROPOSED TOTAL COMPENSATION AND BENEFITS PACKAGE FOR THE PRESIDENT/CEO POSITION AND OBTAINED A SIGNIFICANT NUMBER OF DATA POINTS TO ASCERTAIN ITS REASONABLENESS AND APPROPRIATENESS. THE BOARD APPROVED THE COMMITTEE'S RECOMMENDATION FOR THE PRESIDENT/CEO'S TOTAL COMPENSATION PACKAGE. |
| FORM 990, PART VI, SECTION C, LINE 19 |
PATH GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST; MOST DOCUMENTS ARE ALSO AVAILABLE ONLINE. |
Attach to Form 990 or 990-EZ.