2016Annual Report

2   |   B A S I C H E A L T H I N T E R N A T I O N A L | B A S I C H E A L T H . O R G  

SCREEN.

TREAT.

CURE.

There is no reason for a woman to die from cervical cancer. It is the goal of BHI to create a

sustainable model for cervical cancer screening and treatment in low-resource countries by training local health professionals, treating

patients, publishing best practices research, and contributing to policy reform that supports

screening efforts.

O U R M I S S I O N : T O E R A D I C A T E C E R V I C A L

C A N C E R

  |   32 0 1 6   A N N U A L R E P O R T

2016 was a landmark year in which we achieved several 

extraordinary goals. Our five-year Cervical Cancer Prevention in El

Salvador (CAPE) implementation project concluded after

introducing low-cost HPV testing throughout the Paracentral

region. As a result of this project’s success, the Salvadoran Ministry

of Health is acting to secure funds to procure low-cost HPV tests

and scale the project nationally, which is expected to start in

2017. In addition, as Principal Investigator of an ambitious cervical

pre-cancer treatment study being implemented through BHI as a

subcontractor to the Cleveland Clinic, I was awarded the second

phase of competitive funding from the National Institutes of Health

(NIH).  

More than 28,000 women were screened for HPV during the three

phases  of the CAPE project. In conjunction with the scale-up of this

project, we began investigating whether a national screening

program can also include self-sampling with HPV tests—enabling

women to perform the test themselves, thereby preserving privacy

and increasing comfort. CAPE has proved so successful that the

Ministry of Health aims to procure tests and screen at least 80,000

women  by June 2019, with the intention of scaling this program

nationally.  In effect, BHI, in partnership the government of El

Salvador, created health policy that will improve the lives of  

thousands of women and their families. As a medical provider

with over 20 years of  public health experience, I am amazed

and elated by this remarkable  accomplishment.

The cervical pre-cancer treatment study funded by the NIH is

scheduled to begin this year at sites in El Salvador, Peru, and

Colombia.  We will be comparing treatment with gas-based

cryotherapy, the standard cervical pre-cancer treatment,

against the LMIC-adapted CryoPen®, the gasless cryotherapy

system customized for low-resource countries. Additionally,

we continue to work with our Germany-based industry partner

in developing another innovative device, the thermoablator,

which uses heat instead of freezing temperatures to destroy

pre-cancerous cells. We have been invited to present our

cutting-edge research at multiple national and international

forums in recognition of our diligent efforts to improve

screening and treatment.  

Cervical cancer eradication truly is an attainable goal. We at

BHI are incredibly humbled and inspired to participate in this

important work. I wholeheartedly believe that with

persistence, creativity, and cooperation, we can achieve the

dream of a world in which no woman dies from cervical cancer. 

                                             

                                           With gratitude, 

A NOTE FROM MIRIAM B H I F O U N D E R A N D P R E S I D E N T

2016 CONFERENCES PRESENTATIONS AWARDS

B A S I C H E A L T H I N T E R N A T I O N A L | B A S I C H E A L T H . O R G  4 |  

JANUARY • Dr. Cremer and Dr. Masch meet

 with Pink Ribbon Red Ribbon

FEBRUARY

•  BHI co-hosts a  symposium on World Cancer Day in El Salvador with the Salvadoran

Ministry of Health and PAHO.  Representatives from the Bill and Melinda Gates

Foundation, NCI/NIH, IARC, and Harvard University are in attendance

• Dr. Maza presents innovative technologies in cervical cancer prevention at the

Cancer Institute of Mexico  in Queretaro, Mexico

MARCH • Dr. Cremer presents at the Society of

GYN Oncology in San Diego, CA • BHI leads a health delegation to Arcatao,

El Salvador

MAY  • Dr. Cremer and LMIC-Adapted CryoPen

team present at NIH/NCI technologies conference in Washington, D.C.

• Dr. Masch hosts Haiti sans Cervical Cancer (HsCC) Meeting in Washington, D.C.

during ACOG

APRIL  •Dr. Maza attends IDCCP meeting

in  Washington, D.C. • Dr. Cremer participates in a roundtable in Santiago, Chile to help create guidelines for cervical cancer screening in Latin  America

•Dr. Maza and Catherine Platt  conduct an initial needs assessment visit to  Antigua and Barbuda

•Dr. Alfaro presents at the ASCCP meeting in New Orleans, LA 

JUNE • Dr. Maza named a future leader as part of the IARC “50 for 50” Initiative, and presents

at the IARC conference in Lyon, France • Dr. Masch & Dr. Alfaro present at Eurogin

in Salzburg, Austria 

  |   52 0 1 6   A N N U A L R E P O R T

AUGUST •BHI follow-up meeting  with the Governor

 of Antigua and Barbuda • CDC Foundation visits BHI in El Salvador • Nepalese government officials visit BHI in

El Salvador 

OCTOBER  • With the help of our many generous

donors, BHI raises over $60,000 during the Revlon ‘Love is On’ Challenge

• Dr. Maza attends Cancer Prevention and Control in the Americas Summit in

Panama 

NOVEMBER • As a past UICC Young Leader, Dr. Maza is invited

to the World Cancer Summit  in Paris, France  • Dr. Cremer presents at the IEEE-NIH (Institute for

Electrical and Electronic Engineers) Conference in Cancun, Mexico  

DECEMBER•BHI representatives meet with Joe

McCannon from The Billions Institute for a Strategic Planning Meeting in

NYC   • Dr. Cremer speaks at Case

Western Reserve University for a Global Health Seminar 

SEPTEMBER • Dr. Maza attends the Central AmericanLeadership Forum in Antigua, Guatemala

• Dr. Cremer gives Grand Rounds at Cleveland Clinic Foundation (CCF)

OCTOBER (CONT.) • Dr. Masch presents on clinical experiences with HPV in Austin, TX

• Dr. Masch travels to Haiti to help lay the groundwork for HsCC and to meet with Haitian leaders working in cervical cancer prevention

• Dr. Cremer named as a Top 10  finalist at the Medical Innovation Summit andpresents on a panel at the Cleveland Clinic 

6   |   B A S I C H E A L T H I N T E R N A T I O N A L | B A S I C H E A L T H . O R G  

EMPOWERING WOMEN

9 out of 10 women who die from cervical cancer live in low- and middle-income

countries (LMICs). Where a woman is born should not determine whether she dies

from a preventable and treatable disease.

BHI has been working for over 10 years to change this reality by increasing access to

screening and treatment while involving women in their own healthcare decisions. 

  |   72 0 1 6 A N N U A L R E P O R T

2016 marked the completion of BHI’s 3-phase, 5-year Cervical Cancer Prevention in El Salvador (CAPE) project, in which 28,000 women were enrolled and screened.

One of CAPE's goals is to create a framework for infrastructure that can be replicated in resource-poor countries worldwide. With each successive phase, BHI turned more control over to the Salvadoran Ministry of Health (MOH). We anticipate that by 2019 the MOH will run the program independently of BHI.

This is the first project that has systematically looked into HPV implementation within a public health system to provide decision makers with evidence of its utility. This project has been so successful that the Salvadoran Ministryof Health (MOH) has incorporated the HPV screening 

C E R V I C A L C A N C E R P R E V E N T I O N P R O G R A M I N E L S A L V A D O R ( C A P E )

Dr.  Miriam Cremer with women who have received treatment through BHI programs in El Salvador. 

BHI team member speaks with a woman in her home during the careHPV Self-Collection Project. 

Women who are less likely to visit a clinic to have a pelvic exam are more likely to test positive for HPV.

To better reach this vulnerable population, and to provide women withthe autonomy to have a say in their own healthcare, we launched an HPV self-sampling implementation project in 2016 in partnership with the Rising Tide Foundation (RTF).

The goal is to provide women with an acceptable and effective alternative to having a pelvic exam in a clinic.  By self- collecting a sample in the comfort and safety of their own homes, women 

c a r e H P V S E L F - C O L L E C T I O N P R O J E C T

algorithm into its national cervical cancer screening guidelines. The project has drawn representatives from more than 5 countries and 10 international organizations to our base in El Salvador, demonstrating the global significance and applicabilityof CAPE. 

will retain control of  their own health. Satisfaction with this method will encourage more women to be tested.

Enrollment in the self-collection study is progressing ahead of schedule, and in 2016 more than 1,300 women in El Salvador have successfully self- collected their own HPV samples.  An initial analysis of the results indicates that this form of testing is acceptable to both patients and providers. Importantly, we are reaching higher- risk women since the HPV positivity rate in this population is higher than inthe CAPE study. 

8   |   B A S I C H E A L T H I N T E R N A T I O N A L | B A S I C H E A L T H . O R G  

ADVANCING RESEARCH

Standard treatment for cervical precancer in the U.S. is oftentimes not feasible

or accessible for use in low-resource settings. To reach the most vulnerable

populations, treatment devices must be developed with the unique resources

and challenges of these areas in mind. 

By increasing cost-effectiveness and designing for greater mobility and durability of

devices, BHI is dedicated to rectifying unequal access to treatment. 

  |   92 0 1 6   A N N U A L R E P O R T

The LMIC-adapted

CryoPen® is a treatment

device for cervical precancer,

designed especially for use in

low-resource settings

In 2016, BHI, as a

subcontractor to the Cleveland

Clinic, completed Year 2 of our

grant from the NIH to fund the

device's development

The success of the first phase

of our research led to an

additional $3 million funding in

the competitive reapplication

for this cycle of NIH grants in

October

Initial testing of the device is

promising in terms of efficacy,

while ultimately decreasing

costs and increasing durability 

The WiSAP LMIC-adapted

Thermoablation device uses

heat instead of cold to treat

cervical precancer

It was used frequently in

Europe before alternatives

were introduced into high-

resource settings

We are redesigning

this technology to fit the

demands of use in remote

areas-- making it more

portable, durable, and

economical

Preliminary data on this device

was collected and we are

hoping to initiate a more

comprehensive study in 2017

BHI is sub-contracted on an

NIH grant from MD

Anderson/Rice to test a novel

imaging device

The mobile colposcope, called

the MobileODT, utilizes cell

phones to allow remote health

workers to consult with

specialists

The device also allows women

to see and learn about their

own anatomy, which can allow

for greater patient awareness

and investment in personal

health 

LMIC-ADAPTED

CRYOPEN®

ENSURING TREATMENT FOR ALL WOMEN

REDUCING COSTS AND INCREASING DURABILITY

BRINGING EXPERTISE TO REMOTE AREAS

THERMOABLATIONMOBILE

COLPOSCOPE 

1 0   |   B A S I C H E A L T H I N T E R N A T I O N A L | B A S I C H E A L T H . O R G  

IMPROVING GLOBAL OUTREACH

Ongoing collaborative research in 3 countries

Conferences in 13 countries

Site visits from over 15 international organizations & countries

By creating an expansive global network of people and organizations dedicated to

achieving the same outcome—a world where no woman dies from cervical cancer, a

preventable disease—we are accelerating the translation of research to practical use

in communities around the globe. 

2 0 1 6   A N N U A L R E P O R T   | 1 1

Dr. Maza, BHI's Chief Medical Officer, named a Future Leader as

part of the International Agency for Research on Cancer's

(IARC's) "50 for 50" Initiative

BHI invited by the CDC Foundation to collaborate on the

IDCCP's (Improving Data for Decision-Making in Global Cervical

Cancer Programs) toolkits to include HPV Indicators 

BHI and El Salvador's Ministry of Health co-sponsored a

symposium on World Cancer Day, titled "Unamonos Contra el

Cancer: Tu Puedes, Nosotros Podemos" ("Let's Join Together

Against Cancer: You Can, We Can")

BHI awarded grant by the American Society of Cytopathology

(ASC) to devise an advocacy campaign to increase awareness

about cervical cancer and to help reach more women

BHI GLOBAL ACTION:

2016 HIGHLIGHTS

2016  FINANCIALS

1 2 |   B A S I C H E A L T H I N T E R N A T I O N A L | B A S I C H E A L T H . O R G  

REVENUE*

Foundation Contributions      $1,250,000        $1,370,000

Grants and In Kind                             $123,201             $153,908                  Donations

Individual Business                            $188,752                $87,580    Contributions

Interest Income                                               $612                         $546

Total Income                                      $1,562,565        $1,612,034

*Unaudited

Administration                  $226,526            $217,348

Development                      $123,648            $123,908            

Projects                                    $536,990            $449,366

Research                                 $600,479            $772,586

Patient Care                            $69,837               $43,413

Total Expenses              $1,557,480       $1,606,621

*Unaudited

EXPENSES* 2015         2016

2015         2016

48%

28%

3% 14%

8%

RESEARCH           PROJECTS          ADMINISTRATION

                DEVELOPMENT              PATIENT CARE *

2016 EXPENSES

*BHI has a global public health mission, however we occasionally provide individual patient care. 

  |   1 32 0 1 6   A N N U A L R E P O R T

BASIC HEALTH INTERNATIONAL, INC.

BOARD OF DIRECTORS

Joseph Platt, Chair Elizabeth T. Barton

Deepa Desai

Liz Lange Dr. Amy Woolever

ADVISORY BOARD

Dr. Juan Carlos Felix Melissa Rendler-Garcia

Miriam Hess

Wendy Liberante Ricardo Perdomo Dr. Laura Schiller

Einhorn Family Charitable Trust The Rising Tide Foundation

The Platt Family Foundation The Bristol-Myers Squibb Foundation

The Amgen Foundation Lui & Wan Foundation

Goldman Sachs Charitable FundAmazon Smile

The University of Southern California

MANY THANKS TO OUR 2016  INDIVIDUAL DONORS AND FOUNDATION SUPPORT.  YOUR  GENEROUS CONTRIBUTIONS

MAKE OUR WORK POSSIBLE. 

$25,000+ Deepa Desai and

Sumit Raipal

$1000+ Jonathon Beitz

Miriam Cremer and Ian Nixon Sumi Desai Esther Fein

Juan Carlos and Betsy Felix John Gussenhoven

Miriam Hess Wendy Liberante

Catherine Platt Roxane Reardon and Brian

Bolster Jennifer Rothenberg

Laura Schiller

$500+ Elizabeth Barton

Joseph and Susan Browdy Alaska Woman's Cancer Care

Linus Chuang Liz Lange and David Shapiro

Rachel Masch Julia Masch

Dr. Elizabeth Toro Jill Whyte

Amy Woolever and Daniel M. Krainin

$200+

Susan Atkins & Eben Shapiro Joseph and Denise Augello

William and Anne Baretz Sheldon Cremer 

Sloan Maasikas Jason Masch

Mauricio and Michelle Maza Hemant Nayak Sherilyn Sage

Rebecca Schundler Eric Sherman

David, Suzanne and Darren Skolnik

Nikki Zite

$100+ Ilana Addis

Ahmed Shagufta Familia Flores Alfaro 

Christina Arnett Jess Atrio

Sheri Lee Babbio Carol Baretz

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Jillian Garai Lydia Garcia Erica Gibson

Enid Gramazio Ed Grubach

Dawn Harbatkin Mark Hauser

Stanley Hernandez Stephan Hilgers

Heidi Huser Rachel K. Jones

Pakawadee Khovidhunkit Jaime Knopman

Melissa Knorr Liz Landau

Diana Lardy Susanna Mac

Yvette Martas Megan McCarren Christine Navarro

Vanessa O'Connell and Eric Neibart Amy Novatt

Oladoyin Oluwole Paulina Ospina

Ricardo Perdomo Uma Perni

Kameelah Phillips Rebecca Podolsky Tom Randall and

Katrina Armstrong Melissa Rendler-Garcia

Ricardo A. Sagrera Lisa Sampson Lana Selitsky

Samual and Elaine Simon Vanita and Jim Solomon

LaClaire and Bobby Stewart Peg Sullivan

Tim and Maggie Sweeney  

Heather, Terbell, and Mark Wilson

Jeanne Theoharis Mary Jean Uy-Kroh, MD

Philip Weber Rosemary and Jerry Wein

Katharine White Penny White

Anthony and Carole Yates 

$50+ Paula Albertson

Linda and Frank Alexander Katie Bergman Sylvie Blaustein Christy Boraas Sonya Borrero

Dianne and Bruce Braun Raffi Chalian

Karen Clements Danielle Evonich John Fitzgerald

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Matthew Siedhoff Brad Simon

Bill and Judy Simonet Sheila and Lewis  Skolnik

Elana Story Karen Vivo

$10+

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William and Diane Blocker Kimberley Bullard Beverly Craigwell

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