Socios En Salud history

1994 - At the urging of longtime PIH supporter Father Jack Roussin of the Society of St. James in Boston, PIH teams up with the poor residents of Carabayllo, a shantytown district on the outskirts of Lima, Peru, and creates Socios En Salud (SES). Following the community-based model developed in Haiti, they conduct a community health survey in Carabayllo, discovering persistent barriers to health care. SES begins to fill in those gaps, training residents as community health workers and developing health interventions targeted to community members’ needs.

1996 - PIH and SES begin a joint project to treat drug-resistant TB patients in Carabayllo. Community residents are trained to deliver the complex drug therapies, which include up to seven different antibiotics, in patients' homes. Approximately 50 patients begin treatment. This is the first large-scale treatment of MDR-TB in a poor country. 

1998 - This first group of drug-resistant TB patients in Carabayllo completes the two-year course of treatment. Cure rates approach 83 percent – better than in hospital settings in the U.S. PIH and the affiliated Program in Infectious Disease and Social Change (PIDSC) at Harvard Medical School invite international health experts to Boston to discuss clinical findings from the SES project.

1999 - PIH and SES sponsor the first-ever MDR-TB psychotherapy support group. Led by a psychiatrist, the group integrates specialists, community health workers, patients and their family members in an effort to address the debilitating psychological effects of treatment. These results help convince the World Health Organization to reverse its long-held policies, incorporating PIH’s successful approach into treatment initiatives in more than 30 countries and creating the Green Light Committee to make effective MDR TB treatment available to the poor.

2000 - PIH receives a $22.7 million subcontract as part of a five-year grant to Harvard Medical School from The Bill & Melinda Gates Foundation to fund MDR-TB treatment and research. Under this grant, PIH is able to expand our community-based treatment program throughout Peru and train health personnel from other countries with high rates of MDR-TB (such as Russia, where PIH initiates a pilot project).

2002 - The Bill & Melinda Gates Foundation-supported program has over 800 patients in treatment, integrated in some cases with antiretroviral therapy for HIV. Over 200 patients complete treatment and are fully cured. SES completes its expansion into five districts in Lima. The PIH Electronic Medical Records (EMR) system is implemented in Peru, to assist in monitoring patient data.

2003 - In September, SES enrolls the last of the 1,450 MDR-TB patients under the PARTNERS project. Thereafter, SES begins helping the Ministry of Health enroll an additional 250 MDR TB patients to be supported with resources from the Global Fund. By the end of 2003, more than 1,900 patients have been enrolled, with some 1,000 in active treatment. PIH and SES collaborators publish the treatment outcomes for the first cohort of Peruvian patients in the New England Journal of Medicine. SES and the Peruvian Ministry of Health increase the training of physicians, nurses, and outreach workers throughout Peru. As a result, the SES MDR-TB program expands to five major cities beyond Lima: Ica, Trujillo, Chiclayo, Chimbote and Arequipa.

2004 - Responsibility for MDR-TB patients is officially transferred from SES to the Peruvian Ministry of Health (MINSA). Of the original 1,450 MDR-TB patients treated by SES under the PARTNERS project, only 438 remain on treatment by the end of 2004. SES equips a new distribution center to centralize the management of medicines and supplies and reinforces the infrastructure for specialized DOTS-Plus care and treatment at 60 local health centers where our patients receive their daily morning therapy. The new Lois and Thomas White Community Center in San Gabriel is inaugurated in February 2004.

2005 - As SES completes treatment of the final group of MDR-TB patients enrolled under the PARTNERS project, we scale up training to help the Ministry of Health assume responsibility for new patients. During 2005, SES trains more than 4,000 doctors, nurses, community health workers and patients, including 3,495 Ministry personnel. At the Ministry's request, SES brings its experience in community-based treatment of MDR-TB to boost flagging enrollment and adherence in Peru's national HIV treatment program. After implementing use of paid community health promoters and other key elements of the SES model, the program increases enrollment rates dramatically.

2006 - Nearly 500 MDR-TB patients in Lima are declared completely cured, another 500 are on treatment, and SES begins working with the Ministry to enroll patients in Arequipa, a large southern city. To help improve quality of care for MDR-TB patients, the National TB program begins using the PIH Electronic Medical Records System to track their treatment regimens. SES staff continues to train fellow Peruvian health care professionals in the management of MDR-TB. The program also receives international recognition, responding to requests for trainings from the Haitian Ministry of Health.

2007- 2008 - SES continues to prioritize primary health care, particularly in the shantytowns on the outskirts of Lima. Here, the team is now operating 16 botiquines (small rural health posts) that serve patients who would otherwise have no access to primary care. SES also focuses on breaking the cycle of poverty and disease in this area by implementing a pilot program to improve the academic performance of 70 at-risk and under-performing children. More than three quarters of the enrolled children significantly improve their academics over the course of the year. During this year, SES also begins a collaboration between the Department of Mental Health and the National TB Program to provide mental health services to MDR-TB patients. Through SES's solid collaboration with the National TB Program, the total number of patients receiving ambulatory treatment for MDR-TB since 1996 reaches 10,000 by the end of 2008.

2009 - Peru boasts the highest cure rate for MDR-TB in the world. SES continues to support nearly 1,500 MDR-TB patients, and provides clinical, nutritional and psychosocial support for 1,000 people living with or affected by HIV; launches an effort to increase green spaces and improve air quality in one of the most polluted districts in Lima; and begins the Danos Una Mano (Give Us a Hand) campaign as an attempt to build alliances with businesses, the government, and other organizations to raise money for the fight against drug-resistant tuberculosis. SES also continues its commitment to sharing knowledge and experience, sending a training team to Nicaragua and hosting MDR-TB practitioners from Russia, Pakistan, Azerbaijan and the Unites States. SES also hosts representatives from 19 countries on five continents for the World Health Organization’s third “TB Consultants Course,” marking the first time the course had been conducted in Latin America. SES also organizes a conference on the neuropsychiatric and psychosocial aspects of HIV, with an impressive roster of speakers from Peruvian and international universities.