Socios En Salud history

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

1996 - PIH and SES began a joint project to treat drug-resistant TB patients in Carabayllo. Community residents were trained to deliver the complex drug therapies, which include up to seven different antibiotics, in patients' homes. Approximately 50 patients began treatment. This was 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 have completed treatment with a full cure. 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 bear 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.