2022 ANNUAL LETTER

March 2022

Dear Colleague,

Five years ago, I had the great privilege of launching Resolve to Save Lives, incubated at Vital Strategies. We started with a simple question: How do we save the most lives? In just five years, we’ve catalyzed initiatives to save four million lives and helped 15 countries in Africa find and stop outbreaks faster.

Today, we begin a new chapter as an independent, non-profit organization. In our next five years, our heart disease prevention programs will scale up with the goal of saving an additional 10 million lives. Years of in-depth work at local, national, and global levels have made us purpose-built to improve preparedness. RTSL had become a crucial resource in this now-or-never, Covid-created moment to improve global epidemic prevention.

To have the biggest impact, it all starts with one.

The best public health programs learn continuously and rapidly incorporate lessons to increase impact. Events of the past year have reinforced three key insights to me and to the team at RTSL, and will drive our work in the years ahead:

Fast action is crucial.

From measures blunting the impact of Covid to regulations eliminating trans fat, from laboratory improvements to scaling up effective diagnosis and treatment of hypertension, delays are deadly.

Partnerships are powerful.

No organization or institution working alone can make as much progress as a productive partnership. Effective policy recommendations from the World Health Organization (WHO), funding from the World Bank and others, advocacy from civil society, scientific insights and excellence in public health implementation enabled the large-scale progress we describe here.

Effective communication saves lives.

In order to work with communities, engage and strengthen the public’s trust, and demonstrate to policymakers the benefit of public health action, effective communication is essential.

These fundamental concepts informed our work over the past year in our two focus areas: prevention of epidemics and the control of cardiovascular disease.

PREVENT EPIDEMICS

Covid has killed nearly 20 million people worldwide in just over two years. Most of these deaths could have been prevented if governments had supported public health systems and these systems had responded faster and more effectively. RTSL’s Prevent Epidemics team provides financial and technical support to improve Covid response efforts while strengthening preparedness for the next health threat. During the past year, we:

  • Helped catalyze substantial improvements in rapid detection and response in more than 15 countries in Africa.
  • Provided more than $3 million to more than two dozen countries in rapid response funds for rapid detection and control of cases, clusters, and outbreaks. We also continued advocacy for increased and sustainable funding for US and global public health.
  • Coordinated the Partnership for Evidence-Based Response to COVID-19, which helps countries optimize mitigation measures by combining phone surveys with data on epidemiological trends, media insights and population mobility. We also helped launch the Africa CDC Covid dashboard to inform health officials and government leaders on outbreak response, decision-making and planning.
  • Identified 7-1-7 as a global target to find every outbreak within seven days of emergence, report within one day, and begin effective response within seven days. We are working with public health leaders to test this concept in Nigeria, Uganda, and Ethiopia and finding that it not only increases accountability but also enables rapid improvements in prompt detection and response.
  • Launched our Epidemics that Didn’t Happen report, which highlights inspiring stories of countries that prevented epidemics or reduced their impact.
  • Developed and supported an interactive nationwide Covid tracker in partnership with the New York Timesone of the most frequently visited sites during the pandemic. With county-level risk assessments for each of the more than 3,000 US counties, the tracker estimates the severity of local spread based on confirmed case count data in each area.
  • We launched the Voices of Long COVID media campaign to increase public awareness of long Covid and increase vaccine uptake. The campaign was incorporated into the U.S. government’s multimillion-dollar media campaign, We Can Do This on TV, radio, digital, and social media.
  • Supported country-led initiatives to strengthen laboratory networks in 12 countries in Africa serving more than 600 million people – nearly half the population – enabling faster and more reliable testing for Covid and other infections. One example: We worked with a coalition including the Nigeria Centre for Disease Control and Prevention, Gavi, the Vaccine Alliance, and WHO to reduce the time needed to confirm yellow fever from more than 30 days to less than 24 hours, creating a model for rapid improvement in the diagnosis of deadly diseases.

IMPROVE HEART HEALTH

Every year, cardiovascular disease kills more people than all infectious diseases combined and twice as many as Covid at its deadliest. We are making substantial progress eliminating trans fat from the world and improving hypertension control. Trans fat is replaceable by healthier oils: After replacement, only your heart will know the difference.

Nutrition

  • Helped draft, provide evidence for, and enlist support to pass policies to eliminate trans fat in 33 countries covering 2.6 billion people (one third of people in the world). These policies will save close to 3 million lives in the next 25 years.
  • Provided scientific and technical assistance for three important resources from WHO: a public food procurement action frameworksodium scorecard, and global sodium benchmarks. These will help reduce dietary sodium and thereby prevent high blood pressure and heart disease. Public food procurement and service policies ensure that only healthy food is available in public settings, including government buildings, schools, childcare centers, nursing homes, and hospitals.


Hypertension Treatment

  • Served as international technical partner to the impressive India Hypertension Control Initiative (IHCI). During the Covid pandemic, IHCI facilitated door-to-door medication delivery to ensure uninterrupted treatment for patients with high blood pressure, diabetes and other conditions. Despite the pandemic, India reached its Phase 2 goal of expansion to 100 districts covering a total population of more than 250 million people.
  • Scaled up use of our Simple mobile application by frontline healthcare workers. Simple is a free, ultrafast, open-source, user-centered software tool we created to enable health care workers to improve control of blood pressure. As of March 1, 2022, Simple was in use in more than 6,600 health facilities reaching more than 1.7 million patients across India, Bangladesh, Ethiopia, and Sri Lanka. Metadata shows that the average time a healthcare worker needs to enter information for each patient is only 16 seconds, and the app saves nurses an average of 30 minutes every day! We are also adapting Simple to the open-source DHIS2 platform used by more than 60 countries—an initiative that could enable effective information systems for chronic disease control in dozens of countries.
  • Participated in drafting and facilitated the release of WHO’s new Guideline for the Pharmacological Treatment of Hypertension in Adults. This new guideline – the first update in 20 years – recommends what governments, health system managers, and health care workers can do to treat hypertension effectively and reduce the risk of cardiovascular disease and death.


Resolve to Save Lives brings life-saving programs to scale through rigorous science, meticulous management, and focused policy action. None of this progress would have been possible without the generous support of our donors, including: Bloomberg Philanthropies, the Bill and Melinda Gates Foundation, Gates Philanthropy Partners, funded with support from the Chan Zuckerberg Foundation, #StartSmall, and the Stavros Niarchos Foundation. These funders recognize the power of rapid, flexible action to accelerate progress against under-addressed public health threats. For this I am deeply grateful.

In the next year, working with partners, RTSL will:

  • Continue to innovate and deploy effective public health responses to Covid to reduce death, social dislocation, and economic loss.
  • Advance the 7-1-7 target to accelerate progress toward and increase funding and accountability for a world much safer from pandemics.
  • Accelerate the push for global elimination of trans fat—the WHO target for global elimination is 2023!
  • Improve hypertension treatment for more than 10 million patients.
  • Make substantial progress toward sodium intake reduction in at least five countries.
  • Support and build teams among our superb staff so that Resolve to Save Lives continues to be a wonderful organization to work at or with—and that saves millions of lives.
  • Promote justice and inclusion in our staff, our work, and our communities.


The healthier future we envisioned five years ago is taking shape. Our efforts and those of our partners are helping transform possibilities into reality. We are resolved to be a catalyst for a healthier future.

Thank you for being part of creating a healthier world.

Dr. Tom Frieden
President and CEO
Resolve to Save Lives