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Archive for the ‘Rare Disorders’ Category

Revenue Diversification

Saturday, December 19th, 2009

The economic downturn that began officially in the Fall of 2007 is slowly coming out of its two-plus year grind in the US.  Among those I’ve had the honor to serve, there are winners and losers during this time. Some clients are stronger and in a better market position and some in weakened positions or gone altogether.

The winners are invariably those with the most diversified revenue streams and a strong commitment to keeping revenues in a balanced proportion.

The best example is Community Anti-Drug Coalitions of America or CADCA .  CADCA was a creation of the George HW Bush administration with funding from the Robert Wood Johnson Foundation and the James S. & John L. Knight Foundations and operated for several years almost exclusively on foundation grants of significant size.  CADCA has grown from a $1.5 million operation in the mid-1990s when I first began working with them to a $9 million national leader in substance abuse prevention and community problem solving.

Led by a team of very capable and experienced senior managers (also a deliberate choice of its Board and Chairman/CEO), CADCA  has seen its reliance on foundation funding drop from 90% of its revenues in 1997 to around 8%. Its unrestricted support is greater than its foundation supports and 80% of its funding comes from training fees, events, state contracts, federal contracts, corporate donations and membership dues.  International programming, new to CADCA at the beginning of the recession in late 2007 is now generating more than 10% of revenues.

Any one of these could diminish and the others are positioned to pick up the slack.  As CADCA re-invests revenues in continually improving its offerings to community leaders, states, federal agencies and supporters, its revenues grow as they sponsor or purchase services.

This financial strength was due to deliberate planning, consistent and focused leadership, experienced and patient senior staff and Board members.  Major General Arthur T. Dean earned much of the credit for his leadership as CEO and Chairman of the last ten years, but it was also the commitment and dedication of several senior managers building their individual units simultaneously that made CADCA’s market leadership possible.

Other organizations can do the same if they commit to an optimal revenue mix and stay true to achieving that mix.  Over-reliance on any one source of revenue in non-profits as in business can lead to very tough times when that one source weakens.

For help in thinking through a plan to achieve optimal revenue mix, please contact Bauler Consulting at 508-405-0308.

Gaucher Initiative at 10: Steadfast in Spite of Controversy

Sunday, August 9th, 2009

It was thrilling to learn from Jack Blanks recently that the Gaucher Initiative lives on 10 years after we brokered the deal that created the partnership between Project Hope and Genzyme.  Genzyme CEO Henri Termeer and Gaucher Initiative manager Tomye Tierney and the dedicated physicians who choose to devote their careers to rare disorders deserve credit and recognition.

Genzyme has long been questioned for the cost of Cerezyme and pilloried for starting patients on treatments with no funding in place to sustain care. It’s been questioned for asking governments to pay for care for a few residents at costs out of proportion with public health needs.

These are very complex issues. Who decides to deny a person - child or adult - treatment for a life-threatening illness? What ethical responsibility do we have to provide treatment? How do you sustain and deliver shareholder value for a business whose mission is to discover, manufacture, sell and distribute life saving therapies? If not Genzyme, then who?

Genzyme’s choice was to confront these questions. Genzyme’s choice was to find a way to deliver care, train practitioners, build markets and keep searching for treatments for rare disorders while big pharma seeks products with huge markets.  This is not to criticize big pharma’s business model - they are fundamentally in a different business.  Where reasonable, they often step up as we see with Merck and Mectizan and with the HIV drugs for which the Clinton folks negotiate.

Congratulations to Genzyme, Project Hope and the experts running the program on ten years.

For more, see: http://harvardbusiness.org/product/genzyme-s-gaucher-initiative-henri-termeer-and-tomye-tierney-video/an/303809-VID-ENG

The Embodiment of Commitment - River Blindness

Tuesday, July 28th, 2009

Opening my recent issue of “Eye of the Eagle” - the Carter Center health newsletter, I became nostalgic for the days in the early 1990s and humbled by the work of my colleagues Dr. Frank Richards, Dr. Donald Hopkins and everyone at the Carter Center involved in its oncherciasis (River Blindness), guinea worm, lymphatic filariasis and other vector borne disease efforts.

They are the genuine embodiment of commitment, leadership and determination for the results they’re delivering in 2009, thirteen years after the Carter Center absorbed the work of the River Blindness Foundation.

In the 11 countries where it operates or oversees Mectizan distribution programs, including those in the Americas, the Carter Center reached 98% of the eligible population in 2008 - some 13.5 million people.

Over 198,000 community level health workers delivered those 13.5 million ivermectin treatments - a virtual army of trained health workers in some of the world’s most remote locations.

When I worked at the River Blindness Foundation in the early 1990s, we thought hitting the 1 million treatment mark was a big deal - and it was.  Today with eonchoceriasis limination achieved in some places, programs ceasing due to no sign of disease and the end in sight for all six countries in the Western Hemisphere in 2012, a global success is at hand.

Commitment, leadership and bravery typify the work in these remote places including hostile areas in the Sudan and Nigeria are the quiet and humble hallmarks of the River Blindness story.

From a very obscure corner of the Internet, I congratulate the Carter Center and am grateful to Frank, Don, President Carter, John Moores and all who followed us at the River Blindness Foundation and continue the success today.

- Bradley C. Bauler, July 2009


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