Executive Summary

Every year, millions die of treatable diseases like TB, HIV, and hepatitis C. The knowledge and expertise needed to address these and other conditions is not getting from specialists in major medical centers to the rural, underserved, or marginalized patients who need it most. This systemic inequity is compounded by the fact that, in most low- and middle-income countries (LMICs), social determinants of health like education, access to water and sanitation, and food insecurity determine more than half of all health outcomes.

Project ECHO partners with local organizations, institutions, and governments to get health care providers in rural and underserved areas the knowledge, mentorship, and support that they need to provide best-practice care to patients in their own communities. Using simple videoconferencing, the ECHO Model connects remote providers with teams of specialists at academic or other medical centers in ongoing programs for specific diseases, conditions, or pressing health topics. Specialists and local providers collaborate via ongoing telementoring sessions that use case-based learningto find solutions for local health challenges in an all teach, all learn setting. This “drip irrigation” approach not only builds critical expertise; it also creates supportive communities for resource-stretched frontline health care workers.

With a proven track record in reducing health care system inequities, the ECHO Model is now also being used by governments and organizations around the globe to to accelerate progress on the 2030 United Nations Sustainable development goals. In education, ECHO provides a support system for educators, with ECHO sessions that promote equitable learning, improve school-based mental health resources, and provide a platform for education innovation. ECHO Education programs are empowering future generations of decision-makers, advocates, and engaged citizens to build a more equitable world. This same fast, cost-effective and scalable approach is being used to help organizations and governments accelerate their progress toward UNSDGs in other social determinants of health.

We will empower millions of health care workers to bring best-practice care to hundreds of millions of people in the Global South, and enable millions of teachers and education leaders bring education best practices to those countries, helping local organizations and communities reduce inequity and meet UNSDGs by:

1) Supporting our partners in meeting the continuing direct and indirect impacts of infectious diseases, building systems to address maternal and child health, supporting better treatment for non-communicable diseases, and fostering resilience and preparedness for future outbreaks, pandemics and other health crises.

2) Working with ministries of health to leverage the benefits of the ECHO Model to address inequity in the social determinants of health, including education systems, ensuring both girls and boys receive a quality education.

3) Expanding our partner networks and infrastructure in these regions to provide better essential health and education services, respond to future pandemics and emergencies, and build stronger, more sustainable societies.

4) Sustaining our partners for the long term by building evidence for ECHO’s impact, and engaging advocates and policymakers to catalyze governments’ support of their ECHO programs.

By 2030, Project ECHO will provide 2 billion of the most underserved people in the Global South with access to quality services across health and the social determinants of health, substantially improving their lives.

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Accomplishments

In 2023, Project ECHO leveraged massive (5X) pandemic-era growth into a global network of ECHO programs designed to address a wide range of local priorities. Many of these priorities were identified in ECHO’s LMIC Needs Assessment, co-created with ministries of health and other partners in the Global South to provide ECHO partners around the globe with a roadmap for creating their own locally relevant ECHO programs. 

ECHO’s effectiveness as a tool for emergency preparedness and response was proven in this year of horrific global crises. Soon after the 2023 Sudan conflict began, Project ECHO connected Sudanese ECHO networks with global emergency response experts. The resulting program was launched in just four days and features twice-weekly live learning sessions centered on WHO’s Basic Emergency Care curriculum. These virtual trainings have helped tens of thousands of Sudanese health workers acquire new skills in emergency care, trauma, mental health, and infectious diseases. 

Similar programs are taking place throughout Africa, addressing both conflict and infectious disease outbreaks. Late in 2023, Project ECHO launched the first-ever WHO Collaborating Centre for Digital Learning in Public Health Emergencies. 

By the end of 2023, Project ECHO had grown to reach 195 countries with 6,000+ programs and 5 million+ ECHO session attendances.  

COVID-19 Response

Responding to the COVID-19 pandemic fully aligns with Project ECHO’s mission to democratize life-saving medical knowledge and care for rural and underserved populations around the world. Project ECHO is playing a vital role in the global response to COVID-19 by partnering with government, medical, philanthropic, and non-profit organizations to help them amplify and accelerate their response to COVID-19. The ECHO Institute has refocused existing and launched new work in reaction to the pandemic and continues to innovate, adapt, and scale COVID-19 preparedness and response programs for greater use worldwide. Its new goals are: to work with state and local governments on information-sharing and training in best practices for COVID-19 response, including training and delivery for vaccines and treatments as these are developed; launch response programs in Africa and across other lower- and middle-income countries and regions; partner with Ministries of Health at local levels to adapt programming to different contexts and priorities; and launch virtual training and support programs that mitigate travel restrictions.

Racial and Ethnic Injustice Response

Disparities in access to adequate health care are often racial as well as economic and geographical. The COVID-19 pandemic has only underscored how a disproportionate burden of disease and death falls onto racial and ethnic populations who already suffer from chronic conditions we know how to prevent, manage, and cure. Project ECHO’s mission from its very beginnings has been to mitigate health disparities by increasing the capacity of healthcare workers serving these vulnerable populations. The ECHO model creates communities of practice as safe spaces for collaborative learning and problem-solving, in which all teach and all learn. This process is critical to democratizing power relations and ensuring that the voices and experience of marginalized populations are heard and valued.