I’m grateful to everyone who has participated in ECHO sessions, started ECHO programs to solve a problem in their community, and funded this work. It is all of you who have made this impact a reality.

People sometimes ask, what’s so special about the ECHO Model?

At its core, the ECHO Model is a simple but potent recipe for holding an ongoing conversation with a virtual community, using cased-based learning and implementation of best practices as the basis for problem solving and learning. In the beginning, we focused on solving the problems of individual patients—how to reduce their high blood pressure, treat their complex diabetes, or get them appropriate addiction services.

Over time, we have learned that the model works just as well to support systems change, whether that is helping clinics improve patient access to care; HIV programs target outreach; or nursing homes reduce use of anti-psychotics and the spread of infections. In every case, ECHO is ensuring equitable access for all.

Because it’s virtual, the ECHO Model delivers results much more effectively and efficiently than traditional face-to-face trainings, which can be prohibitively expensive. A study by the Kenya Ministry of Health AIDS and STI Control Programme found that, while their traditional in-person trainings cost about $800 per person, ECHO training and mentoring—a low dose, high frequency approach—was far less expensive (at $21 per person), and just as effective.

More than a protocol for creating a robust community of practice, the ECHO Model is based on trust, mutual respect, and—dare I say—love; principles that I believe are core to its power and success.

• ECHO grows out of a core commitment to equity and a culture of co-creation: “all teach, all learn.” Since everyone is learning and sharing together, this culture helps to reduce the hierarchy that can often exist between experts and students.
• The model is based on the fundamental idea that knowledge grows with sharing. Unlike material things, knowledge doesn’t diminish when we give it away. If you share your expertise with me, I am enriched by your knowledge and I can contribute my own background and experiences. By sharing our cumulative knowledge and expertise with each other, our impact grows and we create more contextually relevant solutions.
• As participants become more and more expert over time, they are empowered to act as advocates in their organizations and local communities. We have seen this individual transformation happen again and again, creating agents of change in communities that need timely, relevant and actionable solutions.

Experts around the world use ECHO in creative ways to solve a wide range of challenges. We have seen ECHO programs ranging from addiction to kidney disease, diabetes, and even rare diseases, such as Ehlers-Danlos syndrome.

ECHO programs have also been developed to support schoolteachers, farmers, and even workers building clean water infrastructure. The ECHO Model has proven to be effective in supporting frontline professionals in many different domains, wherever problems are complex and local workers need ongoing guidance and mentorship.

The world is falling short on the 2030 United Nations Sustainable Development Goals.

This past year, our team has been pushed to think deeply about how the ECHO Model might be able to help partners globally reach the UN Sustainable Development Goals—the 17 commitments the global community has made to build a more just and sustainable world by 2030.

As we pass the halfway point for reaching those goals, governments, NGOs and grassroots organizations alike are grappling with how to accelerate and focus those their efforts. What’s on the line is our commitment to billions of those most vulnerable to help raise them out of poverty and provide a better future for their children.

How can the ECHO Model help the global community reach the 2030 goals?

Most ideas worth implementing are complex and need to be adapted to local context, politics, and culture. We believe the ECHO Model provides an effective and adaptable tool to help scale best practice implementation in many areas.

A 2020 study by a leading global consulting firm showed that simply by ensuring that people across the globe had access to the existing best practices, we could reduce the global disease burden by 40% over the next two decades. This is low-hanging fruit and a way we believe Project ECHO can make a huge difference.

We know this is possible because the ECHO Model has been used to quickly scale up and strengthen best practice care, leading to significant increases in the number of people treated and the reduced burden of seemingly intractable diseases.

• When the state of Bihar in India faced a significant and sudden increase in the number of people seeking treatment for alcohol addiction, there were very few trained specialists to address the crisis. After a year of working with India’s National Institute of Mental Health and Neurosciences to train district medical officers on addiction medicine, the 22 district officers who participated in an ECHO program treated more than 23,000 patients, greatly improving access to addiction support across Bihar.
• In Namibia, where HIV/AIDS is a leading cause of death, the Ministry of Health launched ECHO programs across the country to teach nurses, physicians and pharmacists about HIV medications that reduce the risk of transmission, among other topics. Health care professionals’ knowledge on HIV improved, and providers collaborated with peers and asked questions, helping them feel less alone and more confident in their work. To date, more than 140,000 Namibians living with HIV have been impacted by Project ECHO.

Providing a helpful roadmap, the Copenhagen Consensus outlines key strategic interventions the global community can make to optimize our ability to reach key SDGs. For example, with relatively modest additional investment, the global community can greatly expand access to tuberculosis treatment, saving millions of lives.

The ECHO Model can play a key catalytic role in this area—ensuring frontline providers have the latest government protocols for treatment, and the most effective strategies to identify hard-to-reach or difficult-to-treat patients. We are already doing this in India, working with state and national government leaders to scale their programs and train thousands of TB workers across the country.

Education is another area where focused investment on teaching reading and basic math can make a significant difference. Our recent programming in education demonstrates that ECHO’s robust system of ongoing mentorship and support is a cost-effective way to up-skill classroom teachers and administrators. This is critical because we know that teacher quality is key to student success.

Should ECHO reach beyond health care?

Believe me, I have asked myself this question more than once. But, encouraged by friends and mentors, we have become convinced that we can contribute an important voice to the broader SDG conversation and community.