NEW MEXICO

Two Decades of Giving New Mexicans Better Access to Health Care and Education

Photographs © 2011 Barry Staverwww.barrystaver.com303.880.8063

In 2023, Project ECHO in New Mexico led the way in tackling our state’s—and our nation’s—most urgent health and education priorities.

We integrated the latest information on brain injuries, fentanyl and sexually transmitted diseases into multiple ECHO programs, and developed new strategies for improving student outcomes in math and reading. Working on the frontlines, we are helping to ensure every New Mexican has equitable access to best practice health care and education.

While expanding our reach across mental health, maternal and child health, substance-use disorder and more, we bolstered our nationally renowned programs for hepatitis-C treatment, HIV prevention and treatment, diabetes care and others.

Our education programs grew to meet massive demand this year. With 23 new programs, including Structured Literacy and STEM ECHOs, we empowered teachers with tangible resources, a supportive community and expert mentoring.

Woman talking to men in orange jumpsuits.

Building Sustainable, Lifesaving Links for Mothers Across New Mexico

In New Mexico, providing timely, best practice care to pregnant mothers and newborns means we are giving our youngest residents the best chance for a long and healthy life.

As a rural state, with 23 Native American tribes, integrating prenatal care within existing provider care, such as primary care, is critical. It’s just as critical to incorporate awareness of traditional birthing practices, culturally appropriate communication and sensitivity to traumatic experiences within hospital settings.

In 2023, the Improving Perinatal Health ECHO program welcomed a new co-director, Nicolle Gonzales, who brings 12 years of experience working with Native communities. Participants, working in gynecology and primary care across the state, learned lifesaving best practices, such as how to treat substance-use disorder; how to link resources to provide continual care before and after birth; and how to safely treat common risk factors in pregnancy—all within cultural contexts.

United States

Focused on Implementing Long-Term Solutions for the Country’s Most Pressing Problems

Project ECHO remained at the forefront of addressing national health priorities in 2023.

Across the United States, the ECHO Institute and our ECHO partners tackled the opioid epidemic. To provide more comprehensive coverage to patients, we used a combination of state and collaborative regional programming, and partnered with the Center for Disease Control and Prevention.

The ECHO Institute launched the first national Violence Prevention ECHO program to equip clinicians with the communication skills needed to have important, and difficult, conversations about substance use and related issues, including domestic violence, suicidality, loneliness and gun violence.

Project ECHO was also included as a key part of the White House’s proposal for a five-year, $12.3 billion hepatitis-C elimination program. With more than 20 years of experience since our first hepatitis-C ECHO program, the ECHO Institute, and our partners across the United States, stand ready to support the initiative.

Ensuring HIV Infectious Disease Expertise Reaches Rural Providers

What began in 2013 as one ECHO program serving physicians in northwestern New Mexico, the HIV Indian Country ECHO now includes programs in rural and under served urban areas across the country.

Grown from New Mexico’s ongoing partnership with the South Central AIDS Education and Training Center, providers in the HIV ECHO meet monthly to discuss the nuances of HIV care: from how to treat HIV alongside substance-use disorders to providing more aggressive forms of HIV prevention, such as pre- and post-exposure prophylaxis medicines..

With the national HIV treatment guidelines reaching hundreds of pages, ECHO specialists meet an important need by distilling their working knowledge into best practices for providers on the ground, providing a lifeline to busy care providers and their rural patients.

There isn’t any way we could be having this impact—here in northern New Mexico, and in both urban and rural places where our participants are based—without ECHO.”

Dr. Jonathan Iralu

Chief Clinical Consultant for Infectious Diseases, Indian Health Services, Gallup Indian Medical Center, Gallup, New Mexico

AFRICA

Building a Sustainable Network in Africa to Meet Fast-Growing Demand

In 2023, we welcomed Caroline Kisia, our first African executive leader who will spearhead our efforts across the continent.

Our LMIC needs assessment, a collaboration with ministries of health and other ECHO partners, highlighted many shared priorities across countries, including mental health, infection prevention and control, and mortality rates for children under five. In line with those priorities, a large anti-microbial stewardship ECHO program, TEACH AMS, launched in four African countries, with plans for significant expansion in 2024.

The ECHO Institute’s designation as a World Health Organization Collaboration Centre for Digital Learning in Health Emergencies strengthened our partnership with WHO AFRO, its regional office in Africa. Through this initiative, ECHO will support WHO’s ongoing efforts to prepare for, and respond to, disease outbreaks and future health emergencies.

Through all of these initiatives, we continued to deepen our relationships with ministries of health across Africa to co-create scalable and affordable solutions that strengthen health systems and improve lives.

ECHO Model Supports HIV Peer-to-Peer Mentorships

Across Africa, Zvandiri, a nonprofit organization working to connect young people living with HIV with peer counselors, is using the ECHO Model to provide supervision and support to the counselors in their important work.

Zvandiri counselors, who are living with HIV themselves, encourage testing, treatment, and medication adherence, in addition to helping their peers access mental health and social protection services, including food support, as needed. Physical and sexual abuse, neglect and substance use are common topics on these calls.

During the ECHO sessions, the counselors and their supervisors meet with relevant ministry of health clinical staff and district social services officers to make recommendations and connect clients with social services and HIV care.

“They also know [how to identify] signs of malnutrition in children, and when they see one of these things, they know where, and how, to get these young people help,” said Ackim Nkomo, Zvandiri regional coordinator and CATS supervisor.

Every month we talk about challenging situations, including mental health and multiple types of violence. We use ECHO’s case management process to review these cases and solve difficult problems, together.”

Peggy Kuchocha

Nurse and Project Coordinator, Young Mentor Mothers Harare, Zimbabwe

INDIA

Transforming Health Care and Education in the World’s Largest Democracy

Through new and expanding partnerships, a rapidly growing network and innovative programming, ECHO India and the country’s network of ECHO partners are making significant strides toward strengthening its health care systems.

Partnerships with key ministries, universities, state government agencies and national institutions continue to be critical to the adoption and impact of ECHO across the country, including new partnerships with National Health Missions, the All-India Institute of Medical Sciences, and the Nursing Division of Directorate General of Health Services at the Ministry of Health and Family Welfare.

In 2023, these partners expanded mentorship and training to tens of thousands of nurses, community health workers, physicians and other frontline health professionals.

ECHO India also pioneered a nationwide program dedicated to the prevention and control of beta thalassemia and other hemoglobinopathies and expanded the Virtual Tumor Board for Enhanced Cancer Care, bringing together more than 700 oncologists from 270 cancer centers to share knowledge and expert recommendations, setting new standards for advanced oncology care in India.

Reaching Further, Faster with Critical Tuberculosis Treatment in India

Thanks to the results of a successful pilot program, ECHO India partnered with the Ministry of Health and Family Welfare to quickly scale the number of ECHO partners addressing tuberculosis treatment across the country.

This new tuberculosis network is focused on preventative care; slowing the spread of new cases by increasing countrywide contact tracing efforts; and disseminating best practices for difficult-to-treat cases, such as pediatric patients and patients with drug resistance.

Health care providers, including nurses and community health workers, in every state in India now have access to virtual communities of practice, telementoring with experts, and case studies that shorten patient treatment time.

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One expert thought a patient had a drug-resistant case [of tuberculosis], needing yet another treatment. But someone else on our ECHO session said, ‘I think it might be something else: let’s run a CT scan.’ And it was just a cyst.

New things emerge from ECHO when we interact with each other like this.”

Dr. Ravindra Kumar Dewan

Director, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India

Asia-Pacific

Expanding in Asia-Pacific to Serve Some of the World’s Most Remote Communities

People wearing masks and lab coats in a lab.

In 2023, Project ECHO made remarkable progress in the Asia-Pacific region, with significant new government partnerships and the growth of programs addressing critical local priorities in health care.

Vietnam’s Ministry of Health signed a Memorandum of Understanding signaling their intent to launch 100 new ECHO Hubs, addressing cancer and other non-communicable diseases. The agreement with the ECHO Institute was celebrated at a signing ceremony in Hanoi in January 2024.

Indonesia’s Ministry of Health also plans to significantly expand its ECHO footprint by developing programs across the country addressing non-communicable diseases and maternal child health. The Ministry signed an MOU with the ECHO Institute in late 2023.

The region’s ECHO network also saw sustained growth in programs addressing cancer care, cardiology, infectious diseases, and neonatal and maternal health.

A National Effort: Detecting and Treating Breast Cancer Early

Detecting and treating breast cancer while the disease is still in its early stages is key to a patient’s survival. Indonesia’s Dharmais National Cancer Center and its Ministry of Health saw an opportunity to use the ECHO Model to reverse a troubling trend: nationally, 70% of breast cancer cases were discovered when the disease had already advanced to the late stages.

In a pilot ECHO program, frontline workers—community health workers and nurses—across the country’s 17,000 islands were trained on early detection. They also learned how to teach their patients to screen themselves for breast cancer.

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Indonesia is an archipelago; it is impossible, and takes too much time, to bring everyone to Jakarta [for cancer treatment].

But the ECHO Model can reach all of Indonesia. ECHO makes sure people get the right diagnosis earlier, by training all of our health care infrastructure: doctors as well as community health workers and nurses.”

Nisa Wayhuni

Program Coordinator, ECHO Dharmais Cancer Center
Jakarta, Indonesia

Latin America

Expanding ECHO’s Reach in Latin America Through New Programs and Partnerships

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Project ECHO celebrated its eighth anniversary in Latin America in 2022, as the region continues to add ECHO Hubs and programs to address its health priorities. La Universidad de la República, in Uruguay, came on board in 2015 with its Frequent Hematology Consultations ECHO. Today, it has become a Superhub and expanded to more than 23 programs. Increasing local and regional leadership, Project ECHO also welcomed CEDIA, the Ecuadorian Corporation for the Development of Research and Academia, as a Superhub this year, joining the Instituto Nacional de Salud in El Salvador and the Fundación Carlos Slim in Mexico. These key partners will foster culturally responsive growth throughout the region as they train and support new ECHO partners.

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Collaborative decision-making, among a group of experts, brings peace of mind, satisfaction and support to providers who may feel isolated, especially in rural areas.”

Dr. Josefina Pagés

Hepatology, Hospital Universitario Austral
Buenos Aires, Argentina

Expanding Mental Health Care in Colombia

Across Latin America, behavioral health, including mental health and substance-use disorders, have historically been deprioritized. In Colombia, a Project ECHO program is working to make a change in one of the country’s most rural regions.

In Chocó and La Guajira, where only two mental health facilities exist, ECHO is used to train primary care providers how to diagnose and treat patients in need of mental health, neurological and substance-use care.

Based on the World Health Organization’s Mental Health Gap Action Program, aimed at strengthening mental health access in low- and middle-income countries, this ECHO program is an important collaboration between the Pan American Health Organization, the Ministry of Health and the national technology and research network (RENATA).

Emergency Preparedness and Response

Managing Global Health Emergencies

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The trusted human networks ECHO and our partners built in response to COVID-19 have proven to be infinitely flexible and expandable, making the ECHO Model a go-to solution for emergency preparedness and response worldwide. In 2023, ECHO was used to bring just-in-time information to frontline responders in multiple global emergencies—from disease outbreaks to military conflict.

Based on that expertise, ECHO was designated as the first World Health Organization Collaborating Centre for Digital Learning in Health Emergencies. Designed to build capacity for emergency response for WHO’s headquarters, regions, countries, and special units, this Collaborating Centre will enable WHO to leverage Project ECHO’s digital learning expertise to strengthen public health emergency preparedness and response workforce capacity, helping WHO member states prepare for new global health emergencies.

Trauma ECHO Program Offers Urgent, Lifesaving Training in a Civil War

When the civil war erupted in Sudan in April 2023, the Sudanese American Medical Association turned to existing Project ECHO program infrastructure from COVID response programs to create an emergency medical program, the Trauma ECHO. With a team based partially in Egypt and partially in Sudan, the Trauma ECHO meets every other week to connect care providers on the ground in Sudan with global experts such as vascular surgeons and emergency medicine professionals provide urgent solutions to traumatic injury management, filling a critical skills gap and helping their country heal.

Our medical training in Sudan does not include traumatic injury management, which is what we needed with the war. We were able to quickly launch this ECHO, even with part of our team isolated in Egypt, in order to meet the emergency need.”

Mohamed Almahal

Director of Humanitarian Relief, Trauma ECHO Program,
Sudanese-American Medical Association
Cairo, Egypt

Gender Equity

An Amplified Focus on Women and Girls

After establishing gender equity as a strategic priority for 2023 and beyond, Project ECHO formed a global Gender Equity Coordinating Group to lay the groundwork for this critical area of focus, with participation from experts around the globe. ECHO established four key priorities, including improving the health of women and girls through their lifespan; enhancing the livelihoods of women in the workforce; and supporting the existing 500+ ECHO programs and 300+ organizations that are improving health and education for women and girls.

To that end, we developed the Project ECHO Gender Equity Collaborative to provide support, inspiration and community to ECHO partners as they work to create gender-equity informed ECHO programs. Our group of experts also worked closely with many program leaders to begin integrating gender equity principles and concepts in their ECHO programs.

Indian Nonprofit Expands Gender Equity Reach

Led by a mother-daughter doctor team, the nonprofit Every Infant Matters teaches local health workers, health providers, and other community members how to amplify prenatal care and medicine distribution.

Its flagship project was preventing blindness by dispensing Vitamin A to malnourished and marginalized children. The World Economic Forum, the Gates Foundation, and others have recognized their impact.

Every Infant Matters has since expanded its training to include holistic health, prenatal care, and gender equity. Its footprint has grown, too. Using the ECHO Model, the nonprofit is now working in the Philippines, Dominican Republic, Nigeria, and Kenya, as well as in India’s most rural regions and tribal populations.

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I created this ECHO to really talk about best practices in caring for adolescents: how to take a sexual history; how to screen for sexually transmitted diseases and discuss contraception; and, then, how to manage basic gynecologic issues.

ECHO has so much support for us and an incredible network. This is the work that makes a difference for gender equity.”

Dr. Eliza Buyers

Director, ECHO Colorado Adolescent Reproductive Health Program
Boulder, Colorado

Infectious Diseases

Uniquely Positioned to Prevent, Screen and Treat in the Global South

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With a greatly expanded network established at the start of the COVID-19 pandemic, Project ECHO is uniquely positioned to support health care systems worldwide as they address the impacts of Long COVID, and prevent, screen for and treat infectious diseases, including tuberculosis and HIV – disease priorities identified by our partners in the Low- and Middle-Income Countries Needs Assessment.

To train clinicians on best practice care for patients with Long COVID, the ECHO Institute launched a global ECHO program, reaching health care providers in 133 countries, as well as a program focused on providers in the United States.

More nationally and locally focused Long COVID ECHO programs launched in India, Uruguay, El Salvador, Zambia, the Democratic Republic of the Congo and Cote d’Ivoire. These programs were created by ECHO partners to deliver locally relevant expertise.

Antimicrobial stewardship is a key factor in disease prevention and control. This year, the ECHO Institute played a key role in the TEACH AMS initiative (Telementoring, Equity, and Advocacy Collaboration for Health through Antimicrobial Stewardship), supporting partners as they launched national programs and by developing a 25-module, open-source core curriculum in partnership with the American Society for Microbiology.

ECHO India Amplifies Tuberculosis Treatment Capacity for Vulnerable Populations

Women and children experience 45% of tuberculosis cases in India, but are some of the patients least likely to receive treatment because of financial barriers. The ECHO Model is reaching health care workers in every state of India, expanding access to treatment options, and setting up best-practice care that includes contact tracing and referral networks to ensure patients receive an initial diagnosis as well as follow-up care.

“Now, at these health care facilities all over the country, there is an expert, and there is also outreach to the community for contact tracing, even for people who might not come in for care,” said Dr. Mahesh Gorla, an assistant professor of pediatrics and a pediatric tuberculosis expert with ECHO India.

Thanks to the ECHO Model, these health care providers—community health workers, nurses, and doctors—now have access to a wide range of experts and case presentations. During their ECHO sessions, they can troubleshoot difficult or nuanced cases, such pediatric or drug-resistant cases.

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It was 15 years back when we made our first task force to get all of us working together on a common platform to find a solution for tuberculosis in India. And ECHO has provided us that platform to bridge [the] gap. I can hardly think of a better opportunity or collaborative experience than we’ve had with ECHO.”

Dr. Anil Jacob Purty

Professor of Community Medicine, Pondicherry Institute of Medical Sciences
Pondicherry, Puducherry, India

Non-Communicable Diseases

Systemic Interventions for Best Practice Care

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With our network of ECHO partners, we are working to expand access to best practice care across the Global South and in underserved communities worldwide where the burden of non-communicable diseases falls most heavily.

New partnerships with ministries of health in Vietnam and Indonesia opened opportunities to bring screening and treatment for cancer and other NCDs to millions of people going without care. This year also saw significant new adoption and expansion of ECHO Programs for cancers that primarily impact women and girls.

In late 2023, the ECHO Institute received an award from the Patient-Centered Outcomes Research Institute to manage a multi-year randomized control trial to study the effectiveness of the ECHO Model in improving outcomes for patients with diabetes. This research will be critical to highlighting the effectiveness of the ECHO Model for improving patient outcomes in the years to come.

With rural patients at a much higher risk of late diagnosis or mortality from noncommunicable diseases, the ECHO Model continues to demonstrate systemic interventions in providing best practice care, at the right time, for underserved populations.

ECHO India Amplifies Mental Health Training for Health Workers

In October 2023, ECHO India supported the launch of a new ECHO partner, the Institute of Mental Health, which is focused on integrating mental health topics into existing ECHO Hubs and programs, as well as creating new programs.

Access to mental health care in India has many barriers, including not enough available providers: countrywide, there is only one psychiatrist per 125,000 people. Patients pay 65% of health care costs out-of-pocket, so many people cannot afford care, especially specialized care.

The Institute of Mental Health is focused on empowering local and rural community health workers and nurses, especially in the remote areas of northern India, to be able to provide basic mental health treatment and know when, and how, to refer patients to specialists.

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This collaborative program with ECHO India is a step in the right direction, equipping our health care workforce with the knowledge and skills needed to provide effective mental health care.”

Dr. Deepika Khakha

Nursing Advisor, Directorate General of Health Services, Ministry of Health and Family Welfare
New Delhi, India

Education

Fostering Gender Equality in the Classroom

Women and girls make up half the population of the world, which also means half of the world’s potential. As a step toward fostering gender equality, ECHO India is laying the groundwork for Gender Equity ECHO programs that support educators in becoming agents of change for gender equality in their schools, families and communities. A teacher’s beliefs, attitude and expertise can impact students’ behavior, empowering them to create gender-inclusive classrooms and promote an equitable atmosphere.

The program focuses on six core areas: awareness, critical dialogue, structural bias, gender in the media, the gender lens and empowerment. By reaching young people as their attitudes are just beginning to take shape, ECHO for Gender Equity is working to build sustainable gender equity across India. By supporting educators as they implement gender sensitization in classrooms, this program will help ensure that student has the tools to reach their full potential.

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A Momentous MetaECHO

Welcoming our partners for the first in-person global event since the pandemic, more than 1,000 ECHO leaders and organizers joined us in Albuquerque, New Mexico, for four days of impactful, actionable discussions, expert speakers, and community-building at the 2023 MetaECHO Conference in September.

Keynote speeches and plenary talks generated conversation around the key levers for changing our world: transformative solutions for mental health; visionary perspectives on gender equity; the latest best practices in crisis response; and a new vision for ECHO to have greater impact beyond health care.

The conference, above all, was a chance for the global ECHO community to share ideas, develop new collaborations and return to their work, inspired.

We look forward to continued momentum, and connections, at our next conference in 2025.

Support Project ECHO

How ECHO Works

Message from Dr. Arora

Dear Friends,

When we first developed the ECHO Model in 2003, I couldn’t have imagined the catalytic power Project ECHO would unleash.

Starting with a single hepatitis-C program, today more than 1,200 partners are running ECHO programs with attendees in nearly 200 countries. More than 2 million people have attended ECHO sessions, and more than 500 peer-reviewed articles demonstrating ECHO’s efficacy have been published. We estimate, conservatively, that more than 200 million patients around the world have benefited.

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.

As we take a bold step on our journey to bring best practices to everyone in need, I invite you to work with us and join the global community working to secure the SDGs by 2030. Together, we
can make a meaningful difference.

Warm regards,
Sanjeev

ECHO Supports United Nations Sustainable Development Goals

ECHO by the Numbers 2023

1,044,084 ECHO Session Attendances

220 ECHO Hubs Launched + 2 Superhubs

1,275
New ECHO Programs Launched

58New Peer-Reviewed Publications Validating the ECHO Model

ECHO ATTENDANCES

*Data may vary year to year based on manual reconciliation between collection platforms

Project ECHO’s unique model is impacting millions of people around the world and has the potential to improve the health and well-being of billions more – quickly, at scale, and at very low cost. We’re proud to support Project ECHO and invite you to join the journey ahead.”

Rohini and Nandan Nilekani

Nilekani Philanthropies, Bangalore, India

ECHO Around the World

global map showing ECHO attendances and global hub and superhub locations

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New Mexico

Tackling Our State’s Most Urgent Health and Education Priorities

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United States

Working Toward Systems-Change for Sustainable Impact

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Global South: Local Leaders Creating Change

2023: A year of committed progress

As health care systems in low- and middle-income countries, particularly in the Global South, build back from the COVID-19 pandemic, they face significant challenges —many of which cannot be solved without growing and strengthening the health care workforce.

We worked with ECHO partners, ministries of health and other key constituents in 35 countries to identify the greatest needs and ECHO-focused solutions that can be implemented quickly, cost-effectively and at scale.

Through our collaborative approach, we produced a report highlighting dozens of ready-made solutions for some of the world’s most challenging problems.

Read the Report

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Africa

Co-Creating Scalable and Affordable Solutions

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India

Strengthening Health Care Systems Since 2008

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Asia-Pacific

Impact at Scale Through Government Partnerships

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Latin America

Local Leaders Paving the Way

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As a WHO Collaborating Centre, Project ECHO’s experience and expertise in delivering complex public health knowledge rapidly, at scale, and at low cost not only helps advance WHO objectives but helps ensure our member states are prepared for the next crisis.”

Heini Utunen

Unit Head, Learning and Capacity Development for Health Emergencies,
World Health Organization
Geneva, Switzerland

ECHO Strategic Initiatives

SYSTEMS FOR CHANGE

Four Cross-Cutting, Impactful Initiatives

Every year, we identify initiatives where we can focus efforts to make the most impact—
whether that’s strategies for partnering with other organizations in particular disease states and practices, or evaluating our own processes to improve outcomes, as we’ve done with gender equity. This year we looked both externally and internally to create greater impact in the some of the world’s most pressing problems.

Learn more about our 2023 strategic initiatives: emergency preparedness and response, gender equity, infectious diseases and noncommunicable diseases.

Emergency Preparedness and Response

Managing Global Health Emergencies

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Gender Equity

An Amplified Focus on Women and Girls

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Infectious Diseases

Uniquely Positioned to Prevent, Screen and Treat in the Global South

Learn More

Non-Communicable Diseases

Systemic Interventions for Best Practice Care

Learn More

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Education

Giving Educators the Tools to Meet Challenges and Build More Equitable Classrooms

To accelerate the global adoption of ECHO for Education programs, the ECHO Institute
launched the Partner Assistance for Launch Support ECHO Program, which helps potential education partners learn the ECHO Model by experiencing it firsthand.

We also held our first-ever education focused partner launch training in French, to better
support new partners in French-speaking Africa and welcomed our first African
education ECHO programs in Nigeria, South Africa and Cote D’Ivoire.

Paving the way for new types of ECHO education programs, our Indian partners
launched the first program devoted to increasing gender equity in middle school
classrooms.

As ECHO for Education continues to evolve, we see significant opportunity to impact
many of the challenges facing governments, school leaders and teachers worldwide –
including literacy, social and emotional learning and early childhood development.

Learn More

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Now I feel confident in my ability to find solutions for struggling readers. It makes a difference – my students have gone from barely writing one or two complete sentences to understanding how to write three-sentence paragraphs.”

Arlene Marquez

Special Education teacher
ECHO participant, Structured Literacy for the Classroom Grants, New Mexico

Research and Evaluation

2023 Research Highlights

The immense body of research highlighting ECHO’s effectiveness for improving outcomes continued to grow in 2023. More ECHO partners in the Global South are producing significant peer-reviewed research publications that illustrate the impact of their work on patients and communities worldwide.

ECHO Providers Successfully Support Rural Diabetic Patients

When looking at the effectiveness of the New Mexico Endocrinology ECHO Program, a weekly telementoring program for primary-care physicians and community health workers in 10 rural clinics, they found patients of the rural ECHO providers experienced positive results: a significantly greater reduction in their average blood sugar level (HbA1c), and they were significantly more likely to achieve a blood sugar level of less than 8% on the A1C test when compared to patients of The University of New Mexico’s Diabetes Specialty Clinic.

Bouchonville et al. (2023)

Leveraging the ECHO Model to Treat Opioid Use Disorder

Buprenorphine is an opioid prescription drug taken as a replacement in the treatment of heroin or other opioid dependence. It is considered particularly useful to expand treatment access, especially in rural areas, because it can be prescribed in a typical office-based setting, rather than inpatient at a hospital.

Six months after participating in the Medication for Opioid Use Disorder ECHO Program, providers who attended more ECHO sessions were significantly more likely to begin prescribing buprenorphine and to prescribe the drug to additional patients than providers who attended fewer ECHO sessions.

Salvador et al. (2023)

ECHO Primary Care Physicians Effectively Diagnose Autism

Diagnosing autism in the primary-care setting may lead to earlier diagnosis and quicker connection to evidence-based therapies and interventions. PCPs trained in diagnosing children through the ECHO Autism STAT (Screening Tool for Autism in Toddlers and Young Children) Program were able to diagnose autism almost as effectively as ASD specialists, with a 95% confirmed diagnosis rate.

Sohl et al. (2023)

Reducing the Mental Health Treatment Gap in Rural India

With the hope of reducing the “treatment gap” for mental health and substance-use disorders in rural India, the National Institute of Mental Health and Neurosciences used the ECHO Model to train community health workers for 18 months on how to identify and provide treatment referrals to individuals in need. The study noted a “significant decrease” in the treatment gap for severe mental health and substance use disorders.

Gakkhar et al. (2023)

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In Indonesia, a country made up of tens of thousands of islands and archipelagos that are spread across thousands of miles of ocean, Project ECHO provides a solution for improving care in the hardest to reach places.
Through our partnership with Project ECHO, we have a solution to accelerate training of thousands of nurses and doctors in best practice cancer care, improving the lives of millions of people in every part of the country.”

Dr. R. Soeko Werdi Nindito D.

President Director, Dharmais National Cancer Center
Jakarta, Indonesia

Funders

2023 Funders

American Society of Addiction Medicine
Association of State and Territorial Health Officials
Board of Trustees of The Leland Stanford Junior University
Bristol Myers Squibb
Bristol Myers Squibb Foundation, Inc.
Centers for Disease Control and Prevention
Chronic Liver Disease Foundation, Inc.
Clinton Health Access Initiative
Dallas County Hospital District
ECMC Foundation
Elizabeth Glaser Pediatric AIDS Foundation
F. Hoffmann-La Roche Ltd
Family Health Centers of San Diego, Inc.
Family Health International
Fort Defiant Indian Hospital Board, Inc.

Foundation for Opioid Response Efforts
GE Foundation
Genentech, Inc
Gilead Sciences, Inc.
HHS Agency for Healthcare Research and Quality
HHS Assistant Secretary for Preparedness and Response
HHS Health Resources and Services Administration
Indian Health Service Navajo Area
JHPIEGO Corporation
Johnson & Johnson Services, Inc.
Laura and John Arnold Foundation
Leona M. and Harry B. Helmsley Charitable Trust
Los Alamos National Laboratory Foundation
Medscape, LLC
Merck Foundation
Ministry of Health of the Republic of Armenia
National Center for Chronic Disease Prev
National Foundation for the Centers for Disease Control and Prevention, Inc.
National Philanthropic Trust
New Mexico Corrections Department
New Mexico Department of Finance & Administration
New Mexico Department of Health
New Mexico Early Childhood Education and Care Department
New Mexico Public Education Department
New Venture Fund
Northwest Portland Area Indian Health Board
Northwest Regional Education Cooperative
Pennsylvania State University
Pfizer, Inc
Regents of the University of California
Reginald S. Lourie Center for Infants and Young Children, Inc.
Robert Wood Johnson Foundation
Schmidt Initiative for Long Covid, LLC
Silicon Valley Community Foundation
Southcentral Foundation
The Audacious Project
The University of New Mexico, College of Population Health
The World Bank
UBS Optimus Foundation
United States Department of Agriculture
United States Department of the Interior
Valhalla Charitable Foundation
W.K. Kellogg Foundation
World Health Organization

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Join Us in Saving and Improving the Lives of Millions Around the World.

Your generosity makes a difference. Join Project ECHO in getting the right knowledge to the right places at the right time so we can bring best-practice health care and education to everyone, helping them achieve their full potential. Backed by a solid body of research, Project ECHO’s potential is unprecedented. Put simply, we are changing the way knowledge is shared to advance human health and well-being. The result looks different in every community, but the impact is always profound.

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With ECHO’s telementoring, a primary care provider at a rural clinic becomes a resource for the other providers and other staff of that clinic. It’s great for a rural system […] that doesn’t have a lot of specialists. These frontline primary folks in a lot of rural, small clinics can have access to real mentoring with ECHO.”

Dr. Alithea Gabrellas

Infectious Disease Specialist, Gallup Indian Medical Center, U.S. Indian Health Service
Gallup, New Mexico

NEW MEXICO

Two Decades of Giving New Mexicans Better Access to Health Care and Education

Building Sustainable, Lifesaving Links for Mothers Across New Mexico

Read more >

United States

Focused on Implementing Long-Term Solutions for the Country’s Most Pressing Problems

Ensuring HIV Infectious Disease Expertise Reaches Rural Providers

AFRICA

Building a Sustainable Network in Africa to Meet Fast-Growing Demand

ECHO Model Supports HIV Peer-to-Peer Mentorships

INDIA

Transforming Health Care and Education in the World’s Largest Democracy

Reaching Further, Faster with Critical Tuberculosis Treatment in India

Asia-Pacific

Expanding in Asia-Pacific to Serve Some of the World’s Most Remote Communities

A National Effort: Detecting and Treating Breast Cancer Early

Latin America

Expanding ECHO’s Reach in Latin America Through New Programs and Partnerships

Expanding Mental Health Care in Colombia

Emergency Preparedness and Response

Managing Global Health Emergencies

Trauma ECHO Program Offers Urgent, Lifesaving Training in a Civil War

Gender Equity

An Amplified Focus on Women and Girls

Indian Nonprofit Expands Gender Equity Reach

Infectious Diseases

Uniquely Positioned to Prevent, Screen and Treat in the Global South

ECHO India Amplifies Tuberculosis Treatment Capacity for Vulnerable Populations

Non-Communicable Diseases

Systemic Interventions for Best Practice Care

ECHO India Amplifies Mental Health Training for Health Workers

Education

Fostering Gender Equality in the Classroom

A Momentous MetaECHO

Message from Dr. Arora

Dear Friends,

ECHO Supports United Nations Sustainable Development Goals

ECHO by the Numbers 2023

ECHO ATTENDANCES

ECHO Around the World

New Mexico

United States

Global South: Local Leaders Creating Change​

2023: A year of committed progress

Africa

India

Asia-Pacific

Latin America

ECHO Strategic Initiatives

SYSTEMS FOR CHANGE

Four Cross-Cutting, Impactful Initiatives

Emergency Preparedness and Response

Gender Equity

Infectious Diseases

Non-Communicable Diseases

Education

Giving Educators the Tools to Meet Challenges and Build More Equitable Classrooms

Research and Evaluation

2023 Research Highlights

ECHO Providers Successfully Support Rural Diabetic Patients

Leveraging the ECHO Model to Treat Opioid Use Disorder

ECHO Primary Care Physicians Effectively Diagnose Autism

Reducing the Mental Health Treatment Gap in Rural India

Funders

2023 Funders

Support Project ECHO

Global South: Local Leaders Creating Change