Adimu Lakini Tutatoboa

Tanzania Human Genetics Organization

We are addressing the critical challenges faced by patients with rare diseases in Tanzania, where timely and accurate diagnosis, effective treatment, and comprehensive care are severely lacking. An estimated 3 million people in Tanzania may be affected by rare diseases, mirroring a global issue impacting over 400 million individuals, with half undiagnosed and an average diagnostic journey of five years.

In Tanzania, limited healthcare resources and infrastructure lead to delayed or incorrect diagnoses and inadequate treatment options. Patients and caregivers face immense emotional, financial, and social burdens, including frequent absences from school or work, high out-of-pocket expenses, and insufficient support systems. Contributing factors include inadequate diagnostic infrastructure, low awareness among healthcare providers, lack of integrated care models, and significant policy and advocacy gaps.

Our solution aims to improve diagnosis and care for rare disease patients by enhancing diagnostic capabilities, raising awareness among healthcare providers, establishing comprehensive care models, and advocating for better policies and support systems.

Our solution, "Adimu Lakini Tutatoboa" (Rare but We Will Succeed), is a comprehensive initiative designed to transform the diagnosis, treatment, and holistic care for patients with rare diseases in Tanzania. Through the Tanzania Human Genome Variation Project, we aim to map the genetic makeup of the Tanzanian population, creating a vital reference dataset that will enable accurate molecular diagnostics and facilitate the development of drug targets and biomarkers for personalized therapeutic interventions.

To further address the challenges faced by patients with rare diseases, we are implementing the Rare Disease Patient Database Project. This project has two primary objectives: to create a comprehensive patient registry of all rare diseases in Tanzania and to perform molecular testing to understand genetic predispositions. These initiatives are essential as over 80% of rare diseases have a genetic basis.

Our approach extends beyond diagnostics to provide holistic care through integrated models that include genetic counseling, mental health support, and physical, occupational, and nutritional therapies. We coordinate the diagnostic process by acting as a bridge between patient groups, hospitals, laboratories, and mental health facilities. THGO partners with major hospitals such as Muhimbili National Hospital, Aga Khan Hospital, and international laboratories, ensuring that patients receive thorough pre-test and post-test counseling and continuous support.

We have successfully seen over 60 patients, provided genetic testing for over 10, and solved about four cases, with several publications underway to report these case studies. Our efforts have been bolstered by partnerships with local and international stakeholders, including patient organizations, universities, and healthcare facilities, ensuring a robust support network for rare disease patients.

Moreover, we engage in high-level advocacy by working directly with policymakers to provide technical recommendations and promote policies that ensure the availability of appropriate services for rare disease patients. We also raise public awareness through campaigns and events like Rare Disease Day, creating a supportive environment for patients and their families.

Looking ahead, our focus includes expanding telemedicine services for remote consultations, enhancing patient registries, and increasing support services for patients and their families. We are also working to engage insurance companies to cover the costs associated with rare diseases, ensuring financial support for patients.

By addressing these critical areas, "Adimu Lakini Tutatoboa" aims to significantly enhance the quality of life for patients with rare diseases in Tanzania, providing them with the comprehensive care and support they need.

Our solution serves patients with rare diseases in Tanzania, along with their caregivers. By improving diagnostic accuracy and speed, we reduce the time and financial burdens associated with lengthy diagnostic journeys. Holistic care models address the clinical, physical, mental, and social needs of patients, significantly enhancing their quality of life. Caregivers benefit from reduced emotional and financial strain, as well as improved support systems. Additionally, our advocacy efforts aim to create a more supportive policy environment, ensuring sustainable improvements in rare disease care.

We selected the Pilot stage because our solution, "Adimu Lakini Tutatoboa," has been launched and is operational in multiple communities in Tanzania, with a particular focus on Dar es Salaam. We have made significant strides in establishing formal diagnostic process guidelines for Tanzania, integrating both private and public healthcare facilities. A key part of our initiative has been the comprehensive training and capacity-building efforts. We have trained over 80 medical doctors and nurses from 20 different hospitals in Dar es Salaam on how to recognize and diagnose rare diseases through specialized workshops. Additionally, we have provided training for nurses in genetic counseling, lab scientists, and bioinformatics professionals.

Our diagnostic process has been trialed in collaboration with over 10 hospitals, involving more than 13 different physician specialties, including pediatrics, oncology, cardiology, neurology, nephrology, emergency medicine, and hearing loss. This collaboration has allowed us to address a wide range of rare diseases and tailor our approach to meet the diverse needs of patients. To date, we have successfully seen over 60 patients, provided genetic testing for over 10 patients, and solved about four cases, with several case studies ready for publication. These efforts have not only improved patient outcomes but also contributed valuable insights to the medical community.

Bringing together various stakeholders has been a cornerstone of our approach. We have recommended policy changes for Tanzania and the SADC region, advocating for better support and resources for rare disease patients. Our advocacy efforts have led to formal engagement with other cities in Tanzania, encouraging them to adopt similar diagnostic and care models. This collaborative approach ensures that our solution is not only effective in Dar es Salaam but also scalable across the country.

Moreover, our holistic care model integrates genetic counseling, mental health support, and physical, occupational, and nutritional therapies, providing comprehensive support to patients and their families. By coordinating the diagnostic process and acting as a bridge between patient groups, hospitals, laboratories, and other facilities, we ensure that patients receive thorough pre-test and post-test counseling and continuous support.

While our solution is still iterating on its design and business model, these initial successes demonstrate our potential for broader impact. We are focused on refining our processes, expanding our reach, and enhancing our support services to better serve the needs of rare disease patients in Tanzania. Through these efforts, we aim to establish a robust and scalable model for rare disease care in Tanzania, ultimately transforming the diagnostic and treatment landscape for these patients.

Our solution, "Adimu Lakini Tutatoboa" (Rare but We Will Succeed), offers an innovative approach to addressing the challenges faced by patients with rare diseases in Tanzania. The core of our innovation lies in combining advanced genomic research, integrated diagnostics, extensive stakeholder engagement, and robust policy advocacy to create a transformative healthcare model.

The diagnostic process is at the heart of our innovation. We have established comprehensive guidelines that integrate both private and public healthcare facilities, standardizing the approach across Tanzania. This includes thorough pre-test and post-test genetic counseling, which enhances diagnostic accuracy and provides crucial emotional support to patients and their families. Additionally, we have trained over 80 medical professionals from 20 hospitals, empowering them to recognize and diagnose rare diseases effectively. This training extends to genetic counselors, lab scientists, and bioinformatics professionals, ensuring a well-rounded and knowledgeable healthcare workforce.

Our stakeholder engagement and policy advocacy efforts further distinguish our solution. We collaborate with over 10 hospitals and more than 13 physician specialties, addressing a wide range of rare diseases, including pediatrics, oncology, cardiology, neurology, nephrology, emergency medicine, and hearing loss. This broad collaboration enhances our diagnostic and treatment capabilities. We have also successfully advocated for policy changes in Tanzania and the SADC region, influencing national health strategies and securing a specific budget for rare disease patients within the Ministry of Health. These efforts ensure sustained support and resources for rare disease care.

Scalability and replicability are integral to our approach. Our success in Dar es Salaam demonstrates the potential for a national model. By engaging other cities and advocating for a national strategy, we aim to replicate our success and catalyze broader positive impacts. We are also exploring telemedicine for remote consultations and expanding patient registries, further enhancing our reach and efficiency, and making advanced care accessible to more patients.

In summary, "Adimu Lakini Tutatoboa" transforms the market landscape by setting a new benchmark for rare disease care in low-resource settings. Our integrated and comprehensive approach not only addresses immediate healthcare challenges but also creates a sustainable model for future interventions. By combining advanced genomic research, extensive training, and strong advocacy, we inspire other organizations to adopt similar approaches, ultimately improving healthcare outcomes for rare disease patients globally. Our solution exemplifies how targeted innovation, coupled with strategic collaboration and advocacy, can drive significant improvements in healthcare, setting the stage for broader adoption and impact in the global health landscape.

We are applying for The Amgen Prize to address several critical barriers that currently hinder the full realization of our solution’s potential and to accelerate our impact on rare disease care in Tanzania. 

One of the most pressing barriers we face is the lack of adequate funding to expand our diagnostic and treatment capabilities. While we have made substantial progress in establishing our initial diagnostic guidelines and training programs, scaling these efforts to a national level requires significant financial investment. The Amgen Prize’s funding would enable us to expand our diagnostic infrastructure and capabilities across more regions in Tanzania, enhance our training programs for healthcare professionals, support the development and implementation of telemedicine services to reach remote and underserved populations, and facilitate the creation and maintenance of comprehensive patient registries and databases.

Our solution relies heavily on advanced genomic technologies and data management systems. However, we face technical challenges in terms of acquiring and integrating the latest technologies and ensuring that our staff are trained to use them effectively. The Amgen Prize can help us by providing access to cutting-edge genomic research tools and technologies, offering technical support and training for our team to stay abreast of the latest developments in genetic research and diagnostics, and helping us enhance our data management systems to handle the increasing volume and complexity of genetic data.

Navigating the regulatory landscape in Tanzania and the broader SADC region can be challenging, particularly when advocating for policy changes and securing approval for new diagnostic and treatment protocols. The Amgen Prize can assist us by providing legal expertise and support to help us navigate regulatory requirements and streamline our advocacy efforts. Additionally, it can offer guidance on best practices for policy engagement and implementation to ensure our recommendations are adopted and enforced.

Building awareness and acceptance of advanced genetic diagnostics and treatments among healthcare providers, patients, and policymakers is essential for our solution’s success. We face cultural and market barriers in terms of skepticism and resistance to change. The Amgen Prize can help us by supporting awareness campaigns to educate healthcare providers, patients, and the public about the importance of genetic diagnostics and personalized medicine. It can also facilitate partnerships with other organizations and stakeholders to strengthen our advocacy efforts and broaden our impact. Furthermore, the prize can provide mentorship and networking opportunities to connect with experts and leaders in the field of rare disease care, helping us refine our strategies and approaches.

In conclusion, The Amgen Prize offers a unique opportunity to overcome the financial, technical, legal, and market barriers we face. With the support and resources provided by the prize, we can significantly enhance our capabilities and expand our impact, ultimately improving the lives of patients with rare diseases in Tanzania. Our goal is to transform the landscape of rare disease care in Tanzania, making advanced diagnostics and personalized treatment accessible to all who need it.

Our team at the Tanzania Human Genetics Organization (THGO) is uniquely positioned to deliver the "Adimu Lakini Tutatoboa" solution due to our deep-rooted connections and understanding of the communities we serve. The team is composed of individuals who are not only experts in their respective fields but also members of the Tanzanian community, giving us an intrinsic understanding of the local context, challenges, and needs of patients with rare diseases.

The Team Lead and many team members have personal and professional ties to the communities in Tanzania, ensuring that our efforts are grounded in local realities. Our proximity to these communities allows us to design and implement solutions that are culturally relevant and practically applicable. We regularly engage with patients, caregivers, and local healthcare providers to gather their input and feedback, ensuring that our initiatives are guided by their experiences and needs. This community-driven approach ensures that our solutions are not only innovative but also deeply aligned with the priorities and preferences of those we aim to serve.

Our team's direct involvement in the community has facilitated strong relationships with local hospitals, healthcare professionals, and patient advocacy groups. These relationships are crucial for effective collaboration and implementation. For instance, our training programs for medical professionals were developed in response to the specific needs expressed by local healthcare providers. This collaborative effort has resulted in over 80 medical professionals from 20 hospitals being trained to recognize and diagnose rare diseases, significantly enhancing the local capacity to manage these conditions.

Additionally, our team includes members who have lived experiences with the healthcare system in Tanzania, either as patients or caregivers. This personal experience provides invaluable insights into the challenges faced by patients with rare diseases and informs our approach to developing patient-centered solutions. By incorporating the perspectives of those directly affected by rare diseases, we ensure that our initiatives are empathetic and tailored to address the real-world issues encountered by patients and their families.

Our extensive stakeholder engagement is another testament to our well-positioned team. We work closely with a wide range of partners, including local and international hospitals, research institutions, and patient organizations. This broad network enables us to leverage diverse expertise and resources, further strengthening our capacity to deliver effective and sustainable solutions. Our successful advocacy efforts, which have led to policy changes and the allocation of a specific budget for rare disease patients within the Ministry of Health, highlight our ability to influence systemic change.

In summary, our team’s deep connections to the Tanzanian community, combined with our professional expertise and personal experiences, uniquely position us to deliver the "Adimu Lakini Tutatoboa" solution effectively. Our community-driven approach ensures that the design and implementation of our initiatives are guided by the input, ideas, and agendas of the people we serve. This alignment with local needs and priorities, coupled with our strong collaborative relationships, empowers us to make a meaningful impact on the lives of patients with rare diseases in Tanzania.

Impact Goals for the Next Year:

In the next year, our goal is to extend our diagnostic services to at least five additional regions in Tanzania. This expansion will involve training an additional 100 healthcare professionals, including doctors, nurses, and lab technicians, in the recognition and diagnosis of rare diseases. By broadening our geographic reach and enhancing local capacity, we aim to provide timely and accurate diagnoses to more patients who currently lack access to specialized care. We will measure our progress by tracking the number of new regions covered, the number of healthcare professionals trained, and the number of new patients diagnosed.

We plan to double the number of patients receiving genetic testing by improving our laboratory infrastructure and establishing new partnerships with local and international laboratories. This will ensure that more patients benefit from advanced genetic diagnostics, leading to more precise and personalized treatment plans. Our progress will be measured by the number of genetic tests conducted, the establishment of new partnerships, and the reduction in turnaround time for test results.

Increasing awareness about rare diseases among communities is a critical goal for the coming year. We will conduct targeted awareness campaigns, including community workshops, radio programs, and distribution of educational materials, to educate the public about the importance of early diagnosis and available resources. These efforts will help reduce stigma and encourage more individuals to seek medical advice. Success will be measured by the reach of our campaigns, the level of community engagement, and the increase in the number of individuals seeking diagnostic services.

Impact Goals for the Next Five Years:
Over the next five years, we aim to scale our diagnostic services nationwide, ensuring that every major region in Tanzania has access to trained healthcare professionals. This will involve ongoing training programs, the establishment of regional diagnostic centers, and continuous support for healthcare workers. We will measure success by the number of regions covered, healthcare professionals continuously trained, and the overall increase in diagnosed cases.

We aim to develop and implement comprehensive support systems for patients with rare diseases, including telemedicine services, genetic counseling, and mental health support. This holistic approach will improve the overall quality of life for patients and their families. Progress will be tracked by the number of patients accessing these services, patient satisfaction levels, and improvements in health outcomes.

A long-term goal is to influence national health policy to better support rare disease patients. We will continue to engage with policymakers, advocate for increased funding, and work towards the integration of rare disease care into the national health agenda. Success indicators will include policy changes enacted, the amount of funding allocated, and the institutionalization of rare disease programs within the health system.

To achieve these goals, we will employ a robust monitoring and evaluation framework. This will include regular data collection and analysis to track progress against our indicators, periodic surveys to assess community awareness and satisfaction, and continuous feedback loops with healthcare providers and patients to refine and improve our interventions.

Theory of Change for "Adimu Lakini Tutatoboa"

Goal:
The ultimate goal of our program, "Adimu Lakini Tutatoboa," is to significantly improve the diagnosis, treatment, and management of rare diseases in Tanzania, thereby enhancing the quality of life for patients and their families. 

Activities:
Our program involves a series of targeted activities designed to achieve our goal. These activities include training healthcare professionals in rare disease recognition and diagnosis, establishing a detailed patient registry, and providing genetic counseling. Additionally, we conduct workshops to educate medical professionals, collaborate with local and international hospitals and laboratories for genetic testing, and engage in public awareness campaigns to educate the community about rare diseases. We also work on policy advocacy to secure better resources and support for rare disease patients.

Outputs:
The immediate outputs of these activities are multifaceted. Firstly, we will see an increase in the number of trained healthcare professionals who can accurately recognize and diagnose rare diseases, which enhances the local capacity to address these conditions. Secondly, the development of a detailed genetic database and patient registry will be crucial for identifying genetic predispositions and managing rare diseases more effectively. Thirdly, our genetic counseling services will provide patients and their families with essential support and information, helping them navigate the complexities of their conditions. Lastly, our advocacy efforts will raise awareness about rare diseases and result in increased policy support and resources dedicated to these patients.

Outcomes:
The short-term outcomes of our program include improved diagnostic accuracy and reduced time to diagnosis for rare disease patients. As more healthcare professionals become adept at identifying these conditions, we expect to see earlier and more accurate diagnoses. Additionally, with the establishment of a genetic database and patient registry, there will be better tracking and management of rare diseases, leading to more personalized and effective treatment plans. Increased awareness and support from our advocacy efforts will also lead to greater community understanding and reduced stigma associated with rare diseases.

Long-Term Impact:
In the long term, our program aims to transform the landscape of rare disease care in Tanzania. By creating a robust and scalable model for rare disease diagnosis and management, we envision a future where patients receive timely, accurate diagnoses and comprehensive care. This will lead to improved health outcomes, enhanced quality of life, and reduced mortality rates for rare disease patients. Additionally, our efforts will contribute to a more informed and supportive healthcare system, capable of addressing the unique challenges posed by rare diseases.

Evidence and Measurement:
To ensure the effectiveness of our program, we will employ a robust monitoring and evaluation framework. This includes regular data collection and analysis to track progress against our indicators, such as the number of healthcare professionals trained, the number of genetic tests conducted, and patient outcomes. We will also conduct periodic surveys to assess community awareness and satisfaction with our services. By continuously gathering and analyzing data, we can refine our strategies and ensure that our program remains responsive to the needs of rare disease patients in Tanzania.

5 members of the executive committee

1 admin secretary

20 members making the research, diagnostic, training and advocacy teams

5 years

At the Tanzania Human Genetics Organization (THGO), we prioritize diversity, equity, and inclusion (DEI) in all aspects of our work. Our commitment to creating a welcoming and inclusive environment for all team members is reflected in our diverse leadership, proactive policies, and ongoing efforts to ensure equitable opportunities.

Diverse Leadership Team
Our leadership team includes individuals from various backgrounds, encompassing genetics, medicine, public health, and community advocacy. This diversity brings a wide range of perspectives and experiences, enriching our decision-making processes and ensuring that our strategies are well-rounded and effective. We have a higher representation of women than men and actively seek to promote women in STEM fields.

Minimizing Barriers to Opportunity
We are dedicated to minimizing barriers to opportunity through inclusive hiring practices and professional development. Our recruitment process is designed to be unbiased and inclusive, with diverse hiring panels and standardized interview questions to reduce unconscious bias. We provide mentorship and career development programs for both students and experienced professionals.

Welcoming and Inclusive Environment
Creating a welcoming environment is central to our organizational culture. We have a zero-tolerance policy for discrimination and harassment, implemented through our operational manual on gender equality and workplace harassment. We strive to make our meeting practices inclusive, allowing everyone to participate fully. We celebrate cultural diversity through various initiatives and events, fostering a sense of belonging among team members.

Goals for Diversity, Equity, and Inclusion
We have set ambitious goals to enhance our diversity, equity, and inclusion. We aim to increase the representation of women and individuals from diverse ethnic and socioeconomic backgrounds in leadership and across the organization. Our outreach efforts to various communities and educational institutions are expanding, and we are creating more pathways for professional development and leadership within THGO.

Commitment to Continuous Improvement
We understand that fostering a diverse, equitable, and inclusive environment is an ongoing process. We continuously seek feedback from our team and stakeholders to improve our practices. By prioritizing DEI, we are not only building a stronger organization but also ensuring that we are better equipped to serve the diverse needs of the rare disease community in Tanzania.

Our services do not distinguish based on background, religion, color, or race, reflecting the rich and diverse population of Tanzania. In conclusion, our commitment to diversity, equity, and inclusion is reflected in our leadership, policies, and everyday practices. We are dedicated to creating an environment where all team members feel respected, supported, and valued, ensuring that we can effectively address the challenges faced by rare disease patients in Tanzania.

Key Resources:

We rely on financial resources, skilled personnel, and strategic partnerships. Our team includes medical professionals, genetic counselors, lab scientists, bioinformatics experts, and advocacy specialists. Additionally, we require advanced genomic testing equipment and robust data management systems. Financial resources are crucial for scaling our operations, conducting training programs, and maintaining our patient registry and database.

Key Activities:
Our primary activities include conducting genomic research, training healthcare professionals, providing genetic counseling, and engaging in public awareness campaigns. We also collaborate with hospitals and laboratories to facilitate accurate and timely genetic testing. Our advocacy efforts focus on influencing health policies to secure better resources and support for rare disease patients. 

Type of Intervention:
Our intervention includes workshops, services, and products. We conduct workshops to train medical professionals on rare disease recognition and diagnosis. Our services include genetic testing, counseling, and patient support. Additionally, we develop educational materials and run awareness campaigns to inform the public about rare diseases.

Segments:
Our key beneficiaries are patients with rare diseases and their families. These individuals benefit directly from our diagnostic and counseling services, which provide them with accurate diagnoses and personalized treatment plans. Healthcare professionals also benefit from our training programs, which enhance their ability to diagnose and treat rare diseases.

Channels:
We reach our beneficiaries through partnerships with hospitals, direct community engagement, and digital platforms. Workshops and training sessions are conducted in collaboration with local healthcare facilities. Public awareness campaigns utilize media channels such as radio, television, and social media to disseminate information widely. Our digital platforms facilitate telemedicine consultations and provide access to educational resources.

Value Proposition:
Our value proposition lies in providing accurate and timely diagnosis, personalized treatment plans, and comprehensive support for patients with rare diseases. By addressing the unique needs of these patients, we improve their quality of life and reduce the burden of rare diseases on their families. For healthcare professionals, we offer valuable training and resources that enhance their clinical practice.

Impact Measures:
We measure our impact through several indicators, including the number of healthcare professionals trained, the number of genetic tests conducted, patient satisfaction levels, and improvements in health outcomes. 

Partners and Key Stakeholders:
We collaborate with a wide range of partners, including local and international hospitals, research institutions, patient advocacy groups, and government agencies. These partnerships are essential for resource sharing, capacity building, and policy advocacy. We also engage with community leaders and organizations to ensure our programs are culturally relevant and widely accepted.

Cost Structure:
Our major expenditure areas include personnel costs, training programs, laboratory operations, and public awareness campaigns. 

Revenue:
Our revenue sources include grants from international organizations, donations from philanthropists, and funding from government programs. We also explore revenue from fee-based services for those who can afford it, ensuring that our services remain accessible to underserved populations.

Surplus:
Any surplus generated is reinvested into expanding our services, improving our infrastructure, and furthering our research initiatives. This ensures that we continuously enhance our capacity to serve patients with rare diseases.

Our plan for financial sustainability relies on a diversified revenue model that combines fundraising campaigns, donations from philanthropists, support from local donors, service contracts, and partnerships with various organizations. This multi-faceted approach ensures that we can cover our expenses while scaling our operations and enhancing our impact on rare disease care in Tanzania.

Fundraising Campaigns:
We conduct regular fundraising campaigns to engage the community and raise funds for our initiatives. These campaigns include events, online crowdfunding, and awareness activities that attract donations from individuals and businesses. By leveraging the power of community support, we generate significant financial resources to sustain our programs.

Donations from Philanthropists and Local Donors:
Philanthropists and local donors play a crucial role in supporting our organization. We have established strong relationships with several key donors who are committed to advancing rare disease care in Tanzania. These donations provide a reliable source of funding for our core activities, including training, genetic testing, and patient support services.

Partnerships with Organizations:
We have secured funding and in-kind support from several organizations, including Illumina, Inqaba Biotech, SCIEX, Africa Biosystems, University of Groningen and Muhimbili University. These partnerships provide us with the necessary resources, such as advanced genetic testing equipment and expertise, to carry out our mission effectively. By collaborating with these organizations, we also gain access to additional funding opportunities and technical support.

Service Contracts:
We engage in service contracts with hospitals, clinics, and research institutions to provide specialized genetic testing and counseling services. These contracts generate revenue that supports our operations and contributes to our financial sustainability. Our partnerships with major hospitals in Tanzania and international laboratories have been instrumental in establishing these service contracts.

Government Support:
While we have not received direct funding from the government of Tanzania for our organization, we have been a catalyst in securing government funding for rare disease patients to access education and hospital care. This advocacy has resulted in tangible benefits for the patient community and has strengthened our reputation as a key player in rare disease care.

Evidence of Success:
Our financial strategy has proven successful to date. We have raised funds through our campaigns and received substantial support from philanthropists, local donors, and partner organizations. For instance, our collaborations with Illumina and Inqaba Biotech have provided us with advanced equipment and financial support. Additionally, our service contracts with hospitals and research institutions have generated steady revenue, enabling us to sustain and expand our operations.

Long-Term Financial Sustainability:
Looking forward, we plan to continue diversifying our revenue streams and expanding our fundraising efforts. We aim to increase the number of service contracts and partnerships, explore new grant opportunities, and enhance our fee-based service offerings. By continuously refining our financial strategy and leveraging our successful track record, we are confident in our ability to achieve long-term financial sustainability and make a lasting impact on the lives of patients with rare diseases in Tanzania.