Today, over 2 million children are marginalized by the devastating consequences of a severe yet preventable disability. Known as clubfoot, it affects 175,000 babies every year, but only 20% of children in low-income countries receive the treatment routinely provided at birth elsewhere. This solvable problem—a root cause of poverty—has fallen through the cracks of global development. A $500 solution changes the course of a child’s life forever, yet no one is funding it at scale. $100 million will mobilize an unprecedented effort to end this historically neglected issue. Over 5 years, we will build national treatment systems in 11 of the highest-need countries, addressing 50% of the world’s clubfoot problem. By creating local capacity in these countries to prevent this extreme disability for years to come and designing a roadmap for other countries to follow, millions of children will have the opportunity to achieve their dreams through lasting mobility.
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Millions of children are growing up with an extreme physical disability – one that occurs universally worldwide but presents a bigger problem in LMICs where treatment is unavailable. This condition known as clubfoot affects 175,000 babies each year, causing one or both feet to twist inward and upward and making it difficult and painful to walk. Many of the 2 million children living with clubfoot today—who could be treated—will endure lifelong stigma, neglect, exclusion, and poverty because of their disability. Although clubfoot is equal in prevalence and consequence to other public health crises, it has fallen through the cracks of global development with no major institutional donor funding the solution at scale. MacArthur would be the first. In wealthy countries, treatment that restores full, lasting mobility is routinely provided at birth. Many people, as a result, do not know that clubfoot is one of the largest causes of disability worldwide. And yet, only 20% of children in LMICs have access to the effective, low-cost treatment capable of radically transforming the trajectory of a life. This inequity is driven by several factors. Many people and lay health workers are unaware clubfoot can be cured, so children are often not referred to treatment. There is a severe shortage of healthcare providers trained to treat clubfoot in LMICs, where 90% of children with clubfoot are born. Low-cost clubfoot braces are largely unavailable, and clinics do not provide the 2-4 year follow-up needed to ensure lasting results. Our solution comprehensively addresses these hurdles.
Our model changes the status quo that is leaving millions of children behind by providing the same life-changing treatment to children in LMICs that is widely available elsewhere. This treatment, the Ponseti method, is extremely effective—restoring full functionality and mobility in 95% of cases through gentle manipulation of the feet, a series of casts, a simple outpatient procedure to release the Achilles tendon, and bracing to prevent relapse. The simplicity of this non-surgical treatment is ideal for low-resource settings, where only basic supplies are needed. For less than $500 per child, a life is radically transformed. MiracleFeet’s health systems strengthening model builds capacity into existing local public health infrastructure across the treatment spectrum: mobilizing midwives, rural health clinics, and front-line health workers for early identification and referral; working with government healthcare providers and hospitals for treatment delivery and follow-up; and integrating training into government medical and physical therapy colleges. MiracleFeet’s rigorously tested suite of innovative technologies support local capacity with an app for monitoring quality, SMS tools for communicating with families, and free braces for all children enrolled. Over a 5-year period, we will resolve this disparity in 11 countries where the demand is greatest, building systems to address over 50% of the burden in LMICs forever. Two external evaluations throughout the project will assess the project against its goal to bring mobility, independence, and opportunity to over 200,000 children, train 1,800 providers, and raise awareness that clubfoot disability is a solvable issue.