Advance Access & Delivery (AA&D), 501c3, was founded to address critical challenges in access to medicines and the delivery of comprehensive care, particularly for economically and socially marginalized groups. Initially, AA&D has two primary focus areas.


Focus area 1:
Fighting TB through the Zero TB Initiative &
Zero TB Cities Project. 
The Zero TB Cities Project is a new initiative, formed in 2014 to harness growing momentum behind the idea of bringing the global tuberculosis (TB) epidemic into the elimination phase, with a particular focus on local government participation and catalytic successes in multiple locations. To achieve this goal, the Project acts as a platform for association and mutual assistance between comprehensive programs ambitiously tackling TB in all its forms in specific, geographically designed areas. 

Through this platform, the Zero TB Cities Project:

- Creates and shares new resource streams for new and existing TB programs at key sites.

- Works alongside its partner institutions to build a knowledge-sharing platform on effective methods for diagnosis, prevention, and treatment of TB.

- Supports the creation of innovative partnerships against TB to urgently drive reductions in mortality rates and overall prevalence of the disease.

This initiative is the result of a collaborative research effort funded by Janssen Global, between faculty at the Department of Global Health and Social Medicine at Harvard Medical School, Duke University’s Sanford School of Public Policy and the Duke Center for International Development, alongside resource mobilization by AA&D. This effort is strengthened by collaboration with the Stop TB Partnership in Geneva, Switzerland, housed at UNOPS.  

By implementing a comprehensive set of activities with partner organizations in the first cohort of Zero TB sites over the next three years, the initiative is supporting those who aim to show sharp reductions in tuberculosis deaths and reductions in prevalence rates. This effort will shape an informed, robust global implementation strategy that builds upon the strong evidence base for treating all forms of TB. By bringing new resources to complement significant existing ones, the Zero TB Cities Project is working to shift the global paradigm of care delivery by helping to create “islands of elimination” that cannot be ignored by communities and policy-makers. Zero TB Cities Project sites will help reinvigorate the global TB treatment community’s approach, from gradualist and largely passive enterprise to an ambitious and comprehensive one; to shift from incremental annual improvements to an accelerating global movement for TB elimination. 

Focus Area 2:
Harm reduction policy in the US, and drug access innovations for overdose reversal medication. 

One of the key challenges in the United States today is the epidemic of opioid overdose, compounded by the lack of a comprehensive ability to cope with tragic situation immediately with appropriate care. Today, AA&D is working with partners across the harm reduction community to identify new ways to expand access to the life-saving drug naloxone, and to facilitate its timely and effective use. This off-patent drug is used to reverse the effects of opioid overdose and is remarkably effective, safe and easy to administer. Recent policy changes have made this drug more accessible in terms of the policy environment, but economic and institutional realities keep the drug from being where they need to be, when they need to be there. 

AA&D is working to assist harm reduction efforts by:

- Building an advocacy and safety/harm reduction toolkit for use by the wider community.

- Producing a comprehensive policy analysis in consultation with key stakeholders and community members, mapping out state and federal regulations around naloxone use and distribution and recommendations for a way forward. 

- Hiring training and demonstration experts on safe naloxone use, to work for local organizations in throughout North Carolina, as well as Chicago and New York City.

- Producing analysis of naloxone manufacture and supply chain vulnerabilities that may impact access for those who need it most.

- Building a coalition of city-based advocacy and training groups.