Explore RunFree2030

What is RunFree2030?

RunFree2030 is Global Clubfoot Initiative’s (GCI) strategy to address the injustice of millions growing up with painful, twisted feet; children who should be able to walk, play and run free.  It is a call to action: let us combine efforts and resources to end this injustice in our lifetime.  It is a roadmap: scaling up a proven set of interventions. And it is achievable: if we work together, all children will run free! 

  • RunFree2030 is Global Clubfoot Initiative’s (GCI) strategy to address the injustice of millions growing up with painful, twisted feet; children who should be able to walk, play and run free.  It is a call to action: let us combine efforts and resources to end this injustice in our lifetime.  It is a roadmap: scaling up a proven set of interventions. And it is achievable: if we work together, all children will run free! 

What is clubfoot?

Clubfoot is one of the most common musculoskeletal birth defects that, when left untreated, leads to pain, difficulty walking, stigma, and exclusion from educational, social, and economic opportunities. It affects nearly 200,000 children nearly every year, most of whom are born in low- and middle-income countries (LMIC)  and unable to access the correct treatment. Because clubfoot treatment is relatively easy, affordable, and highly effective, this does not need to be the case and disability caused by clubfoot is completely preventable.

The impact of untreated clubfoot takes a high toll on babies and children with the disability, as well as their families and society.  Children with clubfoot experience significant stigma from having a visible deformity, with bullying and exclusion from their peer groups.  Because they cannot walk long distances, they often are excluded from education.  

Adults with untreated clubfoot are more likely to experience a life of poverty due to missed education and employment opportunities and the emotional toll from this can lead to mental health challenges, isolation, and relationship breakdowns.

The consequences of clubfoot disability place a heavy burden on society with loss of individual productivity and economic contribution, and additional burden on healthcare and welfare systems. The burden is multiplied each year by the number of children born with clubfoot and it who will live with life-long disability if untreated.   

Who are Global Clubfoot Initiative?

Global Clubfoot Initiative developed and launched RunFree2030 in 2017 with their member network that draws from 50+ national and international NGOs. GCI is a consortium of individuals and organisations with technical and programmatic expertise in clubfoot management and implementing service delivery in low- and middle-income countries (LMIC) and includes parents of children with clubfoot, clinicians, and healthcare advocates.  

Since 2007, our successful implementation model has resulted in over 330,000 children receiving effective treatment with many programs reaching >50% of babies born with clubfoot in their countries. 

In partnership with local authorities, this network ambitiously put RunFree2030 into motion and achieved far more than any one organization could on their own.  

How common is clubfoot?

Clubfoot is a leading cause of disability, affecting 1 in 800 live births with 200,000 babies born globally with clubfoot per year, of which approximately 90% are in LMIC. Given how few babies receive treatment, we believe there to currently be nearly one million individuals living with untreated clubfoot.

What is the current global situation regarding clubfoot?

Key:

  • No evidence of Ponseti

  • Evidence of Ponseti (reported)

  • Evidence of Ponseti (unreported)

  • High income country, or less than 50 expected annual cases

How is clubfoot treated and what is the Ponseti method?

Clubfoot is treated using a minimally invasive approach; the Ponseti method. This method is accepted as the gold standard clubfoot treatment and is endorsed by medical associations such as the American Academy of Orthopaedic Surgeons, British Society of Orthopaedic Surgeons,  and World Health Organisation. 

Treatment involves serial castings over 5-8-weeks, a minor outpatient surgical procedure (Achilles tendon tenotomy) and a foot abduction brace, worn while sleeping for 4-5 years to maintain the correction and reduce risk of relapse.  

Corrected feet have the same movement, function and appearance as unaffected feet and are pain free. Treatment transforms the life of a child born with clubfoot, giving them the opportunity to participate fully in their families and communities, go to school and ultimately secure meaningful employment.   

The Ponseti method is cost efficient, relatively simple to apply and effective in up to 98% of cases, making it well suited to low resource settings.  Treatment is most effective if started in infancy, ideally under 2 years of age. Growing evidence indicates that manipulation and casting can also reduce deformity in older children and limit the extent of invasive surgery as well. The Ponseti method makes it possible to address the problem of clubfoot cost-effectively on a global scale. 

More about RunFree2030

What are the objectives of RunFree2030?

Vision:

Goal:

Objectives:

A world where every child with clubfoot can live to the full and walk, play, and run free. 

All children born with clubfoot will be able to access high quality and effective care. 

Accessibility – All prioritised LMIC have a national clubfoot programme delivering comprehensive clubfoot care and most babies born with clubfoot access treatment

Quality care – Exceptional treatment is provided in strict adherence to the Ponseti method

Integration – National programmes are integrated into health systems for long-term sustainability

How does RunFree2030 address the global clubfoot problem?

Multiple factors must be in place for treatment to succeed. Babies with clubfoot must be identified early and referred to treatment in a timely manner. Clinics must be close to the baby’s community and staffed by enough health workers trained in the Ponseti Method. Parents must be educated and supported throughout the treatment journey to ensure that they adhere to the protocol and return for follow-up care. Integrated coordination is required from community level to the stock room so that none of the pieces fall through the cracks and disrupt treatment. 

The fundamental elements that build a clubfoot programme drive its success and is essential for comprehensive service delivery. These elements (detailed fully in Appendix #) should be integrated into health services using existing resources to avoid significant costs.  

How many countries does RunFree2030 target?

Clubfoot is most significant in Lower- and Middle- Income countries, so RunFree2030 prioritises work in the developing world. We have identified 102 countries as LMIC, in line with the World Bank’s classifications, and the strategy incorporates all of these countries within its objectives. 

GCI also works in High Income countries, delivering training to clinicians both within the UK and in other high-income settings, including Australia and Norway in 2024 alongside 4 courses in London and Manchester. The profit raised from running these training events is directed straight into our work in LMIC.

How do we scale clubfoot care?

To build comprehensive clubfoot treatment programmes across all LMIC, we need scale up our work both vertically – integrating into existing health systems – and horizontally – expanding treatment into new countries and reaching more patients. RunFree2030 works by equipping our members for both advocacy and delivery, so that overall coverage increases rapidly across the developing world.

What have we achieved so far?

Our collective impact to date:

• More than 300,000 children treated since 2005, now running free!

• That's 450,000 feet! Each of these children now have the opportunity to participate in education, play, and opportunities alongside their friends and siblings.

• Comprehensive treatment programmes for children with clubfoot initiated in more than 60 low and middle income countries, where 80% of all children born with clubfoot live.

• Trained thousands of clinicians in effective treatment of clubfoot.

• Clubfoot - previously not a well-known condition - raised as a priority in the global health arena and now recognised by the maternal and child health, surgical, assistive technology, rehabilitation, disability and birth defects communities.

• Gained support from professional bodies, local health authorities, governments, United Nations agencies to prioritise clubfoot as an issue that must be addressed.

• Developed a network that is geographically coordinated; there is minimal duplication within countries and so impact, reach and cost-efficiency are maximised.

• Developed a shared approach to resource development and learning - we are willing to share what we create, leading to better quality, sustainability and efficiency of those within GCI.

• A strong focus on sustainability and treatment quality with shared clinical indicators and technology to support M&E.

• Unlocked $38.5 Billion of economic benefit through increased earning potential in children treated - for a cost of $450 per child!

How much does it cost to treat a child?

Our financial modelling suggests the global average cost of treatment per child is just $450. This includes treatment costs such as casting and bracing, as well as programme costs and systems strengthening costs which enable the development of infrastructure and raising of awareness in communities.

How much money is needed for RunFree2030 to succeed?

GCI member NGOs supported treatment in 2020 for more than 30,000 new babies in 60 LMIC at a cost of approximately $15 million. This accounted for only 16% of all expected clubfoot cases in LMIC. To deliver on the aim of RunFree2030, increased investment is urgently needed to prevent an estimated one million children from missing out on treatment and living their lives with severe impairment that could have been otherwise prevented.

To deliver against our objectives for RunFree2030 in full, we estimate a total investment of £xxx will be needed, across the full network of NGOs working towards these goals.

More about
Global Clubfoot Initiative

Who are Global Clubfoot Initiative?

Global Clubfoot Initiative developed and launched RunFree2030 in 2017 with their member network that draws from 50+ national and international NGOs. GCI is a consortium of individuals and organisations with technical and programmatic expertise in clubfoot management and implementing service delivery in low- and middle-income countries (LMIC) and includes parents of children with clubfoot, clinicians, and healthcare advocates.  

Since 2007, our successful implementation model has resulted in over 330,000 children receiving effective treatment with many programs reaching >50% of babies born with clubfoot in their countries. 

In partnership with local authorities, this network ambitiously put RunFree2030 into motion and achieved far more than any one organization could on their own.  

How many organisations are working together on this project?

GCI comprises 55 member organisations ranging from small local charities based in LMIC to large NGOs working across multiple countries.

How can I get involved?

Please consider making a regular gift to GCI to help us support babies born with clubfoot around the world. Your gift will enable us to build stronger treatment programmes across our 102 priority LMIC, and realise our vision of a world where all children born with clubfoot can walk, play and run free.

Where can I learn more?

You can find the executive summary of the RunFree2030 document HERE [link] or read the full 167 [check] page document HERE [link]. 

Please visit globalclubfoot.org for more information about GCI and our programmes outside of RunFree2030.

For more information about clubfoot, visit [link]