Africa COR P OR AT E
Issue 59 Vol 2 Number 888 2014
www.times-publications.com
w w w. c o r p o r a t e - a f r i c a . c o m www.corporateafricahealthfoundation.org
www.corporate-africa.com
PARTNERSHIPS FOR PREVENTION AND CARE
BD Build Partnerships to Fight TB Increasing Equipments to Eradicate HIV/AIDS BBCA Botswana Develops HIV/AIDS PPP Model
Over two-thirds of all people infected with HIV/AIDS live in sub-Saharan Africa, yet the continent relies on just 3% of the world’s healthcare workforce,1 a disparity that creates tremendous stress for caregivers. The International Council of Nurses (ICN), a federation of more than 130 national nurses associations, is addressing this crisis through a program of Wellness Centers for Healthcare Workers and their Families. To learn more, please visit www.icn.ch.
Helping those who help others It is estimated that African health systems may lose 20% of their workers to HIV/AIDS in the coming years due to illness and unacceptable working conditions.2
Uganda 2009
Zambia 2009
Lesotho 2007
Malawi 2009 Swaziland 2006
ICN Wellness Centers
1
BD and ICN are collaborating to establish wellness centers that provide comprehensive health services for healthcare workers and their families in countries hardest hit by HIV/AIDS and the shortage of healthcare workers. The goal is to sustain a healthy, motivated and productive workforce, which in turn will be able to better care for patients. The program includes testing, counseling, stress management, training and treatment.
Recently, BD, ICN and PEPFAR (The U.S. President’s Emergency Plan for AIDS Relief) announced a three-year public-private partnership valued at $1.25 million. The objective is to establish a new Wellness Center in Kampala, Uganda, using one constructed in Swaziland as a model. Named one of World’s Most Admired Companies ®3 as well as one of the World’s Most Ethical Companies, 4 BD provides advanced medical technology to serve the global community’s greatest needs. BD - Helping all people live healthy lives.
World Health Organization, 2006, 2 Joint Learning Initiative, Human Resources for Health, 2006, 3 FORTUNE, March 2009, 4 Ethisphere™ Magazine, April 2009 Please visit www.bd.com BD and BD logo are trademarks of Becton, Dickinson and Company. ©2009 BD
CONTENTS 4..... Egalitarian partnership for effective TB control 10..... Leadership to develop HIV/AIDS PPP model planned for 2014. 14..... Increasing equipments to fight against HIV/AIDS. 18..... Forging new partnerships for the fight against the world’s greatest killer. 22..... Customized containers for global health.
Published By Times Publications Group Ltd Publisher - James Norris Editorial - Patrick Lee Proof Reader- Alison Walters Director - Debra Cartwright Conferences Coordinator - Adam Parker Media Executives - Paula Silverstein, Jevgenyij Danilenko, Eugene Bartas, Martin Sutherland, James Chagula, Anastasia Ayiva Special Project Director - Jian Ping Sun Design - Abidemi Akinwonmi-Pedro Publication Partners - Nepad Council, NASME Nigeria, CNBC Africa, BRICS Summit Group. Subscription details can be obtained from Times Publications Group Ltd. at principal commercial offices: 30-32 Tabard Street, London SE1 4JU; Tel: +44 (0) 20 7089 8830 or Fax: +44 (0) 20 7089 8831. Email administration@times-publications.com or visit our website at www.corporate-africa.com. © Times Publications Group Ltd. 2014 — all rights reserved. First Published in 2003. Distributors in Africa: Shama PLC Tel: +251 11 554 5290, MCS/Caxton International PressTel: +27 11 807 9599, Print Excellence Ltd.Tel: +233 243 213 881, Dominion Bookshop, +233 240 695 791, Publisher’s Distribution Services Tel: +254 20 3222 901, PDS Accountant Tel: +254 20 3222 903, Newsstand Nigeria Tel: +234 802 3382788. Corporate Africa
3
Egalitarian Partnership for effective TB control By Austin Arinze Obiefuna, National Coordinator, Stop TB Partnership, Ghana
W
ords such as “partnership” between public, private, donors and civil society are becoming increasingly trendy in every response coming from the health sector. The World Health Organization (WHO) in its World Health Report during the year 2000 defined health systems as “all the organizations, institutions, and resources that are devoted to producing health actions.”
includes private health facilities, faith based and non governmental organisations; community based organisations, businesses, and so many other nomenclatures like public-private mix (PPM); public-private partnership (PPP) etc; have been coined to make sure that the growing unification of fragmented collaborations are synergised and aligned towards shared responsibilities and mutual targets.
This definition encapsulates a full range of players, engaged in the provision and financing of health services including public, non-profit, and for-profit private sectors; as well as international and bilateral donors, foundations, and voluntary organizations involved in the funding or implementing of health service activities.
Partnering to fight TB and its related diseases is no longer a debate but an unavoidable, and inevitable agenda for implementation. Partnership is innovation on its own, not to talk about the synergies in assorted colours. No one needs to be reminded that TB prevention and control is the mandate of the public sector, but increasingly there has been a global call for partnership and collaboration if we are to bend the curves.
According to a WHO report in 2012, TB killed 990,000 people in 2011, excluding those also infected with HIV. The disease has been reduced in most Western nations; but the same cannot be said of developing countries. Often times when we talk about partnership in TB management, what comes to mind is partnership between ministries of health and private providers, which
4
Corporate Africa
According to the World Health Organisation’s World TB Report of 2013, tuberculosis is currently going undetected and being missed by country’s health systems. Around 3 million people, which are equal to one in three people falling ill with TB, are not being detected globally.
Dr Mario Raviglione, WHO Director of the Global TB Program, in the same report said: “far too many people are still missing out on such care and are suffering as a result.t. They are not diagnosed, or not treated, or information about the quality of care they receive is unknown.” In the same report, around 94,000 TB patients eligible for multi-drug resistant (MDR-TB) treatment were detected in 2012: 84,000 people with confirmed MDR-TB (resistance to both rifampicin, the most powerful TB drug and isoniazid), along with 10,000 with rifampicin resistance detected using Xpert MTB/RIF. But what is more worrying is that several of these MDRTB cases are not on treatment with long waiting lists in countries due to a lack of leadership and other frequently mentioned capacity and logistic issues. This is absolutely unacceptable.
According to Dr Raviglione: “The unmet demand for a full-scale and quality response to multidrug resistant tuberculosis is a real public health crisis. It is unacceptable that increased access to diagnosis is not being matched by increased access to MDR-TB care. We have patients diagnosed but not enough drug supplies or trained people to treat them. The alert on antimicrobial resistance has been sounded; now is the time to act to halt drugresistant TB.” I guess this is a perfect call in the right direction. Another challenge identified relates to the TB and HIV co-epidemic with less than 60 per cent receiving antiretroviral drugs in 2012.
According to WHO report in 2012, TB killed 990,000 people in 2011, excluding those also infected with HIV.
Corporate Africa
5
Why Egalitarian Partnership? Several successes chalked in health and TB management, to be specific, by the WHO and other global health players, have been attributed to partnership. However, but there is still a growing lack of trust, inequality, and insecurity among health response stakeholders. Each sector or constituent player in health management always believe that they are experts and technical people in their own capacity, and must be addressed as such to ensure creativity and innovation. I refer to egalitarian partnership in this article as following the idea that all stakeholders are equal and should have the same rights and opportunities in the planning, implementation, and evaluation of shared vision. Egalitarian partnership is therefore a sine qua non of effective TB control. Partners and stakeholders want to participate in genuine partnerships built under the principles of egalitarianism in which partners share equal rights and opportunities in the TB program. WHO recommends that we can “reach the 3 million 6
Corporate Africa
TB cases missed in national notification systems by expanding access to quality testing and care services across all relevant public, private, or community based providers; including hospitals and NGOs which serve large proportions of populations at risk�. Delving into government-NGO partnership, for many years, both local and international non-governmental organizations (NGOs) have endeavoured to fill the gaps in health service delivery; and research and advocacy. Trying to analyze most of the recent positive development and achievement in health; NGOs have relatively performed better and achieved results because of
Partnering to fight TB and its related diseases is no longer a debate but an unavoidable and inevitable agenda for implementation.
the flexible planning and the ability to design population based projects on health education; health promotion; social marketing; community development and advocacy. If not for strong partnership with civil society. WHO, with its normative functions, may never have had such an ambitious agreement to support the vision for a world free of TB; which are guided on the principles of zero TB death, disease, and suffering due to tuberculosis. This, again, is a very ambitious target, which demands a strong and transparent partnership with clear roles if the vision will ever be achievable. My experience building Stop TB Ghana Partnership, and supporting other countries gives me an edge, and analytical background to decipher several perspectives and “suspicions” in partnership grooming. Afro Global Alliance, a former co-host of the Stop TB Ghana Partnership before it transitioned to its present host under the National TB Program, built a strong
partnership with multi-sector stakeholders to ensure systematic and effective involvement of NGOs, community, traditional and opinion leaders in TB prevention and control. There are several of such NGO creativeness and innovativeness in project implementation and management based on partnership, shared responsibility and mutual accountability which defines, or set the background for engagement of NGOs in TB control. Thanks to the Stop TB Partnership and the Global Fund which have shown great leadership in ensuring that everyone is involved in TB management through transparent and shared vision.
Egalitarian partnership is therefore a sine qua non of effective TB control.
Vector Control Division
Leading Innovation in Vector Control Leading Innovation in Vector Control
OLYSET PLUS ✓ Enhanced performance against pyrethroid resistant mosquitoes ✓ Quick regeneration after washing ✓ The synergist PBO incorporated into every fibre ✓ Building on proven Olyset Net technology OLYSET NET ✓ Highly durable ✓ Kills, repels and prevents bites ✓ Permethrin incorporated into every fibre ✓ Full WHO recommendation & Over 200 million distributed worldwide OLYSET NET Manufacturing ✓ Double benefit—saving lives and creating jobs ✓ Nets where they are needed most ✓ Model for development SUMILARV ✓ Long lasting ✓ Effective at very low doses ✓ Appropriate for even potable water ✓ Unique mode of action Registered trademark of Sumitomo Chemical Co., Ltd.
Leading Innovation in Vector Control www.sumivector.com
Governments are overstretched and have come to realise they can’t do everything by themselves if they are to achieve global, regional and national targets. There have been more collaboration and partnership between the government and the NGOs during the late 1990s and early 2000s, which involved term financing, pocket financing of NGOs, service delivery in TB and HIV and, now in management of basic health units. However, this union between government and NGO seems to be one of the major success stories in TB prevention and control because NGOs are considered to be more effective in the community based health promotion activities. In today’s TB control, there have been increasing calls for better collaboration and egalitarian partnership, especially within the civil society domain. TB is gaining more visibility, resources, support and commitment as a result of partnership.
8
Corporate Africa
Countries are becoming more ambitious in setting targets, cost effective activities, full scale up and universal coverage of all interventions. For future partnership arrangements in health response, it would be better to define clear roles and responsibilities of the parties; nature and timeline of deliverables, and a clear plan of scaling up and sustainability. The problem of lack of trust; capacity issues; and lack of clarity of roles and responsibility on both sides — government and NGOs — must be addressed to ensure meaningful partnership.
TB is gaining more visibility, resources, support and commitment as a result of partnership.
PARTNERSHIPS FOR PREVENTION AND CARE
AFRICA HEALTH CONFERENCE
“The Private Sector Spearheading Public Private Partnerships in Health and Medicare”
T
he 6th Partnerships for Prevention and Care Africa Health Conference will be held at the Gaborone Sun Hotel, Botswana, Southern Africa from April 28th to 30th 2014. The event will focus upon: “The private sector setting the pace for private public partnerships in health and Medicare.” Ongoing efforts to design and implement a national framework for private public partnerships makes Botswana an ideal location for the event which will also promote private public partnerships in the Southern Africa region. The conference will be opened by the honorable Minister of Health for Botswana, Reverend Dr John Seagosing. The Botswana Chamber of Commerce (BOCCIM) and the Botswana Business Coalition on AIDS (BBCA) will partner the event and play leading roles promoting the country’s private sector and the newly designed Private Public Partnership Framework. The role of the private sector in creating public private partnerships is the theme of both the conference and the Africa Health Report, which focuses on promoting key issues surrounding health and Medicare in Africa. This report plays a vital role in partnering African governments’ national response strategies in the fight against diseases such as HIV/AIDS, TB, Malaria, cancer, diabetes etc. It was from the Corporate Africa Partnerships for Prevention and Care Africa Health Project in 2008 that a US$30 million public reference laboratory emerged at the Korlebu Hospital Accra, Ghana. The laboratory is now the major diagnostic, testing and training center for diseases in West Africa. It is a private public partnership between BD and the government. Corporate Africa is offering corporations with CSR programs with prevention and care content an opportunity to engage with governments and life-science organisations at the conference; while also promoting their products and services, building suppliers’ chain and forming collaborations with the public sector across Africa. The 6th Corporate Africa Partnerships for Prevention and Care Africa Health Conference will build upon goodwill from previous events by bringing together responsive investors in health and Medicare from around the world, and encouraring them to share their experiences and enterprise with Botswana to increase Medicare infrastructure development deemed crucial for Africa’s wellbeing and wealth. About Corporate Africa’s Health Conference: Private Public Partnerships across Arica is expanding at pace, with innovations and new opportunities coming on stream across the region’s health and Medicare infrastructure. The sector is ideal for PPPs to become a good option for building capacity in the industry. Ongoing supplies of ARVs and new treatments for disease detection are contributing to fitter populations that are able to engage investors in partnerships to strengthen the continent’s health and Medicare landscape. Africa today has some of the fastest growing economies in the world needing a robust and strong national health service offering patients and consumers supplies at affordable costs for the region to achieve optimum growth.
Leadership to develop HIV/AIDS PPP model for 2014 By Frank Phatshwane, Director, Botswana Business Coalition on AIDS.
T
he BBCA has achieved its mission, which included strengthening the role of Botswana’s private sector in managing and combating the HIV/AIDS epidemic in the workplace. This has been achieved, as well as the sensitizing of the public to HIV/AIDS, development of workplace programs and policies, networking, and coordination of private sector response to HIV/AIDS epidemic. The workplace is a valuable entry point for reaching out to all workers, and is identified as having great potential to facilitate access to prevention, treatment, care and support for workers in order to limit the effects of the pandemic, and assist them to manage it. Significant achievements have been made over the years through these effort. BBCA sensitize and promote its workplace policies and programs in many private sector companies, and training peer educators and counsellors to continuously provide psychosocial support to their employees, among other duties. One significant tasks that BBCA undertook was to develop the private sector HIV and AIDS Workplace Policy 10
Corporate Africa
Guidelines; to guide the development of HIV and AIDS workplace policies and programs. Private sector as a Development Partner has sound, and solid financial management,
The ministry has a policy which stipulates parameters for engaging on PPPs.
project management skills, and expertise, which are critical areas of application to the response of HIV /AIDS. The role of the private sector has been well articulated in Botswana’s Vision 2016, and various national development plans in the past, as well as currently. This being the case, there has been a lack of detailed framework on how the private and public sectors can collaborate. At the National level, the Botswana Ministry of Finance and Development Planning is coordinating the country’s approach to HIV and AIDS in relation to public private partnerships. The ministry has a policy
have built them on a sound PPP framework. Conscious of this fact, BBCA convinced of the need for such collaboration; as well as, within its mandate to coordinate the private sector response on HIV and
It is clear that most countries with a successful PPP program have built programs on a sound PPP framework.
which stipulates the parameters for engaging in PPPs. It is policy for all sectors in Botswana. Although PPPs can be implemented on a oneoff basis without any specific supporting policy framework, it is clear that most countries with a successful PPP program,
AIDS, decided to take the lead to develop an HIV AIDS public private partnership framework. It will serve to provide a long-term contract between private and government agencies, offering public asset or services in which the private party bears significant risk and management responsibility. Furthermore, it will define viable projects to be implemented, full
Corporate Africa
11
work plan and budgets, and good governance of the PPP program that is among others; promoting efficiency, accountability and transparency. It will also serve as an acceleration instrument for the Second National Strategic Framework (2010- 2016). Most importantly, it will generate private sector interest, and public acceptance of the PPP program, which will lure more engagement from the private sector. This arrangement has been acknowledged locally, regionally, and internationally as important in ensuring that current initiatives are sustainable and, to also enhance efficiency and effectiveness of social programs. In efforts for
12
Corporate Africa
implementation, a consultancy firm has been tasked to develop the model.
In efforts for implementation, a Consultancy firm has been tasked with the developing of the model.
BBCA is excited about this on-going process of the development of the model, as it will be one of its more important achievements.
BBCA believes it will increase current efforts by the private sector. We hope that by the time we host the 6th Partnership for Prevention and Care Africa Health Conference, in which we are also excited about taking part in September, that the model will be complete. BBCA acknowledges its funding partners, the National AIDS Coordinating Agency — NACA, UNDP, TSF-Technical Support Facility, and organizations from the private sector.
Private sector as a Development Partner has sound, and solid financial management, project management skills, and expertise, which are critical areas of application to the response of HIV /AIDS.
Increasing equipments to fight against HIV/AIDS Jiru Baku is Crown Agents’ Technical Manager for Health based in Nigeria.
Here he looks at how procurement projects are raising the impact of efforts to tackle HIV/AIDS in Nigeria.
M
uch of the ststistics involved in the global fight against HIV/AIDS seem to be rising and falling in the right directions: new infections fell from 3.4 million in 2001 to 2.3 million in 2012; the 1.3 million people accessing treatment in 2005 rose to 9.7 million by 2012; and in 2011, for the first time, a majority (54%) of people living in low and middleincome countries who were eligible for antiretroviral (ARV) therapy, were receiving it.
In Sub Saharan Africa this figure stood at 56 per cent owing to concentrated initiatives in the region of the world most affected by the disease.
In Sub Saharan Africa this figure stood at 56 per cent owing to concentrated initiatives in the region of the world that has been most starkly affected by the disease.
14
Corporate Africa
The rise in the use of ARVs — as well as the increasing use of fast and effective test kits and preventative measures such as condoms — has been achieved by multilateral efforts to raise awareness and understanding of HIV/AIDS and what steps must be taken to effectively battle against it. At Crown Agents we have worked with donor organisations and with service providers on a range of projects across Africa, particularly in Sub Saharan Africa, to provide the procurement and supply chain expertise that gets the vital consumables in the war on HIV/AIDS — the ARVs, the test kits, the condoms, the opportunistic infection medicines — to the people whose lives can be saved or enhanced by them. As an example of our work in action, the HIV/AIDS programs that we have carried out in Nigeria have already resulted in palpable changes in the provisions, behaviour, and budgets involved in fighting the epidemic. Nigeria’s 170 million-strong population has a 5 per cent prevalence of HIV/AIDS — second
only to South Africa — making efficient and decisive multilateral and government-backed action an imperative for the future health of the Nigerian people.
Making good procurement a priority In 2005, Nigeria’s National Agency for the Control of Aids (NACA) needed a procurement agent to work on several grants that it had received under the Global Fund’s HIV/AIDS program — and it turned to Crown Agents to fulfil that role. The grants had been allocated to fund diagnostics, treatment and prevention programs that traversed the country, making assaults on HIV/AIDS from all angles and stages. The processes of spending and delivering millions of dollars worth of test kits, diagnostics and drugs used all of our extensive tender, contract management, and quality assurance expertise. We distributed health supplies to 32 destinations throughout
the country through our specialist logistics and support team, which handled clearance, inspection, and delivery to final destination.
The provision of effective treatment for those already living with HIV/AIDS is vital — but so are measures to curtail the spread of disease.
We identified suppliers and negotiated contract details with them, ensuring that the costs agreed were reasonable and that Global Fund guidelines were adhered to. We developed and maintained effective working relationships with counterparts in NACA, and periodically submitted procurement and delivery progress reports to provide it with transparency on the services carried out on its behalf.
Corporate Africa
15
By February 2010, we had delivered US$ 2.1 million worth of HIV test kits, US $3.5 million worth of laboratory equipment, reagents and consumables and US$ 23.5 million worth of anti-retroviral drugs, and drugs to fight opportunistic infections. We also purchased over 65,000 kg of breast milk substitutes to support NACA’s Prevention of Mother to Child Transmission (PMTCT) program.
We also purchased over 65,000 kg of breast milk substitutes to support NACA’s Prevention of Mother to Child Transmission (PMTCT) program.
Prevention as well as cure The provision of effective treatment for those already living with HIV/AIDS is vital — but so are measures to curtail the spread of disease. During a six-year procurement program that ran from 2008 to 2013, we sourced and provided condoms for DFID’s Enhancing Nigeria’s Response to HIV/AIDS program (ENR), while also streamlining the procurement process and logistics involved in the dissemination of the condoms. Our role in ENR was expansive and vital, running the length of the supply chain involved. We dealt with assessing potential vendors and bids, taking into account price, specification and delivery. Quality inspection was also another area that we had to cover, which involved reviewing the samples submitted by potential vendors then checking the quality upon delivery using LOT to LOT monitoring tests to ensure that they had not been compromised during the shipping and handling process.
16
The increased number of condoms per carton also demonstrated the interdependence of all aspects of the supply chain: more condoms in a carton meant more money could be generated from selling them, resulting in an increase in program income that will secure the project’s sustainability for the future and ultimately improve work towards the ENR’s overall objective of preventing the spread of HIV/AIDS in Nigeria.
Our impact in numbers
For those tests we had to liaise with the National Condom Quality Assurance Laboratory, a laboratory owned by the Federal Ministry of Health.
The clearest evidence of the impact our work on ARVs, test kits and condoms is having can be seen in the numbers: more than 1 million Disability Adjusted Life Years (DALYs) were averted through our distribution of condoms in 2012; the sale of commodities through the ENR program is expected to add US$ 30 million to the project’s US$ 183 million budget over the course of six years; and the condoms through the programme are estimated to have averted 33,485 cases of HIV over the course of the program.
The shipping and packaging of the condoms was an area in which we were able to make clear and tangible efficiency savings. Following our assessments, we took the step of reducing the pre-packaging of the condoms: this seemingly obvious action increased the number of condoms that could be packed into a shipping carton to 7,200 — more than six times the 1,152 that were previously carried in one carton. Amendments such as these are logical and highly efficient, but still need the initial innovation, evidence, and impetus to move them from the idea phase and put them into action.
Not all of the figures are heading where they need to be, however. In 2012, US$ 18.9 billion was available from all sources for the global AIDS response, but by 2015 that is predicted to rise to US$ 22-24 billion. This points to the crucial importance of considering sustainability and capacity building in HIV/ AIDS prevention and treatment programs if the funding needs are to be met. UNAIDS Executive Director, Michel Sidibé, said that while the resource gap that is facing the efforts is indeed a matter of concern, “the AIDS response has encountered —and overcome — such
Corporate Africa
challenges in the past.� And with growing pools of experience and expertise gleaned through programs such as those that we have enacted, the will and the wherefore to maintain the battle against HIV/ AIDS will likely only grow stronger on its steady progress towards a solution.
In 2012, US$ 18.9 billion was available from all sources for the global AIDS response, but by 2015 that is predicted to rise to US$ 22-24 billion.
Corporate Africa
17
Forging New Partnerships for the Fight Against the World’s Greatest Killer Lucica Ditiu, Executive Secretary of the Stop TB Partnership Renuka Gadde, Vice President, Global Health, BD
I
magine a scenario in which a new airborne disease rabidly spread around the world. Within a few months, the disease is killing 3,800 people a day. Anyone and everyone is at risk of this highly contagious bacteria. Would governments take action? This worst case scenario would mobilize the world to take every action in its power to defeat this killer. Politics would be set aside in favour of cooperation. The full weight of modern science and technology would be mobilized. Front page headlines would fill newspapers and prime time television. No resource or need would be too big to end this collective threat.
sense of complacency. Inventions and innovations, scientific discoveries, incredible advances in technology — even with all this, there are still nearly 9 million who fall ill and 1.3 million who die from TB every year. We are outraged that we still have people dying from TB, a disease that is curable with a
Inventions and innovations, scientific discoveries, incredible advances in technology - even with all this, there are still nearly 9 million who fall ill and 1.3 million who die from TB every year.
Sadly, this scenario isn’t a fabrication. This disease is real, and it’s called tuberculosis (TB). It kills 3,800 people a day, and anyone can catch it through airborne transmission. It has killed more people in the last 200 years than any other disease.Yet, its longevity over the course of history has lulled the world into a false
18
Corporate Africa
six month treatment regimen which costs less than $40 for all six months. In response to this epidemic, governments came together to set a goal of cutting TB deaths in half by 2015 in the United Nations Millennium Development Goals (MDGs).
Recognizing the need to work together, The Stop TB Partnership was established to align actors over the world in the fight against TB. We believe a world with zero new deaths, infections and suffering from TB can be achieved by harnessing the collective power of health workers, governments, the private sector, and civil society. No one should be left behind in the fight against TB. One of our biggest challenges is finding the 3 million people who are “missed” each year by health systems — those who have TB but are not diagnosed and continue to spread the disease. Other patients are diagnosed but not reported, excluding them proper follow within the health system. Because of these missed cases, many do not get the TB care they need and deserve and many die. Children, displaced persons, refugees and miners are just a few in the long list of vulnerable groups being missed.
Health Ministers from countries in Southern Africa are leading the charge to find missing TB cases, where the epidemic causes 550,000 deaths each year. This challenge is amplified by high rates of TB/HIV co-infection, a high number of affected people in vulnerable and poor populations, regional migration patterns, and the high rates of TB among mine workers. As a result, the African region is not on track to reach the MDG-related TB target of halving TB deaths. However, recent political leadership in the African region has highlighted strong country commitment to turn the tide on the disease. In August 2012, Southern African Development Community (SADC) heads of state endorsed the SADC Declaration on TB in the mining sector and called for new partnerships to scale up the TB response. In March 2014, The Deputy President of South Africa invited ministers of health,
Corporate Africa
19
mining, and labour to a historic summit in Johannesburg to agree on a regional harmonization approach to address TB in mining. If mining companies and governments are willing to commit matching resources, the World Bank and the Global Fund will commit up to US$ 100 million each to the effort. The case to invest has been strengthened by new findings from the World Bank, released at the Johannesburg Summit. It would cost US$ 33 million a year to test and treat mine workers in South Africa, Lesotho, Swaziland and Mozambique, which would result in annual savings of over US$ 1 billion from increased worker productivity and reduced costs from treating the disease. TB in the mines is a cross-border issue that requires coordinated action from governments, private sector, civil society, and miners themselves. Working closely with ministries of health and partners, the Clinton Health Access Initiative (CHAI) will identify and cost a number of actionable solutions on TB in mining communities, building on mining-related projects by the World Bank and others. Through findings from this work, they will aim to produce high-level, policy-relevant analysis that can be used to mobilize global resources to address the issue, and the challenge with a comprehensive regional approach. Beyond Southern Africa, governments are building new partnerships in the fight against TB. The BRICS (Brazil, Russia, India, China, South Africa) countries, which have a combined population of almost 3 billion, have agreed to collaborate on improving systems to find and treat patients with TB, improve the supply of TB drugs, and collaborate to develop new drugs and vaccines. They recently joined together on World TB Day to reaffirm their commitment. Brazil will share its expertise in technology research and will develop a program that includes an Indian laboratory that is working with a Brazilian state laboratory to develop a combined form
20
Corporate Africa
of four TB drugs. South Africa is sharing lessons learned in its largescale deployment of a new device known as GeneXpert, which can diagnose a common form of TB drug resistance in less than two hours. Companies are also building new links to strengthen the fight against TB. BD (Becton, Dickinson and Company), a leading global medical technology company, who developed liquid culture technologies to diagnose multidrug-resistant (MDR) strains of TB, has been applying its core competencies in the fight against TB for many years. Through the Labs for Life partnership with the US President’s Emergency Plan for AIDS Relief, and country governments, BD has worked in country settings to strengthen laboratory capacity for microscopy, sputum collection, specimen referral and specimen
In collaboration with the US Agency for International Development in Indonesia, BD is involved with training and strengthening laboratories to ensure that they have capability to handle culture based diagnostics.
tracking systems. In Uganda, this work enabled identifying 3 times more MDR-TB in retreatment cases than what was originally estimated. BD, with guidance from the Stop TB Partnership, has established a TB pillar in the MDG Health Alliance, a group of leaders from the private, public and non-profit sectors that work in partnership with the United Nations Secretary General’s office to accelerate progres. The TB pillar advocates for companies and organizations to work closely with governments to strengthen their countries TB response and promote private sector innovation for TB. They also aim to promote more efficient use of resources
by increasing the quantity and quality of strategic information on TB.
susceptibility testing at 33 government laboratories.
In collaboration with the US Agency for International Development in Indonesia, BD is involved with training and strengthening laboratories to ensure that they have capability to handle culture based diagnostics. In India, close to 60 per cent of patients access TB diagnosis and treatment in the private sector. BD, along with other companies, is part of a unique collaboration aimed at increasing access to the World Health Organization’s approved TB diagnostic technologies via the private sector in India.
It is easy to be overwhelmed by the staggering numbers we face — too often we speak in abstractions and statistics. By keeping our focus where it counts — in regions with high TB rates and groups vulnerable to the disease — we can make swift progress. From treating migrant miners in Southern Africa to rolling out new diagnostic tests in India, every person cured of TB represents a new future for those we’ve reached.
A coalition of more than 50 private laboratories and 10,000 collection centres is supported by manufacturers of TB diagnostic technologies and non-profit organisations such as CHAI. Further, BD is collaborating with the Foundation for Innovative New Diagnostics and Revised National TB Control Program to build capacity for liquid culture and drug
We are joined together by a belief that an end to the global TB epidemic is possible. A sustainable solution — one that benefits both people and economy — will require collaboration among a wide range of partners. Companies have an important role to play, working alongside governments to provide health care to all who need it. We invite you to help us make history in the fight to achieve zero deaths from TB.
foundation foundation for innovative for innovative newnew diagnostics diagnostics
Partnering Partnering against againstTB TB Corporate Africa
21
We Mobilize Medicine. Customized Containters for Global Health
Clinic In A Can is an innovative self-contained medical clinic built in a shipping container. These container clinics are retrofitted and delivered, ready to use, anywhere in the world, providing an instant resource to meet a variety of medical needs.
ter e 6m
c ini l C
Key Features:
Applications:
• Economical
• Mining Camps
• Ready to use
• Government Projects
• Durable
• Disaster Relief
• Made in USA
• Remote Areas
Possible Room Options • Medical Exam Room • Laboratory • Pharmacy • Dental
• Radiology • Surgical Suite • Restroom
Clinic In A Can | Distributed by MOSA Group 22
Thornhill Office Park | Building4, Ground Floor | 94 Bekker Road | Midrand | South Africa 1685 Tel No +27(0) 11 805 5153 | Fax No. +27(0) 11 312 0178 | info@mosagroup.co.za | www.mosagroup.co.za
Corporate Africa
Clinic In A Can
M
osa Group South Africa , is a locally owned and managed company with head oďŹƒce in Midrand, and satellite offices regionally and across the continent, lifts its focus of health care provision for the poor and the needy to new heights Mr Christopher Singo, Executive Director of Mosa Group believes it is imperative to find practical and sustainable healthcare service solutions that help Africa as a continent improve the quality of life for its people. One of the best solutions to improve healthcare services is through the Clinic In A Can. Mosa Group has partnered with the US based NGO, Clinic In A Can, to provide innovative, self-contained medical clinics and hospitals called Clinic In A Can which are built in the United States out of shipping containers.
Mr Christopher Singo, Executive Director of Mosa Group
Clinic In A Can is very economical and practical for municipalities, departments of health, and corporate companies wishing to donate life-saving clinics to NGOs or communities as part of the Social Investment Program. Independent doctors can also operate Clinic In A Can as full medical suites in squatter camps.
A single 12m container can be configured to have a medical exam room, dental exam room and a reception office for less than a million rand delivered to site in South Africa.
The medical room houses a generator and water system that allows the clinic to be operated regardless of the state of the surrounding infrastructure. The Clinic In A Can also has the option of being fully solar powered.
VI PARTNERSHIPS FOR PREVENTION AND CARE AFRICA HEALTH CONFERENCE Businesses in private public partnerships with foreign investors, developmental agencies and the public sector, working to build capacity across national and regional health and Medicare infrastructure.
In partnership with the Botswana Business Coalition on AIDS, Mmegi Newspaper, BD (Becton, Dickinson and Company), and the Ministry of Health DATE: 1st - 3rd September 2014 VENUE: Gaborone Sun International Hotel, Gaborone, Botswana FOR MORE INFORMATION PLEASE CONTACT: www.corporateafricahealthfoundation.org
CONFERENCE COORDINATOR: Aisha Aingal T.: +44 2070898830 - Email: administration@corporate-africa.com
FRANCOPHONE: Melaine Kouassi T.: +225 06178275 - Email: melaine@times-publications.com
REGIONAL COORDINATOR: Joy Ogbuehi T.: +234 8033536288 - Email: joy@corporate-africa.com
EAST AFRICA REPRESENTATIVE: Angela Loloba T.: +254 734540772 - Email: angela@corporate-africa.com
GHANA REPRESENTATIVE: Michael Ampe Kofi T.: +233 288279344 - Email: michael@times-publications.com
DARQ EVENTS BOTSWANA: Lesetse Lathang Bokgobi T.: +267 755821828 - Email: darqevents@gmail.com