Phase III of one of the largest health-screening projects in South Africa finished on World Aids Day, 1 December 2015, in one of the most successful private public partnerships (PPP).
In 2009, the South African National Aids Council (SANAC) embarked on a programme to ensure business participated in the HIV Counselling and Testing Campaign (HCT), with the Global Fund as the international funding agency. The Global Fund provides funding for campaigns that fight HIV in needy countries, while promoting partnerships between governments, civil society, the private sector and affected communities by relaying country ownership and performance based funding for communicable diseases in needy countries.
During Phase I, SABCOHA carried out 44 000 tests focussing on medically uninsured employees in the workplace and the community, where employee wellness was a large focus. EOH Workplace Health and Wellness pledged to help co-fund 14 000 of these tests but subsequently carried out over 22 000, which also included wellness screening.
Targeting SMMEs
In Phase II and III, SABCOHA carried out an additional 44 000 screenings in 18 months, with the focus on micro enterprise. Susan Preller, SABCOHA's COO says, "During this phase, we focused on the environment and social development of micro enterprise by managing the health risk of entrepreneurs in this sector. This is core to the sustainability of any micro enterprise and the programme targeted mostly women as part of the key vulnerable population groups. It also linked to SABCOHA's BizAIDS training, focussing on risk management for micro enterprises."
Visiting the screening site at eMbalenhle in the Gert Sibande District in Mpumulanga, Minister of Health, Dr Aaron Motsoaledi said, "It is exciting to be on the ground and see the project happening. We have gone from talk to seeing results. When you invest in the health of a country, you are investing in the political and economic stability.
"What makes the project unique is the fact that the screening takes place within the informal business sector and remote areas of the country - where people have never been tested. Mobile units are used to take the screening out to the community, ensuring a much larger take up than previously experienced. The addition of wellness screening for lifestyle diseases was also a first. Lifestyle diseases are growing exponentially and taking a toll on our society, in terms of quality of life as well as the economic impact. When you consider that 70% of the women in South Africa are obese, the concomitant lifestyle diseases make this a shocking statistic."
Preller adds, "The success of this model is based upon co-funding from the private sector to strengthen efforts of donor funded programmes. According to the 2008 National Treasury Research on small, medium and micro enterprises (SMMEs), South Africa has an estimated 2.8 million SMMEs that contribute 52% -57% of GDP. SMMEs also provide about 60% of jobs and contribute more than 40% of the country's total remuneration. This means that SMMEs in South Africa employ more people than corporate within the private sector and government combined.
Carl Manser, EOH Workplace Health and Wellness executive - Business Growth and Sustainable Partnerships, says, "It has empowered SMME business owners to educate their workers, customers and family members on the prevention of HIV/AIDS, negotiate safe sex practises and dispel myths and superstitions, a major deterrent in finding out HIV status and other potential health risks and seeking treatment. It is important to understand that managing health risk is key to the success of any small and micro business. The project proves that taking healthcare into the communities - whether it is by 4x4 or using nomadic tents - is possible."
PPPs needed
According to a report by the South African National HIV Prevalence, Incidence and Behaviour Survey 2012, there is still a significant cause for concern and a serious call for intervention as knowledge levels have declined and there is increased risky sexual behaviour. The research showed that people in informal areas continue to be most-at-risk of HIV, with the highest HIV incidence compared to those living in other areas.
There is a continued high HIV prevalence and incidence in the Black African population particularly among females aged 20-34 years and males aged 25-49 years. For this reason, a strong multi-sectoral approach is necessary if socio-economic challenges that continue to fuel the epidemic are to be addressed.
This project has resulted in SABCOHA, the private sector, represented by EOH, other partners and the Global Fund creating a blueprint for others to follow. The collaborative model demonstrates how government and the private sector can work together to fast-track screening to overcome not only HIV/AIDS but also other non-communicable diseases, which are increasing at an alarming rate in South Africa.
Phase III ends on World AIDS Day but SABCOHA and EOH has committed to a further 5 000 screenings in the Vaal Triangle and a further 10 000 in the Free State in January 2016.