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Combatting HIV/AIDS and TB in Africa

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Chief Medical Officer, Dr Brian Brink, outlines the key private sector responsibilities and opportunities in ending epidemics in Africa today.

Chief Medical Officer, Dr Brian Brink, outlines the key private sector responsibilities and opportunities in ending epidemics in Africa today.

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  • 1. Private Sector Responsibilities and Opportunities in Combatting HIV/AIDS and TB in Africa Dr Brian Brink – Chief Medical Officer
  • 2. How Africa turned AIDS around Source: Special Report to the African Union Summit May 2013 2
  • 3. How Africa turned AIDS around Source: Special Report to the African Union Summit May 20133
  • 4. PRIVATE SECTOR RESPONSIBILITIES IN DEVELOPING COUNTRIES
  • 5. APPROACH TO HEALTH Global Health Communities Health Management Information Systems Families Health Insurance Employee Health and Wellness Including HIV/AIDS and TB Occupational Health Anglo American Occupational Health Way Occupational Hygiene Occupational Medicine Leading indicators Leading and Lagging indicators Benchmarking Standards Guidelines Support Assurance 5
  • 6. EMPLOYEE HEALTH AND WELLNESS • Focus on all employees receiving an annual health screening and basic medical examination: – – – – – – – – – Medical history screening for common diseases and lifestyle risks Height, Weight, Body Mass Index (BMI) Visual acuity Blood pressure Haemoglobin Blood sugar Cholesterol Substance abuse screening Voluntary counselling and testing (VCT) for HIV and TB • Early diagnosis, early access to counselling, care, support and treatment. Ensuring that chronic diseases are properly managed. • Reducing absenteeism, improving productivity • Analysis of health trends over time and focusing management attention on emerging health issues 6
  • 7. IMMUNITY (CD4 COUNT) PROGRESSION OF HIV INFECTION OVER TIME HIV TREATMENT Deteriorating health Absenteeism Tuberculosis Disability Risk of death AIDS TREATMENT YEARS 7
  • 8. HIV/AIDS Key indicators 2008 2009 2010 2011 2012 81,450 66,661 73,129 77,075 70,690 18% 18% 16.5% 16.7% 16.8% Estimated number of HIV positive employees 14,444 12,057 12,066 12,864 11,884 Number of employees participating in VCT 63,817 54,662 68,741 70,909 57,810 Number of employees Best estimate of HIV prevalence Number of contractors participating in VCT Percentage employee VCT uptake 37,397 78% 82% 94% 527 1.17% Crude HIV incidence 82% 902 New HIV infections 92% 0.74% Number of HIV positive employees enrolled in HIV wellness programmes 7,361 6,116 7,105 7,846 8,361 % HIV Wellness programme enrolment 51% 51% 60% 61% 70% Number of employees taking ART 3,072 3,211 3,971 4,730 5,332 % of HIV positive employees taking ART 21% 27% 33% 37% 45%
  • 9. HIV Incidence trend amongst employees at Thermal Coal HIV Incidence 2.5% 2.0% 94% of employees retested for HIV every year since 2006 1.5% HIV Incidence 1.0% 0.5% 0.0% 2005 2006 2007 2008 2009 2010 2011 2012 9
  • 10. MOAE0203 Company-level ART provision to employees is cost saving A modelled cost-benefit analysis of the impact of HIV and ART in a mining workforce in South Africa Gesine Meyer-Rath1,2,3,4, Jan Pienaar10,11, Brian Brink11, Andrew van Zyl6, Debbie Muirhead5,6, Emma Beruter6, Alison Grant6,7, Rory Leisegang6,8,9, Lilani Kumaranayake5, Gavin Churchyard6, Charlotte Watts5 , Peter Vickerman5 1 Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK 2 Center for Global Health and Development, Boston University, US 3 Health Economics and Epidemiology Research Office (HE 2RO), Wits Health Consortium, South Africa 4 Faculty of Health Sciences, University of the Witwatersrand, South Africa 5 Department of Global Health and Development, London School of Hygiene and Tropical Medicine, UK 6 The Aurum Institute, South Africa 10 Anglo Coal Highveld Hospital, South Africa 11Anglo American, South Africa 7 Department of Clinical Research, London School of Hygiene and Tropical Medicine, UK 8 Division of Clinical Pharmacology, University of Cape Town 9 Health Economics Unit, School of Public Health and Family Medicine, University of Cape Town
  • 11. CONCLUSIONS OF LSHTM STUDY The cost of AIDS in the workforce is due to: • • • • Increased benefit* payments Absenteeism Training and recruitment Medical costs 44% 39% 7% 10% The cost of ART makes up only 5% of the cost of AIDS The savings under ART are mainly due to reductions in benefit payments and absenteeism costs by 14% - 18% Anglo American Thermal Coal mines have been saving 9% on the annual cost of HIV/AIDS by making ART available to their workforce since 2003 ($31.2 million reduced to $27.6 million) These results are based on real programme experience over 10 years The results demonstrate strongly that investment in treatment is worthwhile *Benefits include: disability, ill-health early retirement, death benefits, dependant pensions 11
  • 12. TUBERCULOSIS
  • 13. ANGLO AMERICAN TUBERCULOSIS INDICATORS 2009 2010 2011 2012 66,661 73,129 77,075 70,690 Pulmonary TB 786 582 758 517 Extra-Pulmonary TB 133 145 148 160 Total new TB cases 919 727 906 677 TB Incidence per 100,000 population 1,379 994 1,175 958 MDR TB Cases 12 19 28 TB Deaths 86 65 59 Employees 13
  • 14. ANGLO AMERICAN THERMAL COAL TUBERCULOSIS STATISTICS Annual TB Incidence Rate/100 000 1000 YTD Forecast for 2012 900 800 700 600 500 400 300 200 100 0 Annual TB Incidence Rate/100 000 2006 2007 2008 2009 2010 2011 2012 937 704 856 712 525 468 696 Annual TB Incidence Rate/100 000 Expon. (Annual TB Incidence Rate/100 000) 14
  • 15. CONTRACTOR CEO HEALTH AND WELFARE SUMMIT Johannesburg - 29 November 2012
  • 16. HEALTH OUTCOMES OF THE CONTRACTOR SUMMIT • All contractors are required to comply with and participate in Anglo American’s occupational health programmes and comply with standards • Long-term contractors will be required to participate in Anglo American’s Health and Wellness programmes in the same way as Anglo American employees. A monthly capitation fee ($20) will be levied if the contractors do not have health insurance. Anglo American will subsidise half the capitation fee. • Basic package of care will include a comprehensive response to HIV and TB including treatment. 16
  • 17. COMMUNITY HEALTH Facilitating tangible health improvements in local communities and Being a positive influence on health in developing countries
  • 18. HEALTH SYSTEMS STRENGTHENING IN RURAL COMMUNITIES • The pillars of health system strengthening are: – Improving health facilities and equipment – Human resources for health – the “health workforce” – Procurement and supply chain management – Financial management and funding (health insurance) – Health information systems – Governance and accountability – Monitoring and evaluation • There are many opportunities for companies to get involved by sharing core competencies. • Anglo American believes that sharing its health information system “theHealthSource” can be of great value for health systems strengthening in rural communities. 18
  • 19. theHealthSource 19
  • 20. THANK YOU

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