Project Masiluleke - Pop!Tech 2008

Project Masiluleke Envisioning the Future of Distributed Healthcare for the Developing World

South Africa has the greatest burden of HIV / AIDS in the world. KwaZulu- Natal province is one of the hardest hit regions in South African.

HIV / AIDS has overwhelmed the healthcare system. 80-90% of hospital beds are ﬁlled with AIDS patients. There are 7,000 counselors in the entirety of South Africa serving 48 million people.

quot;We know the challenges of the systems we are working in. What we need is some sort of innovative intervention that can allow us to spread our wings.quot; Zinhle Thabethe Founder, iTeach KwaZulu-Natal Province, South Africa Partner, Project Masiluleke

10,000,000 200,000 1. AWARENESS 2. REFERRAL 3. TESTING 4. TREATMENT 40% 10% 5% 2% 4,000,000 400,000 500,000 200,000 People estimated HIV positive people People have tested People currently in HIV infected in KZN will develop AIDS and know their treatment. 40% each year status default in 2 years. We are part of an historic partnership to envision new solutions that address gaps at each stage of the epidemic.

10,000,000 200,000 1. AWARENESS 2. REFERRAL 3. TESTING 4. TREATMENT Stage 1: Mobile Awareness We recently launched a service to deliver information on HIV / TB to the broadest population at the lowest cost using mobile technologies.

HOW IT WORKS The service works by embedding health care messages alongside ‘Call-Me-Backs’ a type of free messaging that is unique to Africa and used primarily by low income people in poor communities. These messages contain direct links to AIDS counseling services. MTN, the second largest mobile operator in South Africa has donated 5% of their messaging inventory to this initiative. It is estimated that 80-90% of South Africans have access to a mobile phone.

RESULTS The service went live in October with approximately 1 million messages a day targeting low income South Africans. Overnight Project Masiluleke has tripled the number of calls into the National Aids Helpline to more than 3,000 calls a day. This number should increase even further when the Zulu version of the service launches in November. Over the next three months we will be rotating di erent messages to determine which are the most e ective in motivating people to reach out for counseling and voluntary testing.

But awareness is just the beginning. We are now exploring innovative ways to deliver testing and counseling services directly into people’s homes.

All experts agree that earlier diagnosis and treatment are the only e ective ways to combat this epidemic. quot;A key to this is how do you deliver information – which is what a diagnosis is – at the lowest possible cost.” George Whitesides University Professor of Chemistry, Harvard Founder, Diagnostics For All

10,000,000 200,000 1. AWARENESS 2. REFERRAL 3. TESTING 4. TREATMENT Step 2: Home Testing Services For the next phase of Project M, we are actively exploring a breakthrough distributed diagnostics model: low cost, at-home HIV testing with mobile counseling support.

This solution focuses particularly on young men who are largely absent from the system. 85% of men said they are less likely to test. 78% of men would prefer to test at home. “I wouldn’t visit the clinic because of the undigniﬁed way health care workers handle the issues of patients.” “I don’t want people to see me standing in queues. I want it to be private and secret.”

GUIDING PRINCIPLES Global Local A universal problem that requires local solutions. A Bridge to Healthcare Services Home testing isn’t an isolated event; it’s an entry point. Private, but not Alone Mobile services support the testing process.

The outer packaging provides a strong, positive message of health & wellness that can tailored to di erent regions.

The package opens easily to reveal simple instructions that rely on minimal literacy. All components of the packaging are used.

The instructions are designed for low literacy and provide direct links to mobile support and counseling.

We are collaborating with JOZI one of South Africa’s most popular hip hop bands to support the message.

1 2 3 4 5 6 Mobile support services are integrated throughout the experience.

A wallet-sized pamphlet provides detailed information and links to free mobile support service whether you are positive or negative.

The response through several rounds of focus groups and concept testing has been overwhelmingly positive.

“I think they would love this kind of test. People are so afraid to go to the clinic. We would like to have this test instead.” “It is important, and this system can be easy, because people are afraid, but everyone needs to know their status.” “We are all looking forward to them! You need to hurry up and get them out, so I don’t have to see my other friends die.” “You’re very late. I’ve watched so many of my friends die, because they are too scared to go to the clinic.”

The test kit uses low-cost materials without any wasted components. Assembly is easy.

The components can be distributed in large volumes to rapidly achieve economies of scale.

Communities can participate in assembling the kits while building local pride and fostering a strong sense that they can help themselves.

SCALABLE SOLUTION OFF-THE-SHELF DIAGNOSTICS 1 Rapid advances in low cost diagnostic tools that provide immediate feedback. MODULAR PACKAGING SYSTEM 2 Low cost packaging that can be easily adapted to the needs of di erent markets. MOBILE SERVICES 3 Integrated mobile platform to deliver support through ultra low cost messaging services. 4 LOCAL ASSEMBLY & DISTRIBUTION Active participation by the community in assembling and distributing the solution. 5 TRUSTED NETWORK RELATIONSHIPS Support from mobile network operators to provide mass distribution of health information.

An integrated platform of mobile services can be scaled across the region and to other markets.

The best way to predict your future is to create it. Abraham Lincoln

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Project Masiluleke - Pop!Tech 2008

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