Final Challenging Partnerships Heidelberg Pres


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Presentation to students in the Master of Science in International Health program at the University of Heidelberg on HIV/AIDS Workplace Programs and coopertion with the private sector.

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  • Definition: Along the relationship continuum… The term PPP has been applied to a wide range of concepts. For example: Global health initiatives of large scale (the Global Fund to fight AIDS, TB and Malaria) Business relationships with public organizations (private sector supplying goods, works and services for projects financed by the United Nations) Privatization of public services and the public-private mix of health care provision (those partnerships described at more length by my colleague, Mr. Appelt) Public-private partnerships that are jointly planned, financed and realized by the companies and development aid organizations (those being described in this presentation). “ Partnership” in these cases can be characterized as jointly planned cooperation projects in which the participating organizations: cooperate transparently on a basis of equity to achieve a common goal in sustainable development. For these purposes, the partners contribute their complementary competences and resources and agree to share the risks and benefits of the joint project Proven added-value: Working alone cannot solve the problem PARTNERSHIPS ARE ENTERED INTO WHEN THERE IS NO CLEAR NON-PARTNERING ALTERNATIVE!! Federal Ministry for Economic Cooperation and Development ( German : Bundesministerium für wirtschaftliche Zusammenarbeit und Entwicklung ) works to encourage economic development within Germany and in other countries through international cooperation and partnerships. GTZ is one of several implementing agencies that implement the development policies of the German government.
  • The main principles of effective partnering, if met, ensure that there are advantages for all parties. These include: Equity => Respect Transparency => Trust Mutual benefit => Sustainability Advantages for Companies Advantages are donors’ key assets: GTZ, for example, offers organized, existing structures, a large pool of sector-specific know-how and of human resources from which to draw, and extensive networks of contacts on various levels – in short, GTZ has a large sphere of influence, which means it can influence actors on multiple levels. Corporate Social Responsibility (CSR) is a form of corporate self-regulation integrated into a business model . Essentially, CSR is the deliberate inclusion of public interest into corporate decision-making , and the honoring of a triple bottom line : People, Planet, Profit. There has been a shift in thinking about CSR . Instead of forced into, viewed as potential opportunities; instead of philanthropy, part of core business and strategic investment; from top-down to values-driven. WPPs, for example, are now viewed by businesses as being of direct benefit to business operations. GTZ can contribute financial and personnel…. Advantages for Development cooperation The private sector can mobilize additional resources such as hard and soft assets (cash and gifts in-kind vs. transfer of intellectual property and branding), industry-based knowledge, specialized skills (such as marketing and delivery systems) and extensive professional networks through which they can promote advocacy (business-to-business, -to-consumer, -to-government). Provides jobs opportunities for local population (capacity building is a key focus of GTZ’s work) Allows for transfer of technologies and instruments Helps to secure sustainability The private sector works more effectively and efficiently than the public sector in certain areas. PS also possesses less limited resources. PPPs can also be used to carry out initiatives in other sectors (water, environment, etc.)
  • Global Outlook/Overview The number of people living with HIV worldwide continued to grow in 2008, reaching an estimated 33.4 million. 2.7 million newly infected with HIV 2 million AIDS-related deaths From UNAIDS 2009: In 2008, 67% of all HIV positive people live in Sub-Saharan Africa . Sub-Saharan Africa remains the most heavily affected region, accounting for 71% of all new HIV infections in 2008 -- estimated 1.9 million people living in sub-Saharan Africa became newly infected with HIV in 2008, bringing the total number of people in SSA living with HIV to 22.4 million . Overall, the epidemic continues to have an enormous impact on households, communities, businesses, public services and national economies in the region. There may be fewer deaths and fewer new infections, but there are more people living with HIV….
  • Six national business coalitions on AIDS supported by ACCA: Namibia, Nigeria, Zambia, Mozambique, Tanzania and Kenya.
  • EABC provides a forum for reaching more companies for example, through newsletters and workshops and regional working group with private sector reps from five countries and in cooperation with the East African Community. They can develop standards in harmony with existing international standards and organizations (such as ILO, code of practice of HIV at the workplace). Migration: can increase due to opening of economic free trade/movement in southern Africa….affects all regions!
  • Why does employee health matter to business? HIV/AIDS is weakening people of working age and undermining the human capital base (pool of people with skills): Two out of three people living with HIV go to work each day. Evidence that the workplace is one of the most effective settings for responding to the epidemic! According to the ILO, 9 out of 10 people living with HIV are adults in their most productive years. In 2006, the global labor force had already lost 28 million people to AIDS, a number that is expected to grow substantially without a much stronger response from all sectors of society. Decreased productivity, increased absenteeism, staff turnover, increased costs related to training, recruiting, sick leave, supply chain disruptions, etc. Increased costs: According to the Financial Times, economists at a major mining and extraction company have estimated that the cost of not providing antiretroviral drugs for an HIV-infected employee, through absenteeism, early retirement, treating AIDS-related conditions, death benefits and recruiting replacements, is about US$ 32 000 per person.
  • Decrease costs: According to the Financial Times, economists at a major mining and extraction company have estimated that the cost of not providing antiretroviral drugs for an HIV-infected employee, through absenteeism, early retirement, treating AIDS-related conditions, death benefits and recruiting replacements, is about US$ 32 000 per person. Also, early investments in the AIDS response have proven to have long-term benefits. For example, early HIV education and prevention investments in Senegal, have resulted in one of the lowest infection rates in sub-Saharan Africa. CSR : Being part of an effective AIDS response generates goodwill and demonstrates a company’s commitment to strong corporate citizenship and to the wellbeing of its employees, customers and communities. Companies working in countries heavily affected by AIDS note improvements in productivity, morale and staff turnover when they take an active, visible role in the AIDS response. Innovation : Often working together in partnerships can bring about/inspire new ways of solving problems. Sustainability : It’s easier to get over barriers to finding a new way of operation that is more sustainable. Healthy workplace : In order for business to grow and be successful in the long term, there is a need for a healthy workforce. Specific business sector-based arguments which are context specific, that is, they vary depending on, for example, the disease or location in question.
  • Project Components : not in any specific order! First step is to ensure strong commitment, in which case, focusing on developing a workplace policy may be in order. If a situation analysis is needed beforehand…. Project components are developed and defined by the HIV/AIDS Taskforce of each company according to their specific needs. Analysis, Planning & Coordination Company size, geographical location and workforce structure determine interventions and activities for different project components. Situation analysis is conducted to establish prevalence, organizational structure and profile of the company, understand the legal and policy environment KABP (Knowledge, Attitude, Beliefs and Practice) survey conducted to establish a baseline Risk assessment (prevalence survey and cost benefit analysis): aims to measure and control the impact of HIV/AIDS on a company, e.g.. direct and indirect costs discussed in slide 9. Prevention & Education Awareness Awareness campaigns through behavior change communication (BCC) Promotion of VCT Social marketing of condoms Some examples from earlier WPPs Health Management Analysis of existing service provider landscape (internal and external) Eventual setting up of new health post for treatment of opportunistic infections, STDs and for ARV provision (there may be an existing on-site clinic, if not, may need to explore partnerships with service providers) Workplace policy Formulation of an HIV/AIDS workplace policy Appointment of an HIV/AIDS coordinator and committee Selection of Peer Educators Development of an action plan Monitoring and evaluation M&E systems continuously measure and evaluate the qualitative and quantitative of impact on a short, medium and long-term basis. Results-based monitoring has to accompany all components of a WPP (documentation of STDs, ARV provision, quality assurance of VCT, efficacy of education and awareness campaigns)
  • Background: this example is very interesting as it shows how stakeholders along the supply chain can be reached by a WPP! The port of Beira in Moçambique is situated at the mouth of the Pungue River. The port is jointly owned by the Dutch firm Cornelder (70 per cent) and CFM, the state-owned Mozambique ports and railway company (30 per cent). High adult prevalence rate in Sofala provice and the capital. Possible reasons for high rate in Beira Corridor: Mozambique shares border with Zimbabwe, Malawi, Zambia (HIV rates in these countries are high, migration) About 30 companies located nearby support operations within the harbor. Project started in November 2007 with a duration of 3 years, is a partnership between Cornelder de Mocambique and GTZ. In 2005 the German development agency KfW (Kreditanstalt für Wiederaufbau) had awarded $23 USD in funding to manage cargo handling and maintenance of the port, as well as improve port infrastructure. Also in 2005 some training of HIV/AIDS community leaders and educational sessions were held by the German development agency AwISa. Objectives Companies operating in the environment of the harbor have committed themselves to an HIV/AIDS and general health workplace program and policy.
  • Results to Date Of particular interest in this project is that it has reached the informal sector quite successfully (truck drivers, ship crews, sex workers) VCT training info August 2009 VCT tested 5038 workers and their family members 885 tested positive (17%) 675 women, 165 tested positive (24%)
  • Project Constraints National : firm, clear and uniform government policy, existing government policy on HIV/AIDS and employment, adopted national & international standards on infectious disease control, TB and STIs, existing civil society structures, existing strong business sector Companies: real commitment at both the management and workforce levels, sufficient long-term resources, adequate time allocation , willingness to build up additional human capital, constructive communication with donor (GTZ), human and logistical capacity for internal monitoring processes GTZ : Consideration of social and economic environment, allocating appropriate human resources to select and negotiate with partner companies, secure M&E capacity, handle admin. & logistical issues. Involves intensive communication and interaction with the partners. Need to allocate appropriate time and resources for follow-up Also a need to recognize and appreciate the companies’ priorities (need for mutual respect)! General Challenges Profit motives of company : there is still skepticism about the profit motives of private corporations involved in these partnerships, especially pharmaceutical companies, which often leads people to overlook any of their potential equity benefits. It is important, when choosing a partner from the private sector to assess the risks of exacerbating current inequity by engaging them? Is the partner viable? Balancing the public and private roles and responsibilities! Way Forward: Focus on the concept of „healthy workplaces“!
  • Final Challenging Partnerships Heidelberg Pres

    1. 1. Partnering for Change GTZ and Private Sector Collaboration in the Fight Against HIV/AIDS at the Workplace in Africa Dr. Birgit Lampe, Team Leader, GTZ-SPAA Anita Chávez, Project Officer, GTZ-SPAA MSc Master Course in Public Health Heidelberg, 17 December 2009
    2. 2. Overview <ul><li>Public Private Partnerships (PPPs) </li></ul><ul><li>State of the HIV/AIDS Epidemic </li></ul><ul><li>GTZ and Private Sector Collaboration on HIV/AIDS </li></ul><ul><li>Exercise: Why engage? </li></ul><ul><li>Business Engagement on HIV/AIDS </li></ul><ul><li>Components of an HIV/AIDS Workplace Program (WPP) </li></ul><ul><li>PPP between Cornelder de Moçambique and GTZ </li></ul><ul><li>Considerations of Partnering with Business on Health Issues </li></ul>
    3. 3. Public Private Partnerships (PPP) <ul><li>Types of PPPs </li></ul><ul><li>Global health initiatives </li></ul><ul><li>Business and public organisations </li></ul><ul><li>Privatization of public services </li></ul><ul><li>Jointly planned cooperation projects between development aid organizations and companies in which the participating organisations: </li></ul><ul><ul><li>cooperate transparently </li></ul></ul><ul><ul><li>on a basis of equity </li></ul></ul><ul><ul><li>to achieve a common goal in sustainable development. </li></ul></ul><ul><ul><li>For these purposes, the partners contribute their complementary competences and resources </li></ul></ul><ul><ul><li>and agree to share the risks and benefits of the joint project </li></ul></ul>
    4. 4. PPP: Advantages for all Parties Advantages for companies <ul><li>Mobilization of additional resources for development cooperation </li></ul><ul><li>Providing job opportunities for local population </li></ul><ul><li>Transfer of technologies and instruments </li></ul><ul><li>Securing sustainability </li></ul>Advantages for development cooperation <ul><li>Networks and contacts to governments, NGOs and unions </li></ul><ul><li>GTZ sector- or country specific know-how </li></ul><ul><li>Introducing cooperate social responsibility </li></ul><ul><li>Financial and personnel contribution by GTZ </li></ul>Principles of Effective Partnering: Equity, Transparency, Mutual benefit
    5. 5. State of the HIV/AIDS Epidemic <ul><li>Globally (2008) </li></ul><ul><li>33.4 million people living with HIV </li></ul><ul><li>2.7 million people newly infected with HIV </li></ul><ul><li>2.0 million AIDS-related deaths </li></ul><ul><li>Sub-Saharan Africa (2008) </li></ul><ul><li>67% of all HIV positive people live in SSA </li></ul><ul><li>22.4 million total number of people in SSA living with HIV </li></ul>
    6. 6. GTZ & Private Sector Initiatives on HIV/AIDS <ul><li>1999 PPP Program initiated by the BMZ </li></ul><ul><ul><li>Joint projects in more than 70 emerging/developing countries across a wide-range of sectors </li></ul></ul><ul><li>2000: WPP through PPP between DaimlerChrysler South Africa and the German government </li></ul><ul><ul><li>Extended to the SA subsidiaries of Robert Bosch, T-Systems, Roche, Volkswagen. </li></ul></ul><ul><li>2002: AIDS Control in Companies in Africa (ACCA) </li></ul><ul><ul><li>Established cooperation with subsidiaries of multinational companies (MNCs) in several African countries; </li></ul></ul><ul><ul><li>Directed technical and financial support of all GTZ-supported HIV/AIDS workplace programs; </li></ul></ul><ul><ul><li>Extended support to six national business coalitions on AIDS. </li></ul></ul>
    7. 7. GTZ & Private Sector Initiatives (cont.) <ul><li>2008: Support of the Private Sector in Africa to fight AIDS (SPAA) </li></ul><ul><ul><li>Objective: Strengthen and expand private sector contribution to combating HIV/AIDS at the national level through regional organizations. </li></ul></ul><ul><ul><li>Regional mediative structures can help: </li></ul></ul><ul><ul><ul><li>Raise awareness of members on health-related interventions at work; </li></ul></ul></ul><ul><ul><ul><li>Opportunities for discussing cross-border and standard-setting processes </li></ul></ul></ul>
    8. 8. GTZ & Private Sector Initiatives (cont.) The SPAA Partners Support of the Private Sector in Africa to fight AIDS SPAA Germany Project management Knowledge management Intn’l cooperations EABC (East African Business Council) -120 member companies and associations - Arusha, Tanzania <ul><li>SADC HIV/AIDS Unit </li></ul><ul><li>(South African </li></ul><ul><li>Development Community) </li></ul><ul><li>Gaborone, Botswana </li></ul>PABC ( Pan-African Business Coalition on HIV/AIDS) - 27 member coalitions - Johannesburg, South Africa
    9. 9. Exercise: Why engage? <ul><li>Working with the person next to you, brainstorm and write down what you think are the main interests of the private sector (business) to engage in combating HIV/AIDS? </li></ul><ul><li>Time: 5 minutes </li></ul>
    10. 10. Business Engagement in HIV/AIDS: Impact of HIV/AIDS on Labor <ul><li>Two out of three people living with HIV go to work each day. </li></ul><ul><li>9 out of 10 people living with HIV are adults in their most productive years </li></ul><ul><li>Global labor force had already lost 28 million people to AIDS (2006) </li></ul>
    11. 11. Business Engagement in HIV/AIDS: Other Reasons <ul><li>Decrease costs </li></ul><ul><li>Corporate Social Responsibility (CSR) </li></ul><ul><li>Healthy workplace </li></ul><ul><li>Innovation </li></ul><ul><li>Sustainability </li></ul><ul><li>Sector-based arguments </li></ul>
    12. 12. Main Components of an HIV/AIDS WPP Analysis, Planning & Coordination ------------------ Prevention & Education Awareness ----------------- Monitoring & Evaluation ----------------- Workplace Policy ----------------- Health Management ----------------- Situation analysis Concept development & planning Awareness campaigns Promotion of VCT Social Marketing Access to existing health services Health posts for treatment Condom provision Formulate workplace policy Appoint coordinator & committee Select peer educators Recording and reporting activities Systematic evaluation of all WPP components
    13. 13. PPP Cornelder de Moçambique (CdM) - GTZ <ul><li>Background </li></ul><ul><li>Sofala province adult prevalence rate 26% </li></ul><ul><li>Capital Beira adult prevalence rate 34% </li></ul><ul><li>24 subcontracted Companies with about 1,000 permanent employees and 2,000 part time workers </li></ul><ul><li>Objective </li></ul><ul><li>Create awareness on HIV/AIDS & improve access to prevention, counseling, testing and treatment measures for employees of sub-contractors operating along the value chain of the Beira harbor. </li></ul>
    14. 14. <ul><li>Results to Date </li></ul><ul><li>26 MoUs signed, 26 HIV/AIDS policies </li></ul><ul><li>Agreement between CdM and Beira private clinic </li></ul><ul><li>34 focal persons, 85 peer educators trained </li></ul><ul><li>> 14,000 people reached through sessions </li></ul><ul><li>Two VCT campaings held </li></ul><ul><li>Informal sector workers and employers </li></ul><ul><li>Contributions from third parties (90 PSI/HAI- sponsored theater groups) </li></ul>WPP Cornelder de Moçambique (CdM) - GTZ
    15. 15. Considerations when Partnering with Business on Health Issues <ul><li>Project-specific </li></ul><ul><li>National level </li></ul><ul><li>Company level </li></ul><ul><li>Donors level </li></ul><ul><li>General </li></ul><ul><li>Profit motives of corporations </li></ul><ul><li>Finding a balance </li></ul>The Way Forward: Healthy Workplaces
    16. 16. Thank you for your attention and interest! <ul><li>Contact: </li></ul><ul><li>Dr. Birgit Lampe: [email_address] </li></ul><ul><li>Anita Chávez: [email_address] </li></ul><ul><li> </li></ul>