Envisioning the Future of Distributed Healthcare for the Developing World

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

2. 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.

3. 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.

4. 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

5. 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.

6. 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.

7. 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.

8. 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.

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

10. 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

11. 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.

12. 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.”

13. 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.

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

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

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

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

18. 1 2 3 4 5 6
Mobile support services are integrated
throughout the experience.

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

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

21. “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.”

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

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

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

25. 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.

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

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