Fifth PPM Subgroup Meeting Cairo, June 3, 2008 Tackling Tuberculosis: Engaging the Corporate Sector.
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Transcript of Fifth PPM Subgroup Meeting Cairo, June 3, 2008 Tackling Tuberculosis: Engaging the Corporate Sector.
Fifth PPM Subgroup MeetingCairo, June 3, 2008
Tackling Tuberculosis: Engaging the Corporate Sector
The Global Health Initiative is the health expert team of the World Economic Forum
Our focus is on the role of business in TB, HIV/AIDS and Malaria
Our mission is to catalyze tailor made public private partnerships
Partners
World Bank
Harvard School of Public Health
Board Level Participation Memorandum of understanding
Accenture, Adidas, Aditya Birla Group, Bayer, Boston Consulting Group, BHP Billiton, BD Medical, Chinese National Textile and Apparel Council, Eli Lilly, Eskom, Esquel Group, Exxon Mobil, GlaxoSmithKline, Heineken, iKANG, Jubilant Organosys, Ketchum Inc, Larsen and Toubro India, Merck and Co., Modicare, Novartis, Nike, Pfizer, Reliance Industries, Standard Chartered Bank, Siemens India, Sun International, Tata Steel, Volkswagen South Africa and Unilever Tea Kenya.
Company involvement
Treatment Programmes
AwarenessProgrammes
None
Aware-ness
adhoc
Awareness systematic
Referral of sympto-matics
Diagnosis/ treatment
(workforce)
Diagnosis/ treatment (workplace & dependants)
Diagnosis/treatment Workforce
DependantsCommunity
Engaging the Business Sector in TB care
NTP Collaboration may vary
Employee Access to Health Services
Company Health Clinics/ Hospitals
Public Sector Health facilities
Third Party Health Services(PPs, Panel of doctors, etc)
Bangladesh- Partnering with the Garment Industry
Shared Corporate
Health CentreCOMPANY
CONTRIBUTIONSNGONTP
DIAGNOSIS
TREATMENTM & E
COMPANY MEDICAL CENTRE
Ca
se S
tud
y
Ca
se S
tud
y
Bangladesh- Partnering with Garment Industry
Two models:
NTP(supported by
Leeds University)
Partner NGOsBRACDamien FoundationPSKP
25 PPPs
BGMEABangladesh Garment Manufacturers and Exporters Association
Company DOTS Centres
The Youngone DOTS centre in 2001 detected 668 TB cases; cure rate of
93% achieved in 2006.
Shared Corporate Health Centre
Dhaka EPZ hospital between 2004- 07, around 3000 TB cases were detected with a cure rate of 92% in 2006.
Philippines Workplace Model
PPMD UnitNTP
DIAGNOSIS
TREATMENTM & E DOT
Company clinic
Ca
se S
tud
y
Philippines Workplace Model
PPMD UnitNTP
DIAGNOSIS
TREATMENTM & E DOT
Company clinic
Ca
se S
tud
yCompany A • Major multinational computer chip
manufacturing company (3400 employees)
• Referred 400 employees for sputum testing to a private PPMD unit in 2007
• 17 were diagnosed with TB (based on annual physical examination X-ray results.
Philippines: Workplace Model
PPMD UnitNTP
DIAGNOSIS
TREATMENTM & E DOT
Company clinic
Ca
se S
tud
yCompany B (Stanfilco) • Program extends to employee dependents
and the community• Educated over 3,000 employees, their
families and surrounding community since 2004
• Facilitated the diagnosis and treatment of 100 employees out of 400 referred
• Provided infrastructure support to establish a DOTS facility
Philippines: Unorganised Workforce Model
NTP
DIAGNOSIS
TREATMENTM & E
Local government
support
Walk in
PPMD Unit
Form people associations
Ca
se S
tud
y
Philippines
Ca
se S
tud
y
• Advcocacy
• Diagnosis
• Treatment
PPMD Units: Industrial DOTS Centres
The Makati Medical Center • In 2006, received about 1300 for TB diagnosis- 153
referrals from the organized workforce (formal companies); 324 referrals from the unorganized workforce
• 141 diagnosed with TB- 74 TB cases from the organized workforce, 67 from the unorganized sector.
Our Savior Industrial Clinic • Caters to patients from 35 companies in
surrounding export processing zone (EPZ) area• In 2006, 187 employees referred to the clinic• All diagnosed and managed by the clinic• Treatment success rate of 86%
Philippines: Philam Model- Organised Sector
PhilAm clinic
(HMO)
NTP
DIAGNOSIS
TREATMENTM & E
Company clinic
Ca
se S
tud
y
HMO: Health Management Organisation
PhilAm Care currently covers 160,000 employees across the country.
In 2007, 30 persons referred for TB diagnosis- 10 diagnosed with TB.
Philippines: Philam Model- Unorganised Workforce
PhilAm clinic
(HMO)
NTP
DIAGNOSIS
TREATMENTM & EWalk in
Ca
se S
tud
y
HMO: Health Management Organisation
Form people associations
Key elements of a successful workplace programme
Management support and employee buy-in
Uninterrupted TB drug supply
Detect TB
cases
Provide
treatment
Report cases and track
outcomes
NTP Leadership
Advocacy
Company collaboration
Training
Potential Roles of Corporate Sector
Supply Chain
Community
Workplace(workers)
•Develop and implement workplace DOTS programme
•Extend reach to dependants, community and supply chain (vendors, distributors)
• Spread awareness and counter stigma• Identify TB suspects and refer them for diagnosis• Help TB patients to complete their treatment• Large-scale employers may set up a workplace DOTS programme• Implement infection control mechanisms• Integrate with HIV (including awareness, diagnosis, treatment, care and effective cross referrals)
Potential mechanisms to engage the corporate sector
NTP works directly with companies (signing of MoUs):• Advocacy (one to one meetings, tools, etc)• Training• Diagnostic reagents, microscopes• Anti TB drugs• Supervisory support
NTP may work through business associations, NGOs and civil society
• Global Health Initiative• Global Business Coalition• Regional Chamber of Commerce, Business Associations
(Bangladesh, Brazil)
Global Health Initiative: India Business Alliance
Partner Companies
•Run workplace and community TB and or HIV programmes
•Adopt anti- discriminatory policy and activities
•Provide in kind support•Engaged in R &D
Supporting NGO Network
36 Indian companies today reach several million people with
new TB programmes, few have expanded to TB/HIV Coinfections
Indian Government and technical partners
• Gives free technical support and training • Provides free diagnostic consumables, TB therapy and ART• Supportive supervision and external quality assessment
Challenges to Corporate PPM: Within the NTPs and policy makers
• Hesitation to engage the business sector • Lack of policies and practical guidelines to address specific traits and
needs• Limited capacity (staff time, motivation)- to initiate PPM/sustaining
quality while expanding a challenge
• Lack of information on TB and potential engagement • Little documented evidence on potential modes of involvement • Uptake and sustaining of companies’ interest in collaboration• Limited capacity for public health functions: poor patient retrieval,
limited referral links• Supervision by NTP/ NACP staff not always well received
Within the business sector
Business Engagement is a Win Win Situation
For the NTP– Reaching the ‘unreached’; meeting targets
– Pooling of resources: existing health infrastructures, systems and human resource, management skills
– Standardisation of quality TB care
– Shorter diagnostic delays
For the company
Through prompt diagnosis and effective treatment and by reducing transmission to other workers– Save costs by reducing absenteeism, staff turnover and re-training
– Opportunity for businesses to concretely demonstrate their social commitment
– Goodwill and reputation (indirect marketing)
Business Engagement is a Win Win Situation
For the worker– Improved compliance
– No loss of wages
– Saves cost of treatment
– Minimizes the stigma of TB among employers/ employees
For communities
TB management cures people and returns them to an active, productive life, which in turn benefits their children and other dependants.
• Self assessment tool: Dissemination of tool and analysis of results
• Mapping Exercise of ACSM WG: identify best practices and get insights into existing approaches
• Documentation: Success stories to build evidence base
• Adaptation of existing tools
• TB Toolkit: Indian and South Africa versions available; China in the pipeline
• Collaborative Group on TB/HIV: ILO, Stop TB, UNAIDS, WHO, World Economic Forum and business representatives
• Business Coalitions: mapping by GHI, build TB strategies into Business Coalition mandates
• Continue to use advocacy platforms provided by Global Health Initiative, Global Business Coalition and others
Ongoing and future activities
Working with Business Coalitions on HIV/AIDS
Source: Business Coalition Report 2007, World Economic Forum
Thank You
For more information contact
Monica Yesudian: [email protected] Puri Kamble: [email protected]
Proposed strategies
• Establishing interfaces, common forums with an inclusive
approach to resolve issues, build mutual trust, share
information and improve service delivery
• Well defined transparent mechanisms for dissemination of
experiences
• Strong leadership, flexible support by national
programmes
• Systematic approach, learning from pilots, revision of
strategies, repackaging communication and advocacy
messaging
• Sustained efforts to train and orient different providers-
adapting to needs, perceptions; pre-service training
• Prioritization: which partners to involve and when, to
maximally and rapidly benefit from partnerships
Who is involved?
Heineken: Test TB patients for HIV and vice versa, DOTS is provided and closely monitored by company clinics, with private health providers used at some sites
Anglogold Ashanti: found incidence rate of 3.1% among its workforce in 2006, with over 85% of those infected with TB also HIV-positive; also addressing MDR TB. Based on transmission control, Effective disease management, research, monitoring and evaluation and information, education and communication
Gold Fields: >30 yrs of awareness, diagnosis and treatment; encourage TB patients to test voluntarily for HIV and, if positive, option of enrolling in the company wellness programme; Anti discriminatory policy; encourage contractors; reported cure rate 85%.
Corporate Response: Context
• .
For the company, TB management can
• save costs by reducing absenteeism, staff turnover and re-training costs
– through prompt diagnosis and effective treatment
– and by reducing transmission to other workers
• provides an opportunity for businesses to demonstrate their social
commitment
Corporate Response: Opportunities
Growing concernNearly one-third of over 11,000 respondents from over 130
companies to the Forum’s Executive Opinion Survey (2007) expect the disease to affect their business in the next five years
One out of 10 expects the effects to be serious. Firms in sub-Saharan Africa, Asia, and Eastern Europe are
most concerned.Companies in countries hard hit by AIDS are particularly
worried about TB
TB management cures people and returns them to an active, productive life, which in turn benefits their children and other dependants.
Ca
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y
Philippines- Engaging Businesses in National TB Response
Three models:
National TB programme(NTP)
Phillipppines Coalition Against TB(PhilCAT)
PPPs
Industry
Company Health ClinicsReferrals, DOTS provision
Industrial DOTS CentresPublic or private public-private mix for DOTS (PPMD) units
Health Maintenance Organisations Third Party- PhilAm Care/ Private Hospitals
Philippines
Ca
se S
tud
y
• Referal to local PPMD unit for diagnosis
• Provision of DOTS at workplace
Company Health clinic
Company B (Stanfilco) • "TB DOTS in the workplace" program extends to
employee dependents and the community. • Educated over 3,000 employees, their families and
surrounding community since 2004• Facilitated the diagnosis and treatment of 100
employees out of 400 referred • Provided infrastructure support to establish a DOTS
facility
Company A • Major multinational computer chip manufacturing
company (3400 employees) • Referred 400 employees for sputum testing to a
private PPMD unit in 2007, • 17 were diagnosed with TB (based on annual physical
examination X-ray results.
Philippines
Ca
se S
tud
y
Health Maintenance Organisations (HMOs)