Public-Private partnership structures to combat HIV/AIDS now roll out in Africa

By Henry Neondo

Public-private partnerships that use the organizational structures of private industry to promote HIV/AIDS prevention and treatment are now rolling out in Africa, delegates to a Leadership Forum were told here at a meeting of the 14th Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) held in Abuja, Nigeria from the December 4-9 .

The forum, co-chaired by Donald de Korte of Merck Sharp & Dohme (MSD), showcased a number of projects involving multi-national corporations doing business in Africa.
The projects, which are in various stages of development, included those involving Bonny Island in Nigeria, Daimler Chysler in South Africa, LaFarge and Heineken in Nigeria and Unilever in Ivory Coast.

“We need the skills of big business,” said Laurie Garrett, a senior fellow at the Foreign Relations Council in New York. She opened the meeting with a call for businesses to go beyond prevention and treatment programs for their own employees and commit their organizational skills and networks to stop the spread of HIV across the continent. “Which would you prefer from DHL,” she asked. “Their cash or their delivery system?”
Jay R. Pryor, Managing Director of Chevron-Texaco of Nigeria, Ltd., said businesses had much to offer governments and NGOs in the fight against AIDS. Among other things, he mentioned efficiency, organizational skills, teamwork and “the ability to push things.” But the focus of industry is often on short-term profit, he said, and what’s needed to combat AIDS is a long-term commitment to HIV prevention and treatment programs.

He urged all partners to begin “reading off the same page.”
Emmanuel Alhassan, special advisor on public-private partnerships at the National Action Committee on AIDS in Nigeria (NACA), called the coalitions “a win-win for all partners.”

He said Nigerian businesses had already played a pivotal role in helping to establish youth centers for HIV prevention, toll-free phone lines for confidential HIV counseling and public service announcements about HIV/AIDS on the MTN cell phone service, which has seven million subscribers in Nigeria.

Haladu Zangoma, reported that LaFarge, the cement maker, was now rolling out a comprehensive HIV prevention and treatment program among its 606 employees in Funakaye, Nigeria, a remote region in Gombe State.

The firm’s Nigerian subsidiary, AshakaCem, has teamed up with a German aid agency, GTZ, to offer anti-retroviral drugs for free to any employees or their dependents who test positive for HIV. It is also targeting high risk groups in the community, including truck drivers and commercial sex workers, for HIV education and treatment.
About 15 percent of staff have been voluntarily tested for HIV and 38 staff are now on anti-AIDS medicines, H. Zangoma said.

He said the community-based anti-retroviral program has been slower to roll out because people can’t afford the drugs even at discounted prices. The community soon hopes to receive U.S. government funding, under the PEPFAR program, to pay for the medicines, he said.

Dr. Ngozi Onyia, medical adviser to Nigerian Breweries Plc., a subsidiary of Heineken International, described some of the challenges of implementing a workplace HIV prevention and treatment program among 2,000 employees at five plants that produce Nigeria’s most popular lagers.

She said the HIV policy at the Nigerian subsidiary was developed by Heineken rather than being “home grown.”

Top management at Nigerian Breweries, she said, did not fully appreciate the threat of HIV in Nigeria and was reluctant to associate its brand name with HIV/AIDS. “We have a really excellent program, but there is a reluctance to publicize it for fear of association,” she said.

Another challenge, she said, was implementing the program in face of popular mistrust of government because of “previous corruption, inefficiency, bureaucracy and lack of accountability.”

But Dr. Onyia hailed “a new vision in the public sector” under Nigerian President Obasanjo and said funds provided by outside agencies, including the U.S. government under its PEPFAR program, were being “credibly utilized.”

Participants in the forum described one of the most ambitious public-private partnerships now being launched – a cooperative effort to bring HIV prevention and treatment to workers in the oil and natural gas industry on Bonny Island in the Niger Delta. The area, which is home to 30,000 indigenous people from the Ibo tribe as well as up to 150,000 migrant workers, has high levels of poverty, unemployment, poor sanitation, and other public health problems.

Major corporations are now linking up with tribal chiefs, other community people and government to develop a comprehensive program to combat HIV and offer treatment to those who need it.

Dr. Furo Ibiama told the forum that the chief challenges for the program, which is to roll out in January 2006, are getting the private sector fully engaged and overcoming skepticism in the community. But the need, he said, was great, with an estimated 10 percent HIV infection rate among adults, twice that of the overall prevalence rate in Nigeria as a whole.

He said the injection of disposable income among the oil workers into the local economy had created a booming business at bars, restaurants and night clubs which, in turn, had fueled high-risk behaviors that spread HIV.

Dr. Igor Any-Grah described the anti-AIDS campaign being waged by Unilever, the international manufacturer of brand-name foods and personal care products, among its 2,000 employees at three sites in Ivory Coast. The program, begun in 2001, provides HIV prevention and free access to antiretroviral drugs to employees and their families. It is now attempting to extend HIV testing and treatment to local communities in order to broaden its impact.

Carol O’Brien, South African director of the Global Business Coalition, commended Daimler Chrysler for implementing workplace HIV prevention and treatment programs for its employees in South Africa, which has the largest number of people living with HIV infection of any country in the world.

She said the company, in partnership with other business groups and the Eastern Cape AIDS Council, was now expanding its efforts in the Eastern Cape, which has the highest poverty rate in the country.

C. O’Brien said the experience in South Africa indicates that each partner in a public-private partnership must benefit from participation and that a partnership “only works when both parties want it to work.”