This program earned a Silver award.
It is becoming clearer that the ongoing increase in HIV/AIDS is leading to a concurrent increase in TB. It is estimated that 10-15% of newly-diagnosed HIV+ clients will have active TB. Also, people generally only test for HIV for medical reasons (ie. Because they are already showing symptoms of an illness), which means that there are large numbers of people who do not know their status, are asymptomatic, but who are infectious. In order to try to address this, @heart partnered with Desmond Tutu TB Centre to begin providing outreach VCT centres, which also have TB testing facilities. In other words, the service is brought to the community, both lightening the burden on healthcare centres, and encouraging people to be tested before they start to show symptoms. In partnership with Imizamo Yethu, @heart also provides community support services, carrying out home visits, accompanying clients to the local clinic, and providing information and education on HIV, TB and related health and social issues. The programme aims to test 600 people per quarter per year. Through this, it is also hoped to reduce some of the stigma attached to HIV/AIDS in many communities, to lower the incidence of STIs and drug abuse, and to create caring communities that accept, support and care for their HIV-infected and affected people. It is also important to encourage adherence to ART, and to encourage early testing, so that one’s status is known.
Innovation: By taking the service to communities, the clinics help to reduce the burden on health care centres in the area (thereby improving the quality of service to those attending the health centres); and to encourage testing among those who are still asymptomatic. It is therefore encouraging a preventative, rather than a responsive, approach to HIV and AIDS. By also focusing on TB, it is providing testing, care and treatment for two of the major health problems in the province.
Effectiveness: The clinics have been able to achieve their targets (of 600 people per quarter per year) since 2007. @heart has also been contracted by the Department of Health to deliver an Employee Assistance Programme to personnel in the Cape Winelands Regions for all provincial government personnel. There have also been ongoing negotiations with the local community, to ensure their buy-in and support of the process.
Poverty Impact: By encouraging early testing, the project encourages people to know their HIV status, to access treatment early, and to begin living positively, without posing risk to themselves or others. It also helps to enable health-care centres to provide better treatment, by reducing the burden they face in terms of VCT.
Sustainability: By encouraging local community buy-in, the gains made through the VCT and TB services become more sustainable. The majority of funding (80%) comes from the Desmond Tutu TB Centre, and this is an ongoing partnership. DTTC has also contracted @heart to deliver the service in support of a research report in collaboration with Stellenbosch University, and this has been guaranteed for three years, with the option of extending for five years. Imizamo Yethu also provides 10% of the funds; and the Department of Health provides a further 10%. The Stellenbosch Municipality has also provided buildings and materials for the project; and the training costs (through ATICC) were also covered. A number of corporate sector stakeholders have been approached for funding, through their Corporate Social Responsibility programmes. Thus, the project is seemingly sustainable.
Replication: The need for this service is apparent, both by the ongoing high infection rates across the country, but also by the number of similar projects that have applied for awards over the years. Thus, it seems that these projects are incredibly necessary. Similar projects could be replicated in other areas, although funding and training would need to be accessed. Seemingly, many companies are willing to sponsor HIV projects as part of their CSR, thus it may be relatively easy to obtain funding for similar projects. However, strong community buy-in is necessary. If the community does not support the project, it will fail.