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Fifth PPM Subgroup Meeting Cairo, June 3, 2008 Tackling Tuberculosis: Engaging the Corporate Sector.

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Presentation on theme: "Fifth PPM Subgroup Meeting Cairo, June 3, 2008 Tackling Tuberculosis: Engaging the Corporate Sector."— Presentation transcript:

1 Fifth PPM Subgroup Meeting Cairo, June 3, 2008 Tackling Tuberculosis: Engaging the Corporate Sector

2 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.

3 Company involvement Treatment Programmes Awareness Programmes None Aware- ness adhoc Awareness systematic Referral of sympto- matics Diagnosis/ treatment (workforce) Diagnosis/ treatment (workplace & dependants) Diagnosis/ treatment Workforce Dependants Community 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)

4 Bangladesh- Partnering with the Garment Industry Shared Corporate Health Centre COMPANY CONTRIBUTIONS NGO NTP DIAGNOSIS TREATMENT M & E COMPANY MEDICAL CENTRE Case Study

5 Bangladesh- Partnering with Garment Industry Two models: NTP ( supported by Leeds University ) Partner NGOs BRAC Damien Foundation PSKP 25 PPPs BGMEA Bangladesh Garment Manufacturers and Exporters Association Company DOTS Centres The Youngone DOTS centre in 2001 detected 668 TB cases; cure rate of 93% achieved in Shared Corporate Health Centre Dhaka EPZ hospital between , around 3000 TB cases were detected with a cure rate of 92% in 2006.

6 Philippines Workplace Model PPMD Unit NTP DIAGNOSIS TREATMENT M & E DOT Company clinic Case Study

7 Philippines Workplace Model PPMD Unit NTP DIAGNOSIS TREATMENT M & E DOT Company clinic Case Study Company A Major multinational computer chip manufacturing company (3400 employees) Referred 400 employees for sputum testing to a private PPMD unit in were diagnosed with TB (based on annual physical examination X-ray results.

8 Philippines: Workplace Model PPMD Unit NTP DIAGNOSIS TREATMENT M & E DOT Company clinic Case Study Company 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

9 Philippines: Unorganised Workforce Model NTP DIAGNOSIS TREATMENT M & E Local government support Walk in PPMD Unit Form people associations Case Study

10 Philippines Case Study 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%

11 Philippines: Philam Model- Organised Sector PhilAm clinic (HMO) NTP DIAGNOSIS TREATMENT M & E Company clinic Case Study 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.

12 Philippines: Philam Model- Unorganised Workforce PhilAm clinic (HMO) NTP DIAGNOSIS TREATMENT M & E Walk in Case Study HMO: Health Management Organisation Form people associations

13 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

14 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)

15 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)

16 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

17 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

18 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)

19 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.

20 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

21 Working with Business Coalitions on HIV/AIDS Source: Business Coalition Report 2007, World Economic Forum

22 Thank You For more information contact Monica Yesudian: Shaloo Puri Kamble:

23 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

24 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%.

25 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

26 Corporate Response: Opportunities Growing concern Nearly one-third of over 11,000 respondents from over 130 companies to the Forums 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.

27 Case Study Philippines- Engaging Businesses in National TB Response Three models: National TB programme (NTP) Phillipppines Coalition Against TB (PhilCAT) PPPs Industry Company Health Clinics Referrals, DOTS provision Industrial DOTS Centres Public or private public-private mix for DOTS (PPMD) units Health Maintenance Organisations Third Party- PhilAm Care/ Private Hospitals

28 Philippines Case Study 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.

29 Philippines Case Study Health Maintenance Organisations (HMOs)


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