 |
||||||||||||||||||||
|
||||||||||||||||||||
 |
 |
Bristol-Myers
Squibb Philanthropy – An Introduction to SECURE THE FUTURE® It was early 1999. Even as much of the world was preparing to greet the promise of the new millennium at year-end, in Africa the grim reality of the staggering HIV/AIDS pandemic continued to turn slim hopes into overwhelming despair. As former South African president Nelson Mandela once said, the HIV/AIDS pandemic was a threat that put in the balance "the future of nations. AIDS kills those on whom society relies to grow the crops, work in the mines and factories, run the schools and hospitals and govern countries. It creates new pockets of poverty when parents and breadwinners die and children leave school earlier to support the remaining children." From the start of the HIV/AIDS pandemic in the 1980s through the end of 1999, some 14.8 million people in sub-Saharan Africa had died -- more than the combined populations of New York City and Los Angeles. During this period, more than 20 percent of those who died were children. Even though sub-Saharan Africa has only one-tenth of the world’s population, it accounted for almost 80 percent of all AIDS deaths worldwide and about 70 percent of people living with HIV/AIDS. Life expectancy and years of "healthy life" were in decline and there were extraordinary numbers of orphans, leading to economic havoc and civil disorder. By 1999, Bristol-Myers Squibb, a leading global pharmaceutical company with a large HIV/AIDS antiretroviral franchise, was searching for an additional role to play in fighting the pandemic. With encouragement from U.N. Secretary General Kofi Annan, the company did act, by making the largest corporate commitment up to that time in the fight against HIV/AIDS. Bristol-Myers Squibb’s SECURE THE FUTURE® initiative was born in May 1999, initially in five countries in southern Africa (Botswana, Lesotho, Namibia, South Africa and Swaziland), and then, in 2001, in four countries in West Africa (Burkina Faso, Cote d’Ivoire, Mali and Senegal). It began as a five-year, $100 million commitment and has since been extended. By June 2005, the company had committed $150 million to SECURE THE FUTURE, the first and still largest corporate commitment of its kind to fight HIV/AIDS in Africa. The initiative is an unprecedented public-private collaboration to help alleviate the HIV/AIDS crisis among women and children in sub-Saharan Africa, the region most affected by the pandemic. According to a UNAIDS/WHO report, an estimated 25.4 million adults and children in sub-Saharan Africa were living with HIV at the end of 2004 – that is approximately 64 percent of all people and 76 percent of all women in the world living with the disease. Of the total, there were an estimated 13.3 million women and 1.9 million children younger than 15 years of age living with AIDS in the region. There were 12 million orphans ages 17 and under in the region due to AIDS. SECURE THE FUTURE seeks to prevent HIV/AIDS and STD transmission; to reduce the impact of HIV/AIDS on individuals by empowering infected and affected women and children; and to expand access to treatment by informing public health policy. The initiative is helping to fight this pandemic through funding sustainable and replicable programs focusing on innovative community outreach and education as well as medical research and care. Simply stated, the aim of this program from its very beginnings has been sustainability and capacity and infrastructure building, that is: What models could be developed that could endure long after this program ended? Could sustainable institutions be created and fostered that would allow the people being served to learn to cope with the tragedies of HIV/AIDS? How could small organizations grow into larger organizations, attracting additional funders? Could programs be appropriately evaluated by independent professionals? How could financial and other controls be ensured? Since its inception, a number of principles have guided SECURE THE FUTURE. It is: a public-private partnership as embodied in government policies against HIV/AIDS and compatible with and complementary to health care priorities; governed cooperatively; sensitive to the local context; ethically unassailable, a catalyst for expanded participation; promoting equity; and characterized by grants that must be innovative, sustainable and replicable. Program ideas come from the "field," where local staffs direct the program and local independent advisory boards provide guidance. The active participation of Ministries of Health, medical and educational institutions, physicians and other health care professionals and local non-governmental, community-based and faith-based organizations are integral elements of project creation and funding. Independent auditors ensure financial and other controls in funded programs, and the Yale School of Public Health directs and trains evaluators on the ground to assess program efforts. Since 1999, some 200 grants have been awarded. They have run the gamut from a theatrical troupe that tours villages to promote HIV and sex education and awareness, to programs that offer economic opportunities and training for the grandmothers who have now become the caregivers for AIDS orphans. A new lower-cost test to monitor HIV blood levels has been developed. Programs that help orphans deal with the loss of their parents have been generated. Public health fellowships have been funded, lay health workers have been trained, parish nurses have been given new tools to counsel and care for the sick and dying and for those they leave behind. New approaches to prevent mother-to-child HIV transmission have been explored. Home based care solutions have been developed; counseling programs funded; orphans have been cared for; capacity and infrastructure has been built; and various forms of community outreach encouraged. Medical Research and Care
SECURE THE FUTURE grants are funding five medical centers focused on caring for childen, one in operation since 2003 in Botswana and two under construction, in Lesotho and Swaziland, and two more to be built in Burkina Faso and Uganda. The Botswana-Baylor Children’s Clinical Center-of-Excellence at Princess Marina Hospital in Gaborone has more than 1,200 children in treatment, one of the largest concentrations of children in care in any center worldwide. The center, in partnership with the government of Botswana, is staffed jointly by Baylor College of Medicine and health care professionals from Botswana and other African countries. In addition to caring for children, the center is used for training health care professionals and conducting research for this vulnerable population. Research programs funded by the SECURE THE FUTURE seek to provide practical and sustainable solutions for patients in settings where resources are constrained but where the needs are great. With women and children as the primary beneficiaries, studies to date have generated effective and relevant clinical data which is shared with the African medical communities. The initiative funds clinical trials in antiretroviral therapy; prevention of mother-to-child transmission of HIV; opportunistic infections such as respiratory viruses and hepatitis; and tuberculosis in HIV-infected people. It also funds psychosocial studies focused on such areas as stigmatization.
Through SECURE THE FUTURE funding, the Baylor College of Medicine and Nursing School – in collaboration with UNAIDS, National Nursing Association, and the South African Development Community AIDS Network of Nurses and Midwives – developed a comprehensive HIV curriculum. Initially developed for schools of nursing in Africa, the HIV Curriculum for the Health Professional had been distributed in 47 countries by early 2005. The initiative
also provided funding for the Botswana HIV/AIDS Reference
Laboratory, operated by the Botswana-Harvard Partnership in Gaborne.
SECURE THE FUTURE partnered with the national
government and the Harvard AIDS Institute to create a technologically
advanced laboratory on the grounds of the country’s biggest
hospital, Princess Marina. Projects at the laboratory have included
vaccine research, a large scale research study of antiretroviral
therapy to treat AIDS and HIV infections, and skills transfer and
capacity development.
Community Outreach and Education Many community outreach and education projects demonstrate how communities can mobilize and maximize existing infrastructure in the fight against HIV/AIDS.
There are no real divisions between people living with HIV/AIDS and the people who care for them. It is on this premise that Johannesburg’s Community AIDS Response (CARE) provides support for people living with HIV/AIDS, their families and those who care for them, through an integrated program at large metropolitan hospitals. In the first year of operation CARE supported 1498 people living with HIV/AIDS through 27 volunteer counsellors, befrienders and professionals. During the second year this increased to almost 6000 people. An important aspect to the success of the community projects is the networking between organizations and sharing of lessons. The Botswana Christian AIDS Intervention Programme (BOCAIP), established to reduce the impact of HIV/AIDS through integrated counseling strategies encompassing pre and post test counseling, home visitations and trauma counseling, held a conference attended by religious leaders from all over Africa. The objective of the conference, entitled ‘Working Together – Networking a Pan-African HIV/AIDS Christian Response’ was to strengthen current interventions through the sharing of experiential knowledge and has resulted in the formation of PACANET – a Pan-African Christian Network Initiative. Not only does the initiative provide financial resources but it has assisted with skills development and capacity building. Catholic AIDS Action in Namibia has developed and implemented minimum standards for home-based care in the country. Through the provision of training, supervision and advocacy, Catholic AIDS Action has ensured that these standards are not only maintained but improved in line with international trends. The fellowship
program hosted by the National
School of Public Health at the Medical University of South Africa
(MEDUNSA) provides intensive training in community-based
program strategy and design, implementation and evaluation; health
systems management and health policy development; and the biology
and epidemiology of HIV/AIDS. Program participants receive Postgraduate
Diplomas in Public Health. Some are awarded Masters Degrees. Based on the successes, impact and learnings from SECURE THE FUTURE grants, individually and collectively since its inception, the initiative is pursuing a strategy of focusing on new approaches to fight the pandemic. In the middle of the third year of the initiative, Ministries of Health, Technical Advisory Committee members and other program leaders recommended combining the best learning from the community and medical care grants into model programs that could provide effective comprehensive care, increase access to medicines and monitoring and establish broad-based community support in resource-constrained settings in impoverished urban and remote areas. The result is establishment of the innovative Community-Based Treatment Support Program for sustainable, integrated medical care and community support that can serve as a legacy. Six model collaborative centers have been opened, in South Africa, Swaziland, Lesotho, Botswana, Namibia and Mali. The centers provide medical treatment combined with care and support beyond the clinics, including home-based care, psychosocial counseling, food security, orphan care, and income-generating projects. Another program in the new focus approach is the Bristol-Myers Squibb Foundation NGO Training Institute. Because NGOs and CBOs play a critical role in helping communities deal with the pandemic, strengthening their ability to develop, execute and scale-up programs is an essential and ongoing need. The Institute is designed to develop management, good governance and leadership capacity. In 2004, there were more than 1,700 participants in pilot training courses in five southern African countries. The success of SECURE THE FUTURE cannot be measured by looking at a significant reduction in infections in the countries where the program operates. Rather, it will be measured by the criteria for success set at the beginning of each of the 200 grants – and evaluating how far they have come. It will be measured by the good that organizations and groups do in contributing to their communities and villages and the people they help. It will be measured by their ability to sustain their efforts and expand them – and eventually, indeed, by the public-private partnerships that will be created to begin to reverse and eventually help defeat the pandemic, over time.
|
||||||||
|
Download Acrobat® Reader to view PDF files >>
|
SECURE
THE FUTURE has become an active partner with the medical communities
in host nations. Many successful public-private partnerships have
developed. Significantly, these partnerships, spanning industry,
government, academia and communities, support government principles.
The endorsement of clinical research programs by Ministries of Health
emphasizes the governments’ commitment to finding innovative
ways to fight the disease.
