Private sector-led HIV management programmes are providing a crucial thread of continuity while responses are urgently sought to funding cuts that severely constrain public sector and NGO treatment of the disease.
Maria Rambauli, General Manager of Aid for AIDS (AfA), one of the largest private disease management groups globally, says the disruptions to HIV management programmes are likely to have a profound impact beyond the lives of HIV-positive people to include families and employers.
“Successful management of HIV requires a holistic programme that extends beyond provision of antiretroviral therapy to constant monitoring, maintenance and real-time support for patients. Disruptions to this positive cycle of interventions place at risk the health outcomes that have been achieved over the past few decades,” she says.
The private sector currently funds HIV management for employees of corporates and medical scheme members through organisations such as Aid for AIDS, a burden that would otherwise fall on the public healthcare sector. Rambauli says AfA programmes deployed for corporates and medical schemes help to ensure that people needing care are able to stay economically active and continue to support themselves and their families.
Rambauli says AfA estimates that private sector management programmes have spared both the private and public sector substantial amounts by easing burden of care for both sectors.
“It seems unlikely right now that straight funding replacements can be found for NGO and public healthcare programmes. All organisations, both private and public, are developing responses, but we must acknowledge that there may need to be fundamental changes to how public and private sectors collaborate in managing HIV,” says Rambauli.
She believes that the private healthcare sector can offer significant support to a wider range of companies as well as the public sector in terms of cost and outcomes through enhanced collaboration and sharing of best practices.
Rambauli says AfA has developed unrivalled clinical expertise and disease management insights since its founding in 1998. The clinical expertise developed has also contributed to advances in innovative HIV management through several peer-reviewed research papers published in international academic journals.
AfA integrates all services starting with prevention and HIV awareness education to treatment and optimising the clinical wellbeing of beneficiaries registered on the programme. The organisation serves as care coordinator between the funder, doctors, pathology laboratories, pharmacists, and patients.
AfA manages an HIV population with a lifetime membership exceeding 500,000 individuals, of which 250,000 are currently active members. Among these, 99.3% are on antiretroviral therapy (ART), and 93.6% have achieved viral suppression. Notably, one of the programme’s earliest members joined at its inception and has remained on the programme ever since. Now over 80 years old and long retired, she continues to receive ongoing care and support, a reflection of AfA’s commitment to its members throughout every stage of life.
Rambauli says that more recent innovations in the form of AI and other digital tools are beginning to be brought to bear on AfA’s unique set of 27 years of data with the intention of sharing new insights widely.
“All of us involved in the treatment and management of HIV now have necessity driven opportunity to put our heads together in responding to the serious challenges created by withdrawal of aid funding.
“Any drop-off in the provision of public sector and NGO HIV management programmes will also have an impact on the private sector. But if we are proactive and collaborative, there is much that private and public healthcare can do to mitigate the worst impacts of the HIV funding crisis,” says Rambauli.
