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Focusing
on a positive impact

For the Community, By the Community: Local Solutions Drive Global Goals

8
By Mariana Xavier, Manager Partnerships, J&J Global Community Impact EMEA

As we look to transform health systems and advance the Johnson & Johnson (J&J) commitment to the Sustainable Development Goals, people on the front lines of care will continue to play a critical role in making these objectives a reality.

Ninety million people around the world are infected with HIV and more than half of them live in sub-Saharan Africa. I had a chance to sit down with two of our partners who are at the center of this community, delivering essential testing, treatment, and care to the most vulnerable in the sub-Saharan African region. Joining us today are Ylse van der Schoot, Executive Director of North Star Alliance (North Star) and Kathrin Schmitz, Director of Programs and Technical Support at mothers2mothers (m2m). North Star is a Flagship Partner of Johnson & Johnson Global Community Impact in EMEA, and through the Johnson & Johnson Secondment Program, 10 J&J employees have transferred their skills and helped build the capacity of North Star to connect hard-to-reach populations with health. Mothers2mothers has been a partner of Johnson & Johnson for the last 13 years and assists women and families in five African countries across a range of reproductive, maternal, newborn, child and adolescent health issues.

Read on to learn how these partners are removing barriers to health, delivering care where it’s needed most, and preparing for the 2018 AIDS Conference happening later this month.

Mariana: How is your organization transforming health?

Ylse: North Star Alliance’s 49 Blue Box Clinics operate across 13 countries in the sub-Saharan Africa region. They are located at “hotspots” such as border posts, transit towns or ports where large numbers of trucks stop, load and offload, and where sex work and informal trades flourish. Most are open late, tailored to the hours of our core target populations, and this allows our organization to bring our health programs to the mobile communities who are most at risk. With the support of partners such as Johnson & Johnson, which not only provide funding for our initiatives such as a loyalty program for truck drivers, but also lend employees to transfer skills for example in the areas of marketing, supply chain management, and human resources, we have been able to grow our impact and deliver care to hundreds of thousands of patients a year.

Kathrin: m2m’s mission is two-fold: care and empowerment. We help women and families affected by HIV/AIDS across the African continent access healthcare services, stay in care, and adhere to treatment. We do this by employing and helping to empower HIV-positive women as frontline healthcare workers and peer educators, who work both in healthcare facilities and door-to-door in local communities to deliver services that stop the spread of HIV, help those who have the virus, and address related issues such as tuberculosis and nutrition. We believe in our model, and we’ve seen strong evidence that this “integrated service platform,” as we’re calling it, really works. In 2016, along with our partners, we enrolled almost two million new clients into care, and virtually eliminated the spread of mother-to-child transmission of HIV amongst our enrolled clients for the third year in a row.

We’re also working hard to scale our impact by equipping others to use and spread our model. In Kenya, for example, we helped the government plan and institute a nationwide Mentor Mother program (KMMP) from 2012 - 2017 as a core strategy to end mother-to-child transmission of HIV and syphilis. We’ve handed ownership of the programme off to the government and got the exciting news earlier this year that funding has been secured to expand the program to all 47 of its counties, and in all, almost 1,000 Mentor Mothers will be employed and deployed across Kenya as part of the country’s formal healthcare policy.

An m2m Mentor Mother, Dorothy visits her client Selina and Selina’s daughter, Prosper, in Bangwe, Malawi.

Mariana: How does your organization integrate community-led solutions?

Ylse: North Star is grounded in the needs of the communities in which we operate. In the early 2000s TNT, a logistics company started a partnership with the World Food Programme. During a famine, they discovered that they did not have enough truck drivers to deliver the food to the right locations because half of them were infected with HIV and dying of AIDS. They decided to improve the functioning of the supply chain by investing in the health of their employees, and that’s how our first clinic in Malawi was born.

Today, we are an NGO and our Blue Box clinics are still converted shipping containers painted blue. We chose them because they could be rapidly produced and deployed as needed at a relatively low-cost. Our clinics employ traditional healthcare providers such as nurses who are qualified to do all kinds of services for our clients who come into our clinics, but less traditional members of our team are also a critical component of our approach. For example, instead of waiting for patients to come to our clinics, our outreach coordinators proactively go out with peer educators from among the community to provide information and services.

Kathrin: The magic in m2m’s model is that services are being delivered by peers. There’s a really complex set of factors that prevent women from accessing healthcare or staying in treatment, and someone who’s walked the same path, has faced similar changes, and is from the same community, is uniquely positioned to provide peer education and support. In 2016, there were over 1,500 of these Mentor Mothers employed across eight African nations.

A community Mentor Mother who’s working door-to-door will literally go around in the community and seek out pregnant women or children who seem unwell, asking them if they have been to the clinic to receive antenatal care or HIV testing. Our Mentor Mothers based in healthcare facilities will then help them access services and navigate treatment. These Mentor Mothers are critical to our approach, going the greater distance to deliver care right where it’s needed — at the heart of the community.

Mariana : The annual AIDS Conference is just several weeks away. How will your team seek to shape the conversation about HIV prevention and care?

Ylse : This year, North Star Alliance is creating an experiential and memorable activation to help attendees understand our mission. One half of our booth will show a 360-degree virtual reality film about our work and the other half will have a mini-clinic for people to walk through. We’re really excited about it and we think it’s going to be a hit! We’ll also be participating in satellite sessions and speaking at events around the conference.

Kathrin : On July 23, m2m will host a satellite session about retention in care – a critical element to achieving the Global Goals. This will be the cornerstone of our presence at AIDS 2018, and we are bringing together a broad range of speakers, including our Malawi Country Director, one of our Mentor Mothers, and our partners UNAIDS, UNICEF, and Elizabeth Glazer Pediatric AIDS Foundation, to discuss innovative strategies to retain HIV-positive clients in care and ensure they stay healthy and adhere to their treatment. I’m excited to chair an open and candid session about what has worked and what hasn’t.

Visit the North Star Alliance Booth at the 2018 AIDS Conference to see their 360-degree Virtual Reality film and walk through a Blue Box Clinic.

Mariana: Do you have any final closing thoughts you’d like to share with readers of this blog and attendees of AIDS 2018?

Ylse: For those attending the conference, come to North Star Alliance’s booth (#640) and see for yourself the experience of our reality in Africa. And for the rest of the global community, we need to remember to include all the right people at the table if we want to end AIDS by 2030. Only through the power of many voices and perspectives can we do so.

Kathrin: We’ve made great progress, but we know many challenges lie ahead. 200 babies are still needlessly contracting HIV each day. There are incredibly high HIV infection rates among adolescent girls and young women as well, accounting for over a quarter of all HIV infections in East and Southern Africa in 2016 — even though they only make up 10 percent of the population. As a global community, we must continue to push forward with urgency if we want to end AIDS by 2030. And, we must center the community in all of our discussions, strategies, and actions. For the community, by the community — that’s how we’ll finish the job.

We also welcome everyone attending the AIDS2018 conference to visit the J&J and Janssen booth reinforcing our commitment and holistic response to the HIV pandemic globally, and believe that only by blending community-based solutions and scientific innovation, we will make HIV History.

Register for mothers2mothers’ satellite session, visit the North Star Alliance booth at AIDS 2018, and follow #AIDS2018 to participate in the conversation happening online.