Mobile technology is being employed to help reverse the HIV/AIDS and Tuberculosis crises in South Africa, with a new scheme mooted to use the ubiquitous cell phone to deliver healthcare information and catalyse increased testing.
Annual ideas summit and social innovation network Pop!Tech, in partnership with a coalition of international organisations, has unveiled Project Masiluleke to harness cell phone technology in addressing massive public healthcare challenges.
In the coming year, the initiative will reach millions in South Africa – a country of 48-million people where 90% use mobile phones and AIDS kills 1 000 people every day – connecting citizens nationwide to critical health-related information, as well as lifesaving HIV and TB resources.
The project has also been designed to serve as a scalable, high-impact model that can be replicated worldwide.
Key contributors to Project Masiluleke include global design and innovation firm frog design; South African pro-social mobile messaging group the Praekelt Foundation; South African HIV and TB outreach organization iTeach; cellular telecommunications company, MTN; communications enabler Nokia Siemens Networks; non-profit scientific and educational organisation National Geographic; and a host of other partners.
Together, this team has invested several million dollars of in-kind value to establish the cell phone as a bridge to treatment – bringing those with HIV and TB into the healthcare system much earlier and greatly increasing their chances of living a long and healthy life.
The first stage of the project is built around the use of specialised text messages, delivering approximately 1-million HIV/AIDS and TB messages each day, for one year, to the general public.
These messages are broadcast in the unused space of "Please Call Me" (PCM) text messages – a special, free form of SMS text widely used in South Africa and across the continent.
Utilising technology from the Praekelt Foundation, message content from iTeach, design insights from frog design, and network capacity donated by MTN, the messages connect mobile users to existing HIV and TB call centres. Trained operators provide callers with accurate healthcare information, counseling and referrals to local testing clinics.
After three weeks of beta testing, the project has already helped triple average daily call volume to the National AIDS Helpline in Johannesburg.
Looking forward, assuming only 2% of PCM recipients respond in the coming year – and only half of those initiate an HIV/AIDS test – Project Masiluleke has the
potential to mobilise several hundred thousand South Africans to get tested in its first year alone.
Only 10% of South Africans with AIDS are currently receiving anti-retroviral (ARV) therapy, and of those who begin treatment, more than 40% do not remain on the drugs past two years.
Project Masiluleke will address this problem through the Praekelt Foundation's TxtAlert technology, which uses text messaging to remind patients of scheduled clinic visits – helping to ensure they adhere to ARV regimens.
For Project Masiluleke's second phase, plans are underway to implement "virtual call centres," where existing helplines will be augmented by teams of highly-trained, highly-adherent HIV+ patients.
These individuals will field questions remotely, via their mobile devices, from the general public. Counselors will be closely vetted, trained and represent "gold star" patients – extremely knowledgeable about their illness, diligent about their treatment regimen and intimately familiar with the weight of an HIV+ diagnosis.
These virtual call centres hold the potential to create hundreds of new jobs and considerably increase the capacity of South Africa's health response system.
Ultimately, with more HIV-positive citizens than any country in the world, and infection rates topping 40% in some provinces, South Africa demands a radical solution to truly reverse its HIV/AIDS and TB crises.
For the third phase of Project Masiluleke, the project partners are actively exploring a breakthrough distributed diagnostics model: low cost, at-home HIV testing with mobile counseling support. Analogous to a pregnancy test, these distributed diagnostics would provide a free, private and reliable way for anyone to take the critical first step of knowing his or her status, with high-quality information provided via mobile device.
Stigma is widely considered the number one impediment to increased HIV/AIDS and TB testing. Many in South Africa are unwilling to take the risk of being seen standing in line at a clinic, waiting to be tested.
The country's healthcare system is also tremendously overburdened and incapable of providing care to the millions who need it. A mobile-supported distributed testing service would address these impediments and help close the testing and care gaps – connecting home testers to knowledgeable counselors specially trained for this situation.