Making Connections

Sunday, April 29, 2007

It’ll take 22.5 hours – not counting the 10 hour layover in London – to get to Swaziland. That’s a lot of air miles. But the point of our trip is to lessen the distance between (RED) shoppers around the world and the (RED) shareholders in Africa. Like most businesses, (RED) exists to generate returns and create value. Our dividends are a bit non-traditional, however, as we measure them in number of “lives saved.”

I fly to Swaziland today to meet some of the moms and kids that have been saved since inspired, empowered people started purchasing (RED) items from our brand partners – Gap, Motorola, Converse, Emporio Armani, Apple, and American Express – generating $25 million for the Global Fund to invest in HIV/AIDS programs in Africa. We may only have launched last year, but already (RED) shoppers have put us at number 15 on the list of contributors to the Global Fund. And 100% of (RED) funds go directly into the field to activate efforts that represent the best performing and neediest programs in the Global Fund’s portfolio.

Swaziland was chosen as the second country, after Rwanda, to receive a (RED) grant through the Global Fund. With a population of 1.1 million, Swaziland’s HIV prevalence is 33 percent, and life expectancy is 42. Among pregnant women, HIV prevalence is at 39 percent. More than 70,000 children have been orphaned by this treatable, preventable disease. These data may seem daunting but (RED) consumer power is already making an impact. With an initial disbursement of $5.3 million, (RED) funding has already provided the medicine needed to keep 17,000 people with HIV/AIDS alive, in addition to providing the medicine to ensure that the children of HIV positive moms are born healthy, and providing support for over 59,000 vulnerable children.

But numbers only tell part of a story… usually the dry part… so we are going to share the pictures and words and feelings that make the fine connection, which is the poetry of understanding. Understanding is a two-way street or, maybe a better way to say it, is that understanding is “linked hearts” like the West African Akoma Ntoso symbol featured on some of the (GAP) RED shirts. We want (RED)’s shareholders in Swaziland to feel connected to the (RED) consumer community, just as we want the (RED) community to feel connected to the people we’ll be meeting in Swaziland. We know it’s important to “show the money,” so all can see that (RED) is working. But showing the money, we hope, will also make clear that these connections are real in a much deeper sense. Central to (RED) is the idea that all participants in the value chain get embraced ( ) – the purchaser, the corporate partner, and those impacted by HIV/AIDS in Africa. This world needs more embraces.

More from the Manzini, after meeting up with my travel companions: Christy Turlington Burns, (RED) ambassador; Adele Sulcas from the Global Fund, and Julie Cordua, (RED). Nicole Hahn, who was with us on a May 2006 trip to Rwanda and Lesotho, will also be joining to help us gather this chapter on film. Stay tuned…

--Tamsin


Below are more details about Swaziland, along with our itinerary:

(RED)/GLOBAL FUND SWAZILAND GRANT OVERVIEW

To date, (RED) has generated $25 million for the Global Fund. $11.7 million is already at work in Africa, funding programs in Rwanda ($6.4m) and Swaziland ($5.3m). A third Global Fund grant, in Ghana, will be added to the Global Fund (RED) portfolio later this year.

Swaziland Quick Facts:

• Population: 1.1m
• HIV prevalence: 33%
• Health spend per capita: $66
• Life Expectancy: 42
• Number of people living with HIV: 220,000
• The number of children orphaned by the disease: more than 70,000
• HIV prevalence among pregnant women rose from 4% in 1992, to 43% in 2004, dropping to 39% in 2006

Overview of Swaziland Grant:
Grant amount (5 year total): $52,544,145
Amount disbursed so far: $36,468,215
Amount of RED money disbursed: $5,268,370
Program start date: August 1, 2003
Program end date: July 30, 2008
Principal Recipient: Swaziland’s National Emergency Response Council on HIV/AIDS (NERCHA)

Swaziland Results: (RED)™ money that has flowed to Swaziland supports Global Fund-financed programs which have already:

• reached over 8,200 mothers with services to prevent mother-to-child-transmission of HIV
• trained over 150 midwives and doctors in the prevention of mother-to-child transmission of HIV
• reached almost 100,000 people with voluntary counseling and testing for prevention of HIV
• trained over 70 counselors to teach prevention of HIV
• set up over 35 counseling and testing centers for prevention of HIV
• established feeding schemes in 335 schools
• built 277 community feeding centers (KaGogo centers)
• provided education support for over 59,000 vulnerable children
• provided anti-retroviral therapy for HIV/AIDS to over 17,000 patients
• trained over 800 nurses and doctors in treating patients with HIV/AIDS
• trained almost 3,000 health workers to deliver home-based care for HIV/AIDS patients

Swaziland’s 5-year goals: (RED)™ money that has flowed to Swaziland supports Global Fund-financed programs in Swaziland which aim to:

• reach over 12,000 mothers with services prevent mother-to-child-transmission of HIV
• train over 300 midwives and doctors in the prevention of mother-to-child transmission
• reach over 120,000 people with HIV testing, results and post-test counseling
• train over 1600 nurses and doctors in clinical management of HIV/AIDS
• provide almost 33,000 people with anti-retroviral therapy for HIV/AIDS
• continue to support community feeding centers and school feeding centers already established
• continue to provide educational support for vulnerable children
• train 400 traditional healers in HIV management and referral

Swaziland’s HIV/AIDS program goals for the next 2-3 years are necessarily ambitious, including a four-fold increase in the number of women receiving treatment to prevent mother-to-child transmission of HIV and almost doubling of the number of people on ARV therapy. In order to meet these targets, additional funding of $16 million (during the remaining 2 years of the 5-year duration of this grant) will be needed. The Global Fund will disburse this money in small increments, committed every 3 months, contingent on continued adequate program performance and achievement of results relative to targets jointly agreed between the Principal Recipient and the Global Fund.

NERCHA Overview
The Global Fund grant in Swaziland is managed through NERCHA, the National Emergency Response Council on HIV/AIDS.

NERCHA is mandated by the Swaziland government to coordinate and facilitate the national mulitsectoral response to HIV/AIDS.

NERCHA’s vision: an AIDS-free Swaziland.

NERCHA’s mission: To provide the coordination and facilitation of the national multisectoral emergency response to HIV/AIDS, by creating an environment that supports effective service delivery to the people of Swaziland.

Swaziland’s National AIDS Program (SNAP) was created in the Ministry of Health in 1989. NERCHA was created in 2001, after King Mswati III declared HIV and AIDS a national disaster, in 1999. Swaziland has the highest HIV prevalence in the world.

NERCHA is the Global Fund’s “principal recipient” in Swaziland, meaning all Global Fund financing for the national program is channeled directly to NERCHA. A large majority of this funding goes towards providing antiretroviral treatment free of charge to all Swazis medically “eligible” for ARV treatment. ARVs have only been available free of charge since 2003, when the first Global Fund grant (the (RED) grant) began funding the national program.

NERCHA’s implementation of the national AIDS program focuses on 3 main areas:

1. Treatment, care and support
2. Prevention
3. “Impact mitigation” for Orphans and Vulnerable Children (OVCs)

TRIP ITINERARY
The Global Fund and NERCHA have arranged visits at a variety of locations that receive (RED) money. Below is an overview of each organization we’ll visit and background on a few of the specific individuals we’ll meet.

DAY ONE: Wednesday, May 2
Meet with NERCHA at NERCHA offices:

• Briefing by Derek, Khanya and Dumisani on NERCHA work, with a focus on ARV distribution and orphans and vulnerable children (OVCs)
• Context setting re: issue of HIV/AIDS in Swaziland – how far we have come in the past 3-4 years?
• What has been the impact of the availability of ARV treatment?

DAY TWO: Thursday, May 3
Mbabane ART centre

• Establish the context for how the majority of Swazis receive their anti-retroviral medication.
• Guide: Dr Patrick Okoth, Sibongile and Rejoice on behalf of Dr Velephi Okello, national ART coordinator, who will be out of the country.
  

Baylor Clinic Visit

• Baylor Clinic is a private pediatric AIDS clinic providing “PMTCT+” services (a “whole family” care model); all ARVS distributed here to women and children are Global Fund-financed ARVs
• Guide: Dr David McCollum – context setting for clinic’s activities and GF role
• Ms. Lulu Vilapati, clinic translator and patient liaison – recipient of GF-funded ARVs

Ms. Lulu Vilapati, Age 23
Lulu was tested and diagnosed with HIV in 2003 when she was pregnant and extremely sick with diarrhea, thrush and a host of other common opportunistic infections. In her role as clinic translator, she plays a vital role in comforting families laboring under misconceptions and fears about their own HIV status, as she is a vibrant example of how treatment with ARVs can allow individuals to regain strength and vitality.

Her 25-month old daughter, Sinetepha (“we have hope”), is HIV-negative, thanks to the kind of mother to child transmission prevention efforts that the Global Fund is financing with (RED) money.



Hope Heals Visit

• Hope Heals is a support group for over 100 HIV-positive individuals created by Ms. Sylvia Khuzwayo, and which is run informally from her home
• Guide: Ms. Sylvia Khuzwayo, HIV+ mother and Director, Hope Heals

Ms. Sylvia Khuzwayo, Age 39
Sylvia is a mother who has been living openly with HIV for 7 years. She discovered her status after joining a support group from a desire to do charity work. She lost her husband 9 years ago – the hospital told her it was throat cancer but she later found out AIDS was the cause.

Through Hope Heals, she helps individuals dealing with the difficult practical aspects of their illness and treatment. Living openly with HIV is no small feat in Swaziland, where stigma remains a deterrent to talking about HIV.

DAY THREE: Friday, May 4
Esitjeni Kagogo Centre Visit

• Background: KaGogo (meaning “Granny”) centers are used as service delivery points for small communities, for everything from education to food storage.
• Guide: Ms. Inkhosikati LaMtsetfwa, Director, Esitjeni Centre and volunteer coordinator

Ms. Inkhosikati LaMtsetfwa
Inkhosikati coordinates a group of 23 volunteer caregivers and cooks at the Esitjeni KaGogo Center. The site provides two Global Fund supported functions: (1) a community center called a “KaGogo”, and a neighborhood care point; which serve 230 children from the surrounding area.

KaGogo (“Granny”) centers are used as service delivery points for small communities, for everything from education to food storage. The centers serve as classroom, community meeting space, community kitchen for feeding orphans and, in some cases, as micro-credit and savings program meeting places. The Global Fund finances 277 such KaGogo centers in Swaziland. At Esitjeni, 60 of the children are “double” orphans, 117 have no father, and another 46 have no mother. In Swaziland, grandmothers are well-respected in the community, but also serve increasingly as the main caregiver for families when mothers and fathers pass away.