IN an effort to harness the power of mobile technology to help reverse the HIV/AIDS and tuberculosis (TB) crises in South Africa and beyond, a coalition of world-class organizations, domain experts and cultural figures have unveiled Project Masiluleke. The project embodies a vanguard new approach to these intractable public health challenges, tapping the cell phone as a high-impact, low-cost means to deliver health care information and catalyze increased testing. In the coming year, the initiative will reach millions in South Africa — a country of 48 million people, where 90 percent 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. “Project M” has also been designed to serve as a scalable, high-impact model that can be replicated worldwide.
Project Masiluleke, which means “to give wise counsel” and “lend a helping hand” in Zulu, is the first project of the Pop!Tech Accelerator (www.poptech.org ). Guiding the development of Project M are top HIV/AIDS, TB and mobile health experts in the US and South Africa. Key partners on the project have 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 health care system much earlier and greatly increasing their chances of living a long, healthy life.
The key elements and stages of Project M include:
“Please Call Me” x 1 Million x 365 – The first stage of the project is built around the use of specialized text messages, delivering approximately 1,000,000 HIV/AIDS and TB messages each day, for one year, to the general public. The messages connect mobile users to existing HIV and TB call centers. Trained operators provide callers with accurate health care information, counseling and referrals to local testing clinics. After three weeks of beta testing, Project M has already helped triple average daily call volume to the National AIDS Helpline in Johannesburg. Looking forward, assuming only 2 percent of those receiving messages respond in the coming year – and only half of those initiate an HIV/AIDS test – Project M has the potential to mobilize several hundred thousand South Africans to get tested in its first year alone.
“TxtAlert,” Keeping Patients Connected to Care – Only 10 percent of South Africans with AIDS are currently receiving anti-retroviral (ARV) therapy, and of those who begin treatment, more than 40 percent do not remain on the life-saving drugs past two years. Project M will address this critical problem through TxtAlert technology, which uses text messaging to remind patients of scheduled clinic visits – helping to ensure they adhere to ARV regimens.
HIV+ Virtual Call Centers – For Project M’s second phase, plans are under way to implement “virtual call centers,” 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 centers hold the potential to create hundreds of new jobs and considerably increase the capacity of South Africa’s health response system.
At-Home HIV Testing with Mobile Support – Ultimately, with more HIV+ citizens than any country in the world, and infection rates topping 40 percent in some provinces, South Africa demands a radical solution to truly reverse its HIV/AIDS and TB crises. For the third phase of Project M, 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 HIV status, with high-quality information provided via mobile device. A mobile-supported distributed testing service would help conquer the stigma of being seen standing in line at a clinic, waiting to be tested. The country’s health care 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.
