learning from the past: hiv, tb and the science of service delivery patrick osewe world bank july...

Learning from the past: HIV, TB and the Science of Service DeliveryPATRICK OSEWE

WORLD BANK

JULY 24, 2014

Why is HIV so important?

HIV is unprecedented among epidemics A persistent pandemic that has global reach Garnered sustained global attention for more than a

decade More money mobilised than any other disease Generated many useful lessons for service delivery and

access

What we have learnt from HIV?

Strategic planning

Drug procurementM&E

Civil society involvement

Universal access

Life-long treatment

Targeting high risk groups

Gender Advocacy

ResultsDonor/government involvement

CostingModes of transmission

Behaviour change

Efficiency

What did we learn from reproductive health?

Health systems

M&E

Civil society involvement

Equal access

High risk groups

Gender Advocacy

Results

Donor/government involvement

Behaviour change

How to learn lessons? The example of the Science of Service Delivery Problem-driven approach Context sensitive Feedback loops, evidence and knowledge Multi-sectoral and multidisciplinary approach Adaptive leadership and change management Partnerships

Application to HIV and TB in the mining sector TB in the mines an emergency for 100 years Driven by poor living conditions, occupational risks,

circular migration, and, most recently, HIV Multi-sectoral, cross-border problem Public and private sector cooperation essential

Science of Service Delivery: solutions Targeting of high-risk groups Migrant outreach, multiple countries Testing and extension of occupational health services Contract tracing and family/community involvement Community mobilisation Stakeholder coordination Multi-sectoral, multi-partner approach All have common features with aspects of the HIV response

The South Africa Knowledge Hub Established between the World Bank and the Government of South

Africa in 2012 To extract best practices from South Africa to share with other

countries To bring international best practices to this region Establish a platform for consistent and productive south-south

knowledge exchange Eg, Knowledge Hub events in Pretoria (Sept 2013), Melbourne

(July), Cape Town (Oct)

The South Africa Knowledge Hub (2)

The way forward Encourage active participation by practitioners, implementers, and policymakers:◦ Identify and document lessons learnt – failures and successes◦ Assisted documentation through support services◦ Share experiential knowledge and disseminate best practices◦ Writing and publication workshops

THANK YOU

CONTACTS: ◦ Patrick Osewe, World Bank (posewe@worldbank.org)◦ Hannah Kikaya, Strengthening Health Systems

(Hannah.Kikaya@hmpg.co.za)