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African AIDS Crisis Program From Bristol-Myers Squibb
  On November 24, 2003, Bristol-Myers Squibb held a community press briefing in midtown Manhattan at the Millenium Broadway Hotel at 9am to announce the next phase of their aid program to address HIV/AIDS in Africa. This was followed the next day by a briefing for main stream press. Present were several community press, BMS officials, and officials based in Africa. “Secure The Future” is the name of the BMS program started several years ago. A series of speakers discussed the accomplishments of the program, their personal experiences, what they learned about making change in Africa, and they announced a $30 million commitment for the next phase of the program. Below you will find the BMS Press Release, and papers presented at the press briefing by BMS explaining the accomplishments, experiences, and the funding & programmatic initiatives for next phase which incorporates the provision of treatment for HIV-infected individuals and prevention of mother-to-child transmission.
Reported by Jules Levin
Largest Corporate Commitment of its Kind Poised to More Effectively Fight Pandemic in World’s Hardest-Hit Region
Press Release from BMS: (NEW YORK, November 21, 2003) — On the eve of World AIDS Day, Bristol-Myers Squibb Company (NYSE: BMY) announced today the next phase of SECURE THE FUTURE® with the allocation of six new program grants totaling $30 million. These grants are part of the ongoing $115 million commitment made by Bristol-Myers Squibb and the Bristol-Myers Squibb Foundation as part of the SECURE THE FUTURE initiative, the first significant and largest corporate commitment to fight HIV/AIDS in Africa. The program focuses on sub-Saharan Africa, where nearly 70 percent of people infected with HIV/AIDS worldwide – and 80 percent of the children – live.
“SECURE THE FUTURE is establishing a new paradigm for combating the AIDS pandemic in Africa,” said Dr. Pearl Ntsekhe, director, Disease Control Division, Lesotho Ministry of Health and Social Welfare. “The unique approach of offering both community and medical services is critically important to efforts to stem the devastation of this disease.”
“Through SECURE THE FUTURE, Bristol-Myers Squibb is helping to lead the global fight against the HIV/AIDS pandemic,” said Peter Dolan, chairman and chief executive officer, Bristol-Myers Squibb. “This is one of the greatest human tragedies of all time, and while making a substantial financial commitment is critically important, we have gone beyond that. Our program has pioneered the development of public-private partnerships that are benefiting the hardest-hit populations in Africa, especially women and children.”
SECURE THE FUTURE is a five-year initiative to support projects that help women and children affected and infected by HIV/AIDS. To date, the initiative has provided grants totaling $96 million, including this new allocation, to more than 150 programs in nine countries in southern and western Africa. The goal is to develop sustainable models in resource-limited settings for community outreach and education, as well as medical research and care. The program’s focus has been to address the region’s most significant needs including local training and support for community-based initiatives, building internal resources and infrastructure and implementing modern science within a local context.
The six new grants will fund programs at community and medical centers that incorporate key learnings from other SECURE THE FUTURE programs. The new programs will be launched in Botswana, Namibia, Lesotho and Swaziland, as well as South Africa – the area of the world most devastated by the HIV/AIDS pandemic.
Progress Through Partnerships
SECURE THE FUTURE programs are guided by unique partnerships among Bristol-Myers Squibb, national ministries of health, non-governmental organizations (NGOs), community-based medical and educational organizations, and faith-based organizations (FBOs). Through these partnerships, SECURE THE FUTURE focuses on supporting rural communities challenged with limited resources and with needs that have not been addressed by other programs.
“The relationships we forged through SECURE THE FUTURE are as important as the funds we received,” said Reverend Edward Baralemwa, executive secretary, Pan African Christian AIDS Network (PACANet). “Our partners helped us with process and procedure improvements, they showed us how to achieve our objectives better and they enhanced the well-being of our entire organization.”
The newly issued grants support programs that reflect the best examples of this partnership model. One program will support a partnership program in the isolated Caprivi region of Namibia with a focus on prevention of mother-to-child transmission of HIV/AIDS. The program will establish support group networks and nutrition services and provide care through a new voluntary counseling and testing center.
Another new SECURE THE FUTURE grant that also is designed to help address the problem of mother-to-child transmission of HIV in Swaziland will mobilize people through door-to-door outreach – and build infrastructure through a community initiative that includes volunteers, buddies/mentors and community-based activities.
Another SECURE THE FUTURE grant will fund the country of Lesotho’s first center to provide an antiretroviral therapy program in the Maseru district. The aim is to deliver equitable access to quality care and support.
“Bristol-Myers Squibb understands that developing and providing antiviral drugs are only part of the formula for success in changing the course of the AIDS pandemic in Africa,” said John McGoldrick, executive vice president, Bristol-Myers Squibb. “SECURE THE FUTURE seeks to provide medical treatment to resource-limited communities as well as to educate people on ways to prevent further transmission of the virus and provide support to those infected and affected by the disease.”
Leveraging Lessons Learned
Since its inception, a key principle of SECURE THE FUTURE has been to support innovative community-based programs that have the potential to be replicated and expanded cost-effectively.
“The success of the SECURE THE FUTURE model results from listening to the needs of community members and empowering them to develop the solution,” said John Damonti, president, Bristol-Myers Squibb Foundation. “We don’t tell communities what to do or how to do it, and we don’t just provide funds or do the work for them. We are on the ground in Africa working side-by-side with local organizations to help them build and define their future.”
The Future
SECURE THE FUTURE has engaged Family Health International (FHI), an organization working worldwide to address comprehensive health issues in resource-poor settings, along with local monitoring and evaluation specialists to develop a framework for measuring the success of the new grant programs. These efforts will help ensure that metrics are incorporated at the design stage of new initiatives and that existing resources are invested in the most effective programs.
“We were the first ones in Africa trying to do something no one else has, so it took us a while to develop effective ways to deal with the pandemic. But at this we have learned how to create and support programs with successful treatment outcomes coupled with strong community support for people living with HIV/AIDS,” said McGoldrick. “Our company will continue to stand behind our mission by developing programs that extend and enhance human life and hope that others will join us, because despite all efforts there still remains much, much more to be done if we are to stem the tide of this epidemic.”
Bristol-Myers Squibb is a global pharmaceutical and related health care products company whose mission is to extend and enhance human life.
Major Accomplishments
In the four years since the program’s inception, more than 150 SECURE THE FUTURE‚ grants have been awarded by Bristol-Myers Squibb Company and the Bristol-Myers Squibb Foundation. These grants have supported programs ranging from theatrical troupes that tour villages educating people about HIV/AIDS, to innovative approaches to prevention of mother-to-child transmission. While mistakes have been made along the way, it is clear that amazing success and major accomplishments have been achieved already and continue to be achieved each day.
Community Outreach and Education Grants
  • A small program taught 48 grandmothers to provide home care for their terminally ill children and to care for their grandchildren orphaned by AIDS. The success of this program led to the development of Grandmothers Against Poverty & AIDS (GAPA), an even larger support system for grandmothers in the Western Cape Province of South Africa. GAPA helps older women with informal business ventures and food security initiatives, provides HIV/AIDS care and support training, addresses emotional issues and works to destigmatize HIV/AIDS.
  • In KwaZulu-Natal, South Africa, nearly 100 volunteers have been trained to counsel orphans on the grieving process and help them create memory boxes containing family mementos and important documents.
  • More than 3,000 community health motivators have been trained in Swaziland, and each motivator visits approximately ten homesteads regularly.
  • More than 5,100 people have been supported spiritually, psychosocially and economically in Botswana.
  • A traveling theatrical troupe has performed for nearly 2,000 villagers in Botswana, teaching them about the complexities of HIV/AIDS and preferred solutions.

Medical Care and Research Grants
  • Seventy HIV/AIDS medical care and research programs are underway or complete in sub-Saharan Africa.
  • A new reference laboratory at Princess Marina Hospital was established in Gaborone, Botswana, and was instrumental in developing a national antiretroviral treatment program.
  • The continent’s first pediatric HIV/AIDS center was opened in Botswana; SECURE THE FUTURE provided funds for this world-class center’s construction and operations. The clinic provides care, training and infrastructure for groundbreaking medical research.
  • Three hundred and sixty nurses have been trained to train other nurses in 14 southern African countries on the management of HIV/AIDS, including epidemiology, pathophysiology, testing and counseling, antiretroviral treatment, and psychosocial, legal and ethical issues. The curriculum has been requested by more than 47 nations worldwide.
  • Landmark research in the antenatal prevention of mother-to-child transmission of HIV was funded by a grant from SECURE THE FUTURE.
  • Nearly 10,000 HIV-infected patients have been involved in medical care and research programs.
  • Seventeen publications have been generated from 10 medical care and research programs.

Medical Care and Research Programs
Through SECURE THE FUTURE‚, Bristol-Myers Squibb Company seeks to provide community outreach and education, as well as medical research and care to people living with HIV/AIDS in southern and western Africa. SECURE THE FUTURE awards medical grants to support innovative, therapeutic research conducted by local scientists and doctors. The goal of these grants is to increase the capacity of African countries to manage the AIDS epidemic successfully.
Since the inception of SECURE THE FUTURE in 1999, Bristol-Myers Squibb has awarded 77 medical research grants totaling $45 million. These grants have provided support for many successful initiatives, including:
Creating a Children’s Clinical Centre of Excellence
With approximately one-third of the population between the ages of 15 to 49 diagnosed as HIV-positive, Botswana is one of the countries that has suffered the most during the HIV/AIDS pandemic. Thousands of children also are infected with HIV, and many have become orphans. To address the needs of this vulnerable population, Bristol-Myers Squibb provided nearly $10 million in funding care and research activities through SECURE THE FUTURE at the first center in Africa focused exclusively on caring for children with pediatric HIV/AIDS.
The Botswana-Baylor College of Medicine Children’s Clinical Centre of Excellence at Princess Marina Hospital in Gaborone opened in June 2003. It represents a unique partnership among a government, a corporation and an academic institution. In addition to the support provided by SECURE THE FUTURE, the Baylor College of Medicine’s International Pediatric AIDS Initiative and the Republic of Botswana are supplying resources for the center. The center provides medical care for children living with HIV/AIDS, conducts clinical research and trains health care professionals about the disease. Ultimately, the goal of the center is to serve as a model for the development of other such centers across Africa and around the world. Since its opening, more than 1,000 children already have received treatment at the center. Funding Technological Advances in Botswana
Although Botswana has been dramatically impacted by HIV/AIDS, the country has moved into a leadership role in seeking to stem the tide of HIV/AIDS. SECURE THE FUTURE is supporting this evolution by partnering with the national government and the Harvard AIDS Institute to create the first HIV reference laboratory in the country.
The $4 million laboratory is located on the grounds of Botswana’s biggest hospital, the Princess Marina, and provides the setting for carrying out clinical trials. The laboratory supports a number of projects, including skills transfer and capacity development; the improvement of tools for monitoring HIV/AIDS; assessment of resistance depending on drug regimen; and the first large-scale research study of antiretroviral therapy to treat HIV infection in Botswana. It was recently expanded to increase
Botswana’s capacity to monitor wide-scale antiretroviral treatments. One key clinical trial being funded through the hospital is the TSHEPO Study. The two goals of the study are to evaluate resistance to antiretroviral therapies in a southern African setting and to evaluate adherence to antiretroviral treatment regimens. Programs like the TSHEPO Study are critical to helping not only identify the best treatment regimens for patients, but also the most effective community-based intervention strategies.
Prevention of Mother-to-Child Transmission
Ninety percent of all HIV/AIDS cases in children worldwide are due to mother-to-child transmission of the disease. Although doctors have been successful in reducing the transmission of HIV/AIDS with prepartum and intrapartum treatment of pregnant HIV-positive women, no intervention method has been validated for prevention of transmission to infants whose HIV-positive mothers did not receive antiretroviral therapy antenatally or during labor.
With SECURE THE FUTURE grants totaling more than $600,000, Glenda Gray, M.D., director of the Perinatal HIV Research Unit at the Chris Hani Baragwanath Hospital in Soweto, South Africa, conducted the world’s first research study to determine the efficacy of a postpartum treatment regimen using certain antiretroviral agents for infants. These drugs had been studied for reducing transmission when given during pregnancy or in labor. However, no studies to date had evaluated methods of preventing transmission from mother-to-child after birth. Dr. Gray’s innovative work in this area recently earned her and her co-investigator the prestigious Nelson Mandela Award for Health and Human Rights.
Key Learnings
Four short years after Bristol-Myers Squibb Company first set out to be an active partner in addressing the HIV/AIDS crisis on the African front, the company has learned that to make a difference and mitigate the impact of HIV/AIDS requires more than a significant financial commitment. While its landmark program, SECURE THE FUTURE‚, was the first to successfully face the issue head-on, Bristol-Myers Squibb also was the first U.S. company to try and address a public health crisis in sub-Saharan Africa – a region with a vastly different economy, culture, government and view of medicine. Early challenges led to learnings that continue to influence the priorities, strategies and ongoing successes of the program. Diverse Needs
One of most significant and immediate challenges was understanding and responding to local needs. Even geographically close regions in Africa may have vastly different cultural or socio-economic backgrounds. The chronic nature of HIV/AIDS is underestimated and it is even harder without the basic needs of life. Initially, Bristol-Myers Squibb tried to develop programming based on known public health models and not localized needs. The company soon discovered the need to change its approach, so that it was closely aligned with current governmental AIDS policy and priorities. Only with support and guidance from within the countries, were the supported programs likely to be effective, respond to the needs of the local culture and ultimately become sustainable.
Finding Solutions
Early on, Bristol-Myers Squibb saw the need to redirect efforts. To achieve sustainable change, the company needed to reach out to local organizations and, with their important help, identify workable solutions. Through this process it became clear that the keys to success were to:
  • Identify community programs that work locally and provide the support, guidance and training needed to grow/expand.
  • Build capacity of organizations to plan, implement and monitor programs so that successful programs continue to receive support.
  • Provide resources to increase infrastructure (healthcare, laboratory services, research equipment, transportation).
  • Address other factors driving the pandemic such as food security and poverty alleviation.
  • Implement science of the developed world and create synergies with traditional medicine.

Partnership for Success
SECURE THE FUTURE continues to embrace different forms of partnerships, recognizing these are essential to the overall success of the initiative. Partnerships involve more than financial commitments and can take the form of in-kind donations, skills transferring, best practice sharing, or evaluation. SECURE THE FUTURE has learned that partnering with other organizations such as foundations, faith-based organizations, non-governmental organizations, government agencies, medical institutions and corporations proves to be an invaluable way to provide economic, medical and psychological support to people living with HIV/AIDS. SECURE THE FUTURE continues to evolve as the epidemic evolves and new research and learnings become available.
In an effort to continue to learn from the program, Bristol-Myers Squibb has built ongoing independent evaluation mechanisms into the SECURE THE FUTURE program. Local monitoring and evaluation specialists, working under the direction of the Yale School of Public Health, are reviewing the impact of the program in Africa. The ultimate goal is to continue to shape and refine a philanthropic paradigm that other organizations, governments or foundations can use to develop sustainable and replicable solutions to the crisis in Africa.
$30 Million New Grant Allocations
Since the launch of the groundbreaking SECURE THE FUTURE‚ initiative in 1999, the Bristol-Myers Squibb Company and the Bristol-Myers Squibb Foundation have funded more than 150 HIV/AIDS programs throughout the sub-Saharan region of Africa. To date, $66 million of the $115 million initiative has been allocated to programs focusing on the needs of women and children. SECURE THE FUTURE consults with African governments, medical communities, leaders and civil society organizations to identify the most pressing needs in the fight against HIV/AIDS in an effort to determine how to make the greatest, sustainable impact.
The commitment to stemming the tide of this terrible pandemic continues with six new community-based grants totaling $30 million. Based on key learnings from the past four years, these new grants will all work locally and provide support, guidance and training needed for growth; teach organizations how to apply for funding; provide resources to increase infrastructure; increase access to basic needs such as food and water; and implement science from the developed world within a local context. The six grants will be implemented in the following locations: Swaziland, Namibia, Lesotho, Botswana and South Africa.
Approximately 33.4 percent of the population in Swaziland has HIV/AIDS and the number of orphaned children is 35,000 . With a focus on preventing mother-to-child transmissions, this pilot operational research and community-based program will mobilize people through door-to-door outreach – and build adequate infrastructure through volunteers and buddies/mentors as well as community-based activities. Additionally, the program will teach people about treatment options and provide essential nutritional and psychosocial support. Lastly, this program will pilot the provision of the “Prevention of Mother-to-Child Transmission Plus” concept including triple antiretroviral therapy for HIV-infected mothers, newborns and partners.
There are 230,000 adults and children living with HIV/AIDS in Namibia and 47,000 children under the age of 15 who have lost their mother or father or both parents to AIDS1. Recognizing the severity of this problem, a new SECURE THE FUTURE grant will help establish a program to address the problem of mother-to-child transmission in the Caprivi region.
The program goal is to reduce the prevalence of HIV infection and AIDS morbidity and mortality. SECURE THE FUTURE funds will help educate people and ultimately change perceptions and behaviors through targeted civic education programs; establish capacity-building initiatives such as support groups and nutrition services to those affected by HIV/AIDS; and provide care through a voluntary counseling and testing center.
Anticipated results include an introduction of “Prevention of Mother-to-Child Transmission Plus” and highly active antiretroviral therapy (HAART) in a hard to reach and extremely resource limited region that share its borders with Botswana, Zambia, Angola and Zimbabwe.
Seventy-three thousand children are orphans because of HIV/AIDS in Lesotho. An estimated 31 percent of adults are living with HIV/AIDS and more than half of those are women.1 In an effort to provide much needed education and therapies, a SECURE THE FUTURE grant will fund the country’s first center to provide an antiretroviral therapy program in the Maseru district. The aim is to deliver equitable access to quality care and support for those affected persons.
The program goals will be pursued through a tripartite partnership involving private, community-based and non-governmental organizations, and the public health sector. The focus of this initiative is to provide a learning center for a national rollout of antiretroviral therapy and strengthen the non-governmental organization sector, thus supporting those affected by HIV/AIDS.
Nearly 40 percent of adults in Botswana live with HIV/AIDS and 26,000 people died of AIDS during 20011. To help people living with the condition, a national antiretroviral therapy program was developed. The government of Botswana welcomed SECURE THE FUTURE to extend a partnership to a remote and resource-limited Bobirwa sub-District of Bobonong to fast-track this community inclusion in the national rollout.
SECURE THE FUTURE partnered with the Ministries of Health and Local Government and a community-based association on this program to improve the quality of life for people living with HIV/AIDS through the provision of antiretroviral therapy. The initiative’s key components include strengthening partnerships with clinics and the home-based care association; training healthcare and community workers; community mobilization; and involvement of buddies to increase adherence.
South Africa
SECURE THE FUTURE is working with provincial governments and non-governmental organizations to support two sites in rural areas and informal settlements as the country prepares for a national rollout of antiretroviral therapy. These sites will include community education; counseling and testing through existing structures; strengthening community support for prevention of mother-to-child transmission; and post-exposure prophylaxis for sexual survivors. This program will help the five million children and adults living with HIV/AIDS.
  • Three hundred and sixty nurses have been trained to train other nurses in 14 southern African countries on the management of HIV/AIDS, including epidemiology, pathophysiology, testing and counseling, antiretroviral treatment, and psychosocial, legal and ethical issues. The curriculum has been requested by more than 47 nations worldwide.
  • Landmark research in the antenatal prevention of mother-to-child transmission of HIV was funded by a grant from SECURE THE FUTURE.
  • Nearly 10,000 HIV-infected patients have been involved in medical care and research programs.
  • Seventeen publications have been generated from 10 medical care and research programs.
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