This is an article by Sir Elton John for the Milken Institute 2017 Power of Ideas.
In the 25 years since I founded the Elton John AIDS Foundation, global development has become massively more diverse and multidimensional. Traditional paradigms like North/South are both outdated and misleading: very rich and very poor people live everywhere.
Two things stand out: development is neither incremental, nor necessarily sequential. For example, when smartphones came to market, Africa adopted digital communication virtually overnight, bypassing telecommunications, skipping the need for analogue landlines altogether. As a direct (or indirect) result, in at least nine African countries, more people use mobile money than those who have traditional bank accounts (Harvard Business Review) and Africa’s volume of mobile financial transactions exceeds those in Europe and North America combined (Gartner).
The patterns of change we continue to see in Africa offer the chance for technology to drive development, and no area of development is more critical than health. In the same way that smartphones can extend education to towns without schools, the use of mobile video telephony and built-in sensors can bring medical consultations with specialists to those who live in areas far from hospitals. Since the diagnostics can be transmitted real-time through mobile networks, physicians, not enough of whom exist in Africa, can focus on where they add most value. Simpler tasks are shifted to trained nurses or administrators, or even automated. This is a reality. My foundation is working with technical partners who are already scaling nationwide remote health care in Africa in this way.
The implications of this are immense. Africa’s population, which grows by over 30 million people each year, is expected to reach 2.8 billion by 2060 (World Bank). This is paired with significant economic growth, with countries like Kenya, Uganda and Rwanda growing by more than five percent in 2015. The obstacle is that too many Africans still die because access to reliable, quality health care is beyond their reach. Almost all Sub-Saharan African countries have less than one physician per 2,000 people and less than one hospital bed per 5,000 (World Health Organization). National insurance is in its infancy in most African countries. This is where the private sector can play a central role.
Multinational companies with large workforces or supply chains in Africa can leapfrog slow improvements in national health care by providing a mobile health service for employees at a reasonable premium. This cost is dwarfed by related savings in absenteeism because of ill health. Improved health provides for a stable workforce that can expand and increase in skill level, thereby boosting economic growth. Investment in employees’ health, a truly fragile commodity in much of Africa, makes companies more attractive to workers and customers, and opens channels for ‘commercial diplomacy’ where multinationals need open lines of communication with host governments on a range of issues.
Why do I care about this so much? Because HIV/AIDS was still the number one cause of death in Sub-Saharan Africa in 2015. This holds true even though new medicines are affordable, costing less than $90 per annum, and very effective at protecting health and reducing onward HIV transmission. Young men who are undiagnosed with HIV pose perhaps the greatest threat to the spread of the epidemic. This is partly because too few get tested and therefore unknowingly infect wives, girlfriends, and partners. A mobile app solution, for example, that is designed to keep employees healthy—rather than single them out as an HIV risk—not only removes the stigma of HIV testing, it has the potential to stop the epidemic from spreading. With health care (including an HIV test) framed as an employee perk, what was once considered an uncomfortable inconvenience is now transformed into a valuable reward.
To protect the workforce of the next century, we need to end AIDS. And to end AIDS, we need to reach young people, particularly those who are undiagnosed. Until governments can provide universal health coverage, companies have a unique opportunity to demonstrate vision and care for employees. Businesses can demonstrate their leadership not only by keeping workforce and workforce dependents HIV-free, but by expanding 21st century technologies in a continent that is expanding both in terms of population and economy. Businesses and their leadership play a vital role.as we work—together—to eradicate the deadliest infectious disease of our age.
Power of Ideas