KHOPOTSO: The package is aimed at bridging the gap between public and private healthcare. Private care is too expensive for many, while some working people are daunted by the long queues at public health facilities. Three years of thinking went into the creation of the programme.

Dr NEIL MARTINSON: When we first started off with the idea, antiretrovirals were a bit of a dirty word in this country. So, what we were trying to look at were alternative ways of getting antiretrovirals out to lots of people ‘€“ not just to a few 20 or 30 people’€¦ The one way we saw was the charity way, which is essentially’€¦ providing antiretrovirals for the absolute poor. The other way in South Africa is the medical aid route, which is providing antiretrovirals to the very wealthy – and there’€™s nothing in between. And there are increasing stories of people who are employed who die. Someone says, ‘€œoh, no, my employee was coming to work, and then, the next day they died’€.

KHOPOTSO: The reasons for that are now all too familiar.

Dr NEIL MARTINSON: Because they weren’€™t accessing antiretrovirals. They didn’€™t want to spend a day going off to the public sector, getting seen, telling their employer that they’€™re going off, that probably the employer will guess very quickly that they’€™re HIV-infected.

KHOPOTSO: Dr Neil Martinson is a researcher at the Peri-natal HIV Research Unit of the University of the Witwatersrand and the brains behind the idea. Three years later, the idea has now become a clinic called Zuzimpilo ‘€“ an isiZulu word, meaning gain good health. It’€™s on the corner of Jeppe and Joubert Streets in the Johannesburg CBD. Zuzimpilo Medical Centre is a project of the Peri-natal HIV Research Unit and has been launched with seed money from donors. Provision of affordable healthcare is the cornerstone of the centre. Dr Tinyiko Khosa is the Project Director.

Dr TINYIKO KHOSA: For R350, you are able to access care ‘€“ meaning drugs, meaning consultation and the labs. If for some reason, you become sick in the interim, it doesn’€™t mean that when you come to the unit you’€™d have to pay another R350. That includes unscheduled visits.

KHOPOTSO: That is the monthly fee for people on antiretrovirals and it includes every aspect of care, including tests to measure the CD 4 count and viral load as well as treatment for opportunistic infections. However, the charge does not include hospitalisation. Dr Martinson says patients will save a lot of money with the project.    

Dr NEIL MARTINSON: If you’€™re running a good programme doing appropriate lab tests, doing the other things, the average cost over a year is about R1 200 a month’€¦ People will be paying about a third of that to us for this service.

KHOPOTSO: The service is a one-stop shop for all those who are infected or suspect that they might be HIV-infected.

Dr TINYIKO KHOSA: You come in not knowing your status, we do Voluntary Counselling and Testing, that will be R20. If you test positive, that also includes your CD 4 count’€¦ And if you were to go private for counselling ‘€“ let alone testing ‘€“ you’€™d pay about R100 ‘€“ R150. The kind of test we do is about R60. And if you test positive, the CD 4 count is another R163/R165 in private. So, here for R20 you get tested. If you are positive we do a CD 4 count. And if your CD 4 count shows that you are not eligible for treatment we put you into our Wellness Programme where you’€™ll be seen on a monthly basis. There you’€™ll pay R50 monthly.                                              

KHOPOTSO: The Zuzimpilo Medical Centre aims to attract those who are economically active but earn less than R10 000 per month and are not on medical aid. It’€™s also targeting employers who might want to help their employees access HIV and AIDS care. The centre would like to assure the public that the low charges do not mean a compromised level of care.        

Dr NEIL MARTINSON: We wanted to provide an alternative that provided private sector care at an affordable price.

KHOPOTSO: Dr Khosa echoes the sentiment.

Dr TINYIKO KHOSA: I know here in South Africa’€¦ you look at two prices. If one is R1 200 and another is R350, one believes that when we talk quality the R1 200 is of higher quality compared to the other. It’€™s not that. The care is not compromised.