The AIDS Healthcare Foundation began in the United States, but it has since become every bit a global organization. In today’s conversation, we speak with three AHF team members overseeing the organization’s vital work in Africa and beyond.
AHF Africa – A Global Movement
Speaking with three prominent leaders in the overseas efforts of AHF.
GUEST BIOS:
Peter Reis is Senior Vice President of AHF, supervising multiple divisions and disciplines both in the U.S. and overseas— including the Asia Bureau and the Global Quality Team. He’s been with AHF for 27 years. Bio
Penninah “Penny” Lutung is the AHF’s Bureau Chief for Africa Programs, leading programs in 13 countries across Africa. She’s been with AHF for 18 years. LinkedIn
Ambassador Angelina Wapakhabulo has been with AHF since 2001 in various roles, including Chair of AHF Uganda Cares. She currently serves as a member of the AHF Board and Global Vice Chair. About Amb. Wapakhabulo
CORE TOPICS + DETAILS:
[3:14] – The Cost of Being First
On the decision to make an effort in Africa
The team discusses spending ‘money we didn’t have to make an impact on the world.’ Sometimes, the cost of being a first mover in a moral mission is high. But when you know that you’re on the side of a worthwhile cause, the cost is always worth the outcome
[12:28] – Building Local Trust
Laying a foundation for critical work
Dr. Penninah describes the effort involved in building a connection between their Africa patients and the AHF team. One key element of this trust is the process of hiring local nationals, who have been instrumental in establishing programs in Africa that lead to greater public health.
[19:10] – Connected with Governments, Free from Politics
The careful balancing act that’s made AHF successful worldwide
Peter describes the hallmark of AHF programs in which they work closely in partnership with national and local governments but remain politically impartial and separate from political posturing and messaging. This is an essential trait that keeps AHF able to access communities that need their help the most without alienating the leaders and politicians who can serve as valuable partners.
[23:59] – Accepting Limitations
When you can’t do everything
Based on the trust and service the AHF provides for local communities, those communities often ask AHF members to do even more outside the organization’s scope. While they can sometimes help, such as setting up a borehole to provide clean fresh water to a community in Nigeria, they must sometimes accept that they can’t serve every need, all the time.
RESOURCES:
[0:18] -- AHF Website
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ABOUT AHFTER HOURS:
The AIDS Healthcare Foundation is the world’s largest HIV/AIDS service organization, operating in 45 countries globally. The mission? Providing cutting-edge medicine and advocacy for everyone, regardless of ability to pay.
The AHFter Hours podcast is an official podcast of the AIDS Healthcare Foundation, in which host Lauren Hogan is joined by experts in a range of fields to educate, inform, and inspire listeners on topics that go far beyond medical information to cover leadership, creativity, and success.
Learn more at: https://www.aidshealth.org
ABOUT THE HOST:
Lauren Hogan is the Communications Manager for the AIDS Healthcare Foundation and has been working in a series of roles with the Foundation since 2016. She’s passionate about increasing the public visibility of AIDS, the Foundation's critical work, and how everyday people can help join the fight to make cutting-edge medicine, treatment, and support available for anyone who needs it.
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Lauren Hogan:
Get unfiltered lessons from our leaders at AHF, as we uncover real raw stories of where we came from and where we are going. Join us for an unscripted look at the connections our senior leadership have to our mission, core values, and hot initiatives.
Lauren Hogan:
AHF is the world's largest HIV/AIDS service organization operating in 45 countries globally, 16 states domestically, including DC and Puerto Rico. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay.
Lauren Hogan:
Hello and welcome to the AHFter Hours Podcast. I'm your host, Lauren Hogan, serving as your liaison to take you through this journey to learn more about AIDS Healthcare Foundation.
Lauren Hogan:
Before we start the show, please make sure to remember to check out the show notes so you can follow along. Now let's get started.
Lauren Hogan:
So hello everyone, and welcome to the AHFter Hours Podcast. As always, I am your host Lauren Hogan. And today we have a really special episode. We're going to be spotlighting our Africa Bureau. It's the first time we're going to do a global spotlight. And we've got some amazing guests with us.
Lauren Hogan:
So I just want to introduce Peter Reis, Dr. Penny is with us, and so is Mama Angelina. So Peter, I'm going to turn it over to you first, just to give a quick introduction of who you are and what your role is at AHF.
Peter Reis:
Thanks Lauren. I'm Peter Reis. I'm Senior Vice President of AHF. I supervise a number of divisions and disciplines domestically and globally. The Asia Bureau reports to me, as well as the Global Quality Team. And I've been at AHF for 27 years.
Lauren Hogan:
Penny.
Dr. Penninah I.:
Hi, I'm Penninah Iutung. I'm the Bureau Chief for AHF Africa Programs. We work in 13 countries in Africa. And I've been with AHF. It'll be 18 years, this 5th of March. So I'm happy to join this conversation today.
Lauren Hogan:
And Mama Angelina.
Amb. Angelina:
Thank you. Ambassador Angelina Wapakhabulo, but commonly known as Mama in the AHF circles. Glad to be with you today. I'm 72 years young and I have been associated with AHF since 2001 in various capacities. A Senior Advisor, as Chair of, AHF Uganda Cares, currently as a Board Member of AHF and Global Vice Chair. Glad to be with you today.
Peter Reis:
So just to point out Lauren, she's all of our bosses at this point.
Lauren Hogan:
Exactly, that's what I got from it too Peter, for sure. So, to get the conversation going, I want to ask you guys just to take us back in time to when AHF first entered Africa. And what it looked like then versus what we look like now in that continent.
Peter Reis:
Well, I guess I can start maybe. It really goes back to Durban. All the way to 2000. Where a number of folks from AHF, including Michael, made a decision to go to the Durban AIDS Conference. And it wasn't clear that we were going to go. AHF back in those days was a lean organization financially.
Peter Reis:
And, I remember there was a conversation at senior management, where Michael wondered aloud how much of a difference we could make. But we decided we should go, and we did. And three or four of us went. I decided not to go and did that on purpose. I was chief financial officer at the time and money was tight. And I didn't want to be a drag on Michael's experience, frankly.
Peter Reis:
But I knew at the time that there was no way that we weren't going to do something there, given how bad it was. And I knew that it was going to change the organization forever. And it has.
Peter Reis:
I mean, we're 35 years old now. We've done a lot of amazing things as an organization. But probably nothing more important than the Africa Project and Programme. The journey has been now 20 years. We've made an amazing impact. It's been a moral issue, as much as it's been a clinical situation that needed attention.
Peter Reis:
I think we spent money we didn't have, to make an impact on the world. And we did it for the right reasons. And we were a first mover as a US based organization to go and move into this challenge. And I think we've done an amazing job.
Lauren Hogan:
Mama, I want to turn it over to you. Because, like you said, you've been with AHF since 2001. So what has your experience been just seeing AHF from when we started in Africa to what it looks like now?
Amb. Angelina:
I can assure you, for me, it's been a journey of determination and passion and commitment for a cause beyond the call of duty. Guess what? I met Michael in 2001. And that was in Uganda, when he, with some other doctors whom they had met in South Africa, were hosting an AIDS Conference.
Amb. Angelina:
Peter has just said, money was tight. I met her son with a big smile, with a big heart, with commitment. And one of the challenges is we don't have enough money to facilitate the conference. You know what he does? He calls mom, "Hi, hi mom? How are you?" "Fine." "I need some money." "And how do I send the money?"
Amb. Angelina:
And we are all waiting to see whether the money is going to come or not. Michael asked me, I said, "There's Western Union. And with Western Union, they'll be able to transfer the money and we'll be able to get it.
Amb. Angelina:
Fast forward, I think within 24 hours, we did get that money from Mama. Rest in peace. So, that was my first experience. And from then onwards, it was a journey where we had the first clinic in Masaka. A clinic which was actually a private ward.
Amb. Angelina:
But given the networking that Michael and the resident doctors in Uganda, Dr. Dixon and Dr. Bernard had been able to make. And the LC 5 Chairman in Masaka at the time, Honorable Sempija, they were able to zero on Masaka. Which was the epicenter actually of HIV and AIDS.
Amb. Angelina:
Again, what Peter said was applicable. [Mary Adeya 00:06:54] came. We went downtown shopping materials for curtains, looking for pales and all the items that would be needed to clean up the place. And wow, we go off to Masaka, get the ward. Mary Adeya, with a grandma, who had already lost three sons to HIV and AIDS, who had been working there.
Amb. Angelina:
And a sister who had been working in that clinic, in that ward, called Sister Hope, got down on our knees, scrubbed the floor. Made sure that the curtains were up. And guess what? Come February 2001, against all manners of "This cannot be done." That, "You cannot give ARVs to people who don't have watches." "You cannot have this done in a place where people don't have transport which is reliable."
Amb. Angelina:
But you know Michael, he said it will be done. And come February 2002, we celebrated giving ARVs to our first patient. And that has then grown from one patient client under our care, to over 116,600 on ARVs in our facilities.
Amb. Angelina:
Now, if you want to call that a small journey, that would be very much an understatement. And I'll be adding on more about the journey. But that is from 2002, 1, to currently over 116,000 under our care.
Lauren Hogan:
So, Mama, I just want to emphasize something you said. So over a 20 year span, we went from one client to over 116,000. So to your point, that is definitely no small journey to say the least. So thank you for really providing that keen insight.
Lauren Hogan:
I do want to segue over to Penny and just ask you, because you are the bureau chief in Africa. So, what are some of the differences that you see from a government standpoint, being in Africa and being operational. Versus some of the things that you may see that we have here in the US, when it comes to AHF's operations.
Dr. Penninah I.:
You ask a very important question. Because, going and getting the program started in Africa. Until that, AHF thought very carefully about how we got the program started. Even when we knew that so many patients were dying. And when Peter was talking about when we started, that was the peak of the epidemic here in Africa. In the early 2000s was really the peak of the epidemic. When so many people were dying.
Dr. Penninah I.:
There was so much loss of life. And there was just a lot of hopelessness around it. And AHF being the first provider. Actually in both Uganda and South Africa, AHF was the first provider of ART, in government facilities.
Dr. Penninah I.:
And so, in relation to how AHF works here with government is, our model has always been to partner with government. Because at the end of the day, the government is responsible for its citizens. And we come in and provide the technical assistance, the technical support. To show them that, "You could do it better."
Dr. Penninah I.:
And at the time when AHF was coming into Africa, most governments did not have the money for the drugs. They did not have a solution. They did not know where to buy the drugs. The drugs were not available. They were mostly in the Western world. They were not here.
Dr. Penninah I.:
And so, partnering with government, which included signing MOUs with the governments, memorandum of understandings. So basically having a framework within which we worked. And opening up their facilities, government facilities to offer this much needed care, was a very important model. Because one, it was cost efficient. Secondly, the patients were already there. We didn't need to go to the community to mobilize the patients. The patients were already coming to the government facilities anyway.
Dr. Penninah I.:
And so we needed to utilize what was already available in terms of the resource. And build on top of that, to get the services to the people. As Peter said, AHF's financial envelope was small at that time. And so being very tactful about where to put the money was very critical.
Dr. Penninah I.:
And it's made a big difference in how fast we're able to roll out the programs across the region. Because I think the only exception was in South Africa, where we started more or less like a standard alone facility in the townships. And if you know the history of South Africa, is that there was a lot of AIDS denialism from the government at that point in time.
Dr. Penninah I.:
And so, AHF starting up a clinic within a township community that was really highly burdened with HIV, was more on the advocacy to show that it can be done.
Dr. Penninah I.:
Mama talked about entrusting patients to take their drugs on time, even when a lot of the conversation in the west was they cannot take their drugs on time. That was to show that it can be done. And it can be done well. And you don't need too much to get it done.
Dr. Penninah I.:
And has been very instrumental in not only getting ourselves from patient zero to over 120,000 here in Uganda, but across the other Africa region. We are supporting over 740,000 patients within the 20 year span that we've been here. So, that has been critical.
Dr. Penninah I.:
The second aspect, which has gained a lot of trust for us, not just with government, but with the communities as well, is that we hire local nationals. Peter and a number of other folks Mama mentioned, Maria Adeya, they were very instrumental in getting the program started. And mainly because they had the experience with offering ART. And they needed to learn that experience to us.
Dr. Penninah I.:
But with lots of training, and with just support, and ensuring that they hiring the local people, to run their own programs, has been very critical for our success. And that has also brought a lot of the trust from the government. So, that model itself has been very critical for our success within the bureau.
Peter Reis:
Yeah. I would add, I mean the similarities of the project in the Africa versus the United States is healthcare. I mean, it's a delivery system. The biggest difference is that in the United States, we own and operate everything. We employ everybody, we either rent or purchase or build the facilities. And we're responsible for everything.
Peter Reis:
In Africa and in other parts of the world, it's mostly a model where we have a partnership with the government. And there are various responsibilities and financial supports that we provide, responsibilities that we take up and financial support that we provide, to get the site to be in the best position it can to deliver the care.
Peter Reis:
And I think we've done that very, very well over the years. And I think, back to the journey, as Penny pointed out, we've been very clear that we are going to partner with government and we're going to hire only indigenous people to run the programs. I mean, that was part of the model as well.
Peter Reis:
When many organizations at the beginning of AIDS being dealt with and supported in Africa, where a lot of US based and European based agencies were using experts to run programs, AHF was hiring indigenous people. Training them and putting them in position to deliver care and learn themselves. And so, I think that was a major part of our model.
Amb. Angelina:
Okay. I was just going to add one aspect that also proved very critical for us in partnering with government. When AHF came, they had the Doctor Friends, but we had no office. And one of the first offices was actually at Mulago Referral Hospital.
Amb. Angelina:
It was a two in one facility. An office, a store and everything. But the fact that it was based in the National Referral Hospital, spoke volumes of the kind of relationship that was being built between AHF and Uganda Cares. So, that I think was a very important part in the relationship.
Lauren Hogan:
So this is a perfect segue. Because, Peter, you've already mentioned this and Penny, you just did as well. What would you guys say would be three key things or key tips, for building and sustaining partnerships with governments and communities when expanding into a new territory?
Lauren Hogan:
You've each touched on it a little bit. But what would be the three top priorities that you guys would say would lend to that?
Dr. Penninah I.:
I'll start with this, the key one is to ensure you have an agreement with the government. Don't just go into a place and you don't have an agreement. Because sometimes, if government switches or there's a change in government, you want to ensure that they've already, we've locked them down to some specific agreement.
Dr. Penninah I.:
So it's always critical that we sign these memorandums of agreements in place. The second one is, you have to ensure that they're involved. So you invite them for our events, because you want them to see what you're doing. You also engage them in supervision, in training.
Dr. Penninah I.:
And in that way, you benefit from them seeing what you're doing. But also some of the trainings actually available and provided by the government. So our own staff benefit from those trainings. And we don't have to pay for them.
Dr. Penninah I.:
And partly, you have to ensure that AHF is represented at different levels. Whether it's at the regional level. It may be a district or county or state level, you ensure AHF is represented in the conversations that are going on around HIV and AIDS.
Dr. Penninah I.:
There're always lower-level AIDS committees that take care of the discussions around HIV and AIDS. And then at national level, it's to ensure that AHF is represented within the different technical working groups. Because there will always be a group that just looks at the policies regarding HIV and AIDS on ART or on prevention.
Dr. Penninah I.:
So we ensure that we are part of the conversation. And we are part of the policies that are being made at that level. Thirdly, don't get involved in the politics. We've always been strategic by ensuring that we don't get locked up in the politics. Politics in Africa can be very muddy. So you don't want to get locked up in that because it would work to our disadvantage.
Dr. Penninah I.:
At the community level, it's been important for us to ensure that the community depends on us. And that means we've been able to get the community trust. How do you get the community trust? Is you do a good job. We've definitely done a good job wherever we are.
Dr. Penninah I.:
And we know very well, our patients vote with their feet. That's what most people say. If they like the service, they will come to you. If they don't like, they will walk away. And we've not had patients walking away anywhere we've been.
Dr. Penninah I.:
And also involving the community in the process. So, as you're establishing yourself in the community, ensuring that they own the program. Because they would be the one to market the facility for you or the services that you offer by word of mouth. Patients will come to you.
Dr. Penninah I.:
And then [inaudible 00:18:11] very critical is, we work in very diverse cultures across the bureau. So it's good to have a good understanding of the community and respect the culture. So everywhere we've gone, we ensure that we embrace our core value of respecting diversity. Because that is essential for us.
Dr. Penninah I.:
Irrespective of what the culture is. Whether it's polygamous, whether it... It doesn't matter what it is. Just respect what the culture is. But work to ensure that we are able to deliver the services within whatever the cultural context is.
Peter Reis:
Yeah. I mean, one of the things that we did was, we made sure we were invited. We made sure that the government wanted us there and supported us being there. And the other thing, culturally, we didn't come in and act like we knew everything.
Peter Reis:
We came in and said, "Look, we're here to help. We're here to do what we can. We think we have something to offer. We have some resources, we have expertise and a partnership where we work through what the challenges are and how we can best work together."
Peter Reis:
One of the hallmarks of our programs, both in the United States and around the world, including Africa is, partnership with governments that are strong. And that doesn't mean that everything has been perfect.
Peter Reis:
And Penny, I want to describe what she said about the politics. We have consciously stayed out of the politics of every country in the world. I mean, Uganda had a very anti-gay situation, that caused a lot of strife and worry for a variety of reasons.
Peter Reis:
And we were sympathetic to the need for gay rights activists to make their case. But we also decided we had to stay out of it. We had to be careful to not look to be meddling in the politics of any country.
Lauren Hogan:
I think that's really important though, that you guys said that respecting the culture is such a key priority. Because I think sometimes, as an organization or entity that we are, there's some misconceptions about what you may do abroad.
Lauren Hogan:
So I love that you guys highlighted, saying that we made sure that we respected the culture. So, that way we can get to the work at the end of the day.
Lauren Hogan:
So Mama, I want to bring you back into the conversation really quickly and just ask you as well. You've been a part of this journey for over 20 years. So in your experience, what have you seen as the day to day challenges that we in have been facing in Africa? And how have we been addressing them?
Amb. Angelina:
The challenges in all activities in programs are always there. But I think what has stood out for AHF, is being able to understand what the challenges are. Whether it's a challenge that you can deal with alone or as a consortium of other organizations as well.
Amb. Angelina:
And then, being mindful of what the consequences could be. So that at the end of the day, you do you jeopardize your own programs in the way that you address issues. When it comes to challenges, I think a lot of time was put into understanding what the challenges were, what the issues were in the family.
Amb. Angelina:
So as people came to embrace that there was hope. That AIDS was not a death sentence. That something could be done. I think increasingly saw the way AHF, Uganda Cares in our case, was able to handle it. Definitely made a difference in addressing whichever challenges would come across. And that has continued all along.
Dr. Penninah I.:
I just want to add onto that. To bring other perspectives to some of the challenges we talk about here and we face on a daily basis. We work in some really difficult or insecure and [inaudible 00:22:08] and very remote locations. And you find, for instance, just recently, we had a Cyclone Ana in Malawi, that cut off five of our facilities.
Dr. Penninah I.:
Both patients and staff were affected. And we still had to get services out there. Patients run to camps and we had to ensure that their drugs were going to be with them. And also provide them with other, just household materials that they would need.
Dr. Penninah I.:
And in some of the locations, like Benue state in Nigeria. You find that there are tribal clashes in the place that we work. And staff have talked about situations where they're going to a particular health facility and there's been a tribal clash. And they're passing by dead bodies. But they know that they still have to reach patients who may be deeper in the community.
Dr. Penninah I.:
We have a unique clinic here in Uganda. It's called The Market Clinic. I think anyone who comes to Uganda, we usually like them to have a taste of The Market Clinic. It's a clinic that is stationed right in the heart of this really large market, that has over a 100,000 vendors.
Dr. Penninah I.:
That clinic is quite noisy. Very noisy. But the clinic started from scratch, in collaboration with one of the community groups. And were able to, now the clinic takes care of over 8,000 patients. But it's not an easy location within which to work.
Dr. Penninah I.:
The other aspects are that, as Peter mentioned earlier, we work in very restrictive environments. Where the government policies or the legal frameworks are very restrictive for the NGO work. You find that the NGO space has been restricted, for valid and sometimes questionable reasons. Governments want to have control of what NGOs are doing.
Dr. Penninah I.:
And so that sometimes can hinder how fast you can get a program running or what you can actually do. So those are things you work with on a daily basis.
Dr. Penninah I.:
The other aspects are that we serve very poor communities, generally where we work. And because we do a good job on providing their healthcare needs, the community expects us to go over and beyond. And, you can't provide everything that they need sometimes.
Dr. Penninah I.:
And so, where we can, we've been able to do some things. For instance, we just set up a borehole to provide clean, fresh water for this community in Nigeria. And it did not only serve the small community, but it was able to reach 6,000 households. So, we are able to do some things, over and beyond just providing healthcare where we are.
Dr. Penninah I.:
And lastly, this is an interesting challenge. We do such a good job in multiple locations, that we end up receiving multiple requests from different individuals. Government folks, members of parliament, communities. "Oh please come and start a clinic here." And we can't be all over the place.
Dr. Penninah I.:
So it's becomes a challenge for us as well, to go and reach so many communities. The need is there, but we can't be all over. So some of those are the other challenges that we have to work with on a daily basis.
Lauren Hogan:
So in a more inspirational note, I want to ask to the group. Can any of you guys recall a significant moment that really just highlighted the depth of AHF's impact on the communities that we serve? And in what ways did this growth or improvement just really overall help the bureau?
Amb. Angelina:
Maybe I'll take that up. Dr. Penny has touched on it. I happen to be associated with one of the community groups that specifically works in market communities. Now market communities are not your ordinary communities. The first impression you get is chaos, lots of people, noise and you don't think there's anything organized in that place.
Amb. Angelina:
There are also characteristics of market, community members, which make it very difficult for them to uptake health facilities. For example, a market vendor will not leave their place of work and go two, three kilometers away to get medical support. No, they will not. Because they feel if they do that, then they'll be missing out on their clients.
Amb. Angelina:
Now, why have I brought this up? For me, one of the significant moments, was when AHF Uganda Cares, partnered with this community organization. Develop Initiatives International played a key role in establishing an HIV service model. That enabled sensitization, prevention, counseling, testing, and very critical, providing ARVs all in the marketplace.
Amb. Angelina:
It had never been done. But AHF took the lead and they became part of that model. What was very interesting is given the AHF family spirit, we had had initially Henry Chang and Mary Adeya, and Michael had also been there.
Amb. Angelina:
Then time came when the place was set up. I don't know if some of you still remember, rest in peace, Dr. Farthing. Dr. Charles Farthing, was one of those doctors who, he was the chief of medical I think at the time, would come from the airport, not go straight to his hotel, but would go straight to the market clinic.
Amb. Angelina:
And whether it's language barrier or what, I think he was so well trained. And he would stay there until late. Make sure all the clients had been seen. Because that was his passion to ensure that the clients, even in that setting, were getting the best facility.
Amb. Angelina:
So for me, that was a moment which I think defined, that AHF Uganda Cares, could break the barriers, go to areas which people thought could not be reached, take the ARVs where the people are. And that model has been replicated in other places, in Kampala. But also we had delegations from Sudan. We had delegations from Kenya.
Amb. Angelina:
All coming to see what AHF was able to provide in the marketplaces. And reaching out to the clients and delivering in the marketplace. For me, that was the defining moment.
Dr. Penninah I.:
I mean, what stands out for me was, in 2016, we had the International AIDS Conference in Durban. And it was more or less coming full circle for AHF. Because, the first conference at the height of the AIDS pandemic was held there. And then, many more years down the line, the AIDS conference was going back there.
Dr. Penninah I.:
And so, Michael gave us a task in, especially with the global advocacy department and the terrorist department and said he wanted us to mobilize 10,000 patients for this march. Now just think about mobilizing 10,000 patients. That was quite a big number.
Dr. Penninah I.:
So amids different strategies, we knew that we could depend on our patients. Our patients always loved to come. And always that has been the same thing in every country. We mobilize our patients. They're always there to support us. But 10,000 was a big number. But, with hard work of the team, we managed to go over and beyond that 10,000 patient number.
Dr. Penninah I.:
We mobilized close to 14,000 people, who came for the march. And just seeing this large sea of patients and people marching. And they wore this lime green T-shirts. It was just in your face. We had this really long match. We walked, I think it was about three kilometer walk. It was really significant.
Dr. Penninah I.:
But just seeing that and just knowing that it can get done. You give it a task and you mobilize each and everyone. Every staff member and you can really get it done, was just a moment that cemented our can do attitude. Because you just showed you can get it done. It doesn't matter what the task is. You can get it done.
Dr. Penninah I.:
And I think it's part of the reason why we've gone to all these places, when we didn't know sometimes what we're going to expect. I've taken Peter to some of the places in Nigeria. Very hot, 42 degrees. I don't know what that is in Fahrenheit. In the heat, we reached a moment when Peter stopped sweating. He would just [inaudible 00:31:01] sweat. It poured from head to toe. You feel you're sweating.
Peter Reis:
Yeah.
Dr. Penninah I.:
We reached a moment when he stopped sweating. But, we went to see these really desperate facilities, in knowing that we needed to provide a service.
Peter Reis:
Yeah, it was a surprise to me that I stopped sweating. There've been so many moments to count. But, when we opened the second iterations of iThemba Labantu, in South Africa and the new building in Masaka, those were defining moments. They were much bigger facilities. They sent a signal to the community that not only we were sticking around, but we're going to be bigger and better than we've ever been.
Peter Reis:
Some smaller moments. We have Africa Bureau meetings. And those are so impressive because every year they get bigger. And you can really have a sense of the network of colleagues that we've helped create that are leading across the continent. A continent was that was so challenged and so much was so dire.
Peter Reis:
And there's still a lot of challenges. But the leadership that we've been able to build, is inspiring. And I've had personal moments. I had a moment that I talked about in the 30th Anniversary Film. Where, I'm leaving at the airport and this guy comes up and leans in the car and says, "Thank you for saving my brother."
Peter Reis:
And the same thing, Penny, you were talking the Durban 2016 extravaganza that we were part of. But, Bill Arroyo, our current board chair, had the same experience with a cab driver, telling him, "My cousin was saved by you. Thank you so much."
Peter Reis:
So, I mean, it's been a profound journey, but a successful one. And stirring. And it's been the privilege of my life to do this work. And I have to say, I have to give a shout out to my two colleagues. They're two of my favorite people in the whole world. That are on this call. They're colleagues and they're friends and they're incredibly impactful. And I want to make sure that we don't end this broadcast before I get a chance to say that.
Amb. Angelina:
I was just going to say, Peter, you've reminded me of the opening of the Masaka Clinic. You remember, we had a little hitch. And that hitch-
Peter Reis:
Yes. Just a little bit.
Amb. Angelina:
It was a hitch. And trust our CEO, our president, and our core value that one of them is that it's patient centered. So we won't go into the details of the hitch. But what solved it was our CEO said, "Okay, we are going to go, if all the clients, the market vendors will come with me." And hooray! You should have seen the procession of the clients, the patients, with Michael, with us. It just reminded me of that incident.
Peter Reis:
I remember, clearly.
Lauren Hogan:
I'm sure you guys have got plenty of stories that you could tell. If only we had more time to do it. But we are, like I said, almost at time. So I have one final question for you guys. What can we expect, upcoming from the Africa Bureau? You guys have talked about. There's a need and you guys can't be in 50 million places at once. But what's next? What can we look forward to?
Dr. Penninah I.:
Yeah. I like growth. Mama always likes to say, "You need to consolidate." But I say, "Yes, we shall consolidate where we are, but I still like growth." There's just something exciting about going to a new territory and new location and starting up new clinics.
Dr. Penninah I.:
Because, the joy in that is, you always find people who are in so much need. Even now, when ARVs have been in the continent for a very long time, for over 20 years, they still a big need in a large number of communities. So the joy of going to a new community and just showing them what the age of model can do is very exciting.
Dr. Penninah I.:
So we are planning to grow to Tanzania and Cameroon, as new program startups in the next two years. And then most of the other things are really internal. Honing in our models of care, doing a better job in retaining our patients, in linking more of our patients to care. And also building the internal capacity of our managers. Because the Africa Bureau has close to 2000 staff, AHF employees.
Dr. Penninah I.:
That's really close to the number of employees in the US. So the director and AHF employees are close to 2000. So building their capacity, especially to be better leaders and better managers is one of the areas that we are focusing on, going into the future.
Peter Reis:
Yeah, I would just say, there are more new infections than there are deaths. So every year that goes by, there are more people living with HIV than the year before. And that means we're not getting control of the epidemic in the way that we had hoped. And so I think, treatment as prevention is the number one strategic direction. And getting more people found and getting them on treatment.
Peter Reis:
I mean, we're dealing with scale here. I mean, we need more facilities. And the facilities are overwhelmed oftentimes with too many patients. So I think there's more of that. But I think Penny's point is the well taken one. It's growth and continued investment on our part to keep making a difference like we have been, for 20 years.
Amb. Angelina:
And certainly making use of the experience that we have had over the years to get better and better. And I think we can do that.
Lauren Hogan:
Well, I will just have to say, thank you guys so much. This has been a very inspirational episode to say the least. And just to hear, of all of the progress and the amazing work that we've done in our bureau in Africa.
Lauren Hogan:
No amount of accolades, I don't think, is enough at this point in time, for the work that's being done.
Lauren Hogan:
So thank you guys so much. This was a great episode. And we look forward to seeing you guys on another episode of the AHFter Hours Podcast.
Peter Reis:
Thank you, Lauren.
Dr. Penninah I.:
Thank you. Thank you, Lauren.
Amb. Angelina:
Bye for now.
Lauren Hogan:
Bye.
Peter Reis:
Thank you Mama. Thank you Penny.
Amb. Angelina:
Say hi to my friend.
Lauren Hogan:
Thank you so much for joining us. If you enjoyed this episode and you'd like to help support the show, please subscribe, share it with your friends, like, post about it on social media, or leave a rating and review. Follow us on Instagram @AHfterHours. And see you next time.