PRE-RELEASE VERSION
Paving the Road to Healthy
Highways
A Partnership to Scale Up
HIV & AIDS Clinics in Africa
Source: North Star Foundation
10/2008-5523
This case was written by Aline Gatignon, Research Associate, and Luk N. Van Wassenhove, the Henry Ford Chaired
Professor of Manufacturing at INSEAD and Academic Director of INSEAD Social Innovation Centre. It is intended to
be used as a basis for class discussion rather than to illustrate either effective or ineffective handling of an
administrative situation.
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Social Innovation Centre
Introduction
“At the end of the day I think that Jeffrey Sachs1 said it best: one of the key things
is making sure you’ve got a very simple, focused concept with easy-to-replicate
technology. And if you have that, you can build up the critical mass. Then you
have to be flexible and open enough to learn from the process itself and use that
to improve your product offering.”
Luke Disney, co-Director, the North Star Foundation
Luke Disney felt proud of the North Star Foundation’s management team (see Exhibit 1) as he
mused over the challenges they had overcome together in the past two years since the
organisation was set up. Tasked with creating a network of HIV & AIDS clinics for truck
drivers throughout Africa, they had discovered that leveraging the impact of a good concept
by replicating or ‘scaling it up’ could be harder than it might appear. Yet despite the
difficulties, they had come a long way and now had an impressive track record of treating and
educating hundreds of drivers daily across the African continent to help them stay healthy.
However, Luke knew that the team could not rest on its laurels. Every centre set up was a
victory, but keeping them running and growing the network of clinics remained an ongoing
challenge. Somehow, before the year was out, he would have to present the board with a
sustainable strategy to pave the way forward. “We’ve got a head of steam up, we’ve got
momentum, we’re booking results and there’s growing interest”, he explained, “but we need
something to push us up to the next level.”
If Truckers Won’t Come to the Clinics, the Clinics Must Go to
Them
In 1998, the South African Minister of Transport, Abdullah Omar, appealed to the National
Bargaining Council for the road freight industry to play a part in the fight against HIV &
AIDS.2 He gave the Council, made up of transport companies and truck drivers’ unions,
50,000 rand (a little over €4,000) to address the issue in the industry.
Road freight is the number one means of moving goods through Africa, thanks to the network
of transport corridors crossing the continent. Truck drivers and their assistants are therefore
indispensable to the region’s economic growth. However, they lead hard lives with difficult
working conditions and long hours on the road, which keep them away from their homes and
families. A 2005 behavioural survey of truckers along the Northern corridor transport route
from Mombasa to Kampala revealed that over 60% of those interviewed had spent fewer than
40 nights at home in the past year, while 6% of them had spent less than five.3 After a full
day on the road or during interminable delays at border crossings, truck drivers and their
1
2
3
<http://www.earth.columbia.edu/articles/view/1804.>
Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS).
Kenya. Ministry of Transport. Hotspot Mapping on the Northern Corridor Transport route: Mombasa to
Kampala. Comp. Morris, Chester N., and Alan Ferguson, December 2005.
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assistants often spend the night with sex workers who congregate at truck stops. This has led
to astoundingly high rates of HIV within trucker communities in Africa, which are at least
twice as high as the general population4 and in some cases exceed 50%.5 Due to their high
mobility, truckers are a vector of transmission for the disease throughout the region. As early
as 1996 they had been identified as potentially the main dispersers of HIV infection in subSaharan Africa.6
Thus the task facing the National Bargaining Council was no trivial affair. The Council’s
steering committee decided to start by analysing the scope of current HIV & AIDS
programmes hosted by transport companies. After a tendering process, Paul Matthew, South
African founder and CEO of an education and training consultancy for the transport industry
called the Learning Clinic, was asked to tackle the issue. He recalled the initial reaction:
“Well, the first year it backfired. The employees just felt that it was a way to fire
them. There was a whole stigma involved. They weren’t keen to take part at all.
Also, a lot of transporters have big warehouses, what you call turnaround depots.
And it’s more an administration office with maybe a small warehouse. But our
focus was very much on the drivers, on the mobile population and not on the
workforce that was going to the depot.”
As Paul sat in on one of the early information sessions, a couple of drivers came over to talk
to him. They suggested that it would be easier if the programme didn’t occur in the workplace
but rather in a more confidential, neutral setting. “And that really sparked the idea for me to
take the project out onto the road rather than back into the workplace,” he recalled.
In July 2000, Paul took a caravan to a town called Harrismith, midway between Durban and
Johannesburg along the major N3 highway. “I spent a week there by the side of the road,” he
recounted. “It was a great success. The guys were attending the peer education programme
and the response was just unbelievable.” However, by the end of the week a lot of drivers
were coming back to Paul saying “I just learned in the training programme that I have an STI
(Sexually Transmitted Infection). But what can I do about it?”
Paul realised that traditional healthcare clinics were often situated within town or city limits,
where there was no parking space for the big trailers, which remained under the responsibility
of the drivers. Moreover, clinics were only open during the daytime, whereas Paul had
quickly realised that he had to revise the schedule for his peer education programmes because
drivers would only start coming in at 9 o’clock at night before leaving again around 3 o’clock
in the morning.
4
5
6
Kenya. Ministry of Transport. Hotspot Mapping on the Northern Corridor Transport route: Mombasa to
Kampala. Comp. Morris, Chester N., and Alan Ferguson, December 2005.
Along the main highway from Durban north to Zimbabwe, drivers and sex workers were found to have an
HIV prevalence rate of 56%, with 95% of those tested at one truck stop found to be HIV positive. South
Africa Medical Research council. Targeting HIV-prevention efforts on truck drivers and sex workers:
implications for a decline in the spread of HIV in Southern Africa, Comp. Ramgee, Gita and Eleanor
Gouws, 2001.
Hudson, Christopher P. “AIDS in rural Africa: a paradigm for HIV-1 infection”, International Journal STD
& AIDS Volume 7, Number 4 (July 1996) : 236-243.
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When he got back from Harrismith, Paul ran what he called a ‘recce’, or reconnaissance of the
drivers’ situation on the roads. He identified the major hotspots to target and, together with
the National Bargaining Council, he developed the concept of the ‘Wellness Centres’ – two
six metre-long (20ft) industrial containers combining an educational facility for STI
prevention and a primary health clinic offering behaviour change communication sessions
(BCC) and voluntary counselling and testing (VCT) for HIV & AIDS, as well as treating STIs
and other illnesses and distributing male and female condoms.
Throughout the next couple of years, Paul dedicated a substantial amount of time and effort to
creating a network of roadside Wellness Centres throughout the country, reasoning that the
initiative would only have an impact on HIV & AIDS if truckers could access the clinics all
along their route. In 2005, the Learning Clinic was bought by a major industry leader and the
two companies merged to form IKAHENG under Paul’s direction.
Going Global with the New Kid on the Block?
In 2003, the United Nations World Food Programme (WFP)7 realised that its staff in the field
were falling victim to the HIV & AIDS pandemic. In much the same manner as the South
African National Bargaining Council, WFP asked Robin Jackson and Robin Landis from its
HIV & AIDS department to analyse the agency’s workplace programmes addressing the
issue. Very early on in the process, the two women realised there was a major gap in WFP’s
HIV & AIDS policy.
The ultimate deliverers of WFP’s food aid to its beneficiaries are African truck drivers. WFP
depends on skilled, reliable and experienced drivers, yet the agency’s HIV & AIDS team
realised that their ranks were being decimated by the pandemic. Even more worrying, WFP’s
drivers could be transmitting the disease to the very people the organisation was trying to
help. Under the principle of ‘do no harm’ and the exigency of delivering food efficiently and
responsibly, WFP had a clear moral but also strategic mandate to help its drivers deal with
HIV & AIDS (see Exhibit 2).
WFP was confronted with the same problems as the South African National Bargaining
Council, but in the case of WFP they were aggravated by the fact that the drivers were rarely
direct employees as the agency sub-contracted to the transport industry for freight. How could
the WFP address the prevalence of HIV & AIDS among a population which represented it in
the field but to whom it had no access?
In June 2004, Robin Jackson turned to TNT, a major international transport and logistics
company, for help. After CEO Peter Bakker gave an impassioned speech on the HIV & AIDS
pandemic at one of the company’s global management meetings, he and Robin discussed the
issue over dinner. Bakker said that TNT faced the same problems as the WFP in addressing
HIV & AIDS in their emerging country operations. He promptly suggested that the two
7
WFP is the largest logistics provider of the UN agencies. In 2006, the organisation distributed 4 million
tons of food to 87.8 million of the poorest people in the world, many of them in Africa.
<http://www.wfp.org/aboutwfp/introduction/index.asp?section=1&sub_section=1 as accessed June 6th,
2008.>
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organisations tackle the issue together within the framework of their five-year partnership,
‘Moving the World’8.
In January 2005, 10 senior TNT managers were sent to Malawi with a team from WFP.
Having spent a week identifying areas of common strategic interest, they presented their
conclusions to their respective boards, which agreed to collaborate to address HIV & AIDS
prevalence in trucker communities. As Robin Landis recalled, this was rapidly followed by
action:
“With the weight of the organisation behind us, we very quickly put together a
mission to go out and do what we thought would be a three-month feasibility
study. After the first week on the ground we decided to reconvene and make it into
a pilot, because every single meeting we had with the stakeholders, from
government to NGOs to other civil society actors and a host of players – all said
the same thing: ‘Enough of the studies. We’ve been studied to death.’”
What Paul Matthew now called the ‘Trucking against AIDS’ initiative had been brought to
the team’s attention early on in the process. A dozen Wellness Centres were covering almost
95% of South Africa’s highways, resulting in a reduction of HIV prevalence in the country’s
truck driver population by 17% between 2005 and 2006.9 However, there was still no way to
address the health risks of the 13% of drivers who regularly delivered across borders and
potentially spread HIV & AIDS from one country to another.10
Paul jumped at the opportunity when the TNT/WFP team invited him to Malawi to present his
concept:
“My whole bigger picture has always been that if I’ve got drivers moving through
South Africa who are crossing the border posts, they should continue getting
education and medical support. And Trucking Against AIDS was going to the next
phase, which was doing anti retro viral treatment (ARV)”.
ARVs are distinctive in that they are a lifetime treatment and cannot be interrupted midway
through as this can provoke treatment failure as well as generate virus resistance to treatment.
A KAPB survey (Knowledge, Attitudes, Practices and Behaviours) was developed to identify
hotspots along the continent’s main transport corridors. It was conducted through a
combination of satellite mapping, interviews with truckers and female sex workers, and
information from diaries which the latter were asked to keep. Results confirmed Paul’s initial
insights as to truckers’ lifestyles and working conditions. All over Africa, truckers were
8
9
10
Tomasini, Rolando M and Luk N. Van Wassenhove. “Looking for a Partner: Moving the World. The TPGWFP Partnership”. INSEAD Case Study No. 02/2004-5187.
Samii, Ramina and Luk N. Van Wassenhove. “Learning to Dance: Moving the World. The TPG-WFP
Partnership”. INSEAD Case Study No. 03/2004-5194.
UN World Food Program. Transporters Wellness Centres: Kenya Scoping Document. Comp. Cook,
Alastair. 2007.
Hector, D.A. “HIV/AIDS and its effect on the transport industry along main corridors in the Southern
African Region and within Malawi, Mozambique, Zambia and Zimbabwe.” Diss. University of Derby,
2006.
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engaging in risky behaviour at overnight truck stops, involving unprotected sex with multiple
partners.
On this basis, in August 2005, the WFP/TNT team initially set up a Wellness Centre at the
Mwanza border crossing between Malawi and Mozambique, to test the findings and perfect
the model (see Exhibit 3). TNT’s Malawi offices convinced one of their commercial partners
to donate the containers for the centre, while the land was given by the Malawi Revenue
Authority and the drugs were supplied by the Ministry of Health. An NGO partner was
contracted to run the centre.
Within months, the Mwanza Wellness Centre proved to be an unmitigated success. One of the
advantages to the new and improved Wellness Centres included an easy-to-install, userfriendly IT system which tracked a basic set of key performance indicators (KPIs) (see
Exhibit 4). These revealed that the Centre had lower operating costs and better performance
on KPIs than other existing initiatives. It received on average 50 visitors per day, which was
equivalent to one truck driver visiting the centre for 2.3 trucks crossing the border. Other
visitors were members of local communities and sex workers. “We were watching the client
numbers increase every month through the monitoring and all the reports that we were
getting,” said Robin, adding, “The community members accepted it. The drivers were being
interviewed and they were telling their buddies about it and word-of-mouth was working.”
(See Exhibit 5).
But both parent organisations were aware that creating a network of Wellness Centres would
involve a whole new set of challenges. Although enthusiastic about the project and convinced
by the pilot’s success, Robin Jackson thought: “I’m not in the business of opening and
running Wellness Centres, right? And neither is TNT.” She felt very strongly that the
transport industry itself needed to invest in the project: “They need ownership of it. If you look
at some of the research that’s been done on the various sectors, transportation is the lowest in
terms of its engagement in the AIDS pandemic.”
Because they were both major actors in their sectors, WFP and TNT felt confident that they
could set up a framework within which this buy-in could happen over time. After a year of
paperwork, it got off the ground on September 28th 2006 as the North Star Foundation (NSF),
an independent identity incorporated in the Netherlands. Although board members were
selected from among TNT and WFP staff, they envisioned a day when other corporate or
humanitarian partners would become foundation members and join them in the organisation’s
direction.
However, as the newly-formed management team started attending international conferences
and approaching potential partners, they quickly realised that the NSF would have to depend
on its original founders until it could prove its worth. Board member James Jenkin
remembered his initial frustration when he discovered that the private sector partners they
were counting on already had their own corporate social responsibility programmes and were
not ready to join what they perceived as another company’s initiative. Furthermore, when he
attended the XVI International AIDS conference in Toronto in 2006 with Robin Jackson and
Robin Landis, they discovered that humanitarian players had their own reservations. Their
response, he recollected, was, “Yeah, that’s a nice idea but until you’ve got something to
show that you can do this and you’re actually offering expertise and you’re doing it well,
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nobody really wants to. Funds are already tied up. People need to see statistics and results.
Donors want all this formality behind them.”
So WFP and TNT agreed to cover the start-up costs until the foundation could build enough
critical mass to get the stakeholders involved.
“At first,” said Robin Jackson, “there was some UN funding, but mostly there’s
UN capacity at the country level that North Star Foundation would never be able
to tap into without WFP. Just like WFP would never be able to finance this by
themselves. Peter Bakker spent over a million euros on it. And in terms of setting
it up, giving it a back office, putting two people on it, getting the head of Barclays
Bank to come to a meeting at Davos, Peter’s done a number of things that WFP
certainly wouldn’t have been able to do either. Also, I don’t think this is an
across-the-board comment: ‘The UN is always looked at favourably or the private
sector is always looked at negatively.’ I think it depends who you are pitching to
and which piece of the puzzle you’re putting together. So there’s that nice
complementarity because we have different networks.”
Despite these advantages, the challenges ahead nearly baffled the team, both internally and
externally. Robin Jackson noted that,
“There are some very different corporate cultures, and so it took us a while to
figure out how to work together. We just didn’t talk the same language. At the
same time, we realised that it was a different world out there. There was a lot of
catch up and doing your homework, talking to the players and finding out what
they thought was important, what was missing – you know, like a market analysis.
It’s as simple as that. Then afterwards you’re selling something that there’s an
obvious need for.”
Boots on the Ground Count Ten Times as Much as Tanks on
Paper…
Esther Bosgra, a TNT specialist on retainer to the North Star Foundation after three years as a
programme manager for the Moving the World partnership, was packing her bags for Kenya
where she was to set up the foundation’s local operations, when political unrest broke out in
the country. As the NSF’s management team debated whether to target another country
instead, the situation was resolved and Esther finally set off.
She was very enthusiastic about establishing a network of Wellness Centres for the NSF in
Kenya. In her view, the hotspot survey had revealed a strong market potential: “One of the
places where we are thinking of establishing a centre has, on average, 400 trucks parked per
night with two people per truck and over 800 female sex workers.” Additionally, the UK
Department for International Development (DFID) would be giving WFP close to a million
dollars for a transport sector project on HIV & AIDS, which had led WFP to turn to the NSF
to set up a network of Wellness Centres throughout Kenya. WFP’s backing would also
provide the NSF with the leverage to mobilise a large number of stakeholders, since the UN
agency regularly contracted 42 transport companies out of a total of 288 existing corporations
nationally.
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Esther soon discovered that her task was nonetheless fraught with challenges. Because of the
length of the transport corridors, the NSF neither hoped nor wanted to go it alone. This meant
that she had to mobilise the support of a number of different actors: UN agencies in Kenya for
funding, NGOs which already had in-country HIV & AIDS programmes with which to
network, the transport sector to get the drivers’ buy-in, and local partners to run the centres.
Although its association with WFP gave the NSF a lot of credibility and opened doors for
Esther, she also chafed at the delays that it sometimes caused:
“Especially as in Kenya, where the money goes via WFP, we have to go through
all their rules and regulations. Of course, a lot of the rules are there for good
reason. For example, on quotations and so on there is a very strict WFP rule that
for everything you buy you need to have three quotations. And for the bigger
things that makes perfect sense, but it’s also for when you have to buy a computer
or even something smaller.”
Upon arrival, Esther was also somewhat daunted by the task of linking the NSF’s network
with other NGOs’ initiatives:
“There are 3,000 NGOs in Kenya, I was told yesterday. There must be some competition
and I can’t imagine that so many NGOs work properly together. But one of my goals is
to make sure that whatever we do on the transport corridor is linked to what other
people do. And I really hope that at the end of the day we’ll be able to give out a leaflet
in our Mombasa Centre with the services along the corridor for truck drivers, and then
it doesn’t matter if it’s a Family Health International service or local NGO or NSF
service or whatever.”
In fact, Esther was pleasantly surprised at the positive reception she got from other NGOs
which she approached. Family Health International operated community centres in Kenya
designed to address the root causes of HIV & AIDS by seeking to reduce economic
vulnerability, gender-based violence, and alcohol and drug abuse. Their spokesperson was
very positive about working with the NSF: “If the NSF can step up at other places on the
road, we can build symmetry so a truck driver will be receiving services with a narrower
focus.”
However, Esther also remembered from Paul Matthew’s initial model that creating a network
of Wellness Centres was not enough. Without the transport sector’s buy-in, she knew that
they would remain deserted. As part of her efforts to reach out to the transport sector, Esther
contacted the Secretary General of the Kenyan Long Distance Truck Drivers’ Union, Nicolas
Mbugua. The Union had been working with a number of local HIV & AIDS initiatives for the
transport sector and knew how to overcome drivers’ concerns about stigmatisation: “I was
also a truck driver myself for 20 years, so I know exactly what language to use to them,” he
said.
On the other hand, Trucking Against AIDS and the NSF knew from their experience of
working with the Federation of Eastern and Southern African Road Transport Associations
(FESARTA) that they also needed to coordinate with local transport companies. Their
ownership of the project was essential for marketing the Wellness Centres, for knowledge of
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the local situation, to open doors to the national transport ministries and potentially access
local funding opportunities.
Exhausted after so many meetings, Esther still had to tackle the number one issue facing the
NSF: if the foundation did not directly operate the Wellness Centres, who could?
Growth Strategies for a Sustainable Future
Two years after the inception of the North Star Foundation, this problem was still keeping its
co-director, Luke Disney, up at night. The foundation’s future hinged on the answer.
So far, the foundation had more than achieved the targets set for it by TNT and WFP. The
management team had tested and perfected the model and had proved its worth to a growing
number of interested stakeholders. The Foundation should have eight centres operational by
the end of 2008, and currently had a number of funding proposals pending, including an
opportunity to set up Wellness Centres in Vietnam through the Asian Development Bank.
With start-up costs of $25,000 and annual running costs of $50,000, Wellness Centres had
been “sponsored” by private corporations such as Chevron, by sector initiatives such as the
South African Express Parcel Association and the Walvis Bay Corridor group, and by
government donors such as the UK Department for International Development (DFID).
As it turned out, the running of the centres had proved to be more of a headache than Luke
bargained for: “It’s perhaps the, or one of the key make-or-break factors in your whole
business model.” So far, the Foundation had chosen to delegate the day-to-day operations to
local partners.
“There are numerous advantages to outsourcing it. First of all, you build capacity
locally – so we don’t just select the partners, we train them. We show them our
KPIs, and make sure they can work according to the standards that we consider
acceptable. More importantly perhaps, you invest in their organisation. The
flipside, of course, is that with a new organisation we learn the hard way.
Fortunately, we’ve been coached enough and have been wise enough not to just
dismiss these guys but work with them and try to get them up to our standards,
which is a much more labour-intensive approach, but it pays off.”
In the long term, a second advantage of outsourcing the Wellness Centres operation was that
it kept the Foundation ‘lean and mean’. But until the local implementing partners could
operate more independently, the NSF would have to find a way to fund the core costs incurred
by these capacity-building efforts. Unfortunately, although stakeholders might sponsor a
Wellness Centre’s operating costs for a few years, they were rarely willing to cover the
Foundation’s overheads. This led Luke to formulate three strategic directions for the future to
be presented to the board (see Exhibit 6).
•
The first option for the next few years would be to expand the network by taking direct
control of the establishment and operational running of the centres, thereby giving the
NSF total control over the quality of the services. This would require the establishment of
regional management teams with additional responsibilities, increasing the foundation’s
core costs and limiting network growth to three new Wellness Centres per year. This
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‘operator’ role would bring funding requirements to $2,881,385 over a three-year period
(see Exhibit 6).
•
A second possibility would be for the NSF to become a ‘catalyst’ for the network. The
NSF would create legally independent regional divisions which would nurture a select
number of local implementing partners to operate the Wellness Centres. North Star
Foundation International would then retain two directors to provide regional divisions
with support to cover insurance, governance and legal matters, procurement, international
fundraising, and best practices. Although overhead costs would increase with the
establishment of the regional divisions, these could eventually be spread out over a
maximum of 15 Wellness Centres per division. This would also stimulate local
stakeholder engagement as well as being the most cost-effective method for expanding the
network. Luke calculated that this growth strategy would enable the foundation to
establish up to 10 Wellness Centres per region every year, at a cost of $2,756,810 over a
three-year period. However, this strategy would reduce the NSF’s control over quality by
adding another layer of management at the regional level and keeping it dependent on
implementing partners.
•
The third strategy would imply a greatly reduced presence in the field for the NSF. The
foundation would phase out its current operations and become a regional ‘expert’,
advising other organisations in similar contexts, such as Trucking Against AIDS,
Corridors of Hope and Family Health International. Some of the best practices that the
NSF could improve and disseminate included management procedures, training
programmes, websites, governance standards and learning materials for HIV & AIDS
education. The NSF could also invest in data collection and analysis, and perhaps develop
lobbying activities at the regional and international level. In this scenario, funding
requirements would reach $2,963,350 over a three-year period.
As Luke weighed the costs and benefits of each of these scenarios, he could not eliminate the
possibility that TNT and WFP might pull out of the operation altogether. Although he felt
that this was unlikely in view of their strong commitment, he speculated that if this did
happen the Foundation could potentially be ‘transferred’ to an African organisation, such as
Paul Matthew’s IKAHENG, able to limit costs thanks to local management and perhaps even
access more local or regional funding opportunities. On the other hand, he remained unsure as
to whether this would be attractive to a third party recipient as the foundation’s contractual
obligations would have to be maintained. Also, he worried that the failure or mismanagement
of the project by a new owner could potentially taint both TNT and WFP’s reputation.
As Luke prepared for the upcoming meeting, he knew that his team had done its best to bring
the project this far. But would it be enough to convince the Board that there was light at the
end of the tunnel for North Star Foundation in the fight against HIV & AIDS?
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Exhibit 1
Biographies of Key Case Study Characters
Peter Bakker
Peter Bakker is the CEO of TNT since 1 November 2001, after having been with the
company since 1991 in various positions. It was on his initiative that TNT contacted
WFP and set up the Moving the World partnership between the two organizations in
2002.
Esther Bosgra
Esther holds a Masters degree in International Relations. She has worked as a project
manager on various TNT projects in the Netherlands and is currently Project
Manager for the North Star Foundation in Kenya.
Luke Disney
Luke is currently co-Director of the North Star Foundation. Previously he worked
for three years at TNT as Global Director of Communications for the Moving the
World Foundation, which runs TNT’s partnership with the United Nations World
Food Program. In the past Luke has worked as a senior corporate communications
consultant where he specialized in corporate identity and branding projects. Luke
holds Canadian and Irish citizenship. He currently resides in Utrecht in the
Netherlands with his wife and two children.
Robin Jackson
As Chief of WFP’s HIV & AIDS service during the period evoked in the case study,
Robin took the lead in linking WFP and TNT’s HIV & AIDS response by contacting
the corporation’s CEO Peter Bakker about the issue. Robin was part of the original
team which went to Malawi in 2005 to analyze how the two organizations could
address HIV & AIDS together. Robin is currently Special Advisor to the Director
for External Relations and Partnerships at UNAIDS, and Chairman of the Board for
the North Star Foundation.
James Jenkin
James joined the TNT Group in the Netherlands in 1996. James has been involved
with the North Star Foundation project since its inception and was part of the joint
TNT and WFP delegation to Malawi in 2005. Since that time he has been actively
involved in the set up of the NSF as an independent Foundation in 2006 and
continues to be a NSF Board Member.
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Exhibit 1 (cont’d)
Biographies of Key Case Study Characters
Robin Landis
Robin is an HIV & AIDS policy adviser for WFP in Rome. She was part of the original
team that went to Malawi in 2005 and then helped to set up the first Wellness Center at
the Mwanza border post. Robin has been a driving force within WFP on the issue of
HIV and transport and has been involved in North Star Foundation from the beginning.
She is currently part of the North Star Management Team.
Paul Matthew
Paul is a South African entrepreneur. He grew up close to Port Elizabeth before
moving to Johannesburg as a teenager, where he continued his education. He founded
his company The Learning Clinic in 1996, providing consultancy services for training
and education within the road industry. After Paul helped the National Bargaining
Council to develop the Wellness Center model, the Clinic was charged with operating
the Centers established in South Africa. It was then merged with Ikaheng in 2005, of
which Paul is now the CEO. Paul currently lives in Durban with his family.
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Exhibit 2
Conceptual Framework for the Socio-Economic Impact of the HIV & Aids Pandemic
on Firms
Source: UNAIDS, Global Business Council on HIV/AIDS and Prince of Wales Business Leaders Forum. The
Business Response to AIDS: Impact and Lessons Learned. Geneva. 2000.
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Exhibit 3
Transport Corridors Throughout the African Continent
East African Corridors and Centres
NB: Corridors of
Hope, Trucking Against
Aids and Safe T Stops refer to non-NSF HIV &
AIDS clinics.
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Exhibit 3 (cont’d)
Transport Corridors Throughout the African Continent
South African Development Community Corridors and Centres
NB: Corridors of Hope, Trucking Against
Aids and Safe T Stops refer to non-NSF
HIV & AIDS clinics.
clinics.
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Social Innovation Centre
Exhibit 3 (cont’d)
Transport Corridors Throughout the African Continent
West African Development Community Corridors and Centres
NB: Corridors of
Hope, Trucking Against
Aids and Safe T Stops refer to non-NSF HIV &
AIDS clinics.
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Exhibit 4:
NSF Management Performance Framework – KPIs
Top-level Process
Understand,
define and
respond to
stakeholders’
needs
Deliver primary
healthcare and
health education
solutions for
transport
workers and the
communities
with which they
interact
Deliver
corporate
responsibility
solutions to
sponsors
Critical Success Factor
Provide high, quantified
standards of customer
satisfaction, which are
uniform across the NSF
network, and subject to
continuous evaluation
and review
Wellness centres are
staffed, resourced and
delivering high-quality
healthcare and health
education to customers
in the targeted group
Provide sponsors with a
method of fighting HIV,
quantifying their
contribution for
communication to
stakeholders
Copyright © 2008 INSEAD
Key Performance Indicator
Number of Wellness Centres open
KAPB survey carried out at all centres in last 24 months
Total number of people passing through the centre
Annual operational standards, KPIs and strategy defined
Number of evaluations
Number of days wellness centres open and fully operational
Number of attendees at BCC sessions
Number of copies of BCC material distributed
Number of male condoms distributed
Number of female condoms distributed
Number of peer educators trained
Number of people reached by peer educators
Number of clients treated by clinicians
Number of clients treated by clinicians for STI
Number of occasions medicines needed are out of stock
Number of clients referred to hospital/health centre
Number of clients counselled on HIV testing
Number of clients tested for HIV
Number of occasions VCT kits needed are out of stock
Number of monthly reports not provided by IT system
Centre cost effectiveness
Sponsor report completed and delivered on time
LIP operational report delivered on time
LIP financial report delivered on time
Time to establish Wellness Centre after funding confirmed
16
Target
X
1
Country specific
1/year
Responsibility
NSF/LIP
LIP
centre staff
NSF
Measuring
NSF annual report
NSF annual report
IT system
NSF annual report
1/year/centre
NSF
NSF annual report
20 per month
country specific
country specific
country specific
country specific
country specific
country specific
country specific
country specific
fewer than
10/Month
country specific
country specific
country specific
fewer than
10/Month
0
≤ $3/BCC/person
Monthly
every Q
every Q
12 weeks
LIP
peer educator
peer educator
peer educator
peer educator
peer educator
peer educator
clinician
clinician
IT system
IT system
IT system
IT system
IT system
IT system
IT system
IT system
IT system
clinician
IT system
clinician
counsellor
counsellor
IT system
IT system
IT system
counsellor
IT system
NSF
LIP
NSF
LIP
LIP
NSF
Operational report
Operational report
NSF annual report
Operational report
Operational report
NSF annual report
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Social Innovation Centre
Exhibit 5
Benefits of a Wellness Centre Network
Operational data from Mwanza Wellness Centre from April 2006-March 2007
Source: North Star Foundation.
Schedule, Costs and Benefits for a Network of 20 Wellness Centres Rolled out Over
Five Years
Source: North Star Foundation.
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Social Innovation Centre
Exhibit 5 (Cont’d)
Predicted interventions made by a 20 Wellness Centre network rolled out over five
years. Each centre has the same daily visitor rate, visitor breakdown and
performance as the current Mwanza Wellness Centre.
Source: North Star Foundation.
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Exhibit 6
Funding Requirements for Luke Disney’s Three Strategies for a Sustainable Future
North Star Foundation
(Branching)
Funding
Requirements
under
“Operator”
Scenario
Source: North Star Foundation.
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Exhibit 6 (Cont’d)
North Star Foundation Funding Requirements Under “Catalyst” Scenario (Affiliation)
Source: North Star Foundation.
North Star Foundation Funding Requirements under “Expert” Scenario (Dissemination)
Copyright © 2008 INSEAD
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