Project Masiluleke

A breakthrough approach to reversing HIV and TB in South Africa and beyond

Project Masiluleke is a path-breaking effort that harnesses the power of mobile technology to address one of the world’s gravest public health crises. This ambitious initiative leverages the ubiquity of mobile devices in South Africa to help fight the country’s crippling HIV/AIDS and TB epidemics. Meaning ‘hope’ and ‘warm counsel’ in Zulu, Project Masiluleke brings together a coalition of world-class partners – including iTeach, the Praekelt Foundation, frog design, MTN South Africa, Nokia Siemens Networks and the National Geographic Society – driving adoption of the program in South Africa and beyond. 

Project Masiluleke is a signature program of the PopTech Accelerator – a social innovation incubator designed to foster breakthrough, interdisciplinary solutions to pressing global challenges. The Accelerator aligns world-class companies, foundations, NGOs, funders and thought leaders to collaborate on outcomes none could achieve independently. Each PopTech Accelerator program will focus on using new technologies and approaches to effect scalable, replicable and sustainable social change.

Also available: Project Masiluleke Brief (530KB pdf)

The challenge

“Ground Zero” of the sub-Saharan HIV/AIDS crisis
public service announcement

South Africa has more HIV positive citizens than any country in the world.  In some provinces, more than 40% of the population is infected.  Yet only 2% of South Africans have ever been tested for HIV.

Of those who are HIV positive, a mere 10% are receiving anti-retroviral therapy – leaving 90% untreated, infectious and likely to die.

HIV/AIDS carries a huge social stigma in South Africa, preventing many from getting tested or pursuing treatment, and there is wide-spread misinformation about how the disease is contracted.  Further complicating matters, the nation’s overburdened healthcare system is incapable of providing care to the millions in need – many of whom enter the system with end-stage HIV or full blown AIDS.

Solution genesis

An 8,000 mile journey — a spark in Camden, Maine  

zinny at poptech 2007

In October 2006, Zinhle “Zinny” Thabethe travelled from Johannesburg, South Africa to Camden, Maine to speak at PopTech.  HIV positive herself, Zinny came to share how the disease is affecting her, her family and her country.  More importantly, she came to detail her fight to reverse the course of HIV/AIDS in South Africa – and invite others to join her crusade.  

At PopTech Zinny found a receptive audience, and a series of organic conversations quickly formed an unlikely alliance between a world-renowned design firm, one of the planet’s most visible media brands, South African foundations and leading mobile technology companies.

The video below further details Zinny's journey and the conditions that drove Project Masiluleke's conception.

The Solution

The mobile phone as life-saving device
black scarf blue hat

Project Masiluleke harnesses the mobile phone as a high-impact, low-cost tool in the fight against HIV/AIDS and TB. Nearly 100% of South Africans have access to a mobile device and the project touches virtually every one of them. Conservative estimates indicate Project Masiluleke has the potential to mobilize hundreds of thousands to get tested.

The key elements and stages of Project Masiluleke include:

“Please Call Me” x 1 Million x 365 - The first stage of the project is built around the use of specialized text messages, delivering approximately 1,000,000 HIV/AIDS and TB messages each day to the general public. These messages are broadcast in the unused space of “Please Call Me” (PCM) text messages – a special, free form of SMS text widely used in South Africa and across the continent. Utilizing technology from the Praekelt Foundation, message content from iTeach, design insights from frog design, and network capacity donated by MTN, the messages connect mobile users to existing HIV and TB call centers. Trained operators provide callers with accurate healthcare information, counseling and referrals to local testing clinics.

Since the project's launch, over 685 million PCM messages have been sent throughout South Africa, driving over 1.5 million calls to the National AIDS Helpline.

TxtAlert: Keeping Patients Connected to Care - Only 10% of South Africans with AIDS are currently receiving anti-retroviral (ARV) therapy, and of those who begin treatment, more than 40% do not remain on the life-saving drugs past two years. Project Masiluleke addresses this critical problem through the Praekelt Foundation’s TxtAlert technology, which uses text messaging to remind patients of scheduled clinic visits – helping to ensure they adhere to ARV regimens.

HIV Self-Testing with Mobile Phone Support - Ultimately, with more HIV+ citizens than any other country in the world, and infection rates topping 40% in some provinces, South Africa demands a radical solution to truly reverse its HIV/AIDS and TB crises. The project partners are developing a breakthrough distributed diagnostics model: low cost HIV self-testing with counseling support via mobile phone. Analogous to a pregnancy test, these distributed diagnostics will provide a free, private and reliable way for anyone to take the critical first step of knowing his or her status, with high-quality information provided via mobile device.

Self-testing does raise some serious questions, which require thoughtful analysis and careful planning. However, these concerns must be weighed against the ability to achieve wide-scale testing and earlier entry into care through an option that empowers patients and alleviates stigma. Early response from local health officials, national clinical associations and other leaders in healthcare has been strongly enthusiastic. Most important, feedback from the community confirms individuals are eager to have access to an HIV self-test, with both patients and healthcare workers preferring counseling via cell phone. The Project M team will initiate a global conversation about this and other potentially transformative solutions applicable in South Africa and worldwide. frog design and iTeach are collaborating on visionary design strategies which can guide a possible implementation of this solution.