In this fund, established by medical aid administrators Prosperity Health and Methealth, employer-based insured and previously uninsured groups in Namibia participate in sharing the financial risk of HIV/AIDS.
The establishment of the HIVREF forms part of the PharmAccess Okambilimbili project in Namibia.
Does it sound impossible to give an HIV/AIDS patient N$100,000 cover for a monthly contribution of only N$30? Under a conventional medical aid fund it is impossible, but with a new innovative approach to affordable healthcare it is currently being done.
PharmAccess, a Dutch not-for-profit foundation, in partnership with Prosperity Health and Methealth, has launched a low cost product called Vitality Daycare. This is a basic medical aid fund administrated by MyHealth and it provides HIV/AIDS cover and basic healthcare. Vitality Daycare is registered with Namfisa as a Friendly Society.
The general manager of PharmAccess, Ingrid de Beer said the motive behind the assistance to these medical aid funds is to support greater access to sustainable private HIV medication and AIDS treatment. This is done by subsidizing the monthly premium of lower-end medical aid products. Covering the cost risks of HIV/AIDS, said de Beer, can only work if the risks are shared across the industry. To promote this idea, PharmAccess introduces the concept of a risk equalization fund. This fund is called the Health is Vital Risk Equalization Fund and it provides the cross-industry subsidy of N$30 per contribution to the participating medical aid funds. In addition, for employees who do not have any medical cover at all, PharmAccess allows direct access to Health is Vital for employer groups.
A year ago NHP, Prosperity and the clinic group known as Namibia Health Centres were the only groups providing low cost medical cover or service. Through the funding provided by the Health is Vital Risk Equalization Fund, the number of affordable products has grown, and through Vitality Daycare, ultra-low cost medical care has been brought within the reach of thousands of employed people. De Beer explained that the entire Namibian medical insurance industry rests on the membership of only about 158000 main members. These are the lucky few who can afford monthly contributions to a medical aid fund. Over 200 000 other Namibians, all employed, are still not covered by medical aid as it is often too expensive, either for the individual or for the employer. Affordability is a very valid concern as the small number of insured mostly belongs to high-value high cost medical aid funds. Lower income employees have very limited means to access lower-end medial insurance products, and absolutely no way of affording the high-value products.
De Beer said PharmAccess is a Dutch not for profit foundation which specializes in HIV/AIDS treatment. The objective of PharmAccess is to provide responsible access to care and HIV/AIDS treatment to the previously uninsured target populations in Africa. PharmAccess aims to achieve this by supporting the strengthening of local (medical) capacity, stimulating the opening up of local markets and enhancing access to affordable care and HIV/AIDS treatment, by supporting private sector initiatives which compliment national development objectives.
PharmAccess received a grant from the Dutch Nationale Postcode Loterij, through STOP AIDS NOW!, the Dutch AIDS Funds and HIVOS, the International Humanist Institute for Cooperation with Developing Countries, to support greater access to sustainable private HIV/Aids treatment in Namibia. The funds are utilised to provide a limited duration subsidy to the monthly premiums of new affordable health care products and to fund supporting treatment literacy activities. Treatment literacy activities are undertaken in partnership with NABCOA (Namibia Business Coalition on Aids) and Lironga Eparu (National Association of People Living with HIV/Aids) to create awareness, provide treatment education and mobilize organizations, and individuals, to seek ways of mitigating the impact of HIV/Aids through effective treatment.
Healthcare products that are currently subsidized by PharmAccess with the grant are Vitality Day Care (within the HIVREF) and NHP Economic Plan and NHP Blue Diamond Plan. “Emphasis is placed on trying to encourage medical schemes and employer groups to participate in and support the REF as an industry platform”, said de Beer.