As of 2020, Eswatini, Lesotho, Botswana, and South Africa had the highest rates of Human Immunodeficiency Virus (HIV) in Africa, making Southern Africa the region with the highest rate of the virus globally.
South Africa has the highest HIV prevalence of any country, with 7.5 million people living with HIV in 2019. By 2020, this figure had risen by 300,000, bringing the total to 7.8 million people.
HIV has affected and infected millions of people in South Africa. It weakens the immune system and makes people more susceptible to other illnesses and infections, such as tuberculosis, a significant public health issue in South Africa.
South Africa faces several challenges, including healthcare access, deprivation, gender inequality, and a high prevalence of stigma and discrimination against HIV-positive people, despite efforts to prevent and treat HIV, including providing antiretroviral therapy (ART).
As of 2021, South Africa had the world's largest HIV treatment programme, with 5.5 million people on ART. In 2018, the country met the target of 90% of people living with HIV knowing their status.
Yet, the country struggles to treat more people than any other nation globally, which hinders efforts to increase access to HIV treatment. Some obstacles to testing and treatment include stigma, prejudice, gender-based violence, poverty, and a lack of awareness.
Consequently, Dr Musaed Abrahams (CEO) and Luke Shankland (COO) conceived Aviro Health in 2012 to counsel people with HIV in the country.
Built by experienced co-founders
Abrahams has spent the past 20 years doing HIV-related work. He has nearly ten years of experience working for both the government and the humanitarian organisation, Doctors Without Borders.
In those two decades, he was primarily concerned with healthcare workers and patient education.
Shankland, on the other hand, previously worked as a country manager and board member for Doctors Without Borders. He was the African operations lead for a fintech startup.
How Aviro Health started
Abrahams and Shankland were researching healthcare issues in 2012 when they discovered a lack of communication and patient engagement with healthcare providers.
They soon found that patients needed the right information at the right time to access quality care. That motivated them to research ways to help people receive the appropriate information at the right time, guiding them to the proper facilities or healthcare providers.
"You know, I had the experience in HIV where I saw patients going through counselling but not understanding the HIV condition, including how they should start a treatment," Abrahams explains.
Further, Shankland had a son diagnosed with liver disease at the time. Despite living in Canada, it was difficult for him to navigate the healthcare system and get his son the care he needed.
Because people may struggle to understand how to use the healthcare system due to the complexities of the healthcare sector, the co-founders launched Aviro Health in 2017.
How Aviro Health works
Aviro Health is a South African pocket clinic platform that empowers health system users by improving the standard of care. It is an HIV-focused healthtech startup that uses technology and behavioural science to create, improve, and scale patient support.
It collaborates with healthcare providers, mainly HIV-focused organisations, to provide these services to the public. Examples of these organisations are Health Systems Trust, PSI Kenya, TB HIV Care, and Médecins Sans Frontières.
Aviro’s pocket clinic optimises patient onboarding, counselling, and testing. Patients can access semi-automated support, reporting, and service links via mobile phones or other devices.
Patients can access video counselling in six South African languages on the platform, including Swahili.
After receiving counselling, patients visit a healthcare provider Aviro partners with for an HIV test. So, they either run the test with the healthcare provider or get a kit to take home while they report their results on the app.
Aviro Health provides information on the HIV tests individuals should take, how to begin treatment, why it's a good idea, and how to do it effectively.
For example, after running a test and the outcome is positive, the patient receives counselling via the app and returns to the healthcare provider to start treatment.
Also, if they're negative, the company counsels them on how to remain uninfected. It also informs them where to find Pre-exposure Prophylaxis (PrEP), an HIV prevention drug, and sends a reminder if they schedule another test.
Additionally, it enables healthcare providers to assist patients in achieving specific health outcomes for a range of use cases through carefully crafted medical content and tried-and-true user flows, managed and delivered via a multi-channel platform — Web app, offline app, WhatsApp, and chatbots — with data and analytics capabilities.
Partner healthcare providers can deliver confident, high-quality care by combining patient engagement and data insights.
According to Abrahams, Aviro Health is making a difference in HIV, sexual reproductive health diseases, and chronic diseases such as diabetes and cancer.
It recently launched a pilot project with the University of Pretoria, South Africa, to improve outcomes by digitising the clinical workflow of community healthcare workers seeing patients with diabetes on insulin.
The startup considers the needs of the patient, the healthcare provider, and the healthcare worker before developing a platform to meet those needs. Abrahams claims that everyone, including LGBTQ people, can use it.
Challenges and growth
Abrahams says Aviro Health is the only South African company that offers semi-automated HIV counselling and combines patient-centred content and engagement with technology and data.
Aviro Health currently relies on grants and investments for funding. It generates revenue from its partnerships with healthcare providers through upfront costs, custom development costs, and recurring monthly maintenance fees.
However, Abrahams says funding for HIV has decreased. So, with a team of 16 in South Africa, Kenya, and Canada, it onboards slowly to reduce operational costs. Besides, the unstable power supply in South Africa presents another challenge.
The startup has had over 75,000 patients and collaborates with six HIV foundations. In 2020, the South African company expanded to Kenya. When COVID-19 struck, there were more customers, but after that, business began to decline.
So, the company is looking at providing information for chronic diseases, especially diabetes, and moving more into primary care for patients to find more clients willing to try the pocket clinic.
Additionally, it plans to commit to maintaining a patient engagement platform, whether online or offline. It also wants to enable patient communication among healthcare providers.