In 1984, a year after the Aids virus was identified worldwide, the first HIV clinic was established at the Johannesburg General Hospital. It ran monthly, but by 1989 it was running weekly and had begun dispensing the antiretroviral, AZT.
"At this point we realised that HIV was a long-term, manageable disease and not a death sentence," says Steven Miller, a specialist in infectious diseases, who launched the unit.
By the early 1990s neither medical aid schemes nor the state were covering HIV/Aids costs and Miller decided to devote himself full-time to Aids.
He partnered businessman Eric Benz to launch the innovirInstitute, which has developed a sustainable business in the treatment and management of patients suffering from HIV/Aids. They have developed a holistic approach that assists a patient from first diagnosis, right through to application, pharmacology and patient care, liaising with pharmaceutical manufacturers and distributors. The treatment and care of patients is not limited to individuals, but extends to the whole family.
"We put all the services a patient may need under one roof," says Miller. "The financial benefit is better cost management - you don't have four or five independent practitioners all wanting to earn their margin."
Working like this also makes it easier to share information, an important part of effective treatment, particularly when treatment is tailored to each case.
This is a labour-intensive approach, increased by the focus on data which is captured and analysed in order to measure the efficacy of various treatment regimes.
Innovir has developed a technology program called i-systems which manages and integrates all the patient data - clinical, laboratory, financial and pharmaceutical.
Innovir has two specific objectives: to suppress the virus to the point that it is virtually undetectable in the body; and to prevent the patient from contracting new diseases. There are different ways to achieve each of these outcomes, says Miller, and each treatment route has different degrees of success.
"The number of people on antiretrovirals has become the yardstick for success - it's almost an outcome in itself. Our focus is on the quality of the treatment," he says.
"We compare outcomes and we know, for every rand we spend, which treatment regime is better for an individual."
Though Innovir is a nonprofit organisation, it does charge patients a fee for its service. For patients who are unable to pay, Innovir gets funding through partnerships with international aid organisations.
At present Innovir is managing the health of 2 500 patients and, through its work assisting other companies in the field of disease management, it cares for another 4 000 indirectly.
The company provides advice on the subject of HIV/Aids management as far away as Eritrea.
It has also turned its attention to improving the skills of practitioners, most of whom are unskilled in HIV care. It has developed a Web-based training programme which will be interactive next year.
Teaching to remote regions in and beyond SA is done by means of video conferencing. Last year Innovir got the go-ahead from the World Bank to use the Bank's Satellite Bridge network to broadcast live training to more than 160 countries.
Next year Innovir plans to be more active in managing women's health and fertility. "A big issue is how to have more children safely when one or both parents are positive," says Miller. "There are ways. We also have a management programme during pregnancy. Unlike the public sector, we manage for a 0% transmission of the virus from mother to child."
- Finalists: Roche Diagnostics; Media Works
