For South Africa and the world, 2010 will be remembered for the successful World Cup Soccer. From a South African perspective, we were united by a common purpose in hosting the “beautiful game”. The FIFA 2010 World Cup Soccer was a defining moment in South African history. There were two official 2010 World Cup Soccer songs, “Waka Waka” sung by Shakira and Coco-Cola’s official anthem “Wavin’ flag” by K’naan and David Bisbal. Some of the words from these songs captured the essence of the World Cup but also of Aurum events in 2010. In my report for 2010, I have used an excerpt from one of the songs in each section that is particularly relevant.
Aurum’s theme for 2010 was: “It starts with me, let’s work together in the fight againstTB and HIV” – highlighting that all Aurum staff have an essential role to play in achieving Aurum’s vision of improving the health of individuals and communities. For Aurum, 2010 was a year of change and celebration. I acknowledge both achievements and challenges for each of the programmes and departments in this report.
Aurum restructuring – “The pressure is on!”
In order to build a sustainable, more efficient organisation, Aurum underwent a strategic review process in 2010 that culminated in a strategic roadmap (Figure 1) and new organisational structure to support synergy between business units and core support services, while continuing to embrace Aurum’s values of Integrity, Excellence, Teamwork, Innovation and Respect.
The new structure is modelled on a matrix management approach and includes two business units, the Health Programme and Research units, supported by an Operations Division and core services.
The change in organisational structure and roles and responsibilities was communicated to staff through an internal campaign called “Building Aurum’s legacy.” The logo we designed was made up of Lego blocks to symbolise that we each contribute to Aurum’s legacy one block at a time.
Aurum staff were encouraged to embrace the change and work towards building an Aurum legacy they could be proud of. The new structure was formally introduced in October 2010, and not unexpectedly, resulted in high levels of stress throughout the organisation. But with commitment, perseverance, and good communication, the change was embraced. Allowing time for staff to settle into their new roles within the structure, I am confident that Aurum will continue to grow and have a greater impact on improving health through technical support to the Department of Health and transformative research.
Research Programme – “You’re on the frontline!”
The Research Unit, with executive leadership from Dr Salome Charalambous, was restructured with the establishment of a core group of senior scientists responsible for initiating and leading research which is then implemented by the Operations Division and managed by the two subunits of the Research Unit, the Clinical Trials Unit (led by Dr Lynn Katsoulis) and the Epidemiology Unit (led by Dr Violet Chihota). The intent is to free up the scientists from operational responsibilities and allow them time to conceive and write grants for research proposals and to publish the results of their research.The aim is to do “Aurum-defining research” that will transform policy and practice with respect to TB and HIV – thus positioning Aurum at the “frontline” of research internationally.
The Research Programme has settled into the new structure and is making satisfactory progress. In total, Aurum had over 25 publications in 2010. Notable achievements include Aurum’s contribution to a supplement in the journal AIDS on “Isoniazid preventive therapy for HIV-infected people: evidence to support implementation” which comprised:
- Results on the feasibility of implementing communitywide
- Isoniazid Preventive Therapy (IPT) among South
- African gold miners (the Thibela TB study);
- The role of community mobilisation, effectiveness of TB
- screening prior to starting IPT, safety of IPT;
- The combined effect of IPT on mortality;
- Barriers to IPT; and
- An opinion piece on the effect of IPT on mortality
Other high impact publications included two papers in The Lancet (“Call to action to scale up TB diagnosis, management, control and research; a comparison of two community-based TB case finding strategies in Harare”), two papers in The Lancet Infectious Diseases Journal (“Combined use of isoniazid preventive therapy and antiretroviral therapy to prevent TB”, and “Opportunities afforded by new TB drugs”), and two papers in the journal Thorax (“Comparison of 6 vs. 12 monthlyTB screening among gold miners” and “Excess lung function decline following TB”).
Health Programmes Unit – “You paved the way!”
The PEPFAR programme in South Africa underwent a strategic realignment with the emphasis shifting from service provision to technical support to the Department of Health. Furthermore, in the new Aurum structure, the Health Programmes Unit has to “pave the way” by determining the needs of the Department of Health and set the strategic direction for the Operations Division and what needs to be implemented in the field.
Dr Fazel Randera led the Unit through these changes, which brought with them many challenges and opportunities. Aurum has had to embrace these changes which included withdrawing from some existing geographical areas of operations and moving into some new areas of operations and reskilling staff to provide technical assistance. Achieving a synergistic working relationship between the Health Programmes Unit that provides overall direction to the programme, and the Operations Division that is responsible for implementing the programme plan, was particularly challenging. The two working units have however emerged from this turbulent period stronger and now have a solid collaborative working relationship.
Operations Division – “You’re a good soldier!”
The Operations Division is a newly established component of the Aurum structure that is responsible for the operational implementation of work emerging from the Health Programmes and Research business units. Under the leadership of Dr Petra Kruger, the Operations teams are the “foot soldiers” that are responsible for delivering the outputs from programmatic and research interventions. Despite the challenges of starting a new department, the programme has had some early successes which include offering HIV Counselling and Testing and TB screening in support of the Minister of Health, Dr Aaron Motsoaledi, at the opening of a new HIV clinic at Rorke’s Drift in KwaZulu-Natal. The Operations Division also rapidly reorganised the various skills and talents within Aurum to align with the changing PEPFAR strategy mentioned earlier.
Core Services – “This is your moment!”
Three new core services were established under the leadership of Dr Marianne Felix to support the business units and operations programme. These include quality, monitoring and evaluation and training. In addition, a data management department was established under the leadership of Ms Trisha Crawford, drawing all the data management resources and expertise in Aurum under one roof to maximise future efficiency and effectiveness. Establishing these core services has been challenging due to inadequate human resource capacity and difficulty in finding skilled people to head some of the individual units. However, once they are firmly established and running smoothly, they will truly find their“moment” in the legacy of Aurum.
Support Services – “Today’s your day!”
The strong support services that Aurum enjoys today have been built over time and Aurum is proud of what they have achieved.
The finance and IT departments were ably led by Mr Roshan Jugadoe.The financial status of Aurum has strengthened in the past year, with the creation of a more solid balance sheet to help the organisation weather the volatility that is the grant environment. The whole matter of governance and risk management was also strengthened to move closer to compliance with the King III report and good business practice standards.
Our IT system, championed by Mr Dirk van Schalkwyk, remains a backbone to Aurum’s growth and development, and the envy of other NGOs. In the year ahead we will be implementing the SharePoint System to consolidate and codify organisational knowledge, improve collaboration and foster better communications between the various parts of the organisation.
Our people are always our greatest asset. The Human Resources Department remains central to Aurum, and under the leadership of Mr Sipho Tshabangu, has numerous challenges in the pursuit of making Aurum an employer of choice in a scarce skills environment. Together with the Remuneration and HR Committee of the Board, the HR Department has set out to update all the organisation’s policies and procedures in line with current HR practice and legislation. They also keep abreast of employment conditions in the health sector to ensure that we can achieve our strategic goal of attracting and retaining key staff for the programme, research, operational and support divisions of Aurum.
Lastly, and by no means least, Aurum’s communications and marketing department needs to be commended for its presentation of Aurum to society, the management of the internet site, and the successful management of the numerous events, functions and training that took place during the year.
Annual Aurum Awards – “Your time to shine!”
Every year Aurum celebrates its achievements and acknowledges staff that embodies Aurum’s values. The lively event was held at the Barnyard Theatre; we had an early taste of World Cup Soccer fever and left slightly deaf from all the Vuvuzelas that were blown! Mr Bulelani Kuwane was the well-deserved recipient of the Aurum Award.
World HIV and TB days – “You know it’s serious!”
Despite South Africa having strong policies for TB and HIV, both epidemics remain “serious” public health problems. Aurum marked World TB and HIV days with events at Aurum-supported sites and head office.
Aurum’s impact on policy and practice – “Everyone’s watching!”
In 2010,Aurum contributed to formulating international, regional and national policy on intensified case finding and isoniazid preventive therapy for people living with HIV and among miners. I was appointed as the Chair of the WHO/TDR Disease Reference Group for tuberculosis, leprosy and buruli ulcer in the last quarter of 2009.The first face-to-face meeting of the committee was held at the Aurum Offices in January 2010. The second meeting was held in Manila, Philippines, to finalise the first report and global research priorities for TB, leprosy and buruli ulcer. Dr Fazel Randera represented Aurum at the International Labour Organisation on TB in the workplace, whilst a number of employees presented Aurum’s work and results at various international conferences and academic settings. Aurum played a major role at the South African TB conference. I was the Chair of the Clinical and Epidemiology track and Aurum delivered numerous oral and poster presentations. I was a member of the South African National AIDS Council Technical Task Team on TB/HIV that informed policy on TB and HIV.
Aurum’s future – “People are raising their expectations!”
Although the restructuring process has been stressful, I believe that the new strategic roadmap and organisational structure will make Aurum even stronger and more sustainable into the future. As Aurum grows, so too will the expectations of others of Aurum.
“This time for Africa! This time for Aurum.”
The whole world descended on South Africa for the first ever African Soccer World Cup. By all accounts, the event was a spectacular success and the atmosphere pervaded every corner of society for months.The flags and banners, the paint and people, the drone of the vuvuzelas, and the moments and memories were carried by the media to the far corners of the globe. It was truly a time for Africa.
But the Cup has come and gone and as we return to the reality that is Africa, we are once again confronted by TB and HIV, the scourges which we seek to eliminate as our primary mission. Aurum continues to carry a “Wavin’ Flag” of dedication to this task, a symbol of hope in making a difference to the communities in which we work.
I am once again extremely grateful to all the funders, partners, collaborators, colleagues and staff members who enabled us to achieve what we did, and made us what we are. Without our supporters, just like the World Cup, Aurum’s mission in South Africa would not be possible. With your continued support, 2011 will be a proud and productive time for Aurum in the fight against TB and HIV.
Prof. Gavin Churchyard
Chief Executive Officer