John says, ‘in former days it took enormous labour to try and collate mostly paper or computer data, and by the time you had insights it was six months out of date. What we have now is real time insights drawn from much more data, boiled down into ‘what do I do on a Monday morning’ type advice.
In particular, he says, the 886 healthcare clinics of KwaZulu-Natal have swum into focus. A select few were disproportionately important in the work being done, allowing managers to zero in on their needs and focus resources where most needed.
‘We draw data from Human Resources records, from patients, from laboratories and from healthcare data.’ The result, made accessible to frontline staff such as nurses via an app, allows everyone to sing off the same hymn sheet. Ernest says that they could make ‘optimal and timely decisions…to look up and share data with local managers and clinicians about HIV testing, enrolment in anti-retroviral therapy programmes, and viral load suppression.’
Better patient education and drug taking has allowed HIV-suppression rates among the HIV positive to rise from 57% to 81% in KwaZulu-Natal.
Looking back, John notes that he went to Oxford twice – first as a Sophomore at Dartmouth on a Semester Abroad, when he studied in the Refugee Studies Programme at Queen Elizabeth House under the formidable influence of the late Barbara Harrell-Bond OBE (1932-2018). The later as a Fulbright he took an MSt in Social and Cultural Anthropology.
‘One of the biggest influences of all was volunteering with the Red Cross in Sierra Leone in the summer of 1992, age 21,’ he says. ‘It was a very rural refugee camp with no running water yet unlimited Coca-Cola and Guinness if you could afford them,’ he recalls with a laugh. He reflected deeply on that weird juxtaposition. ‘How was it that a corporation could successfully build a supply chain in a consumer product when water remained elusive?’, he asked himself.
That also explains why later, with Ernest having gone on to complete an MBA at Said Business School when it had just opened, and both of them serving as management consultants, they took the gamble of setting up BroadReach on a mixed model of not-for-profit and for-profit, the idea being to build Coca Cola-like efficiencies and successes but to genuinely reach under-served populations.