Saturday, September 26, 2020

Health for Everyone

All the time that he was toting up figures for a diamond mining giant as well as international accounting and audit firms, Kabelo Ebineng knew that his real calling was elsewhere.
“I have been trained more as a businessman than an accountant,” he says.

The opportunity to become a businessman came in 1990 when he joined Associated Fund Administrators Botswana which was formed in the same year. He was not just a businessman, he was managing director. After 18 years at the helm, he is able to determine that “what I’m doing now has given me the opportunity to use the skills that I have acquired over the years.”

Wrapped up in ‘over the years’ is the story of a corporate world career that spans 28 years, started at Barclays Bank, took him to Anglo American, Deloitte, Coopers & Lybrand and saw him do “all kinds of assignments here and there.”

On account of his association with Anglo American, Ebineng also did accounting work for other companies within the stable ÔÇô like Debswana (working at both Orapa and Jwaneng mines) and De Beers Prospecting.

Having managed the operational and strategic affairs of the Botswana Public Officers’ Medical Aid Scheme (BPOMAS), Pula Medical Aid Fund and AFA since 1991, Ebineng has over 15 years’ private healthcare financing/medical aid administration experience.
Of particular relevance to his association with BPOMAS and PULA and healthcare financing in general, Ebineng is a member of the World Bank’s Advisory Group on Private/Voluntary Health Insurance in Developing countries – Africa Region.

He is a professional accountant (Chartered Institute of Management Accountants: United Kingdom) and also holds an MBA Degree from the University of Cape Town.

For as long as he has been an MD at AFA (and it’s been quite a while) Ebineng has endeavoured to do the kind of business that has a human face on it. Basically, that entails coming up with “workable solutions for the benefit of humanity.”
“I’m trying to come up with solutions that are useful to people, add to the development of humanity and are also beneficial to me as a person,” he says as a matter of fact.
The most important business solution to him is that of ensuring that there is a healthy balance between entrepreneurship and provision of health services. He says with regard to the latter: “Health care should be accessible as well as cost-effective.” Further to that, he sees the provision of health care by the private sector as an issue of development.

When the dark clouds of HIV/AIDS began to gather on the horizon, the instinct of Ebineng and his colleagues at AFA was to draw a plan for a shelter under which the nation would scurry when the viral rain started falling. They subsequently presented their plan to militate against the effects of the disease to their clients ÔÇô BPOMAS and Pula. Their case was that relative to the health and economic benefits that would accrue to the nation, the outlay would be a small price to pay.

Through mathematical and economic modeling, Ebineng & Co. had calculated that the country could afford that plan because there was no way that hundred of thousands of people were going to enroll for anti-retroviral therapy at the same time.
The plan was approved and the result was a medical aid cover for HIV/AIDS patients that have been immensely helpful to the economic fortunes of the country. This was the first such coverage by any medical aid scheme in the developing world.

As a battle front soldier in the war against HIV/AIDS, Ebineng attends a lot of meetings that bring him into contact with professionals from other fields. Something struck him as odd in his early years at AFA when he noticed that a majority of people who attended these meetings were public servants. In conversations with colleagues in the private sector, he got to learn that the general view was that HIV/AIDS was the responsibility of the government.
The conclusion he reached then was that “businessmen were not thinking wisely” because down the line, AIDS was going to “hammer on their employees and their profits” as they would have to go to considerable expense replacing and retraining employees.

Out of that assessment would sprout what would be called the Botswana Business Coalition on AIDS (BBCA) – an AIDS organisation which took root in 1994.
Dr. Edward Maganu, then Permanent Secretary in the Ministry of Health was very enthusiastic about this initiative and got to address a meeting convened at Barclays House in Gaborone. In his address, Maganu impressed upon his CEO audience on how the private sector could assist in the war on HIV/AIDS.
“It was a good meeting. Businesses were represented at CEO level and over 30 people attended. Dr. Maganu left after he gave his speech and we had a very interesting conversation amongst ourselves as business,” he recalls.

What was interesting about that conversation was that one too many businesspeople stood up to say that “the business of business is business” and that the provision of social services was the responsibility of government.
Mercifully though, there were other people at that meeting who took a less rigid view of how business should be conducted and they helped advance the cause of what would be known as BBCA – the first such organisation in Africa. Ebineng’s involvement with the BBCA and HIV/AIDS work includes being a resource person for the Global Business Coalition (GBC) on AIDS, and the World Economic Forum (WEF), on matters of HIV/AIDS advocacy in business. In this respect, Kabelo works closely with United Nations agencies, the World Bank and the GBC in the area of advocacy and finding business-related solutions to the HIV/AIDS pandemic. BBCA was among the first organisations to give advice to the GBC.

At a later stage, the Botswana Federation of Trade Unions was invited to join BBCA. The rationale for this was that business is an enterprise that includes both employers and employees. Although funding is still an issue, Ebineng says that development partners like NORAD have been very helpful.
At the end of the day, however, money is not the only weapon that can be used in the war against HIV/AIDS. Ebineng notes that something as simple as imparting knowledge about the disease and providing counselling in the workplace can go a long way in winning some battles. He gives an example of an amorous m├®nage a trois that involves the secretary, general manager and the service driver.

“Assuming there is no protection, the general manager ÔÇô the brains of the company ÔÇô could be taken out and the business would be badly affected. Preventing a situation like that has nothing to do with money but behaviour. That’s why it is important to share ideas and knowledge about AIDS.”
As Ebineng explains, such sharing has also been good for the international community.

“What we did in Botswana has had an impact elsewhere in the world because in solving Botswana’s problems, we have benefitted other countries somehow. If we come up with programmes that the United Nations finds useful and applies in Zimbabwe or Zambia, we have ensured that health problems in those countries don’t come here. You can be in competition with other countries but you also need to cooperate.”

He adds that such cooperation can lead to healthy cross-pollination of ideas that would further enhance battle strategies that the international community uses in the war against HIV/AIDS.

In terms of what it does, the company that Ebineng heads has been spectacularly successful but there are challenges that it has to deal with. For starters, when AFA was formed 18 years ago, competition for members was not nearly as fierce as it currently is. More importantly, there was no comprehensive policy framework for the health sector and it was only after five years of AFA’s existence that the government came up with the National Health Policy.
“The challenge now is to ensure that issues of social equity and human rights that are contained in the National Health Policy are handled properly. Whatever we do has to follow the policy framework. We have taken the view that health is a socio-political and economic issue and if we are to maximize utility for those that we serve, we should be looking at documents like the National Health Policy, the National Development Plan and Vision 2016,” he says.

In addition to his job at AFA, Ebineng wears some other caps. He is an elected director on the Board of Healthcare Funders of Southern Africa, a trade association whose membership comprises registered health plans in Botswana, Namibia, South Africa and Zimbabwe. He is a member of the Management Council of the International Federation of Health Plans (iFHP), a global trade association of health insurance and plans, with members all over the world, except in a majority of French-speaking countries. The iFHP’s membership varies from country to country and includes profit and non-profit making entities. Ebineng’s professional and technical roles within the iFHP include membership of its Public Affairs Panel which goes back to 1999. The Panel is primarily concerned with the pursuit of meaningful relations with governments, regulators, media and professional bodies in the context of healthcare delivery.
Ebineng is also a member of the 20-person African Think-Tank on HIV/AIDS Management (ATTAM). Established under the auspices of the United Nations and the African Union, ATTAM’s mandate is to give policy direction to the African Centre for HIV/AIDS Management (ACHAM), which is based in Abuja, Nigeria.
His other responsibilities include the co-ordination of the Botswana private healthcare sector activities and deputising for the Minister of Health in the health sector forum of the High Level Consultative Council which discusses national policy issues between the private and public sectors under the chairmanship of the President of Botswana.

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