Incentive scheme for the poor

A participant in the Broccoli Project
incentive scheme with his reward for
having an HIV test.

Men wait in the Tutu Tester mobile
facility for their turn at the test.

Biometric identification helps keep track
of people who have been tested at the
Tutu Tester.
(Images: MarcAnthony Zimmermann)

Jennifer Stern

Despite the efforts of governments, charitable foundations, NGOs and individuals, half of the world’s population remains in poverty, with 3.9-billion people living on less than US$2 a day. It’s even biblical – the poor will always be with us.

But it’s only recently that the poor have ever been seen as anything other than a problem that needs to be swept under the carpet, shipped off across an ocean or dealt with in some way. The most notable of the people proposing a different way of viewing the poor is CK Prahalad, author of The Fortune at the Bottom of the Pyramid.

Prahalad suggests that we stop thinking of the poor as a problem, or a burden, and start thinking of them as creative entrepreneurs and valuable consumers. These people “at the bottom of the pyramid” may not have much individual spending power but, because there are so many of them, collectively they represent Prahalad’s eponymous fortune.

This realisation has not necessarily always been to the advantage of the poor, as it has opened them up to exploitation by ruthless corporations prepared to chase profit by any means. But there are also creative ways to make a profit from the bottom of the pyramid while offering a service that people actually need and want.

So it was with all this in mind that MarcAnthony Zimmermann hit on the idea of an artist-endorsed starter pack for mobile phones. A joint collaboration with cellular operator Cell C, South African kwaito musician Zola and Zimmermann’s company Punq saw the launch of the Hola 7 starter pack in May 2008.

Endorsed by an iconic local musician, the package offered real benefits to the users – allowing them reasonably priced access to the benefits of mobile phone technology. And one thing Zimmermann does like is technology.

“But I really want to use my knowledge and creativity to do something with meaning,” Zimmermann says. “To do something good – while using cool technology, of course.”

One of the most inequitable facts of modern life is that everything is cheaper for the rich. The more you have, the more you get given – a phenomenon graphically illustrated by loyalty programmes. Be it airlines, life insurance, coffee shops or credit cards, the more you spend, the more you are given. And that got Zimmermann thinking.

“How,” he wondered, “could the poor benefit from incentive programmes without being made to spend more?”

And what kind of incentives should they be offered? He is rather scathing of the rewards offered to the rich by most loyalty programmes, calling them “all sorts of junk you didn’t know you didn’t need, or stupidly valued voyager miles”.

For Zimmermann, the one incentive scheme that stood out was Discovery Vitality. While it is still aimed at relatively affluent people, it offers rewards for positive life-enhancing behaviour. You get points every time you go to the gym, if you give up smoking (or have never started), if you lose weight (or don’t have to) and for routine preventive health checks like cholesterol tests and pap smears.

“If the wealthy can be rewarded for healthy life choices with cheaper movies, holidays and aeroplane flights,” he thought, “why can’t the poor be rewarded for similar behaviour with more appropriate incentives?”

And so the Broccoli Project was born. The basic idea is simple. Poor people are encouraged to take preventive health measures, keep their children in school and try to find work if they are unemployed. With families at the bottom of the pyramid, the incentives for these positive efforts are cash or vouchers for food, clothing and/or building materials.

The pilot project was run in conjunction with the Tutu Tester, a mobile clinic run by the Desmond Tutu HIV Foundation. The Tutu Tester travels from community to community offering free HIV, blood pressure and diabetes testing, along with comprehensive counselling services. If anyone is found to be HIV positive, or otherwise at risk, they are referred to primary health facilities.

The Broccoli Project started off giving R75 cash as an incentive to take an HIV test, but they have since teamed up with retailer Pick n Pay and will be giving grocery vouchers in the future.

The project is still in an early phase, but there are plans for expansion. They intend to add tuberculosis to the list of tests on offer, as well as sexually transmitted diseases other than HIV.

All participants will be kept on a biometric database (this is where the cool technology comes in) and will be rewarded for, for example, taking an HIV test every three months, as well as remaining HIV-negative. Those who test positive will be given incentives to take their antiretrovirals. This is an important factor in ongoing treatment, as many of those receiving free antiretrovirals can’t afford to buy the nutritious food they need to maintain health.

Other plans include incentivising people to keep their children in school, and unemployed people to seek work. But there is no limit to the life-enhancing activities that can be added to the programme.

Future plans include a rollout whereby individuals or companies can buy Broccoli vouchers as incentives for employees, or just to give away to destitute people as an alternative to giving them money. The Broccoli Project is a registered Section 18a company, so vouchers will be tax deductable.

The Broccoli Project is currently funded almost entirely from the profits of Hola 7, so Zimmermann is using the profits of selling mobile phone packages to (mostly) the poor to fund an incentive programme to better the lives of the poor. That’s really harnessing the power that resides at the bottom of the income pyramid.

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