The Power of Profit: Citizen-Led Social Enterprises – Tribune

While community-based organizations play a critical role in delivering people-centered HIV prevention, care, and treatment services, their financial sustainability is often a major barrier. Social entrepreneurship could be an innovative business model to generate revenue and keep them afloat, despite declining donor funding. In addition to creating financial stability, social enterprises also have an impact on innovative models of HIV prevention, treatment, and care, new partnerships with the private sector, and greater inclusion of people of diverse gender identities.

Some of these thriving social enterprises were showcased at the world’s largest AIDS conference (25th International AIDS Conference or AIDS 2024). One such example that struck me was India’s first peer-led Treatment, Adherence, Advocacy and Literacy (TAAL) pharmacy, established in 2006 in Pune by the Maharashtra Network of People Living with HIV (NMP+).

The birth of TAAL

The brain behind launching this venture is Manoj Pardeshi, a founding member of (NMP+) and also of the National Coalition of People Living with HIV in India (NCPI+).

“In those initial years, there was no funding. Later, donors came but their funding was in line with their own respective mandates, while the needs of the community might be different. So we thought of setting up a separate funding mechanism that would address our unmet needs. That’s how TAAL became a model of a social entrepreneur to provide quality antiretroviral drugs at affordable rates to those who had access to treatment in the private sector,” Manoj explained.

He said that even though HIV treatment is free in the public health sector in India, some people living with HIV prefer to seek treatment in the private sector due to fear of stigma, discrimination, loss of confidentiality or other reasons. There was a need to find ways to provide them with subsidized, affordable and quality medicines in a friendly and stigma-free environment. Thus, TAAL was born – a peer-led community pharmacy to provide high-quality and affordable peer-led diagnosis, treatment and counselling services to people living with HIV, especially those who were accessing treatment in the private sector.

TAAL has benefited from pharmaceutical companies’ corporate social responsibility programs and received life-saving antiretroviral drugs for less than a third to a tenth of their open market price, passing on the financial benefits to its customers.

From TAAL to TAAL+

Everything seemed to be going well when COVID-19 hit and in 2020, the lockdown suddenly took place. TAAL customers could no longer physically go to the pharmacy to buy their medications.

“This gave us the idea of ​​launching online services across India and not limiting it to just one city. We discussed it with FHI 360, which manages the United States Agency for International Development (USAID) HIV Epidemic Control (EpiC) project, and with EpiC’s support, we put this concept into practice,” shared Manoj.

So, with USAID support, TAAL has evolved from a community pharmacy to TAAL+, an integrated healthcare center. It launched an e-commerce platform in February 2023 – the first-ever peer-led e-pharmacy platform in India.

“Through this platform, we now do online consultations and counselling and our customers can order their medicines online for home delivery across India. The medicines reach their doorsteps within 2-3 days. 70% of our customer base now uses the e-platform,” Manoj said.

TAAL+ is a one-stop shop

TAAL+ is a one-stop shop that not only provides accessible and affordable diagnostic, medication and counselling services for HIV, including access to prevention tools like PrEP and PEP, but also for HIV-related co-infections like tuberculosis, hepatitis B and C and HIV-associated cancers. It also offers testing and medication for non-communicable diseases like hypertension, diabetes, cardiovascular diseases, cervical cancer and mental health management. Pre-exposure prophylaxis or PrEP is a medication taken to prevent contracting HIV and post-exposure prophylaxis or PEP is an emergency medication taken within 72 hours (3 days) after a possible exposure to HIV to prevent HIV.

Manoj’s face lights up with pride and a sense of accomplishment as he shares, “His novel demand generation strategies have helped TAAL+ expand its customer base from 790 in 2022 to 2,786 in 2024. His efforts have led to a 75% increase in revenue – from US$155,034 in 2022 to US$328,212 in 2023. With approximately 10% profit generated each year, TAAL+ today not only meets the quality care needs of people living with HIV but also contributes 16% of NMP+’s total annual revenue.”

Manoj is indebted to pharmaceutical companies Emcure and Hetero who have supported TAAL since its inception. For him, it is the collective strength of the community and partnerships with the private sector that have enabled this social enterprise to reach such heights. This model is one of the first standalone private sector models for people living with HIV, owned and managed by the community of people living with HIV in India.

Queer Bazaar – another Pune based social enterprise

Another interesting example to mention in India is QueerBazaar, a social enterprise founded by the Pune-based Mist LGBTQIA+ Foundation, which started in 2009 as an online collective “by minorities, of minorities, for minorities”.

One of the ongoing challenges for many community organizations, like Mist, is finding sustainable funding. Recognizing the need to diversify its funding sources to further support its cause, Mist launched its first social enterprise, QueerBazaar, an e-commerce platform in 2017.

Shyam Konnur, a queer and human rights activist and CEO of Mist, said, “We had seen that everyone who came to pride parades in the US or UK had beautiful rainbow flags and accessories like wristbands, bandanas etc. But these products were not available in India. Even if someone brought them from abroad and sold them here, we could not afford to buy them as they were very expensive. So we had to sew our own flags which would have looked weird. This got us thinking. We thought that we should offer these products even in India. We did not want to feel like we were missing out. Hence, QueerBazaar was launched in 2017 with the aim of making queer pride products easily available in India at an affordable price and in the process, making the organisation financially self-sustaining.”

From self-financing to diversified financing

But then COVID-19 happened. Shyam shared, “COVID-19 taught us a lesson: you can’t be a self-funded organization forever. All queer organizations shut down during COVID-19 and there was no money. During those two years, we only had two full-time staff, including me, and we couldn’t afford to pay each other. No one wanted to spend money on luxury items during that time. We could make maybe INR 4,000 a month. This was the first time we accepted USAID funding to fund a sustainable project, in addition to our own standalone project of QueerBazaar.”

“When we started working with USAID, we started with the HIV project. But we changed the way we implemented the project. We integrated it into our website, where we had our Queer Bazaar, where we sold our products, and we added HIV services as an add-on. We encouraged everyone who placed an order on the website to get tested for HIV. We leveraged our QueerBazaar platform to connect users to resources for HIV testing, treatment and prevention services, and mental health counseling.”

“We also provide free health insurance to members of the transgender community, and the premiums for all insurance are paid from the revenue generated from our activities. We never imagined that Queer Bazaar would become this beautiful. We thought it would just be an online platform. But the USAID funding has given us more power and more ideas to use it in a more effective way than we initially thought,” Shyam said.

Having started with a few handmade Pride-themed paraphernalia, QueerBazaar now sells over 100 products (both handmade and manufactured) – like printed rainbow flags, phone cases, t-shirts, funky pins, coffee mugs, badges – to name a few, thanks to funding from USAID. More importantly, the platform is also being used to encourage people to access HIV prevention, testing and treatment services, as well as mental health counseling and health insurance.

Peer-led social enterprises “by” and “for” people living with HIV can go a long way not only in empowering community-based organizations, but also in strengthening service delivery mechanisms to help reach the last mile in our efforts to end AIDS by 2030.