by Greg Dardigan,                  Excerpt from UKZNTouch Magazine, Issue 1 2010, pg 36-37.

Thousands of AIDS-infected people in Zululand are receiving antiretroviral treatment thanks to a special treatment and care programme run by the KwaZulu-Natal Department of Health in conjunction with UKZN’s Africa Centre.

The HIV Treatment and Care Programme (HIV-TC) concentrates on the Hlabisa sub-district following a decentralized model which is nurse and counselor driven at the primary care clinic level.  The programme which began in October 2004 has grown exponentially with more than 10 000 HIV-infected people – of whom 10% are children aged 15 or younger – receiving antiretroviral treatment by September 2009.

The Director of the Africa Centre for Health and Population Studies, Professor Marie-Louise Newell, said voluntary Counselling and Testing (VCT) services were widely available, making it quick and easy for anyone to go to a clinic or VCT site for a free and confidential HIV test.

“The programme is also bringing together a number of NGOs which aim to provide home-based care for HIV-infected people who cannot get to a clinic as well as giving training to lay-carers and strengthening their ability to help those in need.”

“We are also supporting the Department of Health in the tuberculosis treatment services (because many people with TB are also HIV infected) and the prevention of mother-to-child HIV infection programme so as to ensure optimal care for people in this area.  We have a way to go yet, and it is not always easy, but I can tell you that this programme in its totality is already one of the best in rural southern Africa,” said Professor Newell.

Professor Newell said she was also excited about the Africa Centre’s Youth Intervention programme, which addresses the vulnerability of young people in acquiring HIV infection.

“We have acquired funding from the Wellcome Trust to start the development of this research, initially on a limited scale.  It will be a school-based intervention for Grade 8 to Grade 11 pupils – and those who have dropped out of school but would have been in those grades had they remained – with support fro teachers and outreach to the school community.”

“This wide scope is, we believe, necessary to achieve not only some increased health-related knowledge in young people but also to try and make them responsible for their actions and to engage their community and environment,” said Professor Newell.

“We are very excited by all the recent developments in research-based data we gather in our ongoing surveillance and from the activities we are involved in at the clinics in our area.”

Historically, maternal and child health have been strong focus points of the Africa Centre with one of the first Prevention of Mother-to-child Transmission Programmes (PMTCT) in South Africa originating at the institution in 2001, together with one of the largest African observational studies on breastfeeding, HIV and maternal and child health care.

The Vertical Transmission Study (VTS) enrolled about 3 000 HIV positive and negative mothers and their children into a breastfeeding intervention and followed the participants for two years with in-depth health care, nutrition, and biomedical and development data.

Professor Newell is an eminent and internationally-ranked maternal and paediatric epidemiologist and the Centre is considered a nucleus for research among international experts in the field of maternal and child health research.

“We are a Wellcome Trust Centre and have received a R225 million grant for the five-year period October 2007 to September 2012.  We receive research grants for specific projects, including the Kesho Bora Mother-to-child transmission trial (from EDCTP) and the microbicide trial (from UK MRC/DFID), from NIH for  modelling of the HIV dynamics on a population level, and for social science work to help us understand the behaviour of the community.

In addition we receive funds from PEPFAR via USAID to support the HIV treatment and care programme.” said Professor Newell.

Along with unique opportunities provided through the centre’s ongoing Demographic and Health Surveillance System activities, both the VTS and the HIV-TC programmes create exciting platforms for cutting-edge research on children and families from biomedical, demographic and social science perspectives.

“Recently we showed that HIV-related mortality among adults between the ages of 25-50 years (those most affected by HIV) declined significantly following the roll-out of the treatment programme, and similarly the decline in mortality among children up to two years of age was associated partly with the decline in the number of infected infants with the PMTCT programme, but largely by the survival of their HIV infected mothers, which is of benefit to both infected and uninfected children,” said Professor Newell.

HIV Treatment and Care programme

The Africa Centre is funded by the Wellcome Trust and was established in 1997 near Mtubatuba in Zululand as a joint project of UKZN and the Medical Research Council of Southern Africa.

The Centre conducts research on population and health issues of importance to developing countries; develops local research capacity and identifies ways to overcome the health challenges facing sub-Saharan Africa.

Professor Newell said more than 500 people were employed by the Centre which also oversees about 500 home-based carers within the HIV treatment and care programme.

The Centre’s mission is: to conduct policy-relevant health and population research, in an ethical manner, in partnership with the community in which it works and to enhance the capacity of sub-Saharan Africa to do research.  As a Wellcome Trust-funded site, it adheres to the principles of open access and broad collaboration in the pursuit of excellence and the subsequent impact on health and population science.