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HIVAN/ECI June 2005 HIV/AIDS Public Health Journal Club
Jo-Ann Du Plessis, Networking Unit, HIVAN.
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?“How many South Africans are dying of AIDS? How good are the data??” was the title of Anneke Grobler?’s discussion of the MRC Burden of Disease Report 2000 at June?’s Journal Club. Because AIDS deaths are not accurately reported, the MRC used modeling and the ASSA model in their report.
An AIDS death is defined as ?“death with HIV as underlying cause when HIV is present and the person dies from subsequent co-morbidity mediated by HIV?”. HIV/AIDS was the leading cause of death in South Africa in 2000, accounting for 29.8% of deaths. One problem with the statistics reported (see PowerPoint presentation for details on the statistics) is that too many deaths were ill-defined or misclassified.
Grobler suggested that the results of the report can be used in health planning and setting research priorities, but that estimates for 2000 are likely to underestimate AIDS mortality. HIV treatment and prevention, as well as the TB control program, needs to be expanded, and South African should adapt national strategies to promote healthy lifestyle that suit local conditions. It is clear that the quality of information on underlying cause of death needs to be improved and that we need to collect timely and reliable statistics related to cause of death, which might include developing rapid surveillance systems.
Jacqui Hadingham discussed ?“Global Trends, Global Funds and Delivery Bottlenecks?”. Both HIV and globalization affect all aspects of life: political, social, economic, research and so on, and these effects are often borne at the level of individual households. In terms of funding, over $20 billion has been committed to HIV and AIDS, so the question is: why is HIV prevalence still increasing?
Delivery bottlenecks hamper the distribution of antiretrovirals (ARVs). It is unlikely that the goals of 3x5 will be met since currently about 9 million people need ARVs and yet only about 1.5 million people (worldwide) are accessing the drugs.
Hadingham concluded her presentation by showing a simple yet illuminating diagram of the interrelationship between funding, bottlenecks and the impact on the health sector:
Note: This overview serves to inform readers about presentations given at the HIVAN/ECI HIV/AIDS Public Health Journal Club on the first Friday of every month, at the Nelson R Mandela School of Medicine. It should be read in conjunction with the PowerPoint presentation slides and/or MS Word documents provided on the top right of this page.
Biosketches
Ms Anneke Grobler
Anneke Grobler, MSc, is a biostatistician at CAPRISA. She has experience in the analysis of clinical trial data for the pharmaceutical industry. She has experience in a wide range of indications, especially oncology and central nervous system disease trials. Anneke has worked on Phase II to IV randomized controlled clinical trials and occasionally on Phase I oncology trials or dose finding studies. The majority of her experience is with Phase III trials, some of them large multicentre and multi-national studies. She has published in the Drug Information Journal on the role of statisticians in the data management process. She is currently the biostatistician at CAPRISA and is involved in numerous studies and clinical trials in the fields of HIV/AIDS and tuberculosis.
Ms Jacqueline Hadingham
Jacqui Hadingham comes originally from a development planning background and completed her MSc in immunology at the University of London.
Jacqui is currently the AIDS Research Co-Ordinator at the University of KwaZulu-Natal, based at the Nelson R. Mandela School of Medicine in Durban, where she is divides her time between work for the AIDS Strategic Initiative and HIV research. |
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