Southern African HIV Clinicians Society

Presentation to the Portfolio Committee on Health

17 June 2008

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MISSION (Fatima Shaik)

To promote the highest quality, cost-effective, ‘best practice’ standard of healthcare for all persons in Southern Africa infected and affected by HIV.

“the voice of reason…”

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What is the Society ? • SAMA Special Interest Group• History• Elected Exco and President• Size and Composition of

membership• BEE

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• Journal (4 per year)• Transcript (6 per year)• Branch meetings, CPD• Database• Website• Clinical Guidelines• Discussion groups• Karabo• Conference support• Accreditation of Foundation for Professional

Development (FPD) courses• Diploma in HIV Management (Colleges of

Medicine)

Major Outputs

Transcript Newsletter of the HIV Clinicians Society - SAMA HIV/AIDS Special Interest Group

A New Look

A New Style

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What’s new…• Clinical Management: Guidelines

– Adult ARV treatment guidelines– Guidelines for treating displaced people – Fertility– Chronic illness– Post Exposure Prophylaxis– Transplant– HIV testing– Prisoners– Life span (with the Actuarial Society of South Africa)– Nutrition– Paediatric ARV guidelines in progress– TB

• Journal expansion/indexing• Expansion to other professions in Health - nurses• Rural support – branches, RuDASA, bursaries for conferences

Branches1999 - Johannesburg (1)

2000 - + Cape Town, Durban (3)

2001 - + East London, Port Elizabeth, Pretoria (6)

2002 - + Botswana (Gabarone), Zimbabwe (Harare), Zambia (Kitwe), Swaziland (10)

2003 - + Bloemfontein, Botswana (Francistown), Nelspruit, Namibia (North) & (South), Zambia (Ndola) (16)

2004 - + Zimbabwe (Mutare), Malawi, Port Shepstone, Umtata (20)

2005 + West Rand, George, Pietermaritzburg, Rustenburg, Nigeria, Lesotho, Zambia (Lusaka) (27)

2006 + KOSH (Klerksdorp, Orkney, Stilfontein, Haartebeestfontein), Middleburg, Ermelo, Vaal Triangle, Polokwane, Kimberly (33)

2007 + Benoni (34) 2008 + Lichtenburg (35)

Membership2001 - 2 0002002 - 3 000 2003 - 5 0002004 - 8 0002005 - 10 0002006 - 11 000 2007 - 12 5002008 - 14 500

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Research (Prof Mark Cotton)

• Researchers linked to Universities– For example - Comprehensive Program for

Research in AIDS - South Africa• Universities of Witwatersrand, Cape Town and

Stellenbosch• Funded through National Institutes of Health, USA• New treatment guidelines for Children adopted by

USA and WHO• Nurse versus doctor treatment• TB and HIV

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Research Networks• Adult AIDS Clinical Trial Group (AACTG)• International Maternal Pediatric and Adolescent

AIDS Clinical Trial Group (IMPAACT)• International Network for Strategic Initiatives in

Global HIV Trials (InSite)• Funded through USA• Collaboration with USA, African, Brazilian, Thai

Research Groups• Pooled expertise and data management• Investigator-driven studies according to needs of

patients

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Guideline Committees• Local, regional• National - Guidelines and Essential Drug list• WHO

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The Southern African Journal of HIV Medicine(Dr Linda Gail Bekker)

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• Peer reviewed : local and international review board

• Quarterly• Launched in 2000• Wide range of subjects• Vehicle for guidelines, best practice descriptions• Published by HPMG (SAMJ, etc)• CPD points

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Readership

• 14 000 copies every quarter• Up to 20 000 at conferences• Practitioners and HIV health care workers• South Africa, Africa and beyond• Mentorship for authors• Local and international papers

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Clinical meetings

• Society branch meetings• Other clinical meetings- CME and research

updates • Research findings and local expertise are

translated into guidelines• Wide range of topical guidelines• Aim to standardise practice and maintain a

high standard of care

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Skills building• Conference attendance through scholarship• Capacity building among practitioners at

conferences, branch meetings (2007- AIDS Conference 1500 attendees, 2008 responsible for 16 skills building session at TB conference)

• Advocacy for best standard of care/prevention• Support for practitioners and services around the

country• Not exclusively physician focused

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The Government, the NSP and the Society – a Winning Formula

( Dr Lulamile Jam Jam)• Prevention still the mainstay message• Comprehensive care includes treating

those HIV Positive• Co infection with TB• HIV is widespread in SA• Positive relationship between

Government and the Society

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HIV THERAPEUTICS

• Costly – life long and complex at times• Dynamic and evolving science• Appropriate therapy is essential• Additional burden to Health Care Services• Treatment is complex - drug resistance occurs

easily in some patients

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GOVERNMENT RESPONSIBILITIES

• Access• Affordability• Alignment with other departmental

programmes

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GOVERNMENT / HIV CLINICIANS SOCIETY SEEK TO ENSURE:

• Best, affordable treatment regimes are made available to all South Africans based on scientifically proven principles

• Where necessary some of the international guidelines may need to be modified to suite the prevailing local conditions

• Discuss and reach consensus on:• Appropriate drug combination therapy• When to initiate ARV treatment • Specific issues: Pregnancy, PEP for survivors of

sexual assault, TB patients

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Monitoring the Programme• Identify issues preventing access to

treatment and care• Evaluate the cost of follow up care• Assess and learn from the Programme

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Partnership seek to ensure that there is ongoing vigilant scientific rationale to justify current therapeutic programmes guided by:* Current medical practice* WHO guidelines* European and American Guidelines* Current research and new information

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The Private Sector (Dr Eric Hefer)

HIV has given South Africa a disproportionate representation in the international pharmaceutical industry by having the worlds largest treatment program.

South Africa initially enjoyed a coveted position for HIV research. Steps have to be taken to reclaim this position to attract and retain the skilled people demanded by the need.

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Opportunities

International recognition: International AIDS Conference 2009 – CapeTown is the Equivalent to the 2010 WorldCupDurban HIV Conference 2009TB & HIV Detection & Treatment ProgramReclaiming recognition for being at theforefront of scientific research for HIV

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Request• We request direct communication to avoid

public, exploitable and confusing exchanges and messages related to HIV.

• We offer expert scientific credible opinion and contributions in HIV related issues to reduce and manage the impact of the pandemic.

• We wish to work in a collaborative and positive manner to support the national government’s policies, programmes.

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Way Forward• The Society offers access to our collective

resources and expertise to cooperate with National and Provincial programs towards successful and sustainable initiatives

• Through our joint effort we can save the lives of millions

• We want to be part of the solution. Thank You