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Southern African HIV Clinicians Society Presentation to the Portfolio Committee on Health 17 June 2008. 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.
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Southern African HIV Clinicians Society Presentation to the Portfolio Committee on Health 17 June 2008
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…”
What is the Society ? • SAMA Special Interest Group • History • Elected Exco and President • Size and Composition of membership • BEE
Major Outputs • 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)
Transcript Newsletter of the HIV Clinicians Society - SAMA HIV/AIDS Special Interest Group A New Look A New Style
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
Branches 1999 - 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) • + West Rand, George, Pietermaritzburg, Rustenburg, Nigeria, Lesotho, Zambia (Lusaka) (27) • + KOSH (Klerksdorp, Orkney, Stilfontein, Haartebeestfontein), Middleburg, Ermelo, Vaal Triangle, Polokwane, Kimberly (33) • + Benoni (34) • + Lichtenburg (35)
Membership 2001 - 2 000 2002 - 3 000 2003 - 5 000 2004 - 8 000 2005 - 10 000 2006 - 11 000 • - 12 500 • - 14 500
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
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
Guideline Committees • Local, regional • National - Guidelines and Essential Drug list • WHO
The Southern African Journal of HIV Medicine(Dr Linda Gail Bekker)
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
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
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
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
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
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
GOVERNMENT RESPONSIBILITIES • Access • Affordability • Alignment with other departmental programmes
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
Monitoring the Programme • Identify issues preventing access to treatment and care • Evaluate the cost of follow up care • Assess and learn from the Programme
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
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.
Opportunities International recognition: International AIDS Conference 2009 – Cape Town is the Equivalent to the 2010 World Cup Durban HIV Conference 2009 TB & HIV Detection & Treatment Program Reclaiming recognition for being at the forefront of scientific research for HIV
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.
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