Network of European/ICPC Cooperation in the field of AIDS and TB Sub-Saharan Africa Case Study Report

Research into the effectiveness of current approaches of the global scientific community in tasking the dual epidemic of AIDS and TB.

 

 

Client

Stellenbosch University / EUCO-Net

Consultancy team

Andrew Charman, assisted by Prof. Dr. Wolfgang Preiser and Prof. Dr Gerhard Walzl

Assignment

There is growing concern within the global scientific community that current approaches towards tackling the dual epidemic of Acquired Immunodeficiency Syndrome (AIDS) and tuberculosis (TB) are not succeeding. The impact of these diseases has steadily increased and coinfection now presents an added challenge to the impact of research and medicine on human morbidity and mortality. The Network for European / ICPC cooperation in the field of AIDS and TB (EUCO-Net) seeks to contribute towards promoting integrated research on the dual epidemic, and fostering collaboration between European institutions and international cooperation partner countries (ICPC).

Methodology

The SSA report was required to address the following topics: i) the epidemiological status of AIDS/TB, ii) the state of the art of research, iii) existing research projects, iv) medical treatment standards and protocols, v) diagnostic standards, vi) scientific challenges & topics for further research, vii) existing national and international funding programmes supporting research in the case countries. Data was obtained through desk-top research, utilizing open-source information. The research team addressed knowledge gaps through focus group discussion and consulting with specialists at Stellenbosch University. The SSA case study focused on 13 countries, namely: Botswana, Central African Republic, Ethiopia, Gambia, Gabon, Malawi, Mozambique, South Africa, Senegal, Uganda, Zimbabwe and Zambia. Country data was recorded in a questionnaire tool. The consultant also detailed the main SSA findings in a written report.

Findings

Sub-Saharan Africa (SSA) faces an immense challenge to reduce the impact of the HIV/AIDs and Microbacterium tuberculosis (MTB) pandemic. Almost 1 million persons died as a direct result of AIDS in 2007, whilst 22 million have been infected with HIV. WHO estimate that at present approximately 4 persons require ART, yet less than half of them receive treatment. The number of persons infected with MTB in SSA has steadily increased and now closely approximates the number of persons with advanced HIV+ requiring ART (3.7 million).

The challenges for scientific research are numerous. Our investigation suggests five areas in which further research and action is required:

  • Identify strategies to combine MTB and HIV/AIDS programmes to optimise treatment.
  • Explore means to improve and sustain the success of ART.
  • Prevent the emergence of ART drug resistance.
  • Improve the diagnosis of active MTB in HIV-infected patients.
  • Identifying, early on, HIV-infected patients at high risk for developing MTB.

African institutions can significantly contribute towards addressing these scientific challenges, but only if they receive a continuous injection of funding. South African institutions are well positioned (scientifically) to lead research, having the human capacity to conduct research and benefiting from supportive state institutions.