• HIV
  • MDGs make way for SDGs this year

    This year, after 15 years, the UN’s Millennium Development Goals (MDG) reach the end of their life. The top priority for the UN’s new Sustainable Development Goals (SDG) is eradicating poverty. Better health is goal 3 of the 17 SDGs. It’s described as “Ensure healthy lives and promote well-being for all at all ages.” The components are:

    Reduce the global maternal mortality ratio to less than 70 per 100,000 live birthsEnd preventable deaths of new born children and under fivesEnd the epidemics of AIDS, tuberculosis, malaria, neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseasesReduce by a third premature mortality from non-communicable diseases by prevention and treatment and promote mental health and well beingStrengthen prevention and treatment of substance abuseHalve global deaths and injuries from road traffi­c accidentsEnsure universal access to sexual and reproductive healthcare, including family planning, information and education, and integrating reproductive health into national strategies and programmesAchieve universal health coverage, including financial risk protection, access to quality essential healthcare and safe, elective, quality and affordable essential medicines and vaccines for allSubstantially reduce deaths and illnesses from hazardous chemicals and air, water and soil pollution and contaminationStrengthen WHO’s Framework Convention on Tobacco ControlSupport research and development of vaccines and medicines for the communicable and non-communicable diseasesSubstantially increase health financing and the recruitment, development, training and retaining health workersStrengthen the capacity for early warning, risk reduction and management of national and global health risks.

    These are wide-ranging. As a strategic framework for African countries’ eHealth plans, they reveal a need for an equivalent wide-ranging and integrated investment, and avoiding a set of independent initiatives. This requires moves towards interoperability, analytics and a socio-technical architecture that extends from healthcare to people and communities. Each of these needs an expansion to current endeavours and a sustainable investment.

  • Social media and Big Data help to develop HIV services

    Social media as a source for Big Data can provide valuable insights about people’s behaviours and their likelihood of engaging in high-risk activities that can lead to contracting HIV. This is a conclusion of Sean D. Young from the Center for Digital Behavior, Department of Family Medicine, University of California (UCLA) in his post in Trends in Microbiology.

    He sets out how social media data can contribute to Big Data science and current approaches to using social media to monitor and predict health behaviours and disease outbreaks. From these, he recommends tools and approaches needed.

    He sees Big Data as a combination of relational and structured data, such as medical and genetics datasets and unstructured such as publically available free text from social media conversations. Some of the conversations contain large volumes of personal information, and it’s feasible to analyse these to collect a range of psychological information about attitudes and behaviours affecting health. Some of the data shows that people who discussed HIV-prevention on social media are more likely to ask for an HIV test. The data can provide part of a forecast healthcare demand and feed into epidemiological studies that monitor risk behaviours and predict disease outbreaks and progressions.

    Using social media for Big Data is not just an analytical activity. It needs:

    A multi-disciplinary team and approach Availability of large and frequently updated datasets An understanding of its limitations, such as data validity levels, missing data, observational data and samples’ representativeness.

    These offer a good model for African countries to adopt for their initiatives. It may be worth adding that it’s advantageous to start small with Big Data.

  • Malawi's new HIV app is now available

    According to a report in Avert, in 2011 more than 10% of Malawi’s 15.9 million people were living with HIV and AIDS, which was also the leading cause of death in the country.

    Since then, the Malawi government has taken a number of positive steps to fight HIV. It now has a large number of initiatives actively seeking to minimise the spread. These include:

    Expanding voluntary HIV testing and counselling (HCT/ VCT) Prevention of mother-to-child transmission services Condom promotion and distribution Voluntary Medical Male Circumcision (VMMC) Blood safety measures Mass media campaigns Life Skills Education (LSE) for young people.

    Using mHealth is the latest initiative to help combat HIV in the country. Airtel Malawi and UNAIDS has signed a Memorandum of Understanding (MOU) to develop a HIV app. ITWEB Africa has the full report. The app will enable people living with HIV and AIDS in the country to access and share information about their medication. Airtel Malawi managing director, Heiko Schlittke, believes that “this mobile phone application will escalate the power of mobile technology in a bid to help reverse the HIV and AIDS crisis in Malawi by reaching out as many infected people as possible.”

    The UNAIDS country director for Malawi, Amakobe Sande, said the app would enable those affected and infected with the virus to access information about supplies of medication as well as experiences at healthcare points across the country. We hope that the mHealth app together with the ground work the government has already done will help to drastically reduce the spread of the disease.

  • SAMBA II helping to make HIV testing easier in Africa

    A new transformative point-of-care diagnostic giving rapid results for HIV detection is being rolled out across Africa. The small, portable machine called SAMBA II, will help transform the lives of millions, especially HIV infants, who have a one in two chance of early death if the HIV infection is not diagnosed and treatment started within the first six weeks of life. According to the Welcome Trust SAMBA II is available in Uganda and Malawi and has recently received product approval in Kenya. It’s the first rapid, accurate and cost-effective DNA diagnosis which can be done at the point of care, in even the most environmentally challenging and resource-limited settings.

    Developed by Diagnostics for the Real World, a spin-out company from the University of Cambridge founded in 2002 SAMBA II instrument has taken ten years to develop. It uses innovative technology for “sample-in-results-out” testing without relying on centralised laboratories or specialist technicians. The complete testing process is provided within SAMBA II instrument using disposable cartridges. The results are shown as a simple blue line and available within 2 hours. It’s similar to a pregnancy test.

    Before SAMBA II, doctors have had to use nucleic-acid-based HIV tests that take many hours to perform and need specialist facilities, highly trained personnel and transport, often over long distances to centralised laboratories. There are many logistical problems that cause long delays. Sometimes, many patients were lost before they started treatment. SAMBA II overcomes many of these challenges.

    Dr Helen Lee, Director of Research in the Department of Haematology at Cambridge University and CEO of Diagnostics for the Real World, said “The beauty of these tests is that they are simple, accurate and have a fast turn-around time.” In addition to delivering accurate early infant diagnosis from a small pinprick blood sample, SAMBA II is also designed to measure the level of HIV in the blood.

    The Welcome Trust funded the early stages of development of SAMBA chemistry, bridging the gap between research and design. It further funding from the US National Institutes of Health (NIH), the Children’s Investment Fund Foundation (CIFF), the UK Technology Strategy Board and UNITAID. Médecins Sans Frontières, is another vital partner who provided access to their African sites for early SAMBA field testing.

    Peter McDermott, Executive Director of Health at CIFF, said “Since 2009, the number of children receiving HIV treatment has increased, but it still falls woefully short, with only 3 out of 10 eligible children having access. This is in part due to the lack of point-of-care testing. SAMBA II provides, for the first time, a transformational platform to address this critical barrier.”

  • Big data, twitter and HIV: it's new, and on its way

    With the large health burden of HIV in Africa, a research study from the USA seems to offer a new opportunity to monitor HIV risk transmission. It’s reported in Science Direct, and says over 9,800 geolocated HIV-related tweets from 2009 showed a significant positive relationship between HIV-related tweets and HIV cases. It suggests the feasibility of using social networking data to evaluate and detect HIV risk behaviours and outcomes. A suggestion is a modest conclusion, so the research team from the University of California-Los Angeles (UCLA) proposes more analysis before converting the findings into operational big data.

    The National Institutes of Mental Health (NIMH) financed the study. It would be good if it continued its support. It has valuable opportunities for African countries.

  • South Africa's SHIP is almost a year on

    Changing and improving healthcare is challenging for all countries. There are always many dimensions to their initiatives that need integrating and coaxing. On 23 April 2013, the South African Department of Science and Technology (DST) launched its Strategic Health Innovation Partnerships (SHIP) as a joint partnership with the Medical Research Council (MRC) as a follow on to the MRC Innovation Centre which was established in 2004. Richard Gordon is SHIP’s director. As SHIP’s first birthday approaches, it seems like a good time to review its progress

    SHIP’s mission is to be a catalyst that develops innovative interventions and brings life-saving drugs, vaccines and medical devices to markets. Part of this is being a funding agency for leading multidisciplinary projects, and managing and coordinating health innovation for South Africa’s strategic disease and technology focus areas. Achieving these goals needs SHIP to:

    Provide strategic and scientific leadership Augment gaps in the innovation pipeline by leveraging non-financial resources Use funds flexibility between disease focus areas based on project needs Ensure that SHIP research is globally aligned and competitive through collaboration with other Product Development Partnership (PDP), Medicines for Malaria Venture and AERAS with its TB vaccine initiatives.

    The MRC pays for SHIP’s infrastructure and salaries. It includes the Technology Transfer unit that implements the MRC’s intellectual property policy and develops pathways to facilitate the seamless movement of new products and services from the laboratory to the market. It also has financial support from the Gates Foundation. This is consistent with the Foundations goal of Africa leading innovation.

    Some of SHIP’s initiatives are to:

    Manage and fund multi-disciplinary, multi-institutional product research, development and innovation from discovery to proof-of-concept Enhance South Africa’s science in the research and development capacity for novel or improved drugs, vaccines and other biologicals, diagnostics and medical devices for high priority diseases Use partnerships with local universities, science councils and the private sector to facilitate the transfer of research outputs into improved health outcomes and social benefit.

    The result of these is a clutch of health technology PDPs, supported by the DST that will:

    Improve the management and financing of health research, development and innovation Leverage local and international funding by acting as a central conduit for foreign institutions seeking partnerships with South African research agencies Manage the DST’s strategic health innovation initiatives.

    These initiatives are South Africa’s:

    HIV/AIDS Research and Innovation Platform (SHARP) Tuberculosis Research and Innovation Initiative (SATRII) Malaria Initiative (SAMI) Non-communicable Diseases Initiative (NCDI) Medical Device Innovation Platform (MDIP) AIDS Vaccine Initiative (SAAVI) including-maternal and child health.

    A Request for Applications (RFA) document describes these. On 22 November 2013, SHIP opened a RFA for Tuberculosis Vaccine Development, HIV Vaccines and Preventions. It closed on 14 February 2014. Another recent initiative is the joint SHIP and the Helmholtz Institute TB Bilateral drug discovery summit in Braunschweig, Germany in October 2013.

    The additional momentum that SHIP brings to these health initiatives shows the added priority needed for eHealth projects. This helps them to go further and help secure the benefits for individuals, communities and the health and social care agencies.

    For more information contact Richard Gordon at Richard.Gordon@mrc.ac.za