Recent Publications


Ideal Clinic Realisation and Maintenance program in South Africa.

To address the historical inequalities in the quality of primary health care services and to lay a strong foundation for the implementation of the National Health Insurance (NHI), the Ideal Clinic Realisation and Maintenance  (ICRM) programme was established in 2015. The ICRM program implementation will hopefully improve the South African health system's performance in managing priority infectious diseases (e.g HIV, TB) and non-communicable diseases (e.g diabetes, hypertension). This health 

Combating TB in South Africa

South Africa is experiencing a dual TB/HIV epidemic. Approximately 360 000 South African had TB in 2019. TB is the leading cause of death among people living with HIV. Of the 58 000 people who died from TB in South Africa, 36 000 were diagnosed with HIV. With the launch of the 2017-2022 National Strategic PLan (NSP), the South African government aims to eliminate TB by 2030. As an organisation working at the intersection of health economics and epidemiology, HE²RO aims to work towards 

Thusa-Thuso: Helping You Help

In September 2016, South Africa began the implementation of WHO’s Universal Test and Treat (UTT) policy in hopes of reaching the 90-90-90 targets by 2020 and reducing HIV- related morbidity, mortality and HIV transmission rates.1,3 Although 3.8 million HIV positive patients are currently receiving antiretroviral therapy (ART) (March 2017), over 2 million patients will have to be enrolled on HIV treatment for South Africa to reach the 90% on ART target.1,4 While the Department of Health 

Primary healthcare seeking behaviour of low-income patients across the public and private health sectors in South Africa

Abstract Background The proposed National Health Insurance (NHI) system aims to re-engineer primary healthcare (PHC) in South Africa, envisioning both private sector providers and public sector clinics as independent contracting units to the NHI Fund. In 2017, 16% of the South African population had private medical insurance and predominately utilised private providers. However, it is estimated that up to 28% of the population access private PHC services, with a meaningful segment of the 

Changing Knowledge and Attitudes Towards HIV Treatment‑as‑Prevention and “Undetectable=Untransmittable”: A Systematic Review

Abstract People on HIV treatment with an undetectable virus cannot transmit HIV sexually (Undetectable=Untransmittable, U=U). However, the science of treatment-as-prevention (TasP) may not be widely understood by people with and without HIV who could benefit from this information. We systematically reviewed the global literature on knowledge and attitudes related to TasP and interventions providing TasP or U=U information. We included studies of providers, patients, and communities from all 

Modelling costs of community-based HIV self-testing programmes in Southern Africa at scale: an econometric cost function analysis across five countries

ABSTRACT Background: Following success demonstrated with the HIV Self-Testing Africa Initiative, HIV self-testing (HIVST) is being added to national HIV testing strategies in Southern Africa. An analysis of the costs of scaling up HIVST is needed to inform national plans, but there is a dearth of evidence on methods for forecasting costs at scale from pilot projects. Econometric cost functions (ECFs) apply statistical inference to predict costs; however, we often do not have the luxury of 

The cost effectiveness and optimal configuration of HIV self-test distribution in South Africa: a model analysis

ABSTRACT Background: HIV self-testing (HIVST) has been shown to be acceptable, feasible and effective in increasing HIV testing uptake. Novel testing strategies are critical to achieving the UNAIDS target of 95% HIV-positive diagnosis by 2025 in South Africa and globally. Methods: We modelled the impact of six HIVST kit distribution modalities (community fixed-point, taxi ranks, workplace, partners of primary healthcare (PHC) antiretroviral therapy (ART) patients), partners of pregnant 

COVID-19 modelling update: Considerations for a potential third wave

The South African COVID-19 Modelling Consortium (SACMC), of which a number of HE2ROs are members, has released a new report about the core modelling team's projections of a potential third wave of COVID-19 cases in South Africa. This report takes into account the impact of the Delta variant and the progress of the vaccination programme. The report is available below. Additionally, the day-to-day development in case numbers, hospital admissions and deaths can be tracked on 

The Cost and Intermediary Cost-effectiveness of Oral HIV Self-test kit Distribution Across 11 Distribution Models in South Africa

Background: Countries around the world seek innovative ways of closing their remaining gaps towards the target of 95% of people living with HIV (PLHIV) knowing their status by 2030. Offering kits allowing HIV self-testing (HIVST) in private might help close these gaps. Methods: We analysed the cost, use and linkage to onward care of 11 HIVST kit distribution models alongside the Self-Testing Africa Initiative’s distribution of 2.2 million HIVST kits in South Africa in 2018/2019. Outcomes 

Costs of integrating HIV self-testing in public health facilities in Malawi, South Africa, Zambia and Zimbabwe

ABSTRACT Introduction: As countries approach the UNAIDS 95-95-95 targets, there is a need for innovative and cost-saving HIV testing approaches that can increase testing coverage in hard-to-reach populations. The HIV Self-Testing Africa-Initiative distributed HIV self-test (HIVST) kits using unincentivised HIV testing counsellors across 31 public facilities in Malawi, South Africa, Zambia and Zimbabwe. HIVST was distributed either through secondary (partner’s use) distribution alone or 

Role of data from cost and other economic analyses in healthcare decision-making for HIV, TB and sexual/reproductive health programmes in South Africa

Abstract An increasing focus on the use of the results of cost analyses and other economic evaluations in health programme decision-making by governments, donors and technical support partners working in low- and middle-income countries is accompanied by recognition that this use is impeded by several factors, including the lack of skills, data and coordination between spheres of the government. We describe our experience generating economic evaluation data for human immunodeficiency virus,