Recent Publications

Cost and cost-effectiveness of dolutegravir-based antiretroviral regimens: an economic evaluation of a clinical trial

Though the DTG-based trial arms were 2% more costly than TDF/FTC/EFV, both had slightly lower cost-per-outcome ($9783 and $9929/patient virally suppressed for TDF/FTCþDTG and TAF/FTCþDTG, respectively) than TDF/FTC/EFV ($10 365). The trial cost per additional virally suppressed patient, compared with TDF/FTC/EFV, was lower in the TDF/FTCþDTG arm ($2967) compared with TAF/FTCþDTG ($3430). In routine care, cost per virally suppressed patient was estimated as similar between TDF/ FTCþDTG 

Perceived efficacy of HIV treatment-as- prevention among university students in Johannesburg, South Africa

Antiretroviral therapy (ART) nearly eliminates HIV transmission. Yet information on treatment as prevention (TasP) has been slow to diffuse in sub-SaharanAfrica. We assessed TasP knowledge among university students in South Africa. University students in South Africa underestimated the prevention benefits of HIV treatment. Low knowledge of TasP could limit demand for HIVtesting and treatment among young 

Is the Risk Really Shared? A Retrospective Analysis of Healthcare Costs of Patients With Type 2 Diabetes Mellitus on a Capitation Model

Objectives: Private managed healthcare organizations in South Africa (SA) use a capitation model of care for patients within their healthcare delivery systems for the optimal management of type 2 diabetes mellitus (T2DM) to reduce healthcare costs. Few studies have categorized healthcare costs at a patient level to determine the actual healthcare costs incurred by private insurers for T2DM in SA. This study estimated the direct medical costs of patients with T2DM registered with a private 

COVID-19 modelling update: Considerations for a potential fourth 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 fourth wave of COVID-19 cases in South Africa. This report takes into account the impact of the vaccination programme, future changes on population behaviour and restriction levels, as well as a potential new variant of concern with immune escape properties. The report is available below. Additionally, the 

Optimal use of COVID19 Ag-RDT screening at border crossings to prevent community transmission: a modeling analysis

Countries around the world have implemented restrictions on mobility, especially cross-border travel to reduce or prevent SARS-CoV-2 community transmission. Rapid antigen testing (Ag-RDT), with on-site administration and rapid turnaround time may provide a valuable screening measure to ease cross-border travel while minimizing risk of local transmission. To maximize impact, we developed an optimal AgRDT screening algorithm for cross-border 

The revolving door of HIV care: Revising the service delivery cascade to achieve the UNAIDS 95-95-95 goals

Antiretroviral therapy (ART) for human immunodeficiency virus (HIV) prevents illness and death from HIV disease and transmission of HIV infection. To encourage global scale-up of ART, the Joint UN Program on HIV/AIDS (UNAIDS) issued the “95-95-95” targets for the HIV “cascade of care.” These targets state that by 2030, 95% of individuals living with HIV will know their HIV status, 95% of people with diagnosed HIV infection will receive ART, and 95% of those taking ART will have 

The Critical Importance of Asking Good Questions: The Role of Epidemiology Doctoral Training Programs

Epidemiologic methods have advanced tremendously in the last several decades. As important as they are, even the most sophisticated approaches are unable to provide meaningful answers when the user lacks a clear study question. Yet, instructors have more and more resources on how to conduct studies and analyze data but few resources on how to ask clearly defined study questions that will guide those methods. Training programs have limited time for coursework, and if novel statistical estimation 
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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 
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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 
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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