All Policy Briefs

Brief #7: Economic Growth – Overview

HIV has increased mortality and slowed population growth. As a consequence, GDP is lower and will remain lower than it would have been without the impact of HIV. Economic modelling suggests that the short- to medium-term impacts of HIV on GDP per capita are unclear, with important effects working in opposite directions. In the longer run, the effects are likely dominated by adverse impacts on education and skills. The empirical evidence on the link between HIV and growth of GDP per capita 

Brief #17: The Economics of HIV and of HIV Programmes in the Era of COVID-19

The Covid-19 pandemic has profound negative implications for the economies of countries most affected by HIV, as well as for donor countries that support the global HIV response. It undermines underlying economic fundamentals and adds considerations for HIV policymaking. This paper explores three interrelated ways in which the Covid-19 pandemic and the response to Covid-19 affect people living with HIV and the HIV response: (1) the health impacts of those living with or at risk of acquiring 

Cost and outcomes of drug-susceptible TB treatment at public and private primary healthcare clinics, Johannesburg South Africa

South Africa carries 3% of the world’s tuberculosis (TB) case burden and is experiencing a dual TB/HIV epidemic: 59% of adult TB patients are also HIV positive. There are no recent published estimates on the costs and outcomes of drug-susceptible TB in South Africa for adults in an out-patient setting with the exception of one paper published in 2003 (using 1997 data) and another in 2006 (using 2001 data) . The proposed National Health Insurance (NHI) system aims to re-engineer primary 

Delays in repeat HIV viral load testing for those with elevated viral loads: A national perspective from South Africa

The World Health Organization recommends national programs use viral load monitoring for patients on ART1 to determine whether treatment has been successful and to guide clinicians on when to switch treatment to second-line regimens, indicated if the virus is resistant to first-line therapy. Not all countries are able to provide viral load testing as part of national programs but for those that do, patients with an elevated viral load (VL) are recommended to undergo adherence counselling and 

SOUTH AFRICA’s 2010 NATIONAL HIV TESTING CAMPAIGN AND NUMBERS ENROLLING IN CARE

HIV testing represents the primary entry point into HIV care and treatment programs for people living with HIV and is the first of UNAID’s 90-90-901 targets. South Africa made a large effort to expand HIV testing in April 2010 by implementing a national testing campaign2. This campaign, designed to increase awareness of HIV status, sought to test 15 million people by June 2011. The monthly number of people tested for HIV increased from approximately 240,000 per month in the period prior to 

APPLYING MACHINE LEARNING TO LABORATORY DATA: PREDICTING SUPPRESSION OF NEXT HIV VIRAL LOAD IN SOUTH AFRICA

During 2018, South Africa was estimated to have more than seven million people living with HIV1, representing the largest single country epidemic2 and treatment program. 3 In September 2016, the National Department of Health revised its treatment guidelines to extend the availability of ART to all people living with HIV, irrespective of CD4 cell count and stage of disease3. This policy, widely referred to as “treat all” or “universal test and treat” (UTT) holds promise to offer 

THE SLATE ALGORITHM FOR SAME-DAY HIV TREATMENT INITIATION: RESULTS OF THE SLATE TRIAL IN SOUTH AFRICA AND KENYA

The World Health Organization recommends "sameday" initiation of antiretroviral therapy (ART) for HIV patients eligible and ready1. This recommendation has been adopted by both South Africa2 and Kenya3. Identifying efficient, safe, and feasible procedures for determining same-day eligibility and readiness is now a priority. The WHO guidelines cited evidence from clinical trials suggesting that offering treatment to patients at their first clinical encounter has the potential to increase 

MAKING BUDGETING WORK: REFLECTIONS FROM THE FINANCIAL CAPACITY BUILDING FOR PROVINCES (FINCAP) PROJECT IN SOUTH AFRICA

The Financial Capacity Building for Provinces (FINCAP) project, run in partnership by the Centre for Economic Governance and Accountability in Africa (CEGAA) and the Health Economics and Epidemiology Research Office (HE2RO), focuses on providing capacity building and technical support to HIV, STI and TB (HAST) programme and finance managers in provincial departments of health in South Africa. The intervention was designed to improve budget planning, costing, expenditure tracking and reporting 

BASly – AN AUTOMATED TOOL FOR ANALYSING HIV and TB RELATED EXPENDITURE

The Basic Accounting System (BAS) caters for the South African government’s basic accounting needs. It is the general ledger where all financial transactions are recorded and classified in accordance with the Standard Chart of Accounts (SCoA) system. Transactions are initially recorded in sub-systems i.e. payroll system, inventory and asset management, pharmaceuticals and payment of utilities. Measures are taken to ensure that information in the sub-systems matches transactions captured in 

Budget execution of the comprehensive HIV and AIDS conditional grant: An analysis of expenditure and performance: HE²RO Policy Brief Number 30

South Africa’s government-wide expenditure on HIV/AIDS programmes is estimated to have almost doubled over the past five financial years from R10.6 billion in 2012/13 to R20.3 billion in 2017/18.1* The majority of this expenditure (85.2% in 2017/18) is funded through the HIV, TB, Malaria and Community Outreach Grant, which is a ring-fenced conditional grant (CG) allocated via the National Department of Health (NDOH) to provincial health budgets. The HIV/AIDS component of this grant is one of 

USING PRIVATE MEDICAL SCHEME DATA TO ESTIMATE SOUTH AFRICA’S HIV CARE AND TREATMENT BURDEN BY GEOGRAPHIC AREA

In 2017, South Africa had 7.2 million people living with HIV, of whom 61% were on antiretroviral therapy (UNAIDS 2018). While HIV treatment in the public sector is well documented through national electronic medical record systems, such as Tier.Net, DHIS, and the NHLS data warehouse, little is known about the role of the private sector in HIV treatment service delivery (Awsumb et al, IAS 2017). In particular, there are no published geographic data describing the HIV disease burden amongst 

Breast cancer screening, diagnostic and treatment services and integration with HIV-related care in Sub-Saharan Africa: Results from an electronic survey

There is very little data on the availability of breast care screening and treatment services in sub-Saharan Africa, and almost no information on integration of HIV and breast care services in this setting. In this study we assessed the availability of comprehensive breast care services and their integration (or not) with HIV care and treatment services in sub-Saharan Africa, with a special focus on South Africa which has placed an emphasis on integration of HIV and SRH care in its public