All Policy Briefs

Policy Brief 7: Technical support to the South African government to improve financial management of HIV/AIDS

Background In 2013, the Financial Capacitation for Provincial HIV Managers (FIN-CAP) programme was launched by HE2RO and the Centre for Economic Governance and AIDS in Africa (CEGAA) to help capacitate national and provincial government departments in the areas of financial management, costing, budgeting, and expenditure tracking for HIV, based on the team’s experience in costing the Provincial Strategic Implementation Plans (PSIPs). To reduce duplication or overlap with similar initiatives, 

Policy Brief 6: The benefits of antiretroviral therapy for patients’ economic well-being

Background Large-scale provision of antiretroviral therapy (ART) for HIV/AIDS began in South Africa in 2004 and has scaled up steadily since then. A decade later, large numbers of patients are now reaching five, eight, or even more years on ART. The long-term biomedical outcomes of treatment have been well documented in South Africa, where antiretroviral provision has been associated with reductions in HIV-associated mortality and increases in life expectancy. Much less is known about the 

Policy Brief 5: Cost and outcomes of paediatric antiretroviral treatment in South Africa

Background In South Africa, as in many countries, access to paediatric antiretroviral treatment (ART) services for HIV/AIDS has lagged behind that of adult services. Reported coverage of the estimated 300 000 treatment-eligible South African children in 2010 was just 36%, compared with coverage of 55% of the approximately 2.5 million treatment-eligible adults. In response, South Africa’s National Strategic Plan for HIV/AIDS sets a target of initiating 90% of eligible children on ART and of 

Policy Brief 4: Changing from stavudine to tenofovir in first line antiretroviral therapy in South Africa

Background Under South Africa’s original public sector antiretroviral therapy (ART) guidelines, introduced in 2004, the antiretroviral drug stavudine (d4T) was one of three antiretroviral drugs (ARVs) that formed the mainstay of first-line treatment. Toxicities associated with stavudine use are common, however, and led to calls to substitute for stavudine a drug with fewer side effects. HERO policy brief 4 -- Changing from stavudine to tenofovir - 15 Oct 

Policy Brief 3: Rapid, Point of Care CD4 testing at mobile and fixed HIV testing sites: Does it increase linkage to HIV care?

Background Effective care and treatment for HIV/AIDS requires the integration of all stages of disease management, which include: (1) HIV testing; (2) referral of those who test HIV-positive to a clinic for assessment; (3) assessment of the patient with CD4 test to determine eligibility for antiretroviral therapy (ART) or pre-ART care; (4) patient enrolment and retention in pre-ART care if not immediately eligible for ART; (5) patient initiation of ART as soon as eligible; and (6) 

Policy Brief 2: Shifting management of stable ART patients from doctors at hospitals to nurses at primary health clinics in South Africa

Background HIV/AIDS is placing the health systems of many resource-constrained countries under tremendous pressure. Shortages of human and infrastructural resources have become a major constraint to continued expansion of access to HIV care and treatment. Shifting clinical responsibilities to lesser trained, less expensive, and generally less scarce cadres of the clinical workforce and to lower level healthcare facilities is widely regarded as one solution to this problem. Policy Brief 

Policy Brief 1: The Incremental Cost of Introducing Xpert MTB/RIF into the South African National TB Programme

Background South Africa bears a large share of the global burden of HIV/tuberculosis co-infection. The Cepheid GeneXpert System using the Xpert MTB/RIF assay http://www.cepheid.com/systems-and-software/genexpert-system/), a cassette-based cartridge, has provided the possibility of a rapid, point-of-care diagnosis of tuberculosis (TB) and, simultaneously, a rapid screen for rifampicin (RIF) resistance. The assay is highly sensitive and specific for M. tuberculosis (MTB) infection and received a