The Africa Centre for Health and Population Studies, based in an area of South Africa where over one in five people are HIV infected, is to receive approximately £15 million over five years, subject to a three year review, from the Wellcome Trust, the UK's largest medical research charity. The Centre will use the funding to improve the health status of people in the area, with a particular focus on HIV infection.
Initiated in 1998 in KwaZulu-Natal, the Africa Centre is a research collaboration between the South African Medical Research Council, the University of KwaZulu-Natal and the Wellcome Trust. It carries out a multidisciplinary programme of research reflecting population and health priorities in sub-Saharan Africa, particularly HIV. Recent successes of the Centre include a study showing the importance of exclusive breastfeeding in preventing transmission of HIV from mother to child.
"The Wellcome Trust grant will help us in our goal of keeping HIV negative people negative and HIV infected people optimally cared for," says Professor Marie-Louise Newell, Director of the Centre. "In South Africa, as in many areas of sub-Saharan Africa, HIV is a major problem, compounded as it is by poverty, migration and lack of access to effective treatments."
With the renewal of funding from the Wellcome Trust, the Africa Centre aims to address questions that will inform the development of appropriate interventions for a community with an HIV prevalence in adults of over 20% and high levels of poverty and unemployment. Researchers at the Centre will monitor the impact of HIV on individuals, their households and the wider community, combining data collected within the bi-annual household survey with that from the annual individual level HIV, health and behaviour surveillance.
In particular, the researchers will look at key questions, such as how communities, households and individuals are affected by simultaneous epidemics of HIV, sexually transmitted infections and tuberculosis; how HIV negative people can be supported to remain uninfected; how best to deliver HIV-related health care in a low-income, resource-poor setting; and how to improve the health of children and adults in an environment challenged by HIV and other adversities. The researchers will extend their HIV research to the over-50s, a vastly under-researched group.
The Africa Centre will also play an important role in monitoring and evaluating the Anti-Retroviral Treatment (ART) Programme, currently being rolled out across Africa, the largest public health programme ever contemplated on the continent. The Centre is one of the few settings where the effects of ART delivery can be monitored and evaluated comprehensively at both population and individual level, through data collected within the population-based HIV and household surveillance linked with the clinical cohort information collected within the HIV-ART programme.
"The impact of the HIV/AIDS pandemic on societies is without precedent in recorded human history, and South Africa is particularly severely affected," says Professor Newell. "In the last 3 years, there has been an enormous effort to roll-out ART across sub-Saharan Africa. Over the coming 5 years, the Africa Centre will evolve from a research centre focused on description to one focused on intervention and implementation. The detailed knowledge of the population obtained since 2000, in addition to the well-resourced ART programme in the sub-district, uniquely places the Africa Centre to answer our primary research question: what is the long-term impact for the population of a well-functioning and comprehensive ART programme in a resource-poor, rural setting""
"The research at the Africa Centre is highly relevant for South Africa, but also will impact on the rest of Africa," says Dr Mark Walport, Director of the Wellcome Trust. "Professor Newell and colleagues are tackling some of the most important questions in HIV research, particularly those dealing with interventions for preventing HIV transmission and the impact of antiretroviral therapy on HIV incidence."
The support was welcomed by Professor Malegapuru Makgoba, Vice-Chancellor of the University of KwaZulu-Natal in South Africa.
“The research at the Africa Centre, situated in rural northern KwaZulu-Natal is unique, cutting-edge and of profound importance to the understanding and interventions on the HIV/AIDS epidemic locally and globally,” says Professor Makgoba. “The renewed funding from the Wellcome Trust is a welcome boost that serves as an inspiration to the programme itself and the scientists researching at the Centre. The University of KwaZulu-Natal is honoured to be associated with this Centre of excellence.”
The Africa Centre is one of four Wellcome Trust major overseas programmes. Others include programmes in Kenya, looking in particular at malaria and childhood infections, and in Malawi, focusing on health problems of local and regional significance such as malaria, HIV, anaemia, tuberculosis and other bacterial and viral infections.