Posts Tagged ‘ARVs’

ZAMBIA IN HIV RESEARCH BOOST

Thursday, May 27th, 2010

From BENEDICT TEMBO in PITTSBURGH, USA

ZAMBIA has been enlisted for the Vaginal and Oral Interventions to Control the Epidemic (VOICE) study, a major HIV prevention trial testing two different approaches for preventing sexual transmission of HIV in women.

VOICE is a tablet and a vaginal microbicide therapy looking at whether some of the same antiretroviral (ARV) medications used successfully for the treatment of HIV are safe and effective for HIV prevention.

Patrick Ndase, regional physician Microbicide Trials Network and Partners Pre-exposure prophylaxis (PREP) Study, University of Washington said Zambia is among four African countries to be an HIV/AIDS Clinical Trial Unit for the Microbicide Trials Network (MTN).
Speaking at the just-ended 2010 Microbicides (M2010) Conference in Pittsburgh, Ndase said Uganda, South Africa and Zimbabwe are the other countries where the study is being conducted.

While VOICE is already underway in South Africa, Uganda and Zimbabwe, Zambia’s investigations have not started because the Centre for Infectious Disease Research in Zambia (CIDRZ) is still waiting for clearance from the Ministry of Health.

The backlash in the aftermath of the mis-representation of the very critical data of the Microbicides Development Programme (MDP) trials in Mazabuka last December has contributed to the hold-up of the CIDRZ study at Kamwala Health Centre in Lusaka.

“The VOICE Study also wants to learn which of these routines women are more likely to follow: taking a tablet by mouth once a day or applying a vaginal microbicide gel every day. This is important because no approach can be truly effective if women are not willing and able to use it,” Ndase said

He said the ARV tablets being tested are called tenofovir and truvada.

“Both are drugs routinely used as part of combination therapy for treating HIV. They are also used to prevent mother-to-child transmission of HIV. The microbicide being tested is called tenofovir gel. It has the same active ingredient as the oral tablet,” he said.

In Zambia, about 300 women are expected to be part of the 5,000 women aged between 18 and 35 who are HIV negative and not pregnant to participate in the trial as volunteers.

“Researchers at the Centre for Infectious Disease Research in Zambia (CIDRZ) hope also to be conducting this study so that Zambian women will have the opportunity to participate,” he said during his presentation on how clinical research works at St. Lawrence Convention Centre on Saturday.

The Research and Ethics Committee of the University of Zambia has endorsed the study, so has the University of Alabama at Birmingham’s school of medicine review board.

VOICE is funded by the US-based National Institutes of Health (NIH).

Women account for over 60 percent of HIV infections in Sub-Saharan Africa and represent one of the largest and fastest growing at-risk populations for HIV, especially in Zambia.

“As such, Zambian women are among those who will benefit most if VOICE or any other trial finds a safe and effective method for preventing HIV,” Ndase said.

VOICE was designed according to the most rigorous international medical practice and ethical standards and includes measures to protect the safety and wellbeing of all participants. Before volunteers can enroll, staff ensure they understand the procedures, risks and benefits of the study, and that they have the right not to participate or to leave the study at any time.

Women who enroll are randomly assigned – like the toss of a coin – to one of five study groups, either to one of  the three tablet groups: tenofovir, Truvada, or oral placebo (a tablet that looks the same but has no active medicine); or to one of the two gel groups: tenofovir gel or placebo gel.  VOICE will involve 5,000 women, 1,000 in each group.

Women use the same product every day for the entire study (about two years) but no one knows which tablet or gel.

Because it is not known whether the study approaches will be effective, researchers do everything possible to help prevent women from acquiring HIV.  All participants receive ongoing HIV risk-reduction counseling, condoms, and diagnosis and treatment of STIs – proven measures for reducing the risk of HIV.

The M2010 started on May 22 ran up to May 25 at Pittsburgh’s David Lawrence Convention Centre.

Nearly 1,000 participants from 47 different countries attended to hear about the latest developments in HIV prevention research.

M2010 is the sixth biennial meeting of the International Microbicides Conference and marks the first meeting in the United States since the 2000 inaugural gathering in Washington, D.C. Other previous meetings have been in Antwerp, Belgium; London, England; Cape Town, South Africa; and New Delhi, India.

ZAMBIA BENEFITS FROM WHO HIV/AIDS INITIATIVE

Monday, August 31st, 2009

By BENEDICT TEMBO

TINY Tim and Friends (TTF) is a small charity which screens orphans for HIV in vulnerable communities surrounding Lusaka and puts those needing treatment on anti-retroviral drugs (ARVs).
“After stabilising them for six months, we transfer them to the regular public system of HIV care. We also source treatment for a lot of vulnerable pregnant women with HIV,” TTF medical director Timothy Meade says.
TTF specialises in taking care of the most vulnerable orphans and their unique needs including adherence to treatment and skills training.
To deliver quality medical care, Dr Meade says TTF uses the World Health Organisation’s Health Access to Research Initiative (HINARI) under which policies and medical procedures have been developed to provide the best HIV treatment for needy orphans.
“One example: An HIV-positive breast-feeding mother needs guidance about weaning and best practices to ensure that infants don’t get infected through breast milk,” Dr Meade says.
He says HINARI has kept the TTF team abreast with current developments and the TTF now has one of the most advanced and informed breast feeding and weaning policies in the country.
Dr Meade says TTF uses HINARI to scan the regional and worldwide medical and social research as it becomes available through medical journals.
“TTF is now recognised by many organisations (both inside and outside the Ministry of Health) as the expert provider of HIV care for one of the most vulnerable populations in need of treatment—orphans and pregnant women,” Dr Meade says.
Dr Meade is among several medical practitioners, scientists and students benefiting from the HINARI initiative.
Kimberly Parker, the HINARI library programme manager based at the World Health Organisation (WHO) head office in Geneva says HINARI was developed by WHO in collaboration with scientific publishers and Yale University Library. It was launched in July 2001.
“It helps to develop country health research and facilitates access of clinical personnel to over 6,200 titles in biomedical and health literature. Institutions in 108 countries are eligible to register, benefiting thousands of health workers and researchers and contributing to improved world health,” Ms Parker says.
University of Zambia Ridgeway campus medical librarian Francina Makondo says before HINARI, students, doctors, lecturers and researchers depended on physical literature in the library.
Ms Makondo says due to budgetary constraints, the medical library at the University Teaching Hospital in Lusaka depended on donations from well-wishers to stock the shelves.
Even the books and journals were stale because of the time it took for them to be received after being posted manually.
“Before HINARI, we had a big problem because we depended on what we sourced in terms of books and periodicals. Increased enrolment at the Ridgeway campus made things worse but since HINARI came on the scene, we have had access to the very latest health information,” she says.
With HINARI medical staff, students, lecturers and researchers no longer have to worry about paying subscription fees to medical databases abroad which cost as much as £10,000 British Pounds.
HINARI has in fact tipped scales in favour of medics, researchers and students in the third world.
“Some of our partners who come from the United States and United Kingdom marvel at how much information we access for free,” Ms Makondo, who also teaches library and information studies at UNZA, says.
Christine Wamunyima Kanyengo, a librarian at UNZA main campus says HINARI has bridged the gap for researchers and doctors in accessing current information.
“If you are a health practitioner, you need current information,” she says.
Ms Kanyengo, formerly a medical librarian at UTH, says WHO has also trained staff in the use of the internet.
Ms Kanyengo and Ms Makondo say with the issue of subscriptions resolved, the biggest challenge facing UNZA now is inadequate computers for student use.
Other institutions in Zambia among the several benefiting from HINARI are the Chainama College of Health Sciences, Malaria Institute at Macha in Choma in southern Zambia, the Tropical Diseases Research Centre (TDRC) in Ndola and the Centre for Infectious Disease Research in Zambia.
HINARI is part of the three public-private partnerships collectively called Research4Life.
Others are the AGORA (Access to Global Online Research in Agriculture) launched in 2003 by the United Nations Food and Agriculture Organisation (FAO), major publishers and Cornell University, to address similar needs in agriculture.
AGORA provides a collection of 1,300 agriculture journals to institutions in 108 countries—enhancing the scholarship of thousands of students, faculties and researchers in agriculture and life sciences in the developing world.
OARE (On-line Access to Research in the Environment), an international public-private consortium coordinated by the United Nations Environment Programme (UNEP), Yale University and leading science and technology publishers, facilitates access to 3,000 journals in one of the world’s largest collections of environmental science research, for 108 developing countries.
Together, the three programmes–HINARI, AGORA and OARE–provide developing countries free or low cost access to academic and professional peer-reviewed content on-line.
“The three programmes share an objective to reduce the scientific knowledge gap between industrialised countries and the developing world,” Ms Parker says.
FAO information management specialist Justin Chisenga says the fact that researchers in Zambia know what is going on around the world helps them to do good research.
“Researchers are now citing articles published this year because they access information almost immediately,” Dr Chisenga says.
Dr Chisenga, based at the FAO regional office for Africa in Accra, Ghana says access to AGORA has contributed to increased agriculture productivity.
“Increased productivity and production means food security, which means good food. Good nutrition is good for health,” Dr Chisenga says.
He is involved in capacity building and outreach programmes for FAO, setting up agriculture information systems and networks. With African farmers having access to research conducted in Europe, Dr Chisenga is now pre-occupied with research being done in Africa.
“Research in Africa has problems getting into international journals. We are working with institutions to set up information networks of local content for interested individuals.”
After helping set up a project called Kenya Agricultural Information Network (KAINet), Dr Chisenga’s next assignments include helping Mount Makulu Research Station to manage electronic information.
His work also involves promoting access to FAO information because every published document is posted on the website.
Information Training & Outreach Centre for Africa (ITOCA), an international NGO based in Centurion, South Africa with regional offices in Kenya and Nigeria, also benefits from HINARI, AGORA and OARE.
ITOCA focuses on ICT for development work in the Sub-Saharan Africa (SSA) region.
One of ITOCA’s major programmes is ICT capacity building and focussing on building user skills on access and use of electronic resources (e-resources) by researchers, academic staff and students at universities, colleges and research institutions in SSA.
“We conduct short courses (3-4 days) on information literacy focusing on the use of e-resources such as AGORA, HINARI, OARE (i.e. Research4Life programmes), TEEAL (The Essential Electronic Agricultural Library), PROTA (Plant Resources for Tropical Africa),” Gracian Chimwaza, ITOCA executive director says.
“These e-resources give free and low-cost access to peer-reviewed literature (scientific journals) to developing countries. This is expensive literature which researchers in developing countries desperately need in their work to improve their research and teaching. They find it difficult to access information because of the high cost of subscription.
ITOCA has been providing this service since 1999 when the organisation was established.
“The Research4Life programmes provide free access to thousands of excellent journals through their online platforms, making it easy for users to access the literature,” Mr Chimwaza, the founding director of ITOCA says.
He says it is critical that the targeted users have the requisite knowledge and skills to access and use the resources effectively, hence the need to train users in the use of the resources.
He says one important role played by ITOCA and many other interested parties include running 6-7 day national/regional e-resources training-of-trainer courses annually in collaboration with universities or research institutions in SSA countries.
“We have conducted 41 workshops in about 30 countries in the last five years attended by over 1,500 professors, researchers, librarians, students and technical staff,” Mr Chimwaza adds.
The participants are tasked to go back to their institutions and disseminate information on the use of e-resources and spread the skill.
In addition, ITOCA works on creating awareness on e-resources through outreach activities such as mounting promotional booths at relevant conferences and meetings. The organisation also runs special local seminars, visiting research and academic institutions to ensure that users know about the existence of e-resources.
ITOCA sources funding for these activities through the programme’s leading partner organisations WHO, FAO, UNEP, Cornell University (USA), Yale University (USA) and donors like The Rockefeller Foundation (USA), CTA (Netherlands), PROTA Foundation (Netherlands), Bill and Melinda Gates Foundation (USA) and IDS (UK).
The partnership’s goal is to contribute to the attainment of six of the UN’s 8 Millennium Development Goals, by reducing the gap in scientific knowledge between industrialised countries and the developing world.
“We certainly have achieved that objective and recognise that it is a goal that requires continuing activity to keep the gains we have made and ensure that the gap continues to narrow,” Ms Parker says.