A new web-based system that makes pertinent data accessible to healthcare practitioners involved in managing South Africa’s HIV epidemic in near-real time will hasten the country’s response to meeting one of UNAIDS three HIV elimination targets: for 90% of people on treatment to have a viral load fully suppressed by 2020.
The first National CD4 / Viral Load Monitoring Dashboard, an online tool that monitors CD4 count and viral load in South Africa’s HIV positive patients, displays and analyses data in a way that healthcare professionals involved in managing the epidemic can easily engage with. It provides information at a national, provincial, district, single facility and individual levels, as well as for designated age groups. Viral load is the best predictor of an HIV positive patient’s response to treatment.
The dashboard has been made possible by PEPFAR and USAID through Rig9ht to Care, Boston University in the US, South Africa’s National Health Laboratory Service (NHLS), the National Institute for Communicable Diseases (NICD) and the national Department of Health (DOH).
Chief medical officer, Right to Care, Dr Pappie Majuba says, “It is accessible to all implementing partners and will be used to evaluate the effectiveness of interventions to contain the HIV epidemic and to fast-track viral suppression in those receiving antiretroviral therapy.”
Pathologist at the NHLS and at the School of Pathology, Wits University, Dr Sergio Carmona explains, “The better we understand how patients are being managed, the better control we have of the epidemic. It will also help to swiftly allocate resources where needed such as infrastructure, nurses and doctors, monitor ‘hot spots’ and expedite the right responses, as well as evaluate the effectiveness of interventions to contain the epidemic. The data system also identifies HIV results for children and adults that require urgent action.”
“The dashboard uses data from SA’s National Health Laboratory Service (NHLS) and from the national DOH Information Systems (DHIS),” says director general of the National DOH, Yogan Pillay. “It was specifically developed because South Africa is one of the few countries that has a national and integrated pathology service through the NHLS.”
Carmona explains, “The NHLS is the sole provider of pathology services to close on 80% of SA’s population. Therefore, the laboratory results from all these individuals since 2004 reside in the NHLS’ corporate data warehouse. This allows for almost national coverage of all South Africans that are infected.”
Associate professor in the faculty of health sciences at Wits University Gayle Sherman says, “Children and adolescents are often overlooked in our response to HIV/Aids. In reporting on national Viral Loads and CD4 counts, particular attention has been paid to these vulnerable populations. The new system will enable healthcare workers to focus attention on high risk, HIV-infected children and adolescents to improve individual outcomes and meet the 90:90:90 targets.”
Right to Care hosted the national launch of the new dashboard today when training with national and provincial stakeholders from the DOH, the 90:90:90 Technical Working Group, and representatives of all implementing partners took place. Training in the provinces will take place from January to March 2017 and in districts from April to June 2017.
The dashboards are a highly effective public health surveillance system. The World Health Organisation defines public health surveillance as the continuous, systematic collection, analysis and interpretation of health-related data needed for the planning, implementation, and evaluation of public health practice.
It is estimated that there are nearly 6.75m people infected with HIV in South Africa with 3.3m on treatment and of those who have accessed viral load testing, over 80% are suppressed.