South Africa shines in global overview of HIV/Aids research excellence

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A global analysis of four years of HIV/Aids research identifies the US as research leader in the field, followed by the UK and South Africa, writes MedicalBrief. The University of Cape Town is named as the most influential research institution in the field, ahead of the US government’s National Institutes of Health, while the University of the Witwatersrand takes sixth position, behind Harvard.

“This report shows the tight relationship between burden of disease and research publishing,” said Dr Linda-Gail Bekker, professor of medicine at the Desmond Tutu HIV Centre UTC and immediate past president of the International AIDS Society. “South Africa is a relatively small country but has carried a massive HIV burden and punched well above its weight in research publishing,” she added. “It also shows that, like the epidemic, the response has been global with significant north-south collaboration.”

The report gives a comprehensive overview of the HIV/Aids research landscape, including the most active nations and institutions and trends in protein research that reflect developments in drug targets. In advance of 2019 World AIDS Day on 1 December, Elsevier’s analytical services team analysed research in the field of HIV and Aids published between 2014 and 2018.

“It’s striking to see that only 13 years after the research community built up a knowledge base in response to this disease, the incidence rate for HIV/Aids began to decline,” said Dr Bamini Jayabalasingham, senior analyst for analytical services at Elsevier. “It speaks to the great impact that research can have in improving public health.”

Their report identifies the US as research leader in the field, followed by the UK and South Africa. Rounding out the top 10 nations are China, Canada, France, India, Italy, Australia and Spain.

Publication output was used an indicator of a country’s contribution to HIV/Aids research. Our colleagues assessed output by country using Elsevier’s Scopus and SciVal, revealing that the US is by far the largest producer, with 35,493 publications related to HIV/Aids between 2014 and 2018. This surpasses the second-highest contributor, the UK, by over 27,000 publications.

Based on global field-weighted citation impact, the study identifies the University of Cape Town (UCT), South Africa, as the most influential research institution in the field, underlining the high priority of HIV/Aids research in countries that are strongly affected by the disease. In fact, the relative activity in HIV/Aids research is highest in four countries in sub-Saharan Africa: South Africa, Uganda, Kenya and Nigeria.

Globally, an estimated 38m people were infected with HIV in 2018, according to the latest data by UNAIDS, and the vast majority – over 25 million – live in Africa.

International collaboration is a main feature of research coming from the top institutions: of the top 10 institutions that produce the most research on HIV/Aids, more than half of the output involves international collaboration. The highest percentage of collaboration can be seen in research by University of Cape Town and the University of the Witwatersrand, Johannesburg, with approximately 72% involving collaborators overseas.

Academic-corporate collaborations are also prominent among the top institutions, with one in five publications from the National Institutes of Health and one in 10 publications from Harvard produced this way.

Professor Salim S Abdool Karim, director of CAPRISA (Centre for the AIDS Programme of Research in South Africa) and CAPRISA professor of global health at Columbia University, added: This insightful analysis clearly demonstrates that the African countries most impacted by the Aids epidemic (Uganda, Kenya, South Africa and Nigeria) are producing disproportionately more HIV papers in relation to their country’s total research publications. In particular, South Africa, which has about one fifth of the global HIV burden, is highly ranked globally for having the third highest number of HIV publications, many of which emanate from international collaborations and are being highly cited.

Research output for HIV/Aids closely followed behind the growth seen for all research between 2009 and 2011. Following a decline from 2011 to 2015, HIV/AIDS related research has not grown at the same pace as all research. This data suggests that the response to a decline in incidence (peaked in 1997-98) and deaths (peaked in 2005) points to the relative success of Aids research.

HIV protein targets have been a major source of focus in the published scientific literature over the past 20 years. Moreover, an increased body of published data has begun to look at the potential of patients’ own intrinsic immune defence system to reduce viral replication.

Globally, 3.4% (2,713) of all HIV research publications in 2014-18 were the result of collaboration between academic and corporate institutions. The top three corporate institutions involved in this research are Leidos (290 publications), Gilead Sciences (178 publications) and GlaxoSmithKline (153 publications).

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