Category Archives: South Africa

July 27, 2012 · 1:01 pm

Late-breaking EGPAF-Funded Study on the Effects of TB Vaccine on HIV-Exposed, Breastfeeding Infants

By Robert Yule

Today, Dr. Heather Jaspan – a recipient of an EGPAF Pediatric HIV Vaccine Program Grant – released late-breaking results from her study at the International AIDS Conference.

The study investigated whether early administration of the Bacille Calmette-Guerín (BCG) vaccine for tuberculosis could be associated with an increased risk of HIV infection for HIV-exposed, breastfed infants in South Africa.

Dr. Heather Jaspan presenting her late-breaker study results.

Dr. Jaspan presents the results of her study and their implications below:

Bacille Calmette-Guerín (BCG) vaccine is given to infants at birth in high Tuberculosis (TB) burdened areas such as Southern Africa to protect them from severe forms of TB.

BCG given to monkeys causes immune cells to be active and replicate faster. HIV preferably infects cells that are actively replicating and have the HIV receptors CD4 and CCR5 on their surface. People who are frequently exposed to HIV yet remain negative have lower numbers of these HIV target cells in their blood.

We hypothesized that the routine immunization of neonates with BCG contributes to generalized immune activation in HIV-exposed infants, resulting in increased HIV target cells and increased risk for HIV transmission via breastfeeding.

We randomly assigned HIV-exposed and uninfected newborns to BCG vaccination at birth versus at 8 weeks of age. We determined the proportion of HIV target cells (activated CD4+CCR5+ cells).

Babies in the early BCG group had significantly higher HIV target cells in their blood than those in the delayed arm. This difference persisted at 8 weeks, despite immune stimulation from routine immunizations at 6 weeks in all babies.

No other cells were activated and no other markers of inflammation increased, suggesting the effect of BCG is isolated to CD4 T cells. Therefore BCG vaccination may increase the risk of HIV infection for HIV-exposed, breastfed infants.

However, other results not presented today show that infants with higher target cell activation had better responses to tetanus vaccine given at 6 weeks of age. This suggests that, in addition to protection against severe TB, BCG may have other benefits for HIV-exposed infants.

Therefore, the potential risks and benefits of BCG need further evaluation and investigation.

Our results can inform policy for the optimal timing of BCG vaccination for HIV-exposed infants, and have implications for the use of related vaccines – such as live, weakened bacterial vaccines – as potential future HIV vaccine strategies for newborns.

Dr. Heather Jaspan is a Senior Lecturer at the University of Cape Town and a Senior Scientist at Seattle BioMedical Research Institute.

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Filed under Advocacy, EGPAF, IAC 2012, Pediatric Treatment, PMTCT, Research, South Africa

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· 10:55 am

[VIDEO] Together We Can End AIDS – Florence on Capitol Hill

On Tuesday, EGPAF Ambassador Florence Ngobeni-Allen was asked to speak at a special breakfast on Capitol Hill hosted by Senators Lindsey Graham (R-SC) and Patrick Leahy (D-VT), and Congresswomen Kay Granger (R-TX) and Nita Lowey (D-NY).

The bipartisan event featured an audience of leading U.S. policymakers and remarks from a roster of champions in the fight against AIDS, including Sir Elton John, UNAIDS Executive Director Michel Sidibe, and Florence.

Here is the video of her speech:

Video courtesy of SABC News (http://www.sabc.co.za/news)

Earlier this week, EGPAF Communication Officer Taylor Moore wrote a blog recounting the event.

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July 26, 2012 · 4:07 pm

mHealth in HIV/AIDS Programs: Exploring its Impact

By Michelle Betton

mHealth (mobile health technology) continues to be a big theme at this year’s International AIDS Conference. Wednesday morning, representatives from the Elizabeth Glaser Pediatric AIDS Foundation, Cell Life, the International HIV/AIDS Alliance, and the mHealth Alliance discussed various mobile technology interventions in HIV and AIDS programs.

EGPAF’s Dr. Apolinaire Tiam from Lesotho

mHealth is currently being used for many different interventions, including education and awareness, supply chain management, training for health workers, and monitoring and evaluation. The work of the panel participants focused on HIV/AIDS interventions in South Africa, Kenya, and Lesotho.

Dr. Peter Benjamin of Cell Life described the work of his organization, which uses technology to improve health and to meet social challenges. Cell Life works in 10 countries in Africa, primarily in South Africa, creating open source eHealth (electronic health) technology. Their products are used in social and behavior change communications, health systems strengthening, and policy amongst other topics.

Caricia Catalani of InSTEDD presented a literature review that delved into the question of whether or not evidence exists proving that mHealth is effective. From her findings (based on 62 articles focused on HIV/AIDS program studies), it remains unclear whether or not mHealth is effective overall in combating HIV/AIDS barriers. Several interventions have been quite effective, such as those focused on youth, community health workers, appointment and adherence reminders, and TB care, while others have not shown conclusive evidence of effectiveness. Catalani stressed that increasing local and end user development of mHealth technologies would likely increase the usefulness and effectiveness of these interventions.

Following on Caricia’s presentation, Evelyn Kibuchi of the Kenya AIDS NGOs Consortium (KANCO) described how a mapping system of facilities and clinics across regions makes facilitation and referral of services easier. Consortium member organizations enter their location and contact information into a database that then shows which services are provided in a given region, and exactly where. This makes it easier for clinics to refer clients if necessary, and helps clients facilitate transportation. In future, KANCO intends to begin sending SMS messages with information on services locally available. There is also the possibility of clients finding and receiving home-based care based on organizations in their vicinity.

EGPAF’s own Dr. Appolinaire Tiam discussed the impact of 3G technology and laptops in Lesotho. Because of Lesotho’s mountainous landscape, HIV test results can take up to 12 weeks to return to families. The Foundation’s Lesotho program acquired laptops with 3G technology for district clinical coordinators, allowing the program to receive digital lab results and send them to families in four weeks instead of 12. Tiam noted that, before the 3G-capable laptops, 55 percent of children who waited for more than two months for HIV test results died before receiving then. With 3G technology in clinics, child deaths have decreased to 5 percent.

While evidence is still inconclusive and barriers still exist to optimal effectiveness of mHealth interventions, there is some evidence that mHealth can have a considerable impact on the health of those affected by HIV/AIDS.

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Filed under EGPAF, Kenya, Lesotho, mHealth, South Africa

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July 25, 2012 · 3:58 pm

EGPAF Talks PMTCT on Voice of America

By Jane Coaston

On Monday, EGPAF Vice President of Program Innovation and Policy Dr. RJ Simonds and EGPAF Ambassador Florence Ngobeni-Allen joined Voice of America’s Linord Moudou to talk about the International AIDS Conference and the state of the fight against HIV/AIDS.

Dr. Simonds discussed the health challenges faced by children living with HIV and the importance of prevention of mother-to-child-transmission (PMTCT). Florence shared her story of testing positive for HIV, losing a child to the disease, and becoming an HIV counselor to help other mothers and children in her native South Africa.

Watch the video: 

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July 24, 2012 · 1:09 pm

An Unstoppable Force

By Taylor Moore

This morning I had the privilege of joining Foundation Ambassador Florence Ngobeni-Allen at a special breakfast on Capitol Hill. It was hosted by Senators Lindsey Graham and Patrick Leahy, and Congresswomen Kay Granger and Nita Lowey, and included a bipartisan audience of leading U.S. policymakers.

I went in to the event expecting a wonderful morning, with remarks from a roster of champions in the fight against AIDS, including Elton John; Michele Sidibe; the Deputy President of South Africa, Kgalema Motlanthe; John McGrue; Dr. Rick Warren, and others.

But the event became much more.

Foundation Ambassador Florence Ngobeni-Allen addressing the Congressional breakfast.

Senator Leahy opened the breakfast calling for bipartisan support for an AIDS-free generation. He expressed his appreciation to the global audience for efforts to continue momentum in the fight against AIDS, and urged his colleagues to remain committed to the cause.

Other speakers echoed that call for a shared responsibility and commitment. Dr. Rick Warren, co-founder of Saddleback Church, spoke of the faith community’s contributions to the fight against AIDS, and the importance of collaboration among private, public, and faith communities in ongoing work against the disease. “Thank you for caring,” he said. “If we want to end AIDS, I am on your side.”

But it was Sir Elton John who summed up the theme of the morning best, stating that “the power of people working for good is an unstoppable force,” and that together, our sustained support and contributions have and will continue to make a dramatic impact in the fight against AIDS.

Elton John’s personal contributions – more than 25 years as a leader in the AIDS community – are emblematic of the unstoppable force he urged others to join this morning.  Also part of that force is Florence Ngobeni-Allen.

Florence spoke to the audience of losing her daughter Nomthunzi to AIDS more than 15 years ago, and how that painful loss led her to become a counselor in her community. At the time, the medicines to keep an HIV-positive child healthy were unavailable in Florence’s home country of South Africa, and too many mothers had to watch their children die from AIDS.

Florence worked as a counselor for these women because she knew what the desperate fight to save a child from an untreatable disease felt like. Motivated by her love for Nomthunzi, Florence became committed to doing anything possible to help other mothers avoid that loss.

When prevention of mother-to-child transmission of HIV services (PMTCT) came to South Africa 10 years ago, Florence’s world changed. As she said in her remarks, she was soon able to share hope, not grief, with the women in her community, and eventually, her role shifted from counselor to advocate and activist, fighting for access to and education about these lifesaving services.

Later, Florence would join many of these women, experiencing the joy of a healthy child herself through the birth of her two HIV-negative children, Alex and Kulani.

Everyone who heard her knew that when Florence spoke, she wasn’t just sharing her own story. She was representing all women affected by HIV — every mother who had lost a child to AIDS, who had experienced the miracle of PMTCT, who had witnessed the epidemic’s impact firsthand, and who was also part of that unstoppable force in the fight against AIDS.

Florence’s personal message of heartbreak and hope, and the reception she received in that room of peers this morning, reminded me that our fight against AIDS is not only a shared fight, but a winnable one as well.

Florence, Sir Elton John, and the other incredible leaders at this morning’s breakfast are representatives of a much larger community committing to a future free of AIDS. And their message this morning was loud and clear: we must remain committed, we must work together.

If we do, we WILL end AIDS.

Florence Ngobeni-Allen, Dr. Rick Warren, and Michel Sidibe

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Filed under Advocacy, EGPAF, IAC 2012, PMTCT, Public Policy, Public-Private Partnerships, South Africa, Uncategorized

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July 22, 2012 · 1:11 pm

Upcoming EGPAF Session: Overcoming Barriers to Implementing Global Plan

By Robert Yule

Join EGPAF, mothers2mothers, Johnson & Johnson, and our other partners at this upcoming session on overcoming implementation barriers to the Global Plan.

This fast-paced session – moderated by Global Post’s John Donnelly – will feature people working on the front lines of program implementation from high-burden countries and representing various implementing organizations. Each presenter will raise a specific challenge, explain how it was addressed, describe the result, and share what is being done next.

The audience will have the opportunity to interact with presenters for further discussion of implementation barriers and solutions.

“Eliminating Pediatric AIDS and Keeping Mothers Alive from an Implementation Perspective – Best Practices, Programmatic Barriers, and Bottlenecks in the Field”
Sunday, July 22, 1:30 – 3:30 PM
Mini Room 1

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Filed under Global Plan, Implementation, India, Kenya, Lesotho, Malawi, PMTCT, Rwanda, South Africa, Swaziland, Tanzania, Zambia, Zimbabwe

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· 11:32 am

An Evening of Inspiration

By Florence Ngobeni-Allen, EGPAF Ambassador

Florence Ngobeni-Allen, Foundation CEO Chip Lyons, and Jake Glaser.

Last night I had the honor of attending an event – hosted by UNAIDS, ONE, the Business Leadership Council, and the Nelson Mandela Foundation – called Uniting for an AIDS-Free Generation. The special evening brought together heroes in the fight against AIDS to celebrate the return of the International AIDS Conference to the United States for the first time in more than two decades.

It was just my second day in Washington, D.C., but the music and speeches made it feel like a true welcome to the conference. Artists including Annie Lennox, Joan Osbourne, Alicia Keys, Herbie Hancock, and the African Children’s Choir  graced the stage and inspired us with their powerful voices.

Speakers like Vicky Kennedy, Bill Gates, John McGrue of the Business Leadership Council, Rep. Barbara Lee, Michel Sidibe, and others shared inspiring words – recognizing our hard work over the past three decades, and the work that still lies ahead.

During the evening, heroes were acknowledged for achievements in the fight against AIDS. And we celebrated some of our major successes - discovering drugs to save the lives of those affected early on in the epidemic, eliminating pediatric AIDS in the developed world, expanding access to lifesaving HIV prevention, care, and treatment services around the world.

We also committed to the goals ahead – an HIV-free generation, access to care and treatment for all, and most importantly, a cure.

But we were reminded of what we need to do to make it happen - including the continuity of funding, private sector support, and strong leadership.

A special moment in the evening was when Barbara Bush, daughter of President George W. Bush, Kweku Mandela, grandson of Nelson Mandela, and Jake Glaser, son of Elizabeth Glaser, took the stage.

Together, these young leaders represented a new population of advocates, continuing the influential work of their families. They spoke about their desire to continue the efforts of those in the room, and their confidence in their peers to make our goals for an AIDS-free world a reality.

Seeing them together was a highlight to me as a mother. My daughter, Nomthunzi, would have been 16 this year, and a part of that passionate group of advocates if she were with us today. I know she was there in spirit, fighting with us.

While the evening left me inspired for the week of work ahead, what really stuck with me was that never once during the evening was one specific race, culture, or community singled out. The event didn’t show that AIDS was an African issue or an American issue. It didn’t speak only to AIDS among people of a particular race, economic status, or sexual orientation.

Instead, the event illustrated our unified efforts in the global fight against AIDS. So often in my work as an activist and advocate, I see people put an emphasis on specific populations, bringing stigma and shame to those infected and affected. It was encouraging to see a group of people from different countries, backgrounds, and experiences, joining together to commit to ending AIDS.

It gave me hope that together we can turn the tide against this disease.

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