By Ciara Staunton, BCL, LLM (Public Law), PhD
South Africa, dubbed the “Rainbow Nation” by Desmond Tutu is one of the nations worst hit by the HIV/AIDS epidemic and most in need of a cure for HIV/AIDS. It has the highest number of HIV/AIDS infected individuals worldwide, and it is estimated that there are currently 6.4million (12.2%) people living with the disease, with prevalence higher amongst the black, poor communities. Since the days of AIDS denialism, prevention and treatment campaigns have seen a stabilisation of new HIV infections, however prevalence remains high.
With a GINI coefficient of 63.1, South Africa is one of the most unequal societies in the world and the poorest 40% of the population accounts for 7% of the household income. This inequality is strongly felt in the health care system where 30% of all of South Africa’s doctors work in public hospitals that cater for 84% of the population. Access to medical services can be therefore problematic for many people living with HIV, and stories of stock outs of ARTs are not uncommon. Poor, black communities are those most affected by the HIV/AIDS epidemic and it is clear that a cure for HIV/AIDS is necessary to bring this epidemic under control.
The searcHIV South Africa site is based at the Centre for Medical Ethics and Law (CMEL), located on the Tygerberg campus of the University of Stellenbosch in the Faculty of Medicine and Health Sciences. Situated in the northern suburbs of Cape Town, the faculty is home to a diverse range of staff and students from a variety of backgrounds, which makes South Africa unique. Although South Africa’s economy is the second largest in Africa, widespread poverty is prevalent, a situation exacerbated by the high HIV/AIDS rates. With an active HIV/AIDS research centre based in Tygerberg Hospital, the CMEL is all too aware of the challenges facing those living with HIV/AIDS and is ideally placed to engage with communities most affected by HIV/AIDS.
The CMEL is headed by Prof Keymanthri Moodley, PI of the South African site. In addition to teaching medical ethics to undergraduate and postgraduate students, Prof Moodley is PI (along with Prof Stuart Rennie) recipient of a Fogarty grant to develop capacity in health research ethics in Southern Africa. She has worked as an investigator on clinical trials, conducts good clinical practice (GCP) and research ethics training for investigators, and has been a consultant to the International AIDS Vaccine Initiative (IAVI). Dr Malcolm de Roubaix is the Project Manager of the South African site. He is a practising anaesthesiologist, chair of a research ethics committee of the University of Stellenbosch and lectures on anaesthesiology and ethics. He is a Fellow of the Department of Philosophy Center for Applied Ethics, Stellenbosch University. Dr. Ciara Staunton is the researcher for the South African site. With an interest in the governance of medical research, particularly innovative research, she has a PhD on regulating stem cell research and is the Chief Legal Officer of the Irish Stem Cell Foundation. Her interest in medical ethics developed during her tenure at the Law Reform Commission of Ireland where she was the legal researcher for the Commission’s projects on Advance Care Directives and the Legal Aspects of Home Care. Dr Theresa Rossouw is a consultant to the South African study site. She is a member of Research Ethics Committees of the University of Pretoria and the Human Sciences Research Council (HSRC). She is an HIV clinician working in primary healthcare clinics and community health centers in Tshwane district, a consultant in the Department of Family Medicine and a Researcher at the Department of Immunology at the University of Pretoria and a member of the Southern African Treatment and Resistance Network (SATuRN). Her research focus is HIV-1 drug resistance and the consequences of HIV-associated chronic immune activation.
References
Bor J, Herbst A, Newell M, Barnighausen T: Increases in Adult Life Expectancy in Rural South Africa: Valuing the Scale-Up of HIV Treatment. Science 2013, 339:961-965.
Fassin D, Schneider H: The Politics of AIDS in South Africa: Beyond the Controversies. BMJ 2003; 326: 495-497.
South African National HIV Survey 2012. http://heaids.org.za/site/assets/files/1267/sabssm_iv_leo_final
