How could e-Health impact HIV / AIDS empowerment in South Africa?



Moderator: Vanessa Carter
Date: 7 February 2019
Time: 
20:30 – 21:30 (SAST)
Hashtag: 
#hcsmSA
How to participate

Facebook event reminder


CHAT OVERVIEW:
Join us for a 60-minute Twitter chat with our special guests. Everyone is welcome including doctors, nurses, entrepreneurs, policymakers, patient advocates, academics, pharma, medical educators, students, payers, IT developers, journalists, data scientists, civil society, NPO’s, researchers, etc. both locally and globally. Our topic for this session will be focused on how e-Health and other digital technologies could potentially improve HIV / AIDS empowerment in South Africa for all stakeholders. The transcript will be recorded by Symplur Analytics.


QUESTIONS:

5 Minute OPENING: Introductions and welcome. Questions start thereafter.

T1: What do you think the greatest challenges are for HIV patients in South Africa?
T2: What challenges do medical professionals have managing HIV in South Africa?
T3: How do you think e-Health and other digital technologies could close gaps for HIV in South Africa?
T4: What do you think could be done to improve HIV besides e-Health?
T5: What do you think are some of the barriers to implementing e-Health for HIV in South Africa?

5 Minute CLOSING: CT: What other thoughts would you like to add?


HOW TO PARTICIPATE:
Start your answers with T1, T2, T3, T4, T5 or CT
 for transcript purposes.
Answer only after the moderator prompts. Questions will be prompted every 10 minutes, but keep answers coming using the relevant T and number. Both panel guests and the public are encouraged to answer. Use the #hcsmSA hashtag in all your tweets so that you are visible to others in the chat and on the transcript.


Video source: VOA News and Right to Care South Africa

How could e-Health impact HIV / AIDS empowerment in South Africa?
South Africa has the most prevalent HIV epidemic in the world with an estimated 7.2 million people living with HIV which is close to 8% of the current population. South Africa accounts for a third of all new HIV infections in southern Africa. In 2017, there were 270,000 new HIV infections and 110,000 South Africans died from AIDS-related illnesses. [1] South Africa introduced free antiretroviral treatment (ART) in the public sector during April 2004 and today it has the largest treatment programme in the world. Since then, around 60% of patients living with HIV now receive access to this life-saving treatment making the country a global leader in HIV research. [2]

ARVs are not a cure for HIV, but they can help to lower a patient’s viral load, fight infections and improve quality of life. [3]. ARVs can also help to lower the chances of transmitting the disease to other people as well as prevent mother-to-child transmission. [4] Having access to these medicines is important to eradicate HIV and AIDS in future. [5]

From the four-million people (+-60%) living with HIV on antiretroviral treatment in South Africa, over 90% are being treated in government hospitals and clinics. This places a heavy burden on already congested, understaffed and underfunded South African public health facilities and makes it difficult for patients to access these essential medicines.

For this reason, innovative projects like the Right to Care Pharmacy ATM Dispensing Unit (PDU) featured in the video above are critical to empowering patients, government and medical professionals to ensure ARVs are accessible. But it shouldn’t stop there, with technology so readily available other barriers contributing towards the treatment of HIV should be addressed too. One such barrier is access to testing so patients can be diagnosed and start treatment sooner. On the 23rd of December 2016, the South African Pharmacy Council (SAPC) officially revoked a regulation that had previously prohibited South African pharmacies from selling HIV self-testing kits and this has been instrumental to providing access to the public so they know their status. HIV self-testing has the potential to impact the first ‘90’ of the UNAIDS 90-90-90 targets, which have been adopted by South Africa, by increasing access and acceptability for traditionally under-tested populations [6] aligning itself to the “Test and Treat Strategy” promoted by the World Health Organisation.

But, what else can be done? Whilst the rest of the developed world moves ahead of us with the implementation of digital technologies like Electronic Health Records (EHR), Mobile Health Apps and other innovations [7] we in South Africa could only dream of, could there be a way to start exploring ideas in the meantime to improve complex issues like HIV treatment? E-health can play an important role in making services more accessible and person-centred, as well as improve the operations and financial efficiency of health systems. [8] Digital innovations like mobile applications (mHealth) also make it possible to improve the collection of data. Developing countries like South Africa do have many challenges in terms of our digital divides which include digital literacy and the cost of data that make it difficult for everyone to participate using technology, however, it has also demonstrated a substantial growth of internet users in recent years. In January 2018, internet penetration was recorded at 54% (30.8 million South Africans) and a total of 29.2 million of the population (51%) accessing the internet on their mobiles. [9] Technology isn’t the only answer to the HIV epidemic, but it is worth exploring and addressing limitations given the potential it could have in future as more of us become Digital Citizens.

What do you think could improve HIV in South Africa? We invite you to share your views in our 60-minute Twitter chat using the hashtag #hcsmSA on the 7th of February 2019 between 20:30-21:30. Our transcript will be recorded and made publicly available by Symplur here after the session. Everyone’s perspective matters.


Health Hashtags:

Healthcare social media (hcsm) hashtags and global communities related to HIV / AIDS:
#AIDS #HIV #EndAIDS


References:

  1. https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/south-africa
  2. https://www.health-e.org.za/2014/04/04/south-africa-celebrates-ten-years-free-hiv-treatment/
  3. https://www.webmd.com/hiv-aids/aids-hiv-medication#1
  4. https://www.avert.org/professionals/hiv-programming/prevention/prevention-mother-child
  5. http://apps.who.int/iris/bitstream/handle/10665/75184/9789241503921_eng.pdf;jsessionid=69A8CF45075F3EC7778513333280122E?sequence=1
  6. https://sajhivmed.org.za/index.php/hivmed/article/view/775/1030
  7. https://www.england.nhs.uk/digitaltechnology/
  8. https://www.avert.org/technology-e-health-and-hiv-programming
  9. https://ewn.co.za/2018/02/05/nearly-60-of-south-africans-now-have-access-to-the-internet

Panel Guests:
The chat session is open to everyone to participate, however, our panel experts bring a unique set of perspectives relating to the topic.


Rene Sparks – @rene_sparks
Rene Sparks is a Clinical Manager at the Networking HIV/AIDS Community of South Africa (NACOSA), a registered nurse and a Masters in Public Health student. She is passionate about making an impact on South African health and civil society and is involved in various public and private health programmes including primary healthcare training, clinical support and community systems strengthening.


Dr Yogan Pillay – @ygpillay
Yogan Pillay is Deputy Director-General at South Africa’s National Department of Health, responsible for many health programmes including human immunodeficiency virus (HIV) and tuberculosis since 2008. He was Chief Director of Strategic Planning in the health ministry 1996–1999, and from 2003–2008, National Coordinator of the Equity Project (1999–2002), a USAID-funded project strengthening primary health care. He held teaching posts at the University of Kwazulu-Natal (previously the University of Durban-Westville) from 1987-1995. Before that, he worked as a clinical psychologist for the Department of Health in KwaZulu-Natal 1984-1986. Pillay graduated with a bachelor’s degree in physiology, biochemistry and psychology from the University of KwaZulu-Natal. He has a PhD in health policy and planning from Johns Hopkins University, Bloomberg School of Public Health (1992–1995). Pillay has been a member of several World Health Organization (WHO) expert committees and is currently on the WHO Strategic and Technical Advisory Group for HIV.


Jaco Fouche – @Jaco68694542 
Jaco Fouche has been involved in community development with his main focus being on changing individuals perceptions about HIV and mental health. He is foremost a passionate activist and has also been living with HIV for the past 25 years. His presentations and talks have been widely appreciated by many audiences including from civil communities, businesses, NPO’s, medical conferences like the South African Society of Clinical Pharmacy (SASOCP) and schools. He has also shared his views on various tv and radio shows across the world. Jaco describes his vision about HIV acceptance using motivational words by Alfred Adler, which are “It is the individual who is not interested in his fellow man that has the greatest difficulties in life and provides the greatest injury to others. It is from among such individuals that all human failures spring.”


Trevor Pols – @SAME_foundation
Trevor is the CEO of the SAME Foundation. Trevor works closely with the South African Department of Health, public government-funded hospitals, and their management and staff, through the SAME Foundation. By facilitating high impact projects for these health facilities, Trevor is able to gain insight from the perspective of public healthcare providers. The SA Medical and Education Foundation has been working in healthcare since 2003, and work on numerous projects where HIV and AIDS are major concerns. SAME Foundation works directly in providing facilities with resources to treat and educate patients who are at risk of contracting or who are living with HIV and AIDS.


Dr Ndumiso Tshuma – @ncdphd
Dr Ndumiso Tshuma holds a PhD in Public Health, Master’s of Business Administration, a postgraduate degree in Public Health Nutrition and a BSc in Nutrition. He has over 10 years’ experience in the NGO sector in South Africa, Swaziland, Lesotho and Zimbabwe. His areas of interest include mhealth integration in disease prevention and treatment adherence. He has been the principal investigator and co-investigator in studies on mhealth and machine learning in the health space. Ndumiso has also conducted research studies in nutrition, maternal health, HIV and TB, non-communicable diseases, youth and adolescent health. His research output currently stands at more than 50 publications comprising journal articles, abstracts, books and technical reports. He is a Public Health Specialist at The Best Health Solutions. One of Dr Tshuma’s latest articles featured in the Mail and Guardian includes “Robots might soon provide services in clinics” which focuses on the implementation of digital technologies like virtual support groups and artificial intelligence (AI) for HIV / AIDS patients in South Africa.


Bhekisisa Centre for Health Journalism – @Bhekisisa_MG
Laura López González is the deputy editor at the Bhekisisa Centre for Health Journalism. The centre is based at the Mail & Guardian. The centre produces solutions-based narrative features, analysis and multimedia as well as opinion pieces. Lopez has spent more than a decade writing about health in globally and in South Africa. Her health coverage has won a number of awards. Most recently, she won a Sikuvile Standard Bank award for her commentary on the Life Esidimeni tragedy. She holds a Masters Degree from the University of Chicago and is a graduate of the Medill School of Journalism at Northwestern University. Follow Bhekisisa on Twitter @Bhekisisa_MG. Want to stay up-to-date with health news? Subscribe to Bheksisa’s weekly newsletter: bit.ly/20aLIdR


Ndumiso Madubela  – @DTHF_SA
Ndumiso Madubela is an early career socio-behavioural scientist. He has strong interests in investigating interventions that improve accessibility and uptake of sexual and reproductive health, HIV prevention and treatment services among young men. Ndumiso has a background in language studies with an M.A in African Languages and an Honours degree in linguistics from UCT. Ndumiso’s current research has a primary focus of finding interventions that not only address the needs of young people, but tailored services are particularly needed in lower socio-economic communities where the burden of disease is highest. Ndumiso’s recent honours include, the Lestrade Scholarship, NRF Grant Holder Bursary for his Masters degree, as well as a fellowship with IAVI and the Desmond TUTU HIV Foundation, where he co-ordinated the men’s dialogues project (aimed at engaging young men to promote positive male norms), that is a component of the Zimele project run by DTHF. He has worked on various socio-behavioural studies mainly around PrEP uptake in young people (Power, 3P, iAccess, Cognitive study). He is passionate about working with young men and finding differentiated models of sexual healthcare services for young men. He has therefore chosen this area as a focus of his PhD.


Dr Jacques Botha – @Qode_Health 
Dr Jacques Botha qualified as a General Medical Practitioner in 2006 at the University of Pretoria and subsequently become involved in medical politics through the South African Medical Association, as an executive member of the Junior Doctors’ Association of South Africa. Dr Botha’s twelve years medical experience includes, public and private sector clinical work at numerous healthcare facilities and practices. He was employed by the South African Medical Association (SAMA) as Strategic Account Manager within the Private Practice Department and later acted as Head of the Department, where he represented all private General Practitioners and Specialist within South Africa. He actively engaged with all strategic role players within the medical industry; including the National Department of Health, Healthcare Funders and Administrators. He ventured into corporate business and served as Chief Executive Officer of the South African National Joint Registry, an affiliation of the South African Orthopaedic Association, while appointed as Managing Director of Digital Health Investments Ltd, a Medical Information Technology and Accounting Bureau companies. Dr Botha served as an independent medical consultant at Medical Practice Consulting before being appointed as Clinical Systems Manager at Pioneering Solutions Studio (Pty) Ltd where he dedicated 100% level of effort towards Qode Health Solutions before its incorporation. Dr Botha moved over to Qode Health Solutions (Pty) Ltd as Chief Customer Officer, overseeing the planning and implementation of all Qode projects.


Fanie Hendriksz – @rightepharmacy
Right ePharmacy is an innovation and solutions company focusing on the “last mile dispensing and distribution” of medicine. It was established in 2015 through an investment from health NGO, Right to Care. Its main aim is to improve access and availability of medication and ultimately improve adherence. Right ePharmacy is an innovative organisation that has disrupted conventional medicine dispensing and distribution to support the healthcare sector in South Africa. It has developed pharmacy automation systems, prescription collection units (PCU) and pharmacy dispensing units (PDUs) or ‘ATM pharmacies’ which are located in high traffic areas in Johannesburg and Bloemfontein. These ATM pharmacies were established in partnership with the Gauteng and Free State Departments of Health. Both systems are supported by integrated cloud-based dispensing software which also enables the remote tele-pharmacy service linked to the PDU.  Fanie Hendriksz is the managing director of Right ePharmacy.


Prof. Jamie Saris – @jamie_saris
Dr Saris is a Senior Lecturer in the Department of Anthropology, National University of Ireland (Maynooth). He holds advanced degrees in Social-Cultural Anthropology from the University of Chicago (MA and PhD), and he has completed a Postdoctoral Fellowship in Clinically-Relevant Medical Anthropology in the Department of Social Medicine, Harvard Medical School (1992-1994). He has been working for more than fifteen years in medical and psychological anthropology in Ireland, North America, and parts of Africa, where he has researched and published on such diverse issues as the social life of mental hospitals, the experience of major mental illness, colonialism and its aftermath, poverty and structural violence, drug abuse, and HIV risk and treatment. Published research articles include “Between the Clinic and the Community: Temporality and Patterns of ART Adherence in the Western Cape Province, South Africa.”


Dr Moeketsi Modisenyane – @moeketsimodise1
Moeketsi is a public health researcher with a strong interest in global health issues; particularly global health diplomacy; migration, health and development; health systems and health governance. He holds the position of Director: International Health & Development at the National Department of Health, South Africa, where he is involved in designing, coordinating and implementing South Africa’s Foreign Policy and Global Health initiatives with other bilateral and international organizations. Moeketsi is also involved in training and capacity building in global health to bring about African voices and perspectives in global health issues. He is an Associate at the Migration and Health Project Southern Africa (maHp). He serves at various national committees such as the Inter-Ministerial Committee on Intellectual Property; the Inter-Agency Clearing Forum (IACF) and Technical Task Team on Migration. He also currently is working with various academic institutes, civil society organizations, regional and international organizations and partners in securing the right to health for migrants and other vulnerable groups in the South Africa, SADC region and globally. Moeketsi is also the Vice President of the Public Health Association of South Africa (PHASA) and holds a PhD (public health) from the University of Pretoria.


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