National HIV dashboard to improve viral load monitoring

Johannesburg – The first national CD4/viral load monitoring dashboard has been launched in South Africa to help doctors and nurses keep a close eye on the health of HIV/Aids patients and reduce fatalities caused by illnesses linked to the epidemic.

The dashboard was launched in Johannesburg on Tuesday by Right to Care in collaboration with the Department of Health, National Health Laboratory Service, National Institute of Communicable Diseases and Boston University.

The ultimate goal of the dashboard is to reach the Joint United Nations Programme on HIV and Aids (UNAIDS) 90: 90: 90 target set for 2020, which says 90% of people infected with HIV should be diagnosed, 90% of them should be on treatment and 90% of them should have their viral load suppressed.

South Africa only has 36 months to reach the target, and it is expected that this initiative will be rolled out to nine provinces between January and March 2017.

It is estimated that there are nearly 6.75 million people infected with HIV in South Africa, with 3.3 million on treatment. Of those who have undergone viral load testing, over 80% are viral load suppressed.

SAnews spoke to the Director General of the National Department of Health, Dr Yogan Pillay, in an exclusive interview at the launch. He said the dashboard data will be communicated monthly and quarterly to all provinces and districts through 4 000 health facilities in the country that are providing services to patients.

The dashboard 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 and individual level.

Pillay said although the programme will be used by health practitioners, patients will feel the benefits as their quality of life will improve as a result. Pillay said while the number of people accessing treatment increases, there is a concern that the number of those defaulting will also increase.

“Two things happen when patients default treatment. One, they get sick… we think they are taking medication but they are not. The second thing is that they can transmit the virus. That is why viral suppression is good for the patient, and good for the community they are living in,” said Pillay.

He said early access to treatment is good, as it helps to suppress viral load. Viral load is the best predictor of an HIV positive patient’s response to treatment. The dashboard will be used to improve the follow-up care of patients with high viral loads.

Dr Sergio Carmona, a pathologist at the National Health Laboratory Service (NHLS), said the data will also help to identify hotspots in the country and where attention needs to be given.

“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 hotspots and expedite the right responses, as well as evaluate the effectiveness of interventions to contain the epidemic,” said Carmona.

The NHLS is the sole provider of pathology services to close to 80% of SA’s population. Laboratory results for all these individuals since 2004 reside in the NHLS’ corporate data warehouse.

Getting rid of stigma

Pillay said South Africa has done well over the years in campaigning against the discrimination and stigmatisation of people living with HIV/Aids.

This has encouraged more people to come out and receive treatment for the disease. But, Pillay said, there is still a high level of internalised stigma in the country, rather than externalised stigma. Pillay said this means that people living with HIV/Aids feel that they are different from other people and are treated differently by other people. This stigma is higher in patients with tuberculosis.

Pillay reckons, however, that things have become better for the country since 2010. -