Where innovation meets implementation

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Feature story

Where innovation meets implementation

03 October 2011

Professor Salim Abdool Karim and his team showing CAPRISA’s Ethekweni research facility to UNAIDS Executive Director Michel Sidibé

In 2010 an announcement was made by the Centre for the AIDS Programme of Research in South Africa (CAPRISA) which rocked the AIDS world and promised hope for millions of women around the world.

The researchers discovered that the antiretroviral medicine tenofovir, when applied to the vagina in gel form, is effective in reducing HIV infections in women by up to 54%.

The discovery was made by Professor Salim Abdool Karim and the team at CAPRISA’s Ethekweni research facility. The centre is located in a historic building built in 1946, originally home to the Durban Chest Clinic, a state-run Tuberculosis facility.

In 2000 the local government built the new state of the art Prince Cyril Zulu Communicable Diseases clinic adjoining the old building which was designed specifically to minimize the risk of cross infection among patients.

It is the largest TB centre of its kind in South Africa, with specially designed ventilation to encourage an in out air flow, vast open waiting areas to reduce the risk of cross infection and huge skylights which enable the suns rays which destroy the TB.

The scientific research being done here gives hope to millions of men, women and children who will lead a longer, healthier life because of these important discoveries

UNAIDS Executive Director Michel Sidibé

The facility is located in central Durban, in the heart of the transport hub for public commuters by rail, bus or minibus taxis.

“This means that the clinic receives a lot of walk-in patients”, explained Santhana Gengiah, Study Coordinator at CAPRISA.  “Accessibility and convenience for clients is paramount”.

The venue provided the perfect location for Professor Karim and his team to set up their HIV research programme as the TB clinic which also has a sexually transmitted infection centre on the first floor, found that around 70% of the patients coming into the clinic also were testing positive for HIV.  

The CAPRISA eThekwini site comprises two sections, a Treatment Clinic for HIV-TB co-infected patients and an HIV prevention clinic.  The prevention section has hosted a number of notable microbicide scientific trials, including the CAPRISA 004 trial and the recently modified Vaginal and Oral Interventions to Control the Epidemic (VOICE) study.

Professor Salim Abdool Karim (left) and UNAIDS Executive Director Michel Sidibé

VOICE is an HIV prevention trial evaluation two antiretroviral based approaches for preventing sexual transmission of HIV in women––daily use of one of two different ARV tablets (tenofovir and Truvada) or of a vaginal gel. The Data and Safety Monitoring Board recommended that VOICE participants in the oral tenofovir arm of the study discontinue their use of the product as the trial was not able to demonstrate that the tablets were effective in preventing HIV in the women enrolled in the trial. VOICE will however continue to test the efficacy of the other oral tablet Truvada and the vaginal gel formulation of tenofovir.

The treatment section of the clinic is perhaps best known for the groundbreaking SAPiT trial, which provided essential evidence for HIV/TB treatment guidelines and informed the current World Health Organization guidelines on the treatment of TB in HIV-positive patients.

The Executive Director of UNAIDS Michel Sidibé recently paid a visit to both the CAPRISA and Prince Cyril Zulu sites, and was impressed by the innovative work being carried out in the name of science and service delivery.

“This is a great example of how scientific innovation meets implementation”, he said. “The scientific research being done here gives hope to millions of men, women and children who will lead a longer, healthier life because of these important discoveries”.