Having been involved in SACEMA since the start, and as director since 2010, Alex Welte is stepping aside to focus on research at the end of June 2016. In this article he shares his reflections on his time at SACEMA, so far.
A new formal ‘R Package’ to support incidence estimation is available on the Comprehensive R Archive Network (CRAN). This is the canonical way that the R community distributes stable packages to share functionality, and it is the heart and soul of the R coding environment. The new release through CRAN will make a substantial range of functionalities around incidence survey design and survey data analysis seamlessly and flexibly available to any skilled R programmer/analyst.
As I write, our annual clinic on the Meaningful Modelling of Epidemiological Data (MMED) is in progress, so is the 7th SA AIDS conference, and I just returned from a meeting in Geneva how best to provide advice to teams planning to estimate HIV incidence from large household surveys. In short, it seems to be a time to reflect, to reconsider what we are trying to do, and whether we are making any useful contributions. We hope these quarterly epidemiological update offerings are food for thought.
SACEMA has been involved in the development of a modelling framework for ‘HIV Affected Children’ (children who are not infected themselves, but who have family members, in particular parents, that are infected). The article describes the process, benefits, and challenges of developing this framework that could be used to estimate the magnitude of negative consequences of adult HIV infection for the health and well-being of children.
On the occasion of AIDS 2014, the twentieth International AIDS Conference in Melbourne, SACEMA released a policy brief on the ongoing debate about appropriate initiation of antiretroviral therapy for HIV positive people.
Once more we are hearing about ‘exponential growth’ – popularly some sort of synonym for ‘rapid growth’ or ‘explosive growth’ – but actually a technical term with a quite specific meaning. This time the talk is about the ongoing Ebola outbreak in West Africa, understandably causing increasing disruption (is devastation too strong a word?) in the region, and alarm much further afield.
The HIV research and activist communities are counting down to the big AIDS conference in Melbourne (20-25 July 2014). One wonders if the ever greater buzz around ‘cure’, which has attracted so much attention in the last few years, will translate into the hot topic of AIDS 2014. This may be exciting basic science, and offer the (hardly imminent) promise of something better than decades of drug regimens for those infected, but it should not detract attention from the complex immediate situation still faced by much of sub Saharan Africa, and other countries, where access to cure is a very hypothetical lofty goal. This Quarterly discusses some of these immediate challenges.
SACEMA has been very active in refining the use of laboratory tests for identifying recent infection (in particular of HIV) for the purpose of estimating disease incidence. We have just published a conceptual analysis of the notion of ‘test optimisation’ in a surveillance context, which should help clarify some persistent confusion that has hindered discourse in this area for years.
Welcome to a special edition of SACEMA quarterly epidemiological update – dedicated to SACEMA’s annual ‘research days’ event and other SACEMA related work. This is a glimpse into exciting trends in public health research, where mathematical methods are increasingly applied to a range of problems, to help leverage limited data, think about prospects for interventions, and formulate new hypotheses and experiments. The article also includes a reflection on modelling as a universal practice in all of science and all that differs are the kinds of models, and the techniques used to set them up and manipulate them.
AIDS 2012 has come and gone. South African researchers and NGOs engaged in AIDS related work were ever visible, presenting new results, chairing key sessions, or delivering invited talks. Before the conference began, it was widely noted that an important shift in debate has occurred in recent years, concerning the coalescence of treatment and prevention. The real discussion is now much more about how, practically, to access the prevention benefit of treatment. This debate, at AIDS 2012, although heated at times, at least did not just go over the same old ground. Furthermore, the progress here has largely been based on the work of South Africans pushing these ideas, and amassing the evidence of early impact of our local treatment programme. It must be said that South Africans are doing some of the most important work in many aspects of HIV research, not just in applications to our specific problems, but also raising the bar internationally in the practice of good science.