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.
Scientists offering papers for publication will be becoming increasingly aware of a significant change in the attitude of journals to the publication of the data used to reach conclusions drawn in their manuscript. New regulations are moving rapidly and uncompromisingly towards a policy where all of the data, and related metadata, required to replicate the reported findings must be made freely available to the world at large. There is much to be said in favour of this argument, but one wonders whether journals have thought through some of the ramifications of the new policy.
2015 signifies the deadline for the Millennium Development Goals (MDGs) which include reduction of the under-five mortality rate by two-thirds, reduction of the maternal mortality ratio by three quarters (both relative to the 1990 figures), and universal access to reproductive health. This issue of the SACEMA Quarterly focuses on various aspects of maternal and child health, and the role of statistical and mathematical modelling techniques in this area of research.
Currently we are faced with two major threats from viral diseases: Over the last 30 years HIV has spread across the world and continues to plague us. Over the last 3 months the hemorrhagic fever caused by the Ebola virus has spread across West Africa killing thousands of people. If we are to contain HIV in the long-run and Ebola, hopefully, in a much shorter time, this will depend on our ability to understand the nature of the threat and the strategies of the disease causing organisms.
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.
Over the past eight years SACEMA has collaborated with the African Institute for Mathematical Sciences (AIMS) and North American scientists in running workshops now held annually at AIMS in Muizenberg, and in the United States at the University of Florida. This editorial particularly celebrates the inputs of five North American scientists who have given freely of their time and efforts in making this valuable training effort possible.
SACEMA’s experience is that low competence and poor self-efficacy in the use of statistical software packages is a major obstacle to acquiring and expanding expertise in statistical analysis. It was therefore decided to increase our efforts to strengthen hands-on capacity and confidence in data management, exploration and visualisation, using the versatile, open-source package R. We plan to offer an intensive one-week course in June 2014 which will include computer practicals with participants’ own data. The course also offers an opportunity to conduct education research.
At the 3rd International HIV Treatment as Prevention Workshop in Vancouver, Canada, in April 2013 I was asked to put forward the case that “Pre-Exposure Prophylaxis (PreP) is not an essential component of Treatment as Prevention (TasP)”. So my job was to convince the public that while PreP may be a useful, and even an important, addition to TasP it is by no means an essential component of TasP. Here I reproduce my argument and invite readers of the SACEMA Quarterly to express their own views on this important issue.
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.
The contributions in this issue of the SACEMA Quarterly focus on different aspects related to TB and incidence of HIV. This editorial focuses on HIV treatment as prevention by presenting the MaxART project (Maximizing ART for Better Health and Zero New HIV Infections). This project pursues the dream of reaching all people in Swaziland who are in need of treatment with an ultimate goal of preparing the country for the possibility of ending the HIV epidemic. SACEMA is one of the members of the MaxART consortium and is involved in various modelling and analysis activities that are presented here.