IDRC contributes to the global fight against HIV/AIDS
July 09, 2014
Canada’s International Development Research Centre (IDRC) was one of the first international donor agencies to recognize the importance of HIV/AIDS as a development issue. Since the mid-1980s, IDRC has taken a broad approach to this research, based on the understanding that factors such as political will, the capacity of healthcare systems, and social and economic progress are crucial to winning the battle against the disease. Research has focused on sub-Saharan Africa, where 25 million people were living with HIV in 2012, nearly 70% of the global total.
Many of the projects IDRC funded have generated new knowledge, technologies, and policies to slow the spread of HIV/AIDS around the world. Here are a few examples:
Protecting infants from infection: Early research in East Africa found that a major risk factor for HIV-1 transmission from mother to child was breastfeeding. Children of HIV-positive mothers who breastfed for longer than 15 months had close to twice the risk of HIV-1 infection than children breastfed for shorter periods. The research by the Kenyan-Canadian team, along with education and counselling, helped slow the transmission of HIV to babies in Kenya and beyond. Because of the importance of breast milk for babies’ health, the WHO recommends that HIV-positive mothers continue to breastfeed for the first year, even if antiretroviral treatment not immediately available.
Learn more: Robbing the cradle (PDF, 828KB)
A diagnostic breakthrough: A rapid, affordable dipstick test to detect antibodies to HIV-1 and HIV-2, developed in the early 1990s by the Program for Appropriate Technology in Health (now known as PATH), was a game changer in diagnostics. It provided small- and medium-sized blood banks and public health laboratories in developing countries a quick and inexpensive test for HIV. PATH transferred the technology to manufacturers in four developing countries: more than 19 million tests have since been sold. The technology has helped lower costs and increase the availability of rapid HIV tests from other companies, leading to more affordable HIV testing, safer blood supplies, faster results for patients, and more accurate data for epidemiologists.
Learn more: A health tech historical profile: HIV dipstick (PDF, 242KB)
Better diagnosis, better treatment: An education program for health workers in South Africa has increased TB detection by 68% and improved the quality of care for both TB and HIV/AIDS. The number of TB patients undergoing voluntary testing for HIV increased by 110%. (Many South Africa’s TB patients are also infected with HIV.) Some 19,000 health workers in 1,925 health facilities across South Africa have received the PALSA Plus training – as the program is called. It has since also been adapted for use in Malawi and is being developed for Northern Canada.
Learn more: Fighting AIDS with evidence
Reducing HIV transmission: A study conducted in China has provided evidence of the effectiveness of antiretroviral therapy in reducing the risk of HIV transmission in heterosexual couples where one partner is HIV-positive. Published in The Lancet in 2013, the ground-breaking research showed a 26% reduction in HIV transmission, suggesting “that such a public health prevention strategy is feasible on a national scale and helps to validate the WHO recommendation in support of the treatment-as-prevention approach,” say the authors. The research was conducted as part of the International Research Chairs Initiative, which pairs top research talent from universities in Canada with counterparts in developing countries to address key development challenges.
Linking food insecurity and HIV/AIDS: Since its launch in 2001, RENEWAL — the Regional Network on HIV/AIDS, Rural Livelihoods and Food Security — has highlighted how Africa’s HIV/AIDS crisis is both a result and a cause of food insecurity. In Malawi, for instance, the risk of sexually transmitted infections increases during food shortages as people resort to high-risk sexual behaviour to support themselves and their families. The network’s research in six sub-Saharan African countries has led to global recognition of the issue. It has also helped inform Uganda’s second National Strategic Plan on HIV/AIDS, Kenya’s sector-specific strategy on HIV/AIDS, and the Southern African Development Community’s HIV/AIDS Framework 2009-2015, among others. UNAIDS now recognizes the issue of food and nutrition as crucial.
Learn more: New insights on AIDS, food, and nutrition
Educating youth about HIV/AIDS: An online portal on HIV/AIDS by and for youth that started in Peru has reached more than one million users. Punto J provides sound information to youth who are disproportionately at risk of contracting HIV/AIDS: they account for about 70% of registered cases of sexually transmitted infections, in particular HIV/AIDS, in Peru. A lack of information on how to protect themselves against sexually transmitted infections is partly to blame. The award-winning portal has been fully endorsed by Peru’s Ministry of Health and is being replicated across Latin America.
Learn more: Youth take aim against AIDS
A comprehensive approach to HIV/AIDS prevention and treatment
IDRC currently supports more than 30 HIV/AIDS- related projects. Our focus continues to be on prevention. For example, researchers are supporting the Government of Botswana’s efforts to reduce the spread of HIV among young women by addressing structural causes such as poverty, poor education, and gender violence. In Burkina Faso, a project explores how cellphones can be used to improve antenatal care and health services for women, children, and people with HIV.
Building local research skills and strengthening institutions so they can become centres of excellence in the region are central to IDRC’s efforts. Those are the key goals of the HIV/AIDS Prevention Trials Capacity Building Grants, funded by Foreign Affairs, Trade and Development Canada and IDRC, and managed by the Global Health Research Initiative, a partnership of Canadian government agencies. The $19.7 million grants (Phases I & II) contribute to Canada’s flagship Canadian HIV Vaccine Initiative, which is led by the Public Health Agency of Canada and co-funded by the Bill & Melinda Gates Foundation.
The grants address one of the biggest hurdles facing Africa’s fight against HIV/AIDS: the shortage of trained researchers and institutions to focus on HIV/AIDS prevention methods, including potential vaccines. Nine teams — working with researchers at Laval University, Dalhousie University, McGill University, Université de Montréal, the University of Ottawa, University of Toronto, University of Manitoba, McMaster University, Simon Fraser University, and the University of British Columbia, as well as the British Columbia Centre for Excellence in HIV/AIDS — are building capacity to carry out randomized controlled trials of interventions in 23 countries across sub-Saharan Africa. They are training a cadre of researchers in areas such as research ethics, clinical laboratory practices, project management, and community-based research. Healthcare practitioners and other stakeholders have also been trained. In Botswana, for instance, a course was organized for 25 parliamentarians on how to interpret research findings, to improve evidence-based decision-making.
By building sustainable African capacity and leadership to carry out HIV/AIDS prevention trials and advancing collaboration between African, Canadian, and international researchers and institutions, this program is an important contribution to Canadian and global efforts to stop the advance of HIV/AIDS.
Photos: Gates Foundation; Soils, Food and Healthy Communities; Gates Foundation.