An International Research
Consortium to Maximise
Benefits & Equity of HIV
Treatment & Care Systems

What are we doing?

The research of Evidence for Action is focused in India, Malawi, Uganda and Zambia, which represent different faces of the epidemic. The consortium also has strong research collaborations in several other countries which form a secondary network; these include Tanzania, Ukraine, Kenya and South Africa.

The research is organised in four key themes:

1. What ‘package’ of HIV treatment and care services should be provided in different settings?

2. What delivery systems should be used in different contexts?

3. How best should HIV treatment and care be integrated into existing health and social systems?

4. How best can new evidence from research be rapidly translated into new policies and actions?

Work carried out so far

The third year of Evidence for Action has seen significant progress. Several Evidence for Action-generated projects have completed analysis and communicated results, including: the WHO Priority Interventions guidelines internationally; the Sources of Information project in Malawi, Uganda, Zambia, China, Nepal and Pakistan; and the Home Based Care project in Zambia. 15 Evidence for Action-generated projects are currently in preparation but not yet started; 8 are underway; and 5 have been completed over the last year. 3 Evidence for Action-related projects are in preparation; 15 are underway; and 9 projects have been completed over the last year.

Evidence-based influence on policy and practice related to HIV treatment and care in low and middle income countries

In May 2009 a workshop was held to update the communications strategy and action plan, taking into account lessons learnt so far. Research projects are designed to be relevant to policy, with several, such as the Wakiso project in Uganda, in direct response to requests from policy makers. Partners have been communicating with stakeholders using a variety of tools and approaches, including face-to-face meetings, workshops, various forms of communications materials and events. 9 articles and book chapters have been published; 10 are currently in press; 18 publications in other formats (such as policy briefs) have been produced; and 30 events held.

Increased capacity of partner institutions in doing research and its effective communication

Research capacity has been increased through exchange visits between partners; workshops on various topics; courses; and other activities. 11 (out of 28) Evidence for Action-generated projects were led by Southern partners during this period. Communications capacity has been strengthened through the Community of Practice; media training and training on writing policy briefs and press releases.

What is the impact of the research programme so far?

Over the last year, communications activities by partners have increased as research projects have more messages to communicate. Examples of the impact of the programme so far include:

• Evidence for Action research has directly informed international guidelines, with IHAA and LSHTM playing a major role in the writing of WHO Priority Interventions for HIV/AIDS Prevention, Treatment and Care for the Health Sector. Our “Sources of Information” study has confirmed that WHO guidelines are viewed as one of the most important sources of information by policy makers and programme managers.
• In Malawi, Lighthouse have carried out pioneering work showing how a real-time point of care electronic data system can be used to improve the operation, monitoring and evaluation of high-burden ART clinics. This evidence has resulted in the Ministry of Health starting to roll-out the electronic data system across Malawi.
• Two major EfA-related trials – DART and Jinja – have demonstrated that simplified delivery of HAART can be very cost-effective. Both trials have received considerable interest at the July 2009 IAS Conference and are set to have a major impact on HIV treatment and care delivery in low income countries. 
• Increased capacity of Evidence for Action partners to communicate strategically