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 Burkina Faso, Nigeria, Tanzania, Ukraine and Zimbabwe.

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?

How are we doing it?

The consortium has established working groups related to the four research themes. A detailed situation analysis of country models of anti-retroviral (ARV) provision in India, Malawi, Uganda, and Zambia has already been carried out, examining what is being done, by whom and where. The situation analysis will inform our research agenda, highlighting key questions and allowing initial comparisons between the focus countries to be made.

Work carried out so far

Whilst the research programme is still in its initial stages, good progress has been made towards the generation of high quality, policy relevant research findings across all the themes. With the exception of the preliminary report of the Situation Assessment (see below), the results of Evidence for Action-generated research projects are not yet available (as is to be expected at this early stage of the programme), however there are results from research carried out by the partners that is related to the four research themes of Evidence for Action and has often benefited indirectly from its existence, although not having been directly generated by the programme (see Annex 5).

Throughout this website we will use the following terminology to identify how research relates to the programme:

1. Evidence for Action-generated: Directly arising from or generated by the programme. These projects may be funded entirely by the programme (eg. Situation Assessment), or co-funded by the programme (eg. by providing time of staff who are paid by the programme) and other sources

2. Evidence for Action-related: Projects involving programme staff within consortium partner institutions and that are directly related to at least one of the programme’s research themes or other objectives (eg. capacity strengthening or communications) but have not been directly generated by the programme

The situation assessment has been instrumental in helping the consortium to identify key research questions and areas for cross-partner work, in addition to being the first Evidence for Action-generated piece of research to be completed. A working paper will be written based on the results of the situation assessment, which will also be used to prompt further input from stakeholders in identifying important research questions.

One of the most important aspects of Evidence for Action’s activities during the first year to ensure that research is relevant to policy has been the stakeholder meetings held in India, Malawi, Uganda and Zambia. There has also been ongoing interaction with international policy makers and networks, including WHO, UNICEF, Stop TB and Stop AIDS.

Also, the programme’s Paediatric HIV Treatment and Care workshop was important in developing research questions across all research themes. This workshop was hosted by ZAMBART in Lusaka in April 2007 and involved all the partner organisations. Paediatric treatment and care had been identified during the inception period as an under-researched area in which the consortium had a comparative advantage. Amongst the topics discussed at the workshop were models of care, adherence, formulations, getting research into policy, pharmacokinetics, cost-effectiveness of Cotrimoxazole, integrating HIV care with other childhood illnesses and identifying infected children early.  This workshop has been partially responsible for the development of proposals for research projects including:

• A project led by the IHAA on community support to HIV treatment and care;

• A MRC-CTU-led project examining PCR DNA for infant diagnosis, mapping its use in partner countries and the consequences of this;

• A policy analysis of Cotrimoxazole prophylaxis in adults and children in Zambia, Uganda and Malawi, led by MRC-CTU and LSHTM ;

• A study into the sexual and reproductive needs of adolescents is planned by IHAA and MRC-CTU;

• A study to examine adherence as an outcome of different packages of care, led by MRC-CTU.