2016 Our passion for what we do makes us pioneers in our - Wits Health Consortium

 
2016 Our passion for what we do makes us pioneers in our - Wits Health Consortium
ANNUAL
REVIEW
  2016
  Our passion
  for what we
 do makes us
pioneers in our
     s e c t o r.
2016 Our passion for what we do makes us pioneers in our - Wits Health Consortium
Contact Information
Wits Health Consortium

Te l e p h o n e : + 2 7 1 1 2 7 4 9 2 0 0

Fax:     + 2 7 1 1 2 74 9 3 0 4

Email: info@witshealth.co.za

We b s i t e : w w w.w i t s h e a l t h . c o . z a

                             WHC 2016 ANNUAL REVIEW
2016 Our passion for what we do makes us pioneers in our - Wits Health Consortium
CONTENTS
                  Wits Health Consortium
                   2016 Annual Review

   EXECUTIVE SUMMARY                      WHC STRUCTURE
                04                                  16

        INTRODUCTION                  B OA R D O F D I R E C TO R S
                05                                  17

  W H C C O M PA N Y P R O F I L E   MAJOR RESEARCH UNITS
                05                                 24

   FINANCIAL OVERVIEW                OT H E R R E S E A R C H U N I TS
                06                                 49

HUMAN RESOURCE OVERVIEW                MESSAGE FROM CEO
                12                                 52

     VISION, MISSION &                     MESSAGE FROM
          VA L U E S                         F A C U LT Y
              14/15                                52
2016 Our passion for what we do makes us pioneers in our - Wits Health Consortium
4                     EXECUTIVE SUMMARY

         We a r e t h e r e s u l t o f o u r h a r d wo r k .
        Our passion for what we do makes us
                 p i o n e e r s i n o u r s e c t o r.

    The Wits Health Consortium (Pty) Ltd (WHC) is a private, wholly owned
    company of the University of the Witwatersrand, Johannesburg (Wits).
    WHC was established as a result of an initiative from the Faculty of Health
    Sciences which proposed the company in order to unlock commercial
    opportunities that would provide additional sources of revenue for the
    Faculty and its Departments. Council approved the Faculty’s proposal
    in October 1997 and the Company was registered in 1998.

    All academic endeavors are directed, managed and controlled
    through the University structures with WHC research active staff joint
    appointed with the University conducting research, managing donor-
    funded activities, clinical trials and pursuing entrepreneurial innovation
    in health.

    WHC operates a Shared Services Centre (SSC) and several key subsidiary
    businesses.
2016 Our passion for what we do makes us pioneers in our - Wits Health Consortium
INTRODUCTION                                                      5

The Wits Health Consortium (WHC) was formed in 1998 as an entity through which the Faculty of Health
Sciences is able to undertake third stream income activities. This is done while supporting academic
research and the management of donor funding for research as well as related activities in the medical
and health sciences industry. We have numerous research entities that we service and they operate in
South Africa, across the African continent, in the US as well as Europe.

We are the enabling environment for an entrepreneurial approach to academia. We perform this role
through our Shared Services Centre (SSC), which employs over 170 skilled staff. By doing what we do
well, we free up our internationally renowned academics and researchers to do what they do best we
enable them to pursue specialist research in their respective fields of expertise.

This report provides an overview of our operations and highlights the success of our research units and
their achievements during 2016.

WHC Shared Support Centre (SSC): These are entities are in support of WHC academic activities and the
Faculty of Health Sciences strategy
We operate a SSC to support research activities and provide the following support:

•      Financial Administration
•      Contract and Legal Services
•      IT Solutions
•      Human Resource Management
•      Training and Development
•      Payroll Services
•      Research Ethics
•      Clinical Trials
•      Grant Management
•      Internal Audits
•      Continuing Professional Development

• Speer IT Services and Solutions:

Software, IT systems, network connectivity and cloud storage and management solutions

• Integrated Health Delivery Network:

Self-funding clinical health centres and medical teaching platforms that offer affordable and quality
healthcare

• Academic Advance:

Good Clinical Practice courses and training, conducted in line with CPD requirements for the Health
Professions Council of South Africa

• Ukwenza Print and Graphics Studio:

Graphic and web design, print and multi-media production and research data collection and design
2016 Our passion for what we do makes us pioneers in our - Wits Health Consortium
6   FINANCIAL OVERVIEW

                    2016

                    FINANCIAL
                    OVERVIEW
                    Our financial
                    overview
                    gives us the
                    opportunity to
                    provide a view
                    of the financial
                    position of
                    Wits Health
                    Consortium.
7
          WITS HEALTH CONSORTIUM PROPRIETARY LIMITED
STATEMENT OF PROFIT OR LOSS AND OTHER COMPREHENSIVE INCOME
For years 2016 and 2015

                                                     2016            2015
                                                       R               R
  Surplus before operating expenses               1,573,710,183   1,119,368,517

  Expenses                                        1,569,938,702   1,114,999,307

  Personnel costs                                  917,041,451    669,782,248

  Consultants                                      99,205,904      25,401,748

  Depreciation                                     29,884,500      23,439,580

  Operational costs                                444,939,393    342,897,899

  Travel costs                                     64,705,781      42,231,367

  Training costs                                   14,161,673      11,246,465

  Surplus before net finance income                 3,771,481      4,369,210

  Net finance income                               39,849,607      26,559,464

  Surplus before income tax                        43,621,088      30,928,674

  Income tax expense                                 92,374         115,282

  Surplus for the year                             43,528,714      30,813,392

  Attributable to
  CORE                                             15,370,117      9,759,875
  Syndicates - Restricted                               -               -
  Syndicates - Unrestricted                        28,158,597      21,053,517
  Dividend declared to the University of
                                                    6,800,000      5,600,000
  Witwatersrand, Johannesburg
8
               WITS HEALTH CONSORTIUM PROPRIETARY LIMITED
    STATEMENTS OF FINANCIAL POSITION
    For years 2016 and 2015

                                               2016           2015
                                                 R              R
      ASSETS

      Non-current assets

      Property, plant and equipment         138,016,083     101,981,483

      Goodwill                                485,608        485,608

      Deferred tax                             53,107            -

                                            138,554,798     102,467,091

      Current assets

      Inventory                               1,352,733      738,014

      Trade and other receivables           238,123,374     187,521,513

      Tax receivable                          111,088         89,903

      Cash and cash equivalents             770,413,738     666,316,694

                                            1,010,000,933   854,666,124

      Total Assets                          1,148,555,731   957,133,215

      EQUITY AND LIABILITIES
      Equity
      Share capital                             100            100

      Accumulated reserves                  351,755,113     315,026,399

                                            351,755,213     315,026,499

      Liabilities

      Non-current liabilities

      Borrowings                              1,654,334      2,148,958

      Deferred income                         1,267,503      5,069,892

      Deferred tax                                -            222

                                              2,921,837      7,219,072
9

                                                         2016                  2015
                                                           R                     R
Current liabilities

Borrowings                                              502,544               464,526

Deferred income                                        3,802,390              3,802,390
Trade and other payables                              185,686,678            165,065,141

Income received in advance                            597,962,591            460,525,793

Unallocated receipts                                   5,924,478              5,029,794

                                                      793,878,681            634,887,644

Total Liabilities                                     796,800,518            642,106,716

Total equity and liabilities                          1,148,555,731          957,133,215

                                      CASH BALANCES

                     900

                     800

                     700

                     600
          Millions

                     500

                     400

                     300

                     200

                     100

                               2012     2013   2014      2015         2016
10

                          PROPERTY, PLANT AND EQUIPMENT

                   160

                   140

                   120
     Millions

                   100

                    80

                    60

                    40

                    20

                            2012    2013    2014    2015    2016

                           INCOME GROWTH PROJECTIONS

                1,800

                1,600

                1,400

                1,200
        Millions

                1,000

                    800

                    600

                    400

                    200

                             2014    2015    2016    2017    2018
11

                           DIVIDEND DECLARATIONS

             8

             7

             6
Millions

             5

             4

             3

             2

             1

                       2012        2013         2014        2015       2016

                              INCOME PER DONOR

           800

           700

           600
Millions

           500

           400

           300

           200

           100
                  ID

                       IH

                               F

                                                  L

                                                        S

                                                              C

                                                                       ER
                                      LS

                                              IA
                               G

                                                       D

                                                             D
                       N
                 A

                                     C

                                                                   TH
                                                        N
                              BM

                                              C

                                                            C
                 US

                                                      FU
                                           ER

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                                          M

                                                   L
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                                          M

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                                     O
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12
     2016 HUMAN RESOURCE OVERVIEW
     JOINT APPOINTMENTS

       EE STS                                                            (All)            EE STS                                                       Active

       Division                                                    Headcount              Joint Appointment Title                                   Headcount

       Clinical HIV Research Unit                                         8               Associate Researcher                                            30

       Health Economics Research Office                                   20              Lecturer                                                        4

       Johannesburg Oncology                                              1               Researcher                                                      74

       MatCH Research Unit                                                7               Senior Researcher                                               13

       MatCH Health Systems                                               3               Associate Professor                                             5

       Non Communicable Disease                                                           Visiting Professor                                              1
                                                                          1
       Research

       Perinatal HIV Research Unit                                        28              Professor (Chair / Personal)                                    1

       Respiratory & Meningeal Pathogens                                                  Grand Total                                                    132
                                                                          13
       Research Unit

       Rural Health Advocacy Project                                      1

       Sbimb-H3ABionet                                                    1

       Wits Reproductive Health & HIV
                                                                          45
       Institute

       Grand Total                                                       128

                                                                Other Syndicates
                                   Respiratory & Meningeal             8%                                  Perinatal HIV Research Unit
                                   Pathogens Research Unit                                                             13%
                                             8%

                                  WHC - SSC
                                    6%

                           Agincourt
                              5%

           Clinical HIV Research Unit
                       4%

                MatCH Research Unit                                                                                                      MatCH Health Systems
                       4%                                                                                                                       20%

        Clinical Laboratory Services
                     3%
        Health Economics Research
                   Office
                     2%
               Non Communicable Disease
                        Research
                           2%
                 Empilweni Services & Research
                             Unit               National Institute for
                              1%               Communicable Disease                                  Wits Reproductive Health &
                                                         1%                                                 HIV Institute
                                                                                                                23%
                                        National Institute for Communicable Disease   Empilweni Services & Research Unit
                                        Non Communicable Disease Research             Health Economics Research Office
                                        Clinical Laboratory Services                  Clinical HIV Research Unit
                                        MatCH Research Unit                           Agincourt
                                        WHC - SSC                                     Respiratory & Meningeal Pathogens Research Unit
                                        Other Syndicates                              Perinatal HIV Research Unit
                                        MatCH Health Systems                          Wits Reproductive Health & HIV Institute
13
2016 HUMAN RESOURCE OVERVIEW CONT.

 SYNDICATES                                        DECEMBER 2016 HEADCOUNTS

 National Institute for Communicable Disease                  36

 Empilweni Services & Research Unit                           38

 Non Communicable Disease Research                            53

 Health Economics Research Office                             72

 Clinical Laboratory Services                                 87

 Clinical HIV Research Unit                                  115

 MatCH Research Unit                                         126

 Agincourt                                                   170

 WHC - SSC                                                   185

 Respiratory & Meningeal Pathogens Research Unit             254

 Other Syndicates                                            269

 Perinatal HIV Research Unit                                 439

 MatCH Health Systems                                        653

 Wits Reproductive Health & HIV Institute                    760

 Total                                                       3257
14
     Our
     Mission is
     to support
     the
     teaching,
     research
     and public
     health
     service
     mission of
     Faculty
15

                              V i s i o n , M i s s i o n a n d Va l u e s

Our Vision is to be a valued strategic partner of Faculty, recognised for the additional resources,
commercial / business expertise and supplementary income we are able to make available to it.

Our Mission is to support the teaching, research and public health service mission of Faculty;
either through the provision of commercial and administrative support for income-generating
activities ancillary to the main objectives of Faculty (namely teaching, research, and the
provision of medical services), or by directly engaging in teaching, research, medical service
or other related activities which are complementary to the main objectives of Faculty.

Our Values:
Stewardship - We recognize our role as stewards of the Faculty’s assets by managing our resources
responsibly, effectively, and efficiently.

Employees - We are committed to the success of our employees, as they are our most valuable resource,
and so provide them opportunities for development, growth and personal success.

Respect - We are courteous, conscientious and respectful in our dealings with our customers, employees,
Faculty and the communities where we work.

Variety - We embrace different viewpoints and support mutually beneficial partnerships among a diverse
mix of individuals, departments, institutions, and community groups. We also embrace the wide and
varied range of activities that we undertake in achieving our Vision and Mission.

Integrity - We conduct ourselves in a fair, ethical and honest manner. We strive to
make all decisions in the best interests of our customers, employees, Faculty and the
communities where we work. We are accountable and answerable for our actions.

Customer     Service   -    We      value   innovative,   timely,    efficient,   solution-oriented,   and
cost-effective services     and systems.        We are committed to achieving the highest
levels   of   customer     satisfaction   achievable,   given     the     resources    at   our    disposal.

Entrepreneurship - We foster a culture where entrepreneurship and prudent risk taking are encouraged,
where the entrepreneur is able to benefit as a partner in their venture.
16                W I T S H E A LT H C O N S O R T I U M S T R U C T U R E

     Our Board of Directors include leading academics, business
     experts and specialist advisors
     •   Professor Martin Veller is the Non-Executive Director and Chairman of WHC
     •   Mr Alfred Farrell is the Executive Director and Chief Executive Officer

     A skilled Executive Team oversees day-to-day operations of WHC and comprises the
     following:
     Mr Alf Farrell                          Chief Executive Officer
     Dr Ntsikelelo Itumeleng Funani          Chief Academic Officer
     Mr Ralph Bagirathi                      Chief Operations Officer
     Mrs Christine Grobler                   Deputy Chief Operations Officer
     Mr Jean Du Randt                        Chief Financial Officer
     Mr Daniel Mosia                         Chief Strategic Officer
     Mr Mamatsabu Maphike                    Chief Risk & Compliance Officer
     Mr Karl Basson                          Head of Speer Management Services (IT)
     Mrs Robyn Hayes-Badenhorst              Head of the Office of the CEO

                   B E H I N D O U R B R A N D I S A G R E AT T E A M
B OA R D O F D I R E C TO R S                                           17

WHC has a highly-respected Board of Directors, selected for their internationally
recognized academic excellence and management experience.

Responsible for overseeing all governance, internal controls, risk management, financial
management and human resource services that WHC provides to its research units and
to the University of the Witwatersrand.

                           Non-Executive Director and Chairman
                           Professor Martin Veller
                           MB BCh, FCS (SA), M Med (Surg)
                           Professor Veller is Dean of the Faculty of Health Sciences at the
                           University of the Witwatersrand and a Professor in the University’s
                           Department of Surgery. He is an expert in Vascular Surgery with
                           extensive academic, research and teaching experience. Professor
                           Veller also serves on the Board of Directors of the Wits Donald Gordon
                           Medical Centre. He has trained at the University of Witwatersrand
                           and at St. Mary’s hospital at London’s Imperial College

                           Executive Director and Chief Executive Officer

                           Mr Alfred Farrell
                           B Comm, B Compt (Honours), CA (SA)
                           Mr Farrell is a skilled financial and accounting manager with many
                           years of experience in senior financial management positions at
                           companies such as the Automobile Association of South Africa,
                           Interleisure and the Premier Group. Prior to joining WHC in 2002, Alf
                           held the position of Chief Financial Officer for BDFM Publishers (Pty)
                           Ltd.

                           Mr Farrell has steered Wits Health Consortium with invaluable insights
                           gained through his successful career. Since joining Wits Health
                           Consortium Mr Farrell has directed its portfolio of development
                           and research programmes, managed through the Shared Service
                           Centre, and has ensured the growth of Wits Health Consortium has
                           been combined with high standards of delivery. Under Mr. Farrell’s
                           tenure the total income of Wits Health Consortium has grown from
                           R150 million in 2002 to over R1.8billion in 2016
18      Board of Directors

     Mr Desmond Arnold
     CA (SA), FCMA, AMP (Wharton)

     Mr Arnold is a highly-skilled accountant and has held
     numerous financial positions in some of South Africa’s leading
     corporates. He is a past President of the South African Institute
     of Chartered Accountants (SAICA) and was awarded
     honorary life membership in recognition of his services to the
     accounting profession. Mr Arnold is Chairman of the WHC
     Audit Committee and is also a member of the WHC Risk
     Committee. He is also a Trustee of the Absa Pension Fund.

     Dr Rachel Chikwamba
     MBA, PhD (Genetics)

     Dr Chikwamba is responsible for strategic alliances and
     communication and is an expert in scientific and industrial
     research. Her research has focused on metabolic engineering
     for nutrition and pharmaceutical applications. She has
     studied in the US and Australia and was an Honorary
     Research Fellow at St George’s Hospital at the University of
     London. She has also taught post-graduate classes at the
     University of Pretoria.

     Mr Prakash Desai
     B Comm, B Compt (Honours), CA (SA)

     With many years of experience and skill in senior
     management roles, Mr Desai supports WHC in areas such
     as risk, audit, strategy and investment. He is currently Chief
     Executive Officer at Afrifocus Securities and worked as a
     former Group Chief Executive and Group Finance Director at
     Avusa. Prior to this, he was a Non-Executive Director at M-net
     Supersport Ltd and at Caxton Publishers and Printers Ltd.
Board of Directors                                           19

Professor Mkhululi Lukhele
MB BCh, M Med (Orthopaedics), FCS (SA)

Professor Lukhele heads up the School of Clinical Medicine
at the University of the Witwatersrand’s Faculty of Health
Sciences. He has published widely and has specialised in
orthopaedic research, including areas such as spinal cord
injuries and spinal tuberculosis in HIV patients. Professor
Lukhele has participated in various multi-national clinical
trial studies and is Academic Head of the Wits University
Division of Orthopaedics.

Professor Johnny Mahlangu
MB BCh, M Med (Haem), FCPath (SA)
(Haem) (Clin Haem)
Professor Mahlangu is Head of the University of the
Witwatersrand’s School of Pathology and Head of the
Haematology Diagnostic Section in the Department of
Molecular Medicine and Haematology. He has peer
reviewed many journal publications and international
congress presentations. He also sits on the editorial boards
of various haemophilia treatment guideline committees
and participates in multi-national clinical trials.

Dr Tshepo Motsepe
MB BCh; MA (Public Health)

Dr Motsepe is a KwaZulu-Natal and Harvard University
graduate. She has worked in private medical practice
locally and abroad and has developed specialist
knowledge in several fields, including family health, refugee
health and HIV. She was Deputy Director of the Chris Hani
Baragwanath Hospital in Johannesburg and Ch airperson
of the Health Accreditation Committee for the Gauteng
Provincial Government.
20      Board of Directors

     Associate Professor Maria Papathanasopoulos
     Professor Papathanasopoulos is an established scientist who has built
     an exceptional reputation in the infectious diseases, bioinformatics,
     and virology fields. She has established world class laboratories that
     conduct innovative research on HIV-1 drug discovery, and vaccine
     designs that are recognised at a national, regional and international
     level. In the last eight years she has completed research for the
     South African Strategic Health Innovation Platform, the South African
     HIV/AIDS Research and Innovation Platform, the National Research
     Foundation, the International AIDS Vaccine Initiative Innovation
     Fund, the Carnegie Foundation, the Poliomyelitis Research
     Foundation and several others.

     Professor Helen Rees
     GCOB, OBE, MBBChir, MA (CANTAB), MRCGP,
     DCH, DRCOG, RCOG FP Instructor
     Professor Rees is Executive Director of the Wits Reproductive
     Health and HIV Institute. Her specialist area focuses on HIV
     and Reproductive Health and she has published extensively
     in these fields. She has been internationally recognised for
     her expertise and for her contribution both nationally and
     internationally to research and medical advances in these
     areas.

     Professor Zeblon Vilakazi
     PhD (Physics)

     Professor Vilakazi is Deputy Vice-Chancellor of Research
     and Post-Graduate Affairs at the University of the
     Witwatersrand. His research interests include computational
     physics and heavy-ion collisions at high energies and his
     work saw him nominated as a Young Global Leader by the
     World Economic Forum in 2010. He is globally recognised
     for his expert knowledge in physics and nuclear research.
Board of Directors                                        21

                       Mr Mahomed Salim Ismail (Mac) Gani

                       Mac Gani is an independent consultant with a distinguished
                       career in accounting and financial management. He spent
                       two years working in London for an auditing firm and has
                       gained valuable experience locally working his way up to
                       being a partner in a leading accounting firm as well as a
                       financial executive leader. He has also developed a special
                       interest in higher education and health services.

                            Sub-Committees

The following Sub-committees have been established to assist the
Board to perform its duties.
•    Audit and Risk Committee
•    Remuneration Committee
•    Strategy and Investment Committee
•    Academic Oversight Committee
•    Social and Ethics Committee (incorporating Sustainability Committee)
•    Directors’ Affairs Committee
22
23

    MAJOR
RESEARCH UNITS
    2016
24                                     MAJOR RESEARCH UNITS

                                         Wits Reproductive Health Institute
                                         The Wits Reproductive Health and HIV Institute (Wits RHI) aims to
                                         tackle Africa’s health challenges through science and innovation.
                                         It is acclaimed for its pioneering research, innovating services and
                                         providing evidence-based policy development and advocacy. Its
                                         areas of expertise cover HIV, Sexual and Reproductive Health and
                                         Vaccine Preventable Diseases.
                                         Who we are: Wits RHI is part of the             Wits   RHI    began    implementing    the
                                         Faculty of Health Sciences of the               OPTIMIZE project, a rigorous clinical
                                         University of the Witwatersrand and             trial that will potentially yield a new
                                         the largest research institute within the       first-line regimen with the potential to
                                         university. It is committed to developing       transform healthcare for HIV-positive
                                         and conducting relevant research,               people. This will operate in tandem
                                         and providing technical assistance              with an engagement programme that
     Professor Helen Rees
                                         and capacity building that is geared            incorporates     communities,    clinicians
     Executive Director of the Wits
                                         to    informing    policy   development         and regulators. If successful, OPTIMIZE
     Reproductive Health and HIV
                                         and    evidence-based        programmes.        will be better tolerated, allowing for
     Institute
                                         We push boundaries with innovation              improved      durability   through   better
     Head Office Contact Details:        in health services by using a multi-            adherence.
     University of the Witwatersrand     pronged approach to improve health
     Hillbrow Health Precinct            outcomes and influence policy. This             Wits RHI was awarded USAID-UNITAID
     Hugh Solomon Building               ranges    from    generating        evidence    funding for ADVANCE, a study that
     Hillbrow, 2001                      related to health issues, to testing            falls under OPTIMIZE and will compare
     Tel: +27 11 358 5300                and      evaluating    interventions,      to   newer drugs in the first line ARV regimen
     Email: rhicomms@wrhi.ac.za          translating   evidence       into     policy.   to standard of care.
     Web: www.wrhi.ac.za                                                                 We continued with three robust United
                                         Strategy in 2016: We continued to grow          States President’s Emergency Plan for
                                         our research footprint in our three key         AIDS Relief (PEPFAR) programmes with
                                         focus areas, namely HIV, Sexual and             a strong implementation science focus,
                                         Reproductive      Health    and     Vaccine     aimed at strengthening care for sex
                                         Preventable Diseases. We consolidated           workers and truck drivers, adolescents
                                         our leadership in the fields of HIV             and the youth. These programmes are
                                         prevention and treatment, completing            aimed at supporting districts to achieve
                                         several globally significant trials. We         their goals for HIV testing, initiation of
                                         also launched several new research              treatment and viral suppression at 12
                                         initiatives on HIV treatment optimisation       months after treatment initiation as laid
                                         for adults and children.                        out by UNAIDS.

                                         Wits RHI has developed a significant            Regarding new developments in HIV
                                         portfolio of HIV treatment optimisation         prevention, technologies continued to
                                         work with the aim of developing                 be developed including Pre-Exposure
                                         safer, more robust and less expensive           Prophylaxis (PrEP). We presented and
                                         antiretroviral therapy (ART) regimens.          published the results of our Microbicide
                                         This reduction in costs will help improve       Trials Network ASPIRE dapivirine ring
                                         health outcomes as more and more                trial. Open-label extension studies now
                                         people access ART                               follow while registration of this product
                                                                                         is pending.
                                         Key       developments         in       2016:   We also initiated enrolment into the
Major Research Units                                                                                    25

exciting HPTN 081 trial of the safety           Wits RHI staff engaged with national                 research      grants     were      investigator
and efficacy of VRC01 monoclonal                policy     makers     on   the       finalisation    driven.
antibodies for the prevention of HIV.           of   a     cervical   cancer        prevention
                                                strategy, and contributed at a global                Wits RHI staff published 83 papers in ISI
Furthermore, 2016 was an important              level to policy initiatives around the               accredited journals. This was achieved
year for launching several programmes           development of vaccines for sexually                 with a staff of 45 joint appointments,
operating at the policy, facility and           transmitted infections.                              while 15% are classified as research
end-user level to demonstrate how                                                                    active. The organisation has a robust
best to deliver PrEP in South Africa to         Wits RHI staff extended their work on                postgraduate support programme with
sex workers, adolescent girls and young         Sexual and Reproductive Health and                   17 PhD candidates affiliated to it.
women. Wits RHI actively contributed            the interface with Vaccine Preventable
to PrEP guidelines and training and             Diseases by initiating several studies on            In 2016 Wits RHI had a staff complement
engaged in technical working groups             vaccination of pregnant women and                    of 748. A significant proportion of
to advise the Department of Health.             or/infants.                                          staff are female, and attention is
We were central to the success of the           The Institute will participate in a phase III        given to ensuring the development
launch of the National Sex Worker               study to determine the immunogenicity                and       representation      of    historically
programme      by    the   South    African     and safety of a Respiratory Syncytial                disadvantaged groups in leadership
National AIDS Council, which included           Virus (RSV) F Nanoparticle vaccine                   and management positions.
PrEP   delivery.    Wits   RHI   staff   also   with aluminum in healthy third trimester             Our contribution to policy continued
supported the national She Conquers             pregnant women (RSV-M-301).                          to gain local and global recognition
campaign, aimed at reducing HIV                 We will also participate in a phase 1/11             in 2016. Our staff were invited to
incidence in adolescent girls and young         double bind, randomised, placebo-                    present at conferences, to contribute
women. An important addition to our             controlled      descending-age,            dose      to conference committees, and to
work has been the inclusion of research         escalation study to examine the safety,              provide expert guidance on policy
around prevention of gender-based               tolerability   and    immunogenicity           of    and programme development. Sixty
violence within these HIV programmes.           the trivalent P2-VP8 subunit rotavirus               presentations were made across a
Results from this work will be known in         vaccine in healthy South African adults,             range of platforms, including 56 oral
the next two years.                             toddlers and infants.                                presentations.

A study to explore strategies to eliminate      Wits RHI is working with the Respiratory             Also, 58 abstract-driven presentations
mother to child transmission of HIV             and Meningeal Pathogens Research                     including 16 oral presentations, 20
(EMTCT) was launched in 2016. Known             Unit (RMPRU) to lead the development                 poster presentations and 22 poster
as the Mother-Infant Pairs Study, this          of   the    African   Local       Initiative   for   exhibitions were made at international
prospective cohort study will provide           Vaccinology           Expertise          (ALIVE)     conferences.
important   data      on   HIV   incidence      consortium,     which      will     strengthen       Apart from its research output, Wits
and risk factors for new HIV infections         vaccinology research capacity in the                 RHI   continued        to   provide     expert
in mothers and infants, explore ART             region, and address a region-specific                guidance on policy and programme
use in pregnancy and post-partum                Vaccine Preventable Disease agenda                   development.       The      Institute   played
and explore the potential for male              across the spectrum, ranging from                    a key role in the development of
involvement in these programmes.                vaccine discovery to vaccine.                        the Prevention of Mother To Child
                                                ALIVE secured a grant from the Bill &                Transmission of HIV National Guidelines.
On a global level, the ECHO study was           Melinda Gates Foundation for start-up
launched in several countries. Aimed at         activities and was recently awarded
quantifying whether there is an excess          a grant by the National Research
risk of HIV infection in women who use          Foundation as a Wits University Flagship
injectable contraception compared               Project.
with other forms of contraception,
this study will provide important and           Other achievements: In 2016, Wits RHI
possibly definitive data to address this        had 67 grants totalling over R400m
question.                                       under management. Of this, 33% of
26                                    Major Research Units

                                      Wits Perinatal HIV
                                      Research Institute
                                      The Perinatal HIV Research Unit (PHRU), celebrating 21 years of
                                      research excellence, aims to improve life through research. PHRU’s
                                      research scope spans HIV and TB prevention and its treatment.

                                      Who we are: The PHRU is a large clinical                We continue to conduct adult, pediatric
                                      research unit with diverse capacity to                  and adolescent HIV and TB research
                                      conduct a range of observational and                    and in 2016, we were awarded The NIH
                                      clinical trial research.     We are a Unit              Division of AIDS clinical research site
                                      of the University of the Witwatersrand.                 (CRS) status in Matlosan, building on our
                                      Although our primary research site                      exisiting CRS’s in Soweto.
                                      remains Soweto, after 20 years, we
     Dr Neil Martinson                have three research sites in Limpopo,                   We continued to recruit into four
     Executive Director of the Wits   one in Botshabelo, in the Free State,                   US       Government-funded             cluster
     Perinatal HIV Research Unit      and a large site in Matlosana (around                   randomized      trails    assessing     earlier
                                      Klerksdorp) in North West Province. We                  diagnosis of TB in household contacts
     Head Office Contact Details:
                                      are expanding capacity at these sites                   of TB cases and HIV-infected pregnant
     New Nurses Home
                                      to conduct clinical research into the                   women.
     Chris Hani Baragwanath
                                      HIV and TB epidemics
     Academic Hospital
                                                                                              In addition to numerous investigator-
     Soweto, Johannesburg
                                      Our External Mission is to conduct                      driven   and    publicly-funded        clinical
     Tel: +27 11 989 9700
                                      community-partnered,                        ethical,    trials, PHRU also conducts clinical trials
     Email: 011 989 9700
                                      innovative       and        multi-disciplinary          for pharma.       PHRU has established
     Web: www.phru.co.za
                                      research that influences knowledge                      important    behavioural       and      social
                                      and policy.                                             science research.         We continue to
                                                                                              advocate for research access and the
                                      Our      Internal       Mission         is        to    provision of care to key communities.
                                      develop       passionate,         caring        and
                                      empowered           researchers        to      work     Strategy in 2016: Our focus was on
                                      in the health development                    sector.    increasing the number of publications
                                                                                              that our investigators authored and
                                      Research in 2016: PHRU continued                        also to increase and diversify grant
                                      having     an       impact        on         clinical   income. Indeed in 2016, PHRU staffers
                                      research. In 2016, we published over                    co-authored 54 publications.
                                      52 manuscripts in international peer-
                                      reviewed      publications.         We         were     In 2016, PHRU continued to participate
                                      awarded       several    new       grants       and     in Community Advisory Boards (CABs)
                                      continued and expanded others. HIV                      alongside traditional healers, religious
                                      vaccine research has been a particular                  leaders, social workers, police officers,
                                      focus and in 2016 PHRU both prepared                    LGBTIs and NGOs participating in CABS
                                      for and recruited to several important                  in Soweto and Matlosana.
                                      clinical HIV vaccine trials.
                                                                                              Research    was     conducted         for   the
                                      Moreover, we planned to expand PHRU                     IMPAACT        network        (International
                                      capacity to recruit at two separate                     Maternal Pediatric Adolescent AIDS
                                      vaccine research sites in Soweto.                       Clinical Trials) and the ACTG (AIDS
                                                                                              Clinical Trials Group).
Major Research Units                         27

PHRU teams also worked on the HPTN                  Facilities in 2016: PHRU continued to
programme          (HIV    Prevention      Trials   enjoy a well-established, world class
Network) and the HVTN (HIV Vaccine                  research facility.
Trials Network).                                    This includes a series of research clinics
                                                    and counselling centres, a pharmacy,
Ground-breaking study in 2016: We                   a laboratory, a data management
launched the first-ever HIV vaccine                 centre,    a    training   centre    and
efficacy study. This will establish whether         administrative offices — each located
an   experimental         vaccine      regimen      at the Chris Hani Baragwanath Hospital.
safely prevents HIV infection among
South African adults. The study, called             Staffing in 2016: In 2016 PHRU remained
HVTN 702, involves a new version of the             a growing research unit with more than
only HIV vaccine candidate ever shown               400 employees on staff. The PRHU team
to provide some protection against the              is led by Dr Neil Martinson.
virus. HVTN 702 aims to enroll 5,400 men
and women, making it the largest and                Funding in 2016:
most advanced HIV vaccine clinical                  We continued to collaborate with
trial to take place in South Africa.                funders worldwide including NIH, US
The Soweto CTU sites will be enrolling              Government’s CDC, the Global Fund
participants into this historic study.              to fight AIDS, TB and Malaria, the Aurum
                                                    Health Institute, WHRI, SAMRC, UKMRC,
Clinical    research      in   2016:      PHRU      Right to Care and SFH/PSI.
recruited or followed up participants
in approximately 45 active studies,
including    clinical     research     sites   in
Limpopo, North West and Free State
Provinces. These studies included a
diverse range of participants              such
as   pregnant       woman,       HIV-infected
children,    HIV     exposed      uninfected
adolescents and adults – both HIV
infected and HIV seronegative.

Mentorships in 2016:            In the year
under review, PHRU continued with
important mentorship and academic
research training. We had the following
mentorships:

•    5 PhD candidates
•    9 Masters students
•    4 NRF National Research
     Foundation Interns
•    1 SHAPe Scholars
•    2 HPTN International Scholars
•    We hosted five graduate students
     from the John Hopkins University
     Center for Global Health
28                               Major Research Units

                                 Wits Clinical HIV Research Unit
                                 & the Health Economics and
                                 Epidemiology Research Office
                                 The Wits Clinical HIV Research Unit (CHRU) and the Health Economics
                                 and Epidemiology Research Office (HE2RO) aim to deliver excellence
                                 and quality clinical research, services and support. CHRU is based in
                                 Johannesburg at the Helen Joseph Hospital and HE2RO’s headquarters
                                 are in Parktown, Johannesburg. Satellite sites operate at the Sizwe
                                 Hospital in Sandringham in Johannesburg and in Durban at the King
                                 Dinuzulu Hospital Complex.
                                 Who we are: The Clinical HIV Research              We are now well-positioned to conduct
                                 Unit (CHRU) is part of the University of           more TB trials. Shorter TB treatment
                                 the Witwatersrand’s Faculty of Health              is a key aim and, during 2016, CHRU
     Professor Ian Sanne
                                 Sciences.                                          embarked on two treatment-shortening
     Division Head of CHRU and
                                                                                    studies, namely the A5349/TBTC study
     HE2RO
                                 As      an     internationally   recognised        31 for drug-sensitive TB and the STREAM
     CHRU:                       research       and   technical       assistance    2 study, which is looking at optimising
     Themba Lethu Wing           unit,    the     CHRU     delivers     clinical,   and shortening MDR treatment.
     Helen Joseph Hospital       epidemiologic and health economic
     1 Perth Road                research services. The unit also ensures           Noteworthy is the NIX trial that was
     Westdene                    that research information is invested at           conducted at the Sizwe hospital. This
     Johannesburg                operational level for the prevention,              study is exploring the use of a shortened
                                 treatment and management of HIV                    oral treatment regimen for XDR TB.
     HE2RO:                      and associated diseases.                           Preliminary results look promising for the
     Unit 2                                                                         treatment of a disease with a very high
     Empire Road                 Where we operate: CHRU is located at               mortality rate.
     Parktown                    the Themba Lethu Clinic in the Helen
     Johannesburg                Joseph Hospital. We are one of the                 Other trials included the REPRIEVE, A5288
     Tel: +27 11 276 8800        largest HIV and TB clinics in South Africa.        and MHAVE studies. The START study,
     Email: info@chru.co.za                                                         originally planned to end in December
     Web: www.chru.co.za         Staffing in 2016: In the year under                2016 was extended for another year.
     Web: www.heroza.org         review, the CHRU expanded its team                 The last patient visit for the A5282 study
                                 and employed more than 90 staff.                   was conducted in 2016.

                                 Research in 2016: Staff continued to               Strategy in 2016: The unit aligned itself
                                 work on important studies initiated                with the current international trend of
                                 previously, including the A5338 study              focusing on drug sensitive and drug
                                 and several other Pharma trials.                   resistant TB trials.

                                 During 2016, CHRU completed the                    Key developments in 2016: During the
                                 A5290 study. Another achievement was               year, we completed important building
                                 the A5300 feasibility study, conducted             renovations at our site, including a state
                                 at CHRU. This vital study will pave the            of the art air filter system for our new TB
                                 way forward for the Phoenix Study,                 clinic.
                                 which aims to look at prophylaxis for
                                 MDR-TB in household contacts.
Major Research Units                                                                                     29

Future    plans:     The    chemotherapy     HE2RO        2016      synopsis:           Significant         records      captured
infusion unit is currently being used for    achievements were                made           during         using TherapyEdge-HIV and 24 in-
the A5263 (Kaposi Sarcoma) study.            the year under review, including the                           depth interviews with patients who
Going forward, this facility could be        following:                                                     initiated ART between April 2004
used for monoclonal antibody infusion                                                                       and March         2005. Final analysis
studies as more of these types of studies    •   In collaboration with the National                         and results will be disseminated in
are being planned internationally.               Department of Health, the World                            2017.
We successfully applied for two grants -         Bank and Boston University, HE2RO                      •   HE2RO published       a    chapter   in
with the TB sequel consortium and with           implemented a large evaluation of                          the 2015/16 South African Health
the PANACEA consortium respectively              the National Adherence Guidelines                          Review discussing the barriers and
and are preparing for these studies to           for Chronic Diseases in South Africa.                      facilitators South Africa faces on
begin in 2017. The TB study concerns         •   The study will assess the impact of                        its journey to achieving universal
pathogenesis and risk factors of long-           a subset of national adherence                             access to sexual and reproductive
term sequelae of pulmonary TB defining           guidelines for interventions                    on         health services nationally.
individual outcomes and public health            HIV patients’ outcomes at public                       •   HE2RO presented results on the
impact. The PANACEA trial involves a             sector clinics. The study will also                        impact of Xpert MTB/RIF testing on
STEP trial looking a novel new TB agents         estimate costs of                 interventions            treatment delays among persons
and treatment shortening regimens.               and describe the cascade of care                           diagnosed with drug resistant        TB
We will also be collaborating with the           for TB, hypertension and diabetes                          at the Union World Conference on
Aurum institute in a TB Study looking            in these state            clinics.                         Lung Health in Liverpool.
at host directed therapies added to a        •   To this end, four field teams have                     •   HE2RO received recognition for an
Rifabutin based TB treatment regimen.            been       established           in       Gauteng,         abstract on poorer health-related
The site is also planning on starting a          North West, Limpopo and KwaZulu-                           quality of life    among      patients
commercial study with long acting Anti-          Natal to collect data from 24 sites.                       with drug-resistant TB. Tembeka
Retroviral agents.                           •   The       study    uses      a        randomised           Sineke was awarded ‘Best Oral
                                                 evaluation         design        to       compare          Presentation’ at the Public Health
Publications in 2016: CHRU actively              health          facilities       where          the        Association of South Africa (PHASA)
published research in leading journals.          interventions have been rolled out                         Conference in 2016.
CHRU and HE2RO staff published 51                with facilities where they have not.                   •   HE2RO also represented the Wits
articles during 2016.                        •   During 2016, 3324 patients were                            Health Consortium large research
                                                 enrolled to the HIV cohorts (96%                           entities on the FHS FRC.
Mentorships in 2016: The unit continued          of study target) and a further 2997
to   attract   quality     post   graduate       patients were enrolled to the TB,
students. In the year under review, three        Hypertension,          Diabetes             cohort.
Masters students and five PhD students           Information has been disseminated
continued with their degrees, with               and shared with the Department of
ongoing supervision from senior staff.           Health.
                                             •   In 2016, HE2RO completed data
Grants submitted and pending in 2016:            collection and preliminary analysis
Grants relate to a variety of important          of    a      mixed-methods                   study
research and service support. These              conducted at an urban, public-
include clinical trials to address the           sector HIV clinic in                  a     tertiary
highest priorities in HIV/AIDS research,         hospital     in     Johannes burg.              This
scientific and laboratory management,            analysis        aimed describe 10-year
the delivery of technical assistance to          treatment outcomes of patients
the South African Department of Health           initiated          at the start of South
for HIV/AIDS diagnosis and treatment             Africa’s National ART programme
and research into, MDR-TB and XDR-TB             in 2004.
and TB.                                      •   This included a 10-year outcomes
                                                 analysis      of     electronic            medical
30                                  Major Research Units

                                    Wits Maternal, Adolescent and
                                    Child Health Systems
                                    The Wits Maternal, Adolescent and Child Health (MAtCH) Systems is
                                    committed to supporting the implementation of sustainable public-
                                    sector health services, with a focus on maternal, adolescent and child
                                    health, HIV and TB prevention, treatment and care.

                                    Who we are: Maternal, Adolescent and             offices in Overport, Mayville and at the
                                    Child Health (MatCH) Systems is a South          KwaZulu-Natal Children’s Hospital.
                                    African      donor-funded         organization   We also have offices in Mtubatuba in
                                    based in Durban in KwaZulu-Natal.                Umkhanyakude and some of our teams
                                                                                     are based in the eThekwini district
                                    We are a division of the Wits Health             office, at eThekwini municipality offices
     Dr Arthi Ramkissoon            Consortium,      with    oversight    by   the   and at the Provincial Department of
     MSc (MedSc) PhD MBA            School of Public Health.                         Health in Pietermaritzburg.
     Divisional Head
                                    MatCH has extensive experience in                MatCH has project staff in Harry Gwala
     Head Office Contact Details:
                                    public      health,     primary    healthcare    and Nongoma.
     145 Prince Street
                                    and service delivery. We have a multi-
     South Beach
                                    disciplinary group of senior academic            In   2016    we    continued      with   our
     Durban
                                    staff, reflecting expertise in medical           international     expansion     under    the
     KwaZulu-Natal
                                    science, epidemiology, public health,            EQUIP project, and had offices in Port
     4091
                                    child    health,      behavioural    science,    au Prince in Haiti, Accra in Ghana and
     Tel: +27 31 350 4242
                                    gender, HIV and TB.                              in Dar es Salaam, Tanzania.
     Email: info@match.org.za
     Web: www.match.org.za
                                    Maternal, new-born and child health              EQUIP is a consortium of partners with
                                    research, including HIV and infant               extensive experience and technical
                                    feeding, is a key focus area of our work,        expertise    providing       comprehensive
                                    led by Professor Jerry Coovadia, who is          high-quality      HIV   service    delivery,
                                    the Director of Health Systems at MatCH.         innovating new approaches to service
                                    He has been at the forefront of this             delivery, scaling viral load technology
                                    field of work for many years. He is also         and analysing cost and outcome data
                                    actively involved in the development             to optimize HIV programmes.
                                    of WHO and National standards, and
                                    the implementation in South Africa of            Our approach: MatCH’s approach is to
                                    breastfeeding policies, which have had           support the South African Government
                                    a positive impact on child health.               to   roll   out   national    programmes,
                                                                                     including the National Core Quality
                                    Where we operate: MatCH has a long               Standards, the Global Plan of Action
                                    history of working in KwaZulu-Natal              on PMTCT, Primary Health Care Re-
                                    to support public sector sexual and              engineering strategy and community
                                    reproductive health; maternal, child             Caregiver programmes.
                                    and adolescent health; and HIV and TB
                                    services.                                        MatCH implemented a WHO/South
                                                                                     African National Department of Health
                                    Our geographic reach: In addition to             Pregnancy Registry pilot project in May
                                    our head office operations in Durban,            2013 and this remained an ongoing
                                    South Africa, MatCH’s has satellite              focus area in 2016.
Major Research Units                                                                                    31

The objectives of the project include                      medical male circumcision programme.                KwaZulu-Natal, North West and Eastern
the following:                                             MatCH started the programme with the                Cape.
                                                           KwaZulu-Natal Department of Health
•     To      collect      information           about     in the province in 2010. MatCH has a                Research activities in 2016: Numerous
      maternal health and medicines                        contract to implement Medical Male                  research        activities      and     positive
      exposure          during        pregnancy            Circumcision Services in four districts in          outcomes were achieved in 2016,
                                                           KwaZulu-Natal. MatCH has circumcised                including the following:
•     To establish a national sentinel                     over 140,000 males since the start of the
      surveillance         system     for         major    programme.                                          •    An evaluation of the MomConnect
      birth     defects       and        still    births                                                            Project at 51 facilities in two districts
                                                           MatCH continued to conduct training                 •    A pregnancy registry study to
•     To routinely provide information                     on a wide range of HIV and sexual and                    prospectively collect information
      and          evidence         to           policy-   reproductive health topics. Since 2009                   about       maternal        health      and
      makers,       health     care        providers       we have trained over 15,000 healthcare                   medicines          exposure          during
      and other stakeholders on the                        providers in KwaZulu-Natal. Key training                 pregnancy
      association         between          maternal        programmes have included HCT/PICT;                  •    A study to establish a national
      health indicators, antenatal care                    ARV     treatment      guidelines;      NIMART,          sentinel     surveillance     system     for
      indicators and the use of specific                   medical      male      circumcision,      family         major birth defects and still births
      medicines during pregnancy.                          planning, male and female condom                    •    Operations/Implementation
                                                           promotion and provision.                                 Science research on HIV/TB
Staffing in 2016: By the end of the                                                                            •    Operations/Implementation
year under review, MatCH had a staff                       All our training materials are in line with              Science research on Adolescents,
complement of 655 people, with 17                          South African National and Provincial                    Girls & Young Women
staff actively involved in research.                       guidelines and policies and are planned             •    A review of routine data and
                                                           and scheduled with the Department of                     service delivery data for medical
Programmes in 2016: MatCH’s portfolio                      Health (DOH).                                            male circumcision in four districts in
of    HIV     treatment       and        prevention                                                                 KwaZulu-Natal
programmes continued to expand and                         In   2016    MatCH      was      successful    in
2016 saw the extension of our PEPFAR                       bidding for a five-year Centre for                  Community         training      and       service
grant, funded via USAID. This is being                     Disease Control grant for Programmatic              in 2016: In the year under review,
used to strengthen the District Response                   Implementation             and       Technical      MatCH provided technical assistance
for Better HIV/TB Patient Outcomes                         Assistance      (TA)    for    HIV/AIDS    and      to National, Provincial and District
in the eThekwini and Umkhanyakude                          Tuberculosis (TB) Prevention, Care, and             Departments of Health. These focused
districts in KwaZulu-Natal.                                Treatment       Services      throughout      the   mainly on improved HIV/TB and MCWH
                                                           Health System in South Africa.                      clinical outcomes.
MatCH’s adolescent, girls and young
women         portfolio     included         DREAMS        This is under the President’s Emergency             We    continued         to     participate     in
funding       in    2016     for    facility       level   Plan for AIDS Relief (PEPFAR) of 2016.              important forums such as the National
interventions in two high prevalence                                                                           DOH Task Force for STI, HIV and AIDS
districts in KwaZulu-Natal.                                Under    this   five-year      grant,   MatCH       Prevention,       the        National     Health
                                                           supports community-based HIV testing                Research Committee, WHO Strategic
The      ELMA        Philanthropies              funded    and      evidence-based            prevention       and Technical Advisory Committee
Unfinished Business project in eThekwini                   programmes        in   the     Harry    Gwala,      and the KZN Children’s Hospital Steering
and        Umkhanyakude             focused          on    eThekwini and Umgungundlovu districts               Committee.
addressing the treatment needs of                          in KwaZulu-Natal.
adolescents and children is also on-
going.                                                     The grant also includes evaluation of the
                                                           implementation of community-based
In 2016 MatCH continued to play                            HIV care and treatment interventions in
an important role in KwaZulu-Natal’s                       three provinces in South Africa, namely
32                                  Major Research Units

                                    MRU (MatCH Research Unit)
                                    MRU (Maternal, Adolescent and Child Health Research Unit) aims
                                    to answer priority questions that will translate into improving sexual
                                    and reproductive health outcomes through expanding access to
                                    appropriate and acceptable contraceptive, HIV prevention and
                                    related health technologies and services.

                                    Who we are: MRU is affiliated to the               than providing them separately.
                                    University of the Witwatersrand’s Faculty
                                    of Health Sciences, the School of Clinical         Other        publications           focused     on
                                    Medicine and to the Department of                  our core research areas including
                                    Obstetrics and Gynaecology.              In 2016   contraception, HIV prevention, safer
                                    we were awarded Unit status.                       conception and other areas of sexual
                                                                                       and reproductive health.
                                    Our mission: We aim to achieve the
     Professor Jennifer Smit
                                    following:                                         Grant awards in 2016: In the year under
     Executive Director MRU
                                    •     Conduct innovative research that             review, MRU successfully applied for and
     Head Office Contact Details:         informs policy and programmes                was awarded several grants through
     MRU (MatCH Research Unit)      •     Conduct research that supports the           collaborations and self-initiated grant
     40 Dr. AB Xuma Street                development of new technologies              applications. One self-initiated grant
     21st Floor, Suite 2117               on sexual and reproductive health,           was awarded from over 800 applicants
     Commercial City Building             HIV and related diseases                     globally.
     Durban                         •     Engage the community in service
     KwaZulu-Natal                        delivery and research                        We have recently learned of two
     4000                                                                              successful NIH applications that were
                                    MRU is based in Durban and our team                submitted with collaborators in 2016.
     Tel: +27 31 001 1941           consists     of   highly    skilled    research,
     Email: jsmit@mru.ac.za         clinical, laboratory, community, data              New research scope in 2016: In 2016,
     Web: www.mru.ac.za             and administrative staff from a wide               we moved into a new area of research
                                    range of backgrounds including clinical,           - Pre-exposure prophylaxis (PrEP) for HIV
                                    behavioural and social science.                    Prevention       The        first      of     these
                                                                                       groundbreaking studies At MRU Is being
                                    Research publications in 2016: In 2016,            carried out in collaboration with Harvard
                                    MRU published 13 articles in peer-                 University     and     the          Massachusetts
                                    reviewed journals. Four of these were              General Hospital in Boston. This five-year
                                    from a recently completed sex worker               NIH grant was awarded for the “PrEP
                                    health     service   intervention       project,   Safer Conception for Women study”
                                    called the “Diagonal Interventions to              which will be offering PrEP as part of a
                                    Fast Forward Enhanced Reproductive                 safer conception package.
                                    Health” (DIFFER) project, funded by the
                                    EU.                                                A second study is being planned with
                                                                                       the Eastern Virginia Medical School
                                    The    project     tested    the      hypothesis   (EVMS)/      CONRAD,         USA       which    will
                                    that combining vertical Sexual and                 be focusing on different branding
                                    Reproductive Health (SRH) interventions            approaches to PrEP delivery.
                                    with horizontal strengthening of health
                                    systems for SRH, within existing health            During 2016, our microbicide research
                                    facilities, is synergistic, feasible, and likely   trials continued at the MRU Edendale
                                    to be more effective and cost-effective            Research Site with the completion of
Major Research Units                                                                                    33

the Phase III Dapivirine Ring Microbicide      strengthen the national FC program’s                     infected   mothers.     In   this   research
Trial -IPM 027. MRU started         the IPM    effectiveness and efficiency.                            we collaborated with HEARD at the
032, a Phase IIIb follow-on trial to IPM                                                                University of KwaZulu- Natal, as well as
027. This is designed as an open- label        AIDS Conference 2016: MRU played                         with Harvard University
clinical trial to collect additional safety    a high-profile role at the International
data and to establish adherence to             AIDS conference held in Durban in July                   Our        menstrual         management
ring use. This study uses the Dapivirine       2016. Professor Smit was an invited oral                 programme           conducted            an
Vaginal Ring in healthy, HIV-negative          speaker in a satellite session on hormonal               acceptability study of menstrual cups
women who were enrolled in the Phase           contraception and HIV, and Deputy                        to high risk women. We entered the
III ring trial IPM 027.                        Executive        Director,      Zonke     Mabude         planning phase of a new intervention
                                               participated         in      the    International        which will introduce menstrual cups in
Complementary             socio-behavioural    Programme for Microbicides’ satellite                    up to 10 higher education institutions
data collection is also underway to            session.                                                 in KwaZulu-Natal. This project is being
collect information around adherence                                                                    funded by the DREAMS Innovation
in microbicide trials.                         We     presented           11      posters        and    Challenge initiative.
                                               contributed two papers to a special
Government initiatives in 2016: MRU            edition     of    the     African       Journal     of   Training and capacity building in 2016:
continued to provide support to the            Reproductive            Health,     which         was    MRU focused on capacity building and
Provincial and National Departments            launched at this conference.                      We     training of researchers locally, regionally
of Health (DoH) (SRH) in policy and            disseminated a policy brief, on the                      and internationally during 2016.
programme issues in the area of Sexual         introduction of the SILCS diaphragm
and Reproductive Health. In line with          in South Africa, in collaboration with                   We are supervising four PhD candidates
this, Professor Smit and Dr Beksinska          PATH, and hosted a stall promoting                       (one in Uganda), and one Masters study
provided editorial and technical support       female condoms. This conference was                      being supervised by MRU researchers.
for the development of a KwaZulu-Natal         also used as an opportunity by MRU
(KZN) DoH Contraception Counselling            to network with established and new                      During 2016, MRU hosted students
Tool for Healthcare Providers.                 collaborators.                                           from the London School of Hygiene
                                                                                                        and Tropical Medicine (UK), from the
Professor Smit and Dr Beksinska led            Pivotal research in 2016: MRU engaged                    University of British Columbia (Canada),
the   contraception       section   of   The   in pivotal research conducted with                       from Berkley University (US), from the
Reproductive Health Chapter              for   vulnerable         populations,           including      University of Washington (US), and from
the special edition of the national            youth, sex workers and recreational                      the University of KwaZulu-Natal in South
yearly South African Publication: The          ARV users.                                               Africa.
District Health Barometer, submitted in
November 2016.                                 A key focus was on areas such as
                                               contraception, fertility choices for HIV
Research in 2016: In the year under            positive and negative women and men
review, we continued research around           (in collaboration with Harvard and the
testing the performance, integrity and         Massachusetts General Hospital).
acceptability of new female condom             We also conducted formative research
prototypes.                                    to determine views and opinions of a
                                               new device “the Smart Diaphragm”
The National SA Female Condom (FC)             designed to detect early signs of
Evaluation project, funded by USAID,           preterm birth (in collaboration with
completed data collection in 2016, and         Perinatal    Services         at   UCSFs        Foetal
disseminations      have been conducted        Treatment Center).
nationally and in every province. The FC       In    our        post-partum            depression
project was a comprehensive mixed-             programme          we     aim      to    decrease
method study to identify strategies to         depression and increase adherence
enhance the FC’s acceptability, and            to   HIV     and        SRH     care      for     HIV-
34                                    Major Research Units

                                      Wits Respiratory and Meningeal
                                      Pathogens Research Unit
                                      The Wits MRC Respiratory & Meningeal Pathogens Research Unit
                                      (RMPRU) aims to conduct epidemiological, clinical and basic science
                                      research into respiratory and meningeal infections. The unit seeks to
                                      improve the diagnosis, management and prevention of these diseases.

                                      Who we are: The RMPRU is focused on                Our       mission:      RMPRU             conducts
                                      research aimed at reducing morbidity               epidemiological,               clinical         and
                                      and mortality from common bacterial                basic science research on vaccine
                                      and respiratory viral pathogens. More              preventable          disease        aimed        at
                                      specifically, we prioritize research on            enhancing the health and survival of
                                      vaccine      preventable       disease      that   African children.
                                      are    major    contributors    to    under-5
     Professor Shabir Madhi
                                      childhood mortality. Furthermore, we               Research in 2016: In the year under
     Executive Director of the Wits
                                      have established ourselves to being                review,     the      Prof    Madhi        and    his
     MRC Respiratory & Meningeal
                                      at the forefront of research aimed                 colleagues published 42 publications,
     Pathogens Research Unit &
                                      at vaccination of pregnant women,                  including multiple publications in the
     DST/NRF SARCHI Chair: Vaccine
                                      too protect the mother, her fetus and              highest-ranking         infectious        diseases
     Preventable Diseases
                                      young infant from vaccine preventable              journals.   The      Research       Chair       was
     Head Office Contact Details:     diseases.                                          a senior author on many of these
     Chris Hani Baragwanath                                                              publications and much of the research
     Academic Hospital                Global        leadership:       RMPRU         is   which was based on outputs of post-
     Chris Hani Road                  internationally recognized for the role it         graduate students under his supervision.
     Soweto                           has played in the clinical development
     2013                             of    live   saving   vaccines       such    as    Rotavirus Vaccine Studies: The Unit,
     Tel: +27 11 983 4283 / 4277      rotavirus vaccine and pneumococcal                 under Dr Michelle Groome, undertook
     Email: madhis@rmpru.cco.za       conjugate       vaccine.        Furthermore,       the first study on a sub-unit rotavirus
     Web: www.nicd.ac.za              it has been at the fore of vaccine                 vaccine, which is being developed as
                                      studies aimed at pregnant women,                   a possible improvement to the current
                                      including reporting on the first placebo-          live   attenuated           rotavirus     vaccine,
                                      controlled randomized trial of influenza           the clinical development of which
                                      vaccine in pregnant women It has                   also was spearheaded in Africa at
                                      also undertaken the first studies of an            RMPRU. These          results were published
                                      investigational multi-component Group              in Lancet Infectious Diseases. Since the
                                      B streptococcus conjugate vaccine                  introduction of rotavirus vaccine into
                                      in pregnant women; a portfolio of                  the South African public immunization
                                      research that is ongoing- including                program, it has been estimated to
                                      discovery research on other potential              prevent 3000 fewer diarrhea related
                                      GBS vaccine epitopes. This is pertinent            deaths in South Africa each year, as
                                      to Africa and South Africa, which                  well as approximately 39,000 fewer
                                      has reported the highest incidence                 hospitalizations.
                                      of invasive GBS disease globally. The
                                      unit also does important work on                   Pneumococcal vaccine studies: The
                                      vaccines and their impact on Vaccine               Unit   continues       undertaking          studies
                                      Preventable Diseases (VPDs).                       on     prevention       of      pneumococcal
                                                                                         disease through vaccination with the
                                                                                         pneumococcal conjugate vaccine.
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