The Health Economics and Epidemiology Research Office (HE²RO), a syndicate of the Wits Health Consortium at the University of the Witwatersrand, is a small research unit dedicated to understanding the economic and epidemiological consequences of the HIV & AIDS epidemic and the effectiveness, benefits, and costs of interventions.

HE²RO collaborates with the Centre for International Health and Development of Boston University in the USA, the Clinical HIV Research Unit of the University of the Witwatersrand, and Right to Care. Hero’s co-directors are Prof Sydney Rosen, Dr. Ian Sanne, and Prof Matthew Fox.

HE²RO’s offices are provided by Right to Care and are in the Themba Lethu Clinic at Helen Joseph Hospital. Hero currently has several economic and epidemiological studies underway in South Africa. It also undertakes analyses of other issues, as requested by its research partners and other stakeholders, participates in domestic and international research conferences, and provides training and teaching in health economics and epidemiology.

Economic studies

Patient-level social and economic outcomes of treatment

Little is known about how antiretroviral therapy for HIV & AIDS affects the social and economic welfare of individual patients. In collaboration with three Right to Care supported treatment sites in Gauteng and Mpumalanga Provinces, Hero is assessing the impact of antiretroviral therapy on the labour productivity, quality of life, household welfare, and treatment costs of a cohort of approximately a thousand adult patients. Cohort follow-up is expected to continue through 2009. The study is being funded by the US Agency for International Development, Right to Care, and the US National Institutes of Health.

Cost-effectiveness of models of delivering adult and pediatric antiretroviral therapy

To achieve South Africa’s targets for treatment of HIV & AIDS, antiretroviral therapy must be delivered in a wide range of settings and at multiple levels of the healthcare system. Hero is conducting an analysis of the costs and outcomes of providing antiretroviral therapy under diverse treatment models in South Africa. Results are available for five Right to Care supported adult sites; the protocol for a parallel paediatric study has been developed. More sites, larger samples, and longer periods of follow up will be added in 2008 and 2009. The funder for this study is the US Agency for International Development.

Patient-level sustainability of antiretroviral therapy

For individual patients receiving antiretroviral therapy, long-term retention in the treatment programme is essential to success. Hero is conducting a study to estimate the rate of antiretroviral treatment patient retention and attrition during the first three years after initiating antiretroviral therapy and describe the main reasons for, and predictors of, attrition. The study is being conducted at two Right to Care supported sites in South Africa, a public hospital in Gauteng Province and an NGO clinic in Limpopo province. Results are expected in early 2009.

The funder for this study is the Doris Duke Charitable Foundation.