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WHC News Journal - July 2022

Page 1

MAGAZINE Volume 1: July Edition

Dear colleagues, I am pleased to share with you the first edition of our Wits Health Consortium online magazine. By showcasing the projects being undertaken within our Consortium and the people leading them, we hope that our magazine will play a part in stimulating communication and collaboration between our clients. Upon review of the high qualify of articles received from contributors we felt that a “newsletter” format would not do them justice. So, our newsletter concept evolved into a magazine format where you may read the full articles without having to “click” to a link! In every issue of our magazine, we will feature the work being done by entities within our Consortium. In this issue we have featured some of the work that is being done by Wits RHI, the MRC/Wits-Agincourt Research Unit, Ezintsha and Wits VIDA. Our magazine also celebrates the international recognition bestowed upon our colleague Professor Helen Rees by The University of London and the Harvard Public Health Magazine recently! It is a privilege to have a renowned academic and leader like Professor Rees among us! Lastly, if you would like to share any information or news that may be considered for inclusion in future issues of our magazine or any suggestions on how we may improve this communication platform, please direct them to Brad Aigner at baigner@witshealth.co.za

Enjoy!

Alfred Farrell

Executive Director and Chief Executive Officer of WHC


CONTENTS

01

Professor Helen Rees bestowed an

Honorary Doctorate by University

of London

05

Ezintsha works to improve aspects of health care in the public sector

09

Professor Helen Rees, OBE, the Founder and Executive Director of Wits RHI, the largest research Institute at the University of Witwatersrand in Johannesburg, South Africa had an Honorary Degree bestowed upon her by the University of London on Thursday 14 July 2022.

Ezintsha works to improve aspects of health care in the public sector, with a particular focus on treatment optimisation, drug access and medical technologies in the areas of HIV and noncommunicable diseases (NCDs). Based on our experience, expertise and success, Ezintsha aims to find ways to move the needle on global health...

Wits VIDA - We Make Life Count VIDA was established in 2019 and was a succession to the Pneumococcal Diseases Research Unit and subsequent rebranded Respiratory and Meningeal Pathogens Research Unit which had been established in 1997. VIDA research is focused on...

03

Partnering with rural communities to prioritise population research

07

Wits RHI - A renowned multi-

disciplinary African research

institute

10

Over four decades of apartheid rule (1948 – 1990), South African Bantustans endured systemic, racist inequalities that resulted in ‘homelands’ for black South Africans that were least-resourced, received separate and inferior services, and lacked formal records of births and deaths. The undertaking began, in 1992, with producing Agincourt’s...

Wits RHI is a renowned multi-disciplinary African research institute that was established by Professor Helen Rees in 1994 to support the new South African (SA) government to formulate and implement new national policies around sexual and reproductive health.

The Power of Partnerships

At the beginning of the third wave (Delta), management and COVID-19 clinicians in key Gauteng public sector hospitals worked with the GDOH Acting HOD and HQ officials to submit a proposal to the Solidarity Fund to support the...

Acknowledgements

We would like to thank the following people for their contributions to this issue: Kurium Govender

Project Administrator

MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt)

Kurium.Govender@wits.ac.za | www.agincourt.co.za

Holly Fee

Head: Strategic Development

Ezintsha

hfee@ezintsha.org | www.ezintsha.org

Deshni Naidoo

Communications Manager (Comms)

Wits RHI

DNaidoo@wrhi.ac.za | www.wrhi.ac.za

Theranne van Vuren

Research Administration Manager

Wits Vaccines & Infectious Diseases Analytics (VIDA) Research Unit

theranne.vanvuren@wits-vida.org

Raylene Eksteen

Head: Durban Hub

Wits Health Consortium

resksteen@witshealth.co.za

Editorial Team Editor

Bradley Aigner

Layout & Design

Bradley Puckree


Inspiring Excellence Professor Helen Rees bestowed an Honorary Doctorate by University of London Professor Helen Rees, OBE, the Founder and Executive Director of Wits RHI, the largest research Institute at the University of Witwatersrand in Johannesburg, South Africa had an Honorary Degree bestowed upon her by the University of London on Thursday, 14 July 2022. She was bestowed a Doctor of Science (Medicine) honoris causa degree. The University of London bestows these honorary degrees to people of eminence and distinction.

This comes quick on the heel of being acknowledged as one of 25 standout voices in public health in Africa in the Harvard Public Health Magazine.

Professor Rees has also received two other accolades this year, namely the platinum South African National Batho Pele Award for excellence in contribution to the South African COVID-19 response and the Officer of the French National Order of Merit by President Macron for her contribution to global health and to the COVID-19 response.

Professor

These awards demonstrate Professor Rees’s international recognition as an award-winning global health practitioner who has dedicated her professional career to improving public health in Africa, with a focus on vaccine preventable diseases, HIV and sexual and reproductive health.

an

ability

to

create

consensus,

to

a

is

a

Medical

Personal

Doctor

Professor

in

by the

University of Witwatersrand’s Department of Obstetrics and Gynaecology, an Honorary Professor

in

the

Department

of

Clinical

Research at the London School of Hygiene and Tropical Medicine and an Honorary Fellow at

Professor Rees is recognised as an outstanding chairperson with

profession,

Rees

synthesize

Murray

Edwards

College,

Cambridge

University.

recommendations from multifaceted inputs, and to link science to policy. She has chaired over 100 national and international scientific and policy committees, has over 250 scientific academic publications, has delivered over 400 invited plenary and keynote addresses, and contributed to the organisation of more than 100 conferences. She serves as the chairperson of the WHO African Regional Immunisation Technical Advisory Group (RITAG). She has chaired many WHO committees and is Chair of the IHR Polio Committee, Co-chair of the SAGE Ebola Vaccine working group and a member of the

WHO

Scientific

and

Technical

Advisory

Group

on

Infectious Hazards (STAG-IH).

www.witshealth.co.za

1


Professor Rees is a keen advocate for increasing

In South Africa, Professor Rees is a member of SA’s

research capacity in Lower Middle Income Countries

Ministerial Advisory Committee on COVID-19, a

(LMIC) and the African region and is a member of the

member of the SA National Essential Medicines

Facilitation Committee of the COVID-19 LMIC Clinical

Committee

Research Coalition and of the African Union/African

member of the Ministerial Advisory Committee on

CDC’s COVID-19 vaccine research committee.

COVID-19 vaccines. As chair of the SA Regulatory

on

COVID-19

therapeutics,

and

a

Authority, she has been involved in development of She has joined the many regional and global voices

regulatory guidelines for COVID-19 diagnostics,

calling for equitable global access to COVID-19 vaccines,

therapeutics and vaccines.

therapeutics and diagnostics.

Professor Rees is a member of the WHO’s IHR Emergency Committee on COVID-19 responsible for advising WHO’s Director General on the declaration of a global Public Health Emergency of International Concern and the associated global temporary recommendations. Through her work with Gavi, CEPI, the COVAX Facility and WHO both globally and in the African region, she continues to serve on the following committees for COVID-19

vaccines:

member

of

the

WHO

IHR

Emergency Committee for COVID-19, member of WHO SAGE COVID-19 Vaccine Committee and member of the COVAX Independent Advisory Group on COVID-19 vaccines. In these roles she has advised on the selection of and investment in COVID-19 vaccine candidates. She is also a member of the COVAX committee on COVID-19 maternal immunization.

Professor Helen Rees has had an Honorary Degree of

Doctor of Science(Medicine) conferred upon her by the University of London. Congratulations on this remarkable achievement!

www.witshealth.co.za

2


Partnering with rural communities to prioritise population research Over four decades of apartheid rule (1948 – 1990), South African Bantustans endured systemic, racist inequalities that resulted in ‘homelands’ for black South Africans that were least-resourced, received separate and inferior services, and lacked formal records of births and deaths. and

taking

a

enumerating

baseline 58,000

census people,

of

20

villages

including

–

15,000

Mozambican refugees displaced by the civil war. Over the ensuing years, the annual census, which tracks vital events (births, deaths and migrations) and indicators of socio-economic status amongst others, demonstrated rapid and profound health, population and social transitions. These were driven in large part by the devastating impact of the HIV/AIDS epidemic and impressive albeit late introduction of PMTCT and antiretroviral

therapy

predominance

of

–

and

alongside

HIV/AIDS,

emerging

the non-

communicable diseases.

Figure 1. Fieldworkers collecting data for census. Photo by Paul Weinberg.

By the late 1990s, work transitioned from designing and From 1982, staff of Wits University’s Health Systems

testing decentralised health systems to a population-

Development Unit (HSDU) were working in Gazankulu in

based research platform conducting work relevant to

the rural northeast of South Africa adjacent to the

other transitioning rural communities in south and sub-

Kruger National Park and close to the border with

Saharan Africa.

Mozambique – their base was Tintswalo Hospital in

Agincourt HDSS was able to “nest” studies along the life

Bushbuckridge, now a rural sub-district.

In the early

course, probe questions arising from the observed

1990s, anticipating approaching democratic change and

health and social transitions, establish cohorts, and trial

deeply aware of the deficiencies in rural health services

interventions. In 2004, the Agincourt Health and

in the context of broader rural realities, the staff of the

Population Unit was officially recognised as a SAMRC

HSDU re-focused their approach to rural health systems

and Wits University research unit, becoming the MRC/

development.

Wits

Rural

By expanding its infrastructure, the

Public

Health

and

Health

Transitions

Research Unit (Agincourt). The surveillance area now They quickly learned that there was no reliable

includes 31 villages and some 120,000 people in 20,000

population information on which to base rational

households

decision-making. Using first-hand experience of health and demographic surveillance systems (HDSS) visited in

From March 2020, the Unit’s longitudinal data platform

Bangladesh and Senegal, Steve Tollman and team set

and infrastructure (specifically an extended call centre)

out to establish one in Agincourt, a remote area of

enabled a rapid response to the urgent challenges

Bushbuckridge

other

posed by the COVID-19 pandemic, repurposing existing

infrastructure, save for a network of clinics and a

studies and tackling new questions to serve the national

community health centre.

response and contribute the rural component – often

far

from

tar

roads

and

This would serve as a

demonstration area in which to co-develop and model

otherwise missing – to the national picture.

functioning district and sub-district health systems to inform district, provincial and national policy-makers.

Together with partners, the Unit’s COVID-19 response within the first few months included: health systems

The

undertaking

began,

in

1992,

with

producing

Agincourt’s first maps (which were hand-drawn)

R&D; analyses of existing HDSS and other data to provide evidence for decision-making;

www.witshealth.co.za

3


epidemiology on community burden and transmission dynamics of SARS-CoV-2 in a rural setting (with NICD); and social, behavioural and economic impacts during and post-lockdown to guide local and provincial programmes and national policy. Linkage of the population platform to clinic and hospital records enabled the introduction of “dashboards” as a basis for decision-making and resource deployment by clinical and service leadership. On the global front, the Agincourt Research Unit is leading a multinational Excess Mortality initiative to characterise all-cause and cause-specific mortality during COVID-19 times (using verbal autopsy data) in low- and middle-income settings. The initiative, funded by the Bill and Melinda Gates Foundation, capitalises on several population research networks namely, CHAMPS; ICDDR,B; INDEPTH; INSPIRE; and SAPRIN and involves 19 urban and rural population research platforms in East, West and Southern Africa, and South Asia.

Leadership of the Agincourt Research Unit has been forward-thinking, having played a leading role in the establishment of the International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH); supported the establishment of DIMAMO a rural HDSS linked to the University of Limpopo; and participated centrally in establishing the South African Population Research Infrastructure Network (SAPRIN).

2022 marks 30 years of the MRC/Wits-Agincourt Research Unit making it one of the longest running research centres of its kind in sub-Saharan Africa. The work is supported by close participation of the community and local government, dedicated staff, and a rich network of local and global partnerships and collaborations.

The Agincourt Research Unit has been resilient to pressures and adaptable to change. The rapid and complex transitions experienced by our rural communities means that the Agincourt longitudinal research platform gains in value with increasing time, with the nested studies benefiting greatly from what it has to offer.

Figure 2. Access to potable water remains a priority issue impacting health and

socioeconomic development. Photo by Jackie Roseleur.

Figure 3. Merga Agaa, Cho Kabudula (Agincourt Research Unit), and Gezahegn Negassa collaborating to clean and harmonize Kersa HDSS's dataset at an in-person data harmonisation workshop for the Excess Mortality initiative at Wits University in March 2022.

www.witshealth.co.za

4


Ezintsha works to improve aspects of health care in the public sector Ezintsha works to improve aspects of health care in

Characterizing Long-COVID and related disability in local

the public sector, with a particular focus on treatment

populations is an important first step to understanding

optimisation, drug access and medical technologies in

the burden of morbidity and potential requirements of

the areas of HIV and non-communicable diseases

the

(NCDs). Based on our experience, expertise and

disability, an understanding which we hope to achieve

success, Ezintsha aims to find ways to move the needle

through this study.”

health

system

in

addressing

symptoms

and

on global health, and use what is learned to inform public health policy and practice in South Africa, the

Since the COVID-19 pandemic began, there have been

Southern African region, and other parts of the world.

many diagnostic tools developed and launched around the world, while readily accessible and cost effective

Ezintsha’s study, Characterising Long COVID in South

COVID therapeutic interventions have been scarce.

African Adults, is funded by the SAMRC. It will explore

Ezintsha

and document the consequences of Long-COVID in

combination with the opportunity presented by the

three large, well-described clinical cohorts of African

imminent availability of molnupiravir, to develop a map

patients surviving SARS-CoV-2 prior to vaccination,

for early treatment of COVID 19. The CoTeT project will

recruited from prevention and early treatment clinical

find

trials conducted between 2020 and 2022, and from

treatment initiation following a positive test result,

hospitals.

using a point-of-care antigen test, to support the most

The

syndrome,

common

in

COVID-19

is

the

using

optimal

survivors, can affect every organ system through as-yet

cost-effective

uncharacterised

scaled

of

diagnostic

pathway

likely

limited

to

tool,

in

immediate

drug

supply,

immunological

optimizing case finding within the first 5 days of symptom onset using a simplified checklist, and linking

appear to be more severe in those at risk for, or

appropriate, easy-to-identify patients in a primary care

surviving, severe COVID disease.

or community setting to immediate treatment initiation.

Symptoms and dysfunction tend to slowly resolve but it

In the process, high-quality safety and efficacy data on

is unclear if disability or organ damage is permanent in

local populations in urban, semi-urban and rural areas

some patients. Almost all studies on Long-COVID have

will be accumulated, and an advisory group led by the

been undertaken in higher income countries, and

SA DoH to advise on pathways to diagnosis and early-

largely in hospitalised patients, with little data from

use COVID-19 antiviral treatment will be developed and

Africa.

supported.

study

presumed

COVID-19

mechanisms. The consequences may be disabling and

The

but

use

a

will

significantly

contribute

to

understanding the components of Long-COVID and contribute significant African data to current efforts to develop

both

understandings

syndrome of

the

diagnostic therapeutic

criteria needs

and of

symptomatic survivors, in order to inform South African healthcare. Ezintsha is working on this project with a team from across WHC and the University, spanning Genetics, Infectious Diseases, Cardiology, Psychology, Respiratory and Physiology.

Dr Samanta Lalla-Edward, a Co-Investigator on the study said,

“This

is

an

exciting

collaboration

among

multidisciplinary health researchers of the Wits Faculty of Health Sciences which will not only contribute to advancing Long-COVID knowledge but also support the development of postgraduate, early career researchers.

www.witshealth.co.za

5


The study will develop a primary care COVID-19 testand-treat early-use model, for 2000 early COVID-19 high-risk patients in different clinical settings in South Africa and compare their outcomes to 2000 patients receiving standard of care.

Professor Francois Venter commented, “One of the sad realities of COVID is that it is clear that it is possible to get repeat infections, despite having had previous vaccines and bouts of the virus, and these infections are often severe enough to cause significant morbidity. This morbidity translates into absenteeism at work, as well as occasional hospitalisation and even death, meaning that work on these early treatment drugs is really critical.

However, diagnosing COVID early on is a

challenge in the South African environment, so our parallel work for the Department of Health to show meaningful impact in finding patients early, and then linking them to care quickly so they can get these drugs, is extremely important.”

www.witshealth.co.za

6


Wits RHI - A renowned multi-

disciplinary African research

institute Under the leadership of Prof. Helen Rees, Wits RHI has participated in ground-breaking COVID-19 studies and intervention since the declaration of the pandemic. All our

directors

projects

and

had the

spearheaded institute

various

played

a

COVID-19

key

role

in

contributing and influencing local and global health policy.

We

lead

and

deliver

high

quality

Research

and

Implementation projects that have placed us at the cutting edge of science and have resulted in the growth of the Institute and expanding on our footprint within the communities we serve.

Some of our recent highlights expanded from our COVID-19

portfolio:

ChAdOx1nCoV,

NOVAVAX,

Ensemble and COVPN to pregnant women: Pfizer C4591015. We extended our COVID-19 surveillance and sero-survey

studies

from

EDCTP-COREP

the

general

Household

population:

Wits RHI is a renowned multi-disciplinary African

SAPRIN,

Transmission

to

research institute that was established by Professor

include pregnant women: Pregnancy Surveillance study

Helen Rees in 1994 to support the new South African

and as well as focussed on COVID-19 therapeutic

(SA) government to formulate and implement new

studies: CROWN CORONATION, UNITY, WHO Solidarity

national policies around sexual and reproductive

and the Recovery Trial.

health.

In our HIV prevention portfolio, there was significant As the largest research institute within the University

breakthrough with the approval of the long-acting

of the Witwatersrand, Wits RHI addresses some of the

injectable cabotegravir (CAB-LA) by the U.S. Food and

greatest public health concerns affecting our region,

Drug Administration (FDA). CAB-LA is the first long-

focusing on HIV/TB, sexual and reproductive health,

acting injection for use as pre-exposure prophylaxis

vaccine preventable diseases including COVID-19 and

(PrEP) for the prevention of HIV. This FDA approval was

climate and health. The institute is a pioneer in multi-

based on data from two of our multicenter studies,

disciplinary research as we offer responsive technical

HPTN 083 and 084, that we led.

support and innovation in health services, community

partnerships, evidence-based policy development and

Wits RHI was the recipient of a large PEPFAR-USAID

advocacy

grant,

with

national,

regional,

and

global

MATRIX.

This

focuses

on

research

and

development of new HIV prevention technologies to

stakeholders.

address the unmet needs of adolescent girls and young Wits RHI is part of the Faculty of Health Sciences and

women, pregnant and breastfeeding women and key

is a UNAINDS (Joint United Nations Programme on

populations in SA.

HIV/AIDS), World Health Organistaion (WHO) and (MRC)

MOSAIC is a Wits RHI - USAID award, to expedite the

collaborating centre as well as a United Nations

access to a range of biomedical products that are safe,

Populations Fund (UNFPA) strategic partner.

acceptable, and affordable.

South

African

Medical

Research

Council

www.witshealth.co.za

7


This study has placed us in a unique position to

Officer of the British Empire for contribution to global

significantly contribute to local and global evidence of

health; Officer of the French National Order of Merit

current and future HIV prevention technologies along

for contribution to global health and COVID-19;

with collaborators from across Sub-Saharan Africa and

Receiving the prestigious Ministerial COVID-19 Special

globally.

Award at the National Batho Pele Excellence Awards in

the

Another significant milestone grant that we achieved,

contributions to the COVID-19 pandemic. This accolade

was the expansion of our HIV care and treatment

acknowledges

portfolio through the PEPFAR-CDC called GOPHELEGA.

contributions to COVID-19 research for 2021/2022 and

This grant is one of the largest implementation awards

been made a Doctorate of Science by the University of

ever received by Wits RHI and the Faculty of Health

London which is awarded annually to a ‘person of

Sciences at Wits University. This grant provides Wits RHI

eminence and distinction’. Professor Sinead Delany –

with a great and unique platform to introduce new HIV

Moretlwe, Director of Research has been invited to Co-

technologies,

treatment

Chair a World Health Organisation (WHO) Pregnancy

services in support of the Department of Health and

Therapeutics Group for a 3-year term. This group will

evaluate the impact of our services, science and

focus on HIV, STI and HPV therapeutics. Professor

technologies within the communities we serve.

Thesla Palanee – Phillips, Director of Clinical Trials, was

implement

HIV

care

and

Platinum

and

acknowledged In

our

Climate

and

Health

portfolio,

Wits

RHI

Category

on

in

recognition

recognises

her

her

promotion

of

her

outstanding

and

joint

appointment to Affiliate Associate Professor with the

successfully applied for the National Institutes of Health

University

of

Washington,

Department

of

(NIH) and European Union (EU) funding for HIGH

Epidemiology, School of Public Health, Seattle, USA.

Horizons HE2AT Centre, ENBEL and CHAMNHA studies

This is a monumental achievement in her career.

to develop innovative systems to monitor and mitigate the impact of climate change on the health of vulnerable populations including pregnant women, infants and healthcare workers in Africa. With this funding, Wits RHI will be leaders in building capacity on data science and climate change as well as be a resource for climate change and health initiatives across the African continent and globally.

Amongst all these major project achievements, Wits RHI’s leadership still excelled in receiving prestigious awards this year. Professor Helen Rees has received many awards including being made: Officer of the British Empire for contribution to global health;

www.witshealth.co.za

8


Wits VIDA - We Make Life Count VIDA was established in 2019 and was a succession to the Pneumococcal Diseases Research Unit and subsequent rebranded Respiratory and Meningeal Pathogens Research Unit which had been established in 1997. VIDA research is focused on clinical and molecular epidemiology of vaccine preventable disease, clinical development and evaluation of vaccines, study of the immunology of vaccines including in people living with HIV and basic science research aimed at discovery of potential vaccine epitopes. In the last few years, the Unit has also established a health and demographic surveillance (HDSS) platform to understand the context

in which infections occur and how population dynamics are affected by disease trends, both in children and in pregnant women. This HDSS platform has provided an integral platform to understand COVID-19 epidemiology

and the direct and indirect effects of COVID-19 across all age groups.

The Unit has established itself as a premier clinical trial facility for vaccine research and has undertaken pivotal studies on pneumococcal conjugate vaccine, rotavirus vaccine, as well as being an international leader in vaccine studies in pregnant women aimed at the protection of mother-newborn dyads. Over the past two years, VIDA has been at the forefront of Covid-19 vaccine research in Africa, having spearheaded the first two Covid-19 vaccine studies undertaken only on the continent.

It has also undertaken the first studies of an investigational multi-component Group B Streptococcus (GBS) conjugate vaccine in pregnant women, a portfolio of research that is ongoing, including discovery research on other potential GBS vaccine epitopes. This is pertinent to Africa and South Africa which has reported the highest incidence of invasive GBS disease globally. Most recently, VIDA has pioneered COVID-19 vaccine trials, providing critical evidence on vaccine effectiveness in African populations. A further important respiratory pathogen being investigated by VIDA over the past 25 years is Respiratory Syncytial Virus (RSV). VIDA has been intricately involved in the evaluation of a long-lasting monoclonal antibody that is more affordable than the currently available palivizumab, and is also participating in RSV vaccine trials in pregnant women, including having led the first such study of a nano particle F protein vaccine in pregnant women.

Wits VIDA has furthermore done extensive epidemiology work on COVID-19, in addition to evaluating the safety, immunogenicity, efficacy and effectiveness of COVID-19 vaccines.

The studies done by VIDA on pneumococcal conjugate vaccine and rotavirus vaccine in children contributed to South Africa being the first African country to include both vaccines in its public immunization program, and underpinned the WHO recommendation for the inclusion of these vaccines in public immunization programs of other low and middle income countries. VIDA also performed the first placebo-controlled randomized trial of the influenza vaccine in pregnant women, that contributed to WHO recommending for the prioritization of pregnant women to be vaccinated with seasonal influenza vaccines.

www.witshealth.co.za


The Power of Partnerships

GAUTENG PUBLIC SECTOR COVID-19 AGENCY NURSES PROJECT At the beginning of the third wave (Delta), management and COVID-19 clinicians in key Gauteng public sector hospitals worked with the GDOH Acting HOD and HQ officials to submit a proposal to the Solidarity Fund to support the provision of agency nurses to the eight largest public hospitals in the province. This was to respond to the unprecedented need for significantly more COVID-19 beds. The proposal identified the shortage of nursing personnel as the single biggest bottleneck to opening more COVID ICU, high care and covid general beds. Technical support and leadership for the project was provided by the South African Medical Research Council working with the heads of the nursing management at all hospitals and Wits Heath Consortium (Pty) Ltd were appointed as the project managers.

The collaborative partnership between the Solidarity Fund, the Gauteng Department of Health, The South African Medical Research Council and Wits Health Consortium (Pty) Ltd successfully identified, recruited and deployed nurses with the necessary knowledge, skills and competencies for safe patient care to 8 Gauteng hospitals.

From 1 July 2021 to 31 March 2022 the Solidarity Fund through Wits Health Consortium assisted the Gauteng Department of Health with funding for agency nurses to augment staffing in 8 of the Gauteng hospitals. The highly transmittable Delta variant led to an overwhelming increase in infections resulting in increased hospitalization, and it became evident that the Gauteng provincial health services would not be able to cope with the increased demand for beds. The third wave affected Gauteng more than any province in the country. The Solidarity Fund initially donated R16,692 million and then extended the programme with an additional R6,246 million. The funding received allowed hospitals to use the additional services of over 10 000 nurses.

As a result of this funding a total of 1 428 new beds were opened across ICU, high care, general wards in paediatric obstetric and COVID ICU. This partnership, through the opening of additional beds, contributed to reduced Covid morbidity, closed critical nursing gaps and reduced the work pressures on the small pool of full-time nursing staff in the hospitals. The project demonstrated how relatively small sums of money, when utilised effectively can qualitatively change health outcomes. The data and experience of the hospitals during the third wave highlighted that the SF-GDoH project made a significant impact in hospitals allowing them stay true to the value of saving lives and allowed community members to access and receive the treatment they so desperately required during this period. Given the positive outcome of the project during the third wave, an extension was granted that saw the support being provided through the fourth (Omicron) wave.

The project reflects the impact of an investment in the provision of more than 10 000 nursing shifts to the main public sector hospitals in Gauteng during a time of crisis and represents the best examples of the power of partnership in the face of an unprecedented crisis.

The efficacy of the model was trialed at Steve Biko Academic Hospital and was an overwhelming success which was quickly rolled out to the other 7 hospitals in Gauteng.

www.witshealth.co.za


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