Journal Article > ResearchFull Text
PLOS Med. 2005 February 1; Volume 2 (Issue 2); DOI:10.1371/journal.pmed.0020014
Dentico N, Ford NP
PLOS Med. 2005 February 1; Volume 2 (Issue 2); DOI:10.1371/journal.pmed.0020014
Journal Article > ResearchFull Text
Lancet. 2001 December 8; Volume 358 (Issue 9297); DOI:10.1016/S0140-6736(01)06995-1
Shafer J, Falzon D, Small I, Kittle D, Ford NP
Lancet. 2001 December 8; Volume 358 (Issue 9297); DOI:10.1016/S0140-6736(01)06995-1
Journal Article > ResearchFull Text
Trop Med Int Health. 2010 December 1; Volume 15 (Issue 12); DOI:10.1111/j.1365-3156.2010.02649.x
Bemelmans M, van den Akker T, Ford NP, Philips M, Zachariah R, et al.
Trop Med Int Health. 2010 December 1; Volume 15 (Issue 12); DOI:10.1111/j.1365-3156.2010.02649.x
Objective To describe how district-wide access to HIV/AIDS care was achieved and maintained in Thyolo District, Malawi. Method In mid-2003, the Ministry of Health and Médecins Sans Frontières developed a model of care for Thyolo district (population 587 455) based on decentralization of care to health centres and community sites and task shifting. Results After delegating HIV testing and counseling to lay counsellors, uptake of testing increased from 1300 tests per month in 2003 to 6500 in 2009. Shifting responsibility for antiretroviral therapy (ART) initiations to non-physician clinicians almost doubled ART enrolment, with a majority of initiations performed in peripheral health centres. By the end 2009, 23 261 people had initiated ART of whom 11 042 received ART care at health-centre level. By the end of 2007, the universal access targets were achieved, with nearly 9000 patients alive and on ART. The average annual cost for achieving these targets was €2.6 per inhabitant/year. Conclusion The Thyolo programme has demonstrated the feasibility of district-wide access to ART in a setting with limited resources for health. Expansion and decentralization of HIV/AIDS service-capacity to the primary care level, combined with task shifting, resulted in increased access to HIV services with good programme outcomes despite staff shortages.
Journal Article > Meta-AnalysisAbstract
Int Health. 2013 July 30; Volume 5 (Issue 3); DOI:10.1093/inthealth/iht016
Decroo T, Rasschaert F, Telfer B, Remartinez D, Laga M, et al.
Int Health. 2013 July 30; Volume 5 (Issue 3); DOI:10.1093/inthealth/iht016
In sub-Saharan Africa models of care need to adapt to support continued scale up of antiretroviral therapy (ART) and retain millions in care. Task shifting, coupled with community participation has the potential to address the workforce gap, decongest health services, improve ART coverage, and to sustain retention of patients on ART over the long-term. The evidence supporting different models of community participation for ART care, or community-based ART, in sub-Saharan Africa, was reviewed. In Uganda and Kenya community health workers or volunteers delivered ART at home. In Mozambique people living with HIV/AIDS (PLWHA) self-formed community-based ART groups to deliver ART in the community. These examples of community ART programs made treatment more accessible and affordable. However, to achieve success some major challenges need to be overcome: first, community programs need to be driven, owned by and embedded in the communities. Second, an enabling and supportive environment is needed to ensure that task shifting to lay staff and PLWHA is effective and quality services are provided. Finally, a long term vision and commitment from national governments and international donors is required. Exploration of the cost, effectiveness, and sustainability of the different community-based ART models in different contexts will be needed.
Journal Article > ReviewAbstract
J Acquir Immune Defic Syndr. 2019 January 25; Volume 80 (Issue 5); DOI:10.1097/QAI.0000000000001957
O'Brien DP, Ford NP, Djirmay AG, Calmy A, Victoria M, et al.
J Acquir Immune Defic Syndr. 2019 January 25; Volume 80 (Issue 5); DOI:10.1097/QAI.0000000000001957
Evidence suggests that there are important interactions between HIV and Female Genital Schistosomiasis (FGS) that may have significant effects on individual and population health. However, the exact way they interact and the health impacts of the interactions are not well understood. In this paper we discuss what is known about the interactions between FGS and HIV, and the potential impact of the interactions. This includes the likelihood that FGS is an important health problem for HIV positive women in schistosoma-endemic areas potentially associated with an increased risk of mortality, cancer and infertility. Additionally, it may be significantly impacting the HIV epidemic in sub-Saharan Africa by making young women more susceptible to HIV. We call for immediate action and argue that research is urgently required to address these knowledge gaps and propose a research agenda to achieve this.
Journal Article > CommentaryAbstract
Int J Drug Policy. 2015 May 18; Volume 26 (Issue 11); DOI:10.1016/j.drugpo.2015.05.004
Ford NP, Wiktor SZ, Kaplan K, Andrieux-Meyer I, Hill AM, et al.
Int J Drug Policy. 2015 May 18; Volume 26 (Issue 11); DOI:10.1016/j.drugpo.2015.05.004
Journal Article > Meta-AnalysisFull Text
Lancet Infect Dis. 2015 May 5; Volume 15 (Issue 7); DOI:10.1016/S1473-3099(15)00006-7
Rao VB, Johari N, du Cros PAK, Messina J, Ford NP, et al.
Lancet Infect Dis. 2015 May 5; Volume 15 (Issue 7); DOI:10.1016/S1473-3099(15)00006-7
An estimated 150 million people worldwide are infected with hepatitis C virus (HCV). HIV co-infection accelerates the progression of HCV and represents a major public health challenge. We aimed to determine the epidemiology of HCV and the prevalence of HIV co-infection in sub-Saharan Africa.
Journal Article > CommentaryFull Text
PLoS Negl Trop Dis. 2015 November 12; Volume 9 (Issue 11); e0004075.; DOI:10.1371/journal.pntd.0004075
O'Brien DP, Ford NP, Vitoria M, Asiedu K, Calmy A, et al.
PLoS Negl Trop Dis. 2015 November 12; Volume 9 (Issue 11); e0004075.; DOI:10.1371/journal.pntd.0004075
Journal Article > ReviewFull Text
Lancet Global Health. 2021 May 1; Volume 9 (Issue 5); e681-e690.; DOI:10.1016/S2214-109X(20)30539-8
Park JS, Grais RF, Taljaard M, Nakimuli-Mpungu E, Jehan F, et al.
Lancet Global Health. 2021 May 1; Volume 9 (Issue 5); e681-e690.; DOI:10.1016/S2214-109X(20)30539-8
This paper shows the scale of global health research and the context in which we frame the subsequent papers in the Series. In this Series paper, we provide a historical perspective on clinical trial research by revisiting the 1948 streptomycin trial for pulmonary tuberculosis, which was the first documented randomised clinical trial in the English language, and we discuss its close connection with global health. We describe the current state of clinical trial research globally by providing an overview of clinical trials that have been registered in the WHO International Clinical Trial Registry since 2010. We discuss challenges with current trial planning and designs that are often used in clinical trial research undertaken in low-income and middle-income countries, as an overview of the global health trials landscape. Finally, we discuss the importance of collaborative work in global health research towards generating sustainable and culturally appropriate research environments.
Journal Article > LetterFull Text
Lancet. 2002 April 13; Volume 359 (Issue 9314); 1351.; DOI:10.1016/S0140-6736(02)08303-4
Ford NP, 't Hoen E
Lancet. 2002 April 13; Volume 359 (Issue 9314); 1351.; DOI:10.1016/S0140-6736(02)08303-4