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03 May 2006: No 24/06

DOD PROJECT PHIDISA UPDATE

Project Phidisa, which is a collaborative programme between the SANDF, the US Department of Defence and the National Institute of Health, opened its fifth site in Bloemfontein on the 7th of March 2006.

The last Phidisa site, which will be located in Phalaborwa, will also be opened during the course of the year. So far 4 040 members of the SANDF and their dependants have enrolled in this project, of which 1 100 are receiving treatment, some since 2004.

A fundamental element of clinical research is that participation is voluntary and non-coercive and it provides the opportunity for patients to access tomorrow’s treatments today.

For the Phidisa research results to be valid at least 2 800 members and their dependants should have been on treatment in the early stages of the research and have been monitored for a long period of time.

Since its inception, the goal of Phidisa has been to develop a state-of-the-art clinical research programme within the SANDF that will address scientifically valid research questions that are important and relevant to the mission readiness of the SANDF, with the initial focus on HIV.

Phidisa is currently enrolling patients in two protocols.

Phidisa 1 is a prospective epidemiological cohort study of HIV and risk-related co-infections in the SANDF, for which both HIV negative and HIV positive individuals are eligible, while

Phidisa 2 is a randomised, open label study to compare the safety and efficiency of different combinations of antiretroviral drugs for the treatment of patients. This category of patients is that with advanced HIV disease and/or whose CD4+ cell counts are less than 200 and these patients have not taken drugs previously.

Phidisa 2 therefore takes the first line regimen being used in the national roll-out and compares it to three other regimens in an effort to determine the best one for initial therapy.

The SAMHS ARV roll-out is on the verge of being implemented nationally, and the sites that have been accredited for issuing ARVs are 1, 2 and 3 Military Hospitals, Nelspruit, Kimberley, Durban and Potchefstroom.

Uniformed members of the SANDF and their dependants have a choice to join either Project Phidisa or the SAMHS ARV roll-out.

However, those who have already joined Phidisa must be encouraged to remain in Phidisa so that the SANDF is able to answer research questions that are relevant to SA and the world at large on the use of ARVs in the Military.

Uniformed members of the SANDF and their dependants who do not qualify to join Project Phidisa II are children who are less than 14 years old, pregnant females and members who have been taking ARVs continuously on their own.

Once the roll-out is implemented these members and their dependants should be encouraged to join.

However, these members are eligible to join PI and therefore should be encouraged to do so.

It is also of critical importance that the SAMHS and Phidisa personnel work together in order to ensure the best service for the patients, because there are special benefits in belonging to either Phidisa or the roll-out.

What should be noted is that it is still important to encourage members of the SANDF and their dependants to join Phidisa in large numbers in order to assist the military to find answers to important questions related to HIV and AIDS.

Phidisa clinics are expected to provide the best overall care and give patients feedback on their treatment.

This would promote full participation and ownership because HIV treatment is life-long.

Furthermore, the 1 Military Hospital Phidisa site, which opened on the 19th of January 2004, has experienced challenges in collecting data on the patients, due to the high number of members who have enrolled at this clinic.

This has led to the Phidisa Executive placing temporal restrictions on the number of patients to be enrolled.

The restriction was that only patients whose CD4 count was very low should be enrolled at the 1 Military Hospital Phidisa Clinic.

The above-mentioned restriction has now been removed; members of the SANDF and their dependants are now allowed to enrol new patients who are either negative or positive.

Let us join hands and work together to find answers concerning HIV treatment.

Be part of the solution by calling any Phidisa clinic now and making an appointment.

The enrolment of HIV negative SANDF members would address the stigmatisation related to HIV and AIDS.

Project Phidisa site numbers country-wide are as follows:

• Mthatha – 047 501 5200
• Mtubatuba – 035 772 1079
• 2 Mil hosp – 021 797 0804
• 1 Mil hosp – 012 651 9970
• AMHC FS – 051 436 5085 (Bloemfontein)

Any enquiries in this regard may be forwarded to Capt S.Y. Senokwanyane, tel: 012 6715148