The South African HIV Prevention Research Advocacy Expert Group  & partners are writing to request strong, public, SA government support for the proposed ECHO trial which we understand to be in jeopardy of cancellation.
    

26th September 2014: World Contraception Day

SOLIDARITY STATEMENT TO :

Minister Aaron Motsoaledi, Minister of Health, South Africa
Prof. Glenda Gray, President – Medical Research Council of South Africa
Dr. F. Abdullah, Chief Executive Officer, South African National AIDS Council

The South African HIV Prevention Research Advocacy Expert Group  & partners are writing to request strong, public, SA government support for the proposed ECHO trial which we understand to be in jeopardy of cancellation—a development that would be a blow to SA AIDS and reproductive health programming on the status of the Evidence for Contraceptive Options & HIV Outcome (ECHO) Trial. We strongly believe that the ECHO trial could be one of the most important reproductive health and HIV trials of this decade and further strengthen South Africa’s position on the global stage as a leader in generating scientific evidence that has meaningful impact on improving the lives and wellbeing of all its citizens, especially women via informed, innovative programming.

The ECHO Trial has the potential to provide high quality, evidence based answers to questions about whether three specific contraceptive options (Depo Provera, the Jadelle implant and the copper intrauterine device) might increase women’s risk of HIV acquisition. These questions are of utmost relevance to South Africa. Excluding condoms, injectable contraceptives make up nearly 75% of the contraceptive methods dispensed in South Africa. Within this, the majority of women are receiving Depo. Modeling studies designed to gauge the impact on HIV infections in a scenario where Depo does increase risk, show that the highest burden of new infections attributable to this method is in South Africa. 

The RSA’s new contraceptive policy stresses an increase in the range of options offered to women, and a shift away from Depo based on the current uncertainty regarding its impact on HIV risk. These are key steps and we believe they should proceed with urgency. However, there are no data on the other hormonal methods, such as the implant, that are being introduced today. ECHO will provide an answer for multiple methods—not just Depo—laying the basis for sound public health policy and clear communication. 

We seek to engage with you on ways in which we may see the full funding of the trial to ensure that it takes place. At present, there is a funding shortfall. Unless additional funds are committed, the trial may not take place We welcome South Africa’s current financial commitment to the trial and ask that you consider increasing this amount as well as making a strong, public statement that this research is a priority for our country and the region.

We the undersigned therefore stand in solidarity with the women of South Africa, one of the Sub Saharan countries with the widest use of depot medroxyprogesterone acetate (DMPA) in encouraging our Department of Health, the Medical Research Council, and the South African National AIDS Council to ensure that the ECHO trial is fully funded – as a national imperative, especially as a country whose response to and recent leadership in the national response to HIV is world renowned. 

As we move forward to urgently explore ways to mobilise South African’s en masse to express their support for this trial to be fully funded, and trial recommendations urgently acted upon, we wish to categorically state that our expectation is that our Government in partnership with the Medical Research Council fill the funding gap that is needed to get the ECHO trial underway, not only as a public health imperative, but as an urgent human rights issue.

Media Contact:  Tian Johnson , +27 73 4324069 , tian@genderjustice.org.za 

The SA HIV Prevention Research Advocacy Expert Group has been established to provide senior level advocates and programme leaders a platform to: enhance their individual capacity relating to all aspects of HIV Prevention Research, build the capacity of key individuals in their organization and circles of influence including policy makers, donors and strategic partners on issues of HIV Prevention Research, accelerate the pace and level of public discourse around HIV Prevention Research Advocacy as it pertains to existing as well as potential technologies in their conceptualization, development, trial, piloting, procurement, distribution & marketing stages, serve as a point of entry and access to the HIV Prevention Research Science communities for advocates. 

The SA HIV Prevention Research Advocacy Expert Group is:

Dr. Ntlotleng Mabena – Centre for HIV & AIDS Prevention Studies


Ntando Yola – Desmond Tutu HIV Foundation


Sisonke Msimang – Graca Machel Trust


Phillipa Tucker – AIDS Accountability International


Dr. Johanna Kehler – AIDS Legal Network


Tian Johnson – Sonke Gender Justice