IeDEA-WHO Research-Policy Collaboration: contributing real-world evidence to HIV progress reporting and guideline development

Abstract

Partnerships between researchers and policymakers can improve uptake and integration of scientific evidence. This article describes the research-policy partnership between the International epidemiology Databases to Evaluate AIDS (IeDEA) ( www.iedea.org) and the World Health Organization (WHO), which was established in 2014. IeDEA is an international research consortium, which analyses data on almost 2 million people living with HIV under care in routine settings in 46 countries in Asia-Pacific, the Caribbean, Central and South America, North America and sub-Saharan Africa. Five multiregional analyses were identified to inform the WHO on progress towards the second and third 90s of the 90-90-90 targets in adults and children: (i) trends in CD4 cell counts at the start of antiretroviral therapy (ART); (ii) delays from enrolment in HIV care to ART initiation; (iii) the impact of ART guideline changes; (iv) retention in care, mortality and loss to follow-up; and (v) viral suppression within the first 3 years after initiating ART. Results from these analyses were contributed to the 2015 and 2016 WHO global HIV progress reports, will contribute to the 2018 report, and were published in academic journals. The partnership has been mutually beneficial: discussion of WHO policy agendas led to more policy-framed, relevant and timely IeDEA research, and the collaboration provided the WHO with timely access to the latest data from IeDEA, as it was shared prior to peer-review publication.

Keywords: research-policy partnerships, HIV, cohort data, observational data, World Health Organization.

Figure 1.

Map of the regions of IeDEA. Adapted from www.iedea.org. CCASAnet: Caribbean, Central and South America; NA-ACCORD: North America.

Figure 2.

IeDEA evidence included in WHO Global Health Sector Response to HIV, 2000–2015: Focus on Innovations in Africa, published November 2015 . Retention rates of people on ART in the first 5 years after initiating ART between 2009 and 2014 in IeDEA.

Figure 3.

IeDEA evidence included in the WHO Progress Report 2016 : Prevent HIV, Test and Treat all – WHO support for country impact. Median CD4 cell count at ART initiation among adults by IeDEA regions over time.

Figure 4.

IeDEA evidence from the IeDEA-WHO collaboration: Cumulative incidence of antiretroviral therapy outcomes among adults. Panel A: outcomes recorded in clinic databases. Panel B: outcomes adjusted for unrecorded deaths and transfers among patients lost to follow-up. Reproduced from Haas et al. .