By: Lunga Memela (HST Communications Engagement Lead)
Consider the fact that, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS), South Africa's KwaZulu-Natal (KZN) Province has the highest prevalence of HIV infections globally.
The UNAIDS 95-95-95 mandate to accelerate action to end the AIDS epidemic by 2030 requires that people know their HIV status, start antiretroviral therapy (ART) if they test HIV-positive, and stay on treatment to achieve and maintain viral suppression.
Now consider how much co-ordination, meticulous attention to detail, and quality assurance is required to ensure that the province's HIV Testing Services (HTS) work seamlessly with laboratory services. This entails verifying the number of blood samples collected at local clinics and in community-based settings and test results, so that those found to be HIV-positive can be initiated on the ART regimen best suited for their viral load.
Humble and warm-hearted Eddy Moyambo (pictured above) is Health Systems Trust's (HST's) Co-ordinator responsible for optimising the clinic–laboratory interface (CLI) and ensuring that quality assurance support for HTS is provided to the KZN Provincial Department of Health at facility and community level.
Supporting four PEPFAR districts in KZN
Eddy's role is a vital one in HST's SA SURE PRO project, which is funded by the U.S. President's Emergency Fund for AIDS Relief (PEPFAR) programme through the Centers for Disease Control and Prevention (CDC). The project aims to strengthen and support local capacity to provide sustainable HIV and TB-related care and treatment service delivery in South Africa through technical assistance (training, mentoring, coaching) and supplemental support, including direct service delivery at four PEPFAR districts, namely eThekwini, uMgungundlovu, uThukela and Zululand.
He works collaboratively with the National Health Laboratory Service (NHLS) and the Department of Health to strengthen CLI in the supported districts, providing technical assistance to develop and implement quality improvement (QI) standards, systems and plans for HIV and TB programmes.
Working on the ground with Eddy
"Over time, the strategies for our HIV testing drive have evolved," explains Eddy. "To ensure that we test people as widely as possible, and to secure the necessary yield of results, we place special focus on hard-to-reach key populations such as children, adolescents, young women, and men, making sure that our approach is client-centred and brings the services to where they are."
The team of Clinical Laboratory Advisors (CLAs) ensures that key interventions to address programmatic gaps and data-related issues are implemented; for example: clearing bottlenecks in analysis of blood samples, fast-tracking of result reports, and improved capturing of test results at clinic level.
"With viral load (VL) suppression being the third and final key to epidemic control," says Eddy, "we must close gaps in VL programme performance at district and provincial level, and improve VL monitoring. So the CLA role involves supporting demand-creation activities for VL monitoring, and providing CLI training and capacity-development for staff in the four districts and for the Provincial DoH structures.
Eddy has been at HST for a full decade. He started as a Facility Mentor in 2013 and climbed the ladder in various roles, ending up in his current designation. He considers himself a humanitarian: "Working to improve the lives of ordinary citizens has a feel-good effect on me," he says.
Eddy's typical work-day demands high levels of co-ordination, liaising via phone and e-mail with the CLAs and Special Projects Co-ordinators in each of our supported districts, the National Institute for Communicable Diseases (NICD), the NHLS and HST Administrators. "I report to the SA SURE [PRO] Operations Manager and CDC Points of Contact, and participate in virtual and physical meetings to provide and discuss district and facility support."
Forecasting
Born and raised in the rural village of Muninginisi in Giyani, Limpopo Province, Eddy had wanted to become a professional football player. When he was working as a clinician within the mining industry, he realised the impending and ever-important need for private‒public partnerships to realise the aims of South Africa's National Health Insurance (NHI).
"I look forward to the day when the country and global community reaches the UNAIDS 95-95-95 targets, and more importantly, the sustainability of the gains," he says. "I long for a South African legacy where one day everyone can access quality health services, regardless of their social status."
During his spare time, Eddie enjoys historical literature, sports and music.