Morna Cornell
(PhD 2014)

March 13, 2017

Morna has project managed the IeDEA-SA Data Center at UCT  since January 2007. In 2008, she completed her MPH thesis based on data from one IeDEA-SA cohort. In 2014 she was awarded a PhD for her thesis ‘The evolution and effectiveness of the South African antiretroviral therapy programme’. Her thesis presented five inter-related analyses using data from South African sites within IeDEA-SA in the form of published/submitted papers. The studies included anonymized, patient-level data on adults starting ART to describe patient characteristics and enrolment, and to explore program outcomes including mortality, loss to follow-up and transfers out, as well as chapters focusing on the impact of gender and age on program outcomes. The numbers of patients included in the analyses ranged from 19 481 (restricted to cohorts with South African national identification numbers) to 83 592 adults, followed for up to 168 789 person-years of observation.  The results of the thesis lead to novel conclusions regarding the major challenges to ART program effectiveness in South Africa. While early ART programs were concerned primarily with patient mortality, increasingly the central challenges facing these services are related to their implementation and coverage. Looking forward, the South African national ART program should deliver services to patients earlier in the course of HIV disease, focusing in particular on men and patients over 50 years of age. Additional interventions are required to promote the retention of patients in lifelong chronic care while maintaining effective systems for program monitoring.