Tag Archives: BCPP Trial

The Inner Life of a Complex Clinical Trial

Team Meeting at the BHP Photo By Dominic Chavez

Sent: October 30, 2013
Subject: YA TSIE-In the Field

Hi,
This is to confirm that the YA TSIE Study—The Botswana Combination Prevention Project (BCPP) is underway and the team deployed today 30th October in the field at both Ranaka and Digawana. While there have been challenges and some initial delay in study initiation, it is with great confidence in the team and their ability to rise up to challenges that I am confident this shall become one of BHP’s blue chip studies. I wish the team success and God’s Speed as they roll out this immensely challenging study.
Joe
Dr. Joseph Makhema
C.E.O. Botswana Harvard AIDS Institute

Evolving Guidelines

It was the first week of June in 2015. The BCPP leadership team was stressed. There were even more conference calls than usual. Two upcoming events could change the course of the trial. The first was a June 11th meeting of the Data Safety Monitoring Board (DSMB) at the National Institutes of Health (NIH) in Bethesda. The second was the July meeting of the International AIDS Society (IAS) in Vancouver.

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The Meaning of Ya Tsie

Ya Tsie logo

In the Setswana language, the name of the Botswana Combination Prevention Project is Ya Tsie, a term Dr. Mompati Mmalane came up with. The name comes from a proverb that roughly translates as “Teamwork bears more fruit than individual effort.”

Mmalane explains: “In the past, we used to gather locusts to eat. If you put locusts in a bag, they will fly out. To keep them in, somebody has to help you hold the bag as you gather them. There has to be somebody to help you.

“With this study we are saying, the fight against HIV is complicated—we need people to help us. And now these three partners, Harvard, CDC, and the government of Botswana, have come together to try to prevent HIV and keep it from spreading. The more hands you have to the problem, the better.”

A Month in Shakawe: The Field Team at Work

Keotshepile Molokwane (right) interviews a woman in her yard in Shakawe.

By Martha Henry

Tourists who visit Botswana’s scenic Okavango Delta rarely visit Shakawe, the most remote village participating in the Botswana Combination Prevention Project (BCPP), a large HIV-prevention trial of over 100,000 people. The results of the trial will likely end up as an orderly table published in a prestigious medical journal. Though the numbers in that table may provide much-needed evidence on how best to operate HIV/AIDS programs across the globe, they won’t show the hard work, mistakes, corrections, and triumphs of the field team. The data won’t reveal the thousands of daily interactions between the Research Assistants (RAs) and the villagers—the stories condensed into each data point. Continue reading

Greetings to You All

A BCPP truck with loudspeaker broadcasts in Shakawe.

When the field team for the Botswana Combination Prevention Project arrives in a village, loudspeakers announce the start of the study.

Our people! Greetings to you all!

We are members of the Ya Tsie study which you might have heard about already at a recent Kgotla meeting or have read about it in the flyers posted in different places in your village. This is to let you know that we have arrived in this village and this is the beginning of the study. We are here to invite and encourage you to, first, spread the message about the study. Secondly we encourage you to take part in this study whose purpose is to come up with measures which can stop the spread of HIV in the society.

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Research Nomads

Keitumetse Tshwene, a Research Assistant, carries the equipment necessary for in-home HIV testing and counseling.

By Martha Henry

Each of the two field teams for the Botswana Combination Prevention Project (BCPP) consists of 16 Research Assistants (RAs), seven drivers, two supervisors, two lab assistants, and two IT assistants. Team members come from across Botswana. In addition to Setswana, many of the RAs speak other local languages. They range in age from early 20s to late 30s. Many of them worked as HIV counselors before joining the team. Continue reading

Max Essex: The Persistent Investigator

Dr. Max Essex Photo by Dominic Chavez

By Martha Henry

It’s unlikely that you’ll ever meet anyone more focused than Max Essex. A 1986 New York Times profile described him as “mild mannered” with “a thatch of thick hair” and “among those in the forefront of the worldwide effort to find a cure for acquired immune deficiency syndrome.” Today, though his hair is white, that description still fits. Essex, now in his 70s, still arrives at the office by six o’clock most mornings and spends long days planning and improving research projects around the world. He remains, as the Times reporter described, “deeply exercised about the fate of AIDS patients.”
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The Botswana Combination Prevention Project: A Way to End the Epidemic?

BCPP field team members and villagers in Shakawe

By Martha Henry

The end of AIDS as a public health threat may not come from an effective vaccine, as many had hoped for decades, but from a collaborative effort across nations to prevent new HIV infections. The epidemic that spread mainly through sexual connections may be subdued not from a single breakthrough, but through long-term transnational collaborations. Continue reading