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Emory’s CHAMPS program receives grant to study causes of death in adults with HIV in Africa
Media Contact
Amy Rowland, MSc.
Communication Director, Emory Global Health Institute
woman on mattress with tears

U.S. CDC and photo documentarian Thom Pierce traveled to the epicenter of the global HIV epidemic in South Africa to capture the faces and stories of individuals at the forefront of the response against HIV.

— Thom Pierce, South Africa 2018

A new grant from the Bill & Melinda Gates Foundation will allow the Child Health and Mortality Prevention Surveillance (CHAMPS) network to leverage its laboratory capacity and partnerships in Africa to identify and document causes of death among adults who were living with HIV.

CHAMPS collects, analyzes and shares evidence to prevent child mortality in regions where it is highest in the world. The CHAMPS program office at Emory Global Health Institute coordinates a network of 19 catchments across nine countries.

Despite significant progress in scaling access to antiretroviral therapy for people living with HIV, HIV-related deaths remain unacceptably high in low-resource communities across the CHAMPS network.

Approximately 40% of the WHO-estimated seven million AIDS-related deaths over the next decade could be prevented by addressing advanced HIV disease (AHD). While it is well-established that tuberculosis is a leading cause of death in AHD, the contribution of other underlying causes for most adults who were living with HIV (PLHIV) remain unknown across the African region.

“CHAMPS network data can be used to close critical gaps in understanding the causes of deaths among persons living with HIV, including deaths related to advanced HIV disease,” says Victor Akelo, CHAMPS senior director for science, site strategy and implementation, who will direct the study for the network and lead the Kenya site.

Victor Akelo, CHAMPS senior director for science, site strategy and implementation, will direct the study for the network and lead the Kenya site study.

In 2022, an estimated 21,000 people died from AIDS-related illnesses in Kenya. Thus, “knowing the definitive causes of death can help transform HIV programs and inform targeted investments to reduce HIV transmission, prevent progression to AHD and save lives in these communities,” Akelo says.

Since 2015, CHAMPS has worked with communities and built local capacity to determine definitive causes of stillbirths and child deaths across its network in Africa and South Asia, two regions that account for 82% of under-five child mortality worldwide. The work funded by this new grant will support network partners in CHAMPS sites in Kenya, Sierra Leone, Mozambique and South Africa to enroll and investigate deaths in adults aged 18-64 years with HIV. The study will use CHAMPS procedures and methods with additional tests to investigate markers of AHD.

CHAMPS identifies and analyzes specific causes of death using minimally invasive tissue sampling, histopathology, molecular and microbiologic diagnostics, clinical data abstraction and verbal autopsies. Over the three-year study period, timely, open access to data and expert analysis will be available to local and global health programs, policymakers and practioners to evaluate and guide existing HIV programs, while informing service delivery to underserved communities.

More from CHAMPS network leadership in participating countries


“Mozambique has made remarkable progress in the battle against HIV, as the prevalence rate has decreased from 16.2% in 2009 to 11.5% in 2019. Nonetheless, the limited availability of health care and the stigma associated with HIV still pose significant challenges for the country. Our study’s launch in Mozambique demonstrates our unwavering commitment to evidence-based health care strategies. By utilizing state-of-the-art laboratory facilities and fostering collaborative partnerships, we are well positioned to generate essential insights into the factors contributing to mortality among adults living with HIV. This will help drive progress toward more effective interventions and improved health outcomes.”

– Inacio Mandomando, CHAMPS Mozambique co-director

Sierra Leone

“Recently, we have seen a disproportionately high prevalence of HIV (24%) among adult deaths in Sierra Leone, despite the current prevalence among living adults being estimated at 1.7%. The study to be conducted in Sierra Leone is a significant step in our collective efforts to better address a possible ‘hidden HIV epidemic’ in the country, as well as tackle the complex challenges faced by individuals living with HIV. With the help of rigorous data collection and analysis and existing strong partnerships established across the CHAMPS Sierra Leone platform, we aim to identify factors associated with advanced HIV disease, further explore the root causes of HIV mortality and co-create targeted interventions for saving lives and promoting health equity.”

– Ikechukwu (Ike) Ogbuanu, CHAMPS Sierra Leone site director

South Africa

With a national HIV prevalence rate of 19.6% among adults aged 15-49, South Africa has the highest absolute number of people living with HIV in the world, totaling 8.45 million in 2022.

“This study in South Africa represents a significant opportunity for advancement in comprehending and tackling the challenges encountered by adults living with HIV. Through granular investigation of the causes of death in persons who were living with HIV in the era of antiretroviral therapy, the insights from the study can be instrumental for informing what additional interventions are required to address the ongoing disproportionately higher incidence and mortality rate in this population.”

– Ziyaad Dangor, CHAMPS South Africa co-director

The CHAMPS program office is located at Emory Global Health Institute and led by Cynthia Whitney, CHAMPS principal investigator and executive director. Learn more about the CHAMPS network and leadership.

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