Tier.Net, the software application that monitors patients on HIV and TB treatment, is being implemented in countries such as Mozambique, Malawi, Vietnam and Pakistan.

Representatives from each of the countries were in Cape Town in the first week of September to take part in Tier.Net training at the University of Cape Town’s (UCT) Centre for Infectious Disease, Epidemiology and Research (CIDER). They learnt how to operate the electronic register for monitoring HIV- and TB-infected patients.

“We hold one to two workshops each year for programmes outside of South Africa using the Tier.Net software,” said Technical Advisor: Strategic Information, Centre for Infectious Disease Epidemiology and Research at UCT, Meg Osler.

“Mozambique and Malawi heard about the Tier.Net software through Médicins Sans Frontières (Doctors Without Borders), while Pakistan and Vietnam heard about Tier.Net from the World Health Organization (WHO). Yemen, Sudan, Guinea and the Democratic Republic of Congo are also in the early stages of rolling out Tier.Net in their countries; they joined us for an earlier workshop held in May this year,” said Osler.

Tier.Net is already being used in over 4,000 public sector clinics and 3,000 facilities in South Africa. Tier.Net has proven to be more practical than monitoring systems like eKapa because it operates offline, requiring only a computer. Once clinics have been equipped with bandwidth, they will cross over to eKapa.

“All three systems – paper register, Tier.Net and eKapa – are interoperable,” said Osler. All three systems can be used to produce the same reports that feed into a single provincial and national database for ARV services. The information gathered is used to inform policy and resource allocation.

The application is the result of a collaborative effort between CIDER, the Canadian International Development Agency, the US Centres for Disease Control and Prevention and the WHO. The Western Cape and national government teams also participated in the development of the project.

CIDER has been responsible for overseeing the implementation of Tier.Net and eKapa in the Western Cape, as well as training “master implementers” for the National Department of Health (NDoH). Originally the idea was that Tier.Net would only be used in the Western Cape, but it soon drew the attention of the NDoH, who requested that it be made available to all clinics in South Africa.

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