The Wisepill to help HIV patients remember their lifesaving medication

The death of a woman in a beautiful blue dress is a poignant reminder to Dr Catherine Orrell of the lifesaving power of ARVs.

In the 1990s a woman called Gladys sought treatment for late stage HIV but there was no antiretroviral treatment then, and the fungal ulcers in her mouth prevented her from eating. “She had a beautiful blue dress that she wore to come to the clinic and all the time she came to see me, getting thinner and thinner, she dressed up in that best blue dress. When she died, her family thanked me for all I had done, when in fact all I had done was watch her die with dignity. After 2002, when we gained access to antiretroviral treatment at our Gugulethu site, people began to have the option of saving their own lives and I am pleased to say that most of them did.”

It is stories like these that motivate Dr Catherine Orrell to seek better treatment options for people living with HIV. Though ARVs are widely available today treatment has many challenges. “I have come to realise that adherence to treatment alone does not explain all virological failures. I also question the methods of adherence assessment available in our resource-poor setting, and through my work in pharmacology came the recognition that biological factors, such as drug absorption and metabolism, may also play a role in treatment success.”

People on antiretroviral therapy have to take medication every day of their lives. I hope to make things easier by proving the benefit of a small, locally-made electronic adherence device, the Wisepill. It looks good, not at all like a pillbox, and sends a subtle SMS reminder to take meds. It does not remind them every day, only on the days when they do not manage to open the pillbox in the window of time they usually do, so it is not an intrusion.

“If we can use this technology to improve adherence to ART, then we reduce the burden on the clinics and staff, which might allow us to treat more people over time.” Dr Orrell has been working with HIV-infected patients since 1996, was involved in several of the first programmes to develop antiretroviral therapy in SA and has been training nurses and doctors to deliver ART for 10 years.

“I went into HIV medicine after getting to know a young man with hemophilia who was infected by a blood transfusion in 1984. He, and others living with HIV, were treated so badly by healthcare staff in the early 1990s that I decided I would have to work to change this,” Dr Orrell says.

Dr Catherine Orrell is a medical doctor and clinical pharmacologist who has received a grant from the Discovery Foundation. She is working as a senior investigator at the Desmond Tutu HIV Centre in Cape Town. She is the mother of two young children and she and her husband, Derek Zellie, are keen outdoor enthusiasts who cycle, hike and rock climb and who have climbed Mount Kenya and Aconcagua, the highest mountain in the Andes.

Dr Orrell says, “The Discovery Foundation Award has allowed me to spend a year dedicated to completing a study I am passionate about. It gives me the time to make my research perfect and produce results that will make a difference. I can’t thank the Discovery Foundation enough.”