This World AIDS Day, we’re reflecting on progress made since the Clinton Health Access Initiative (CHAI) began working 10 years ago – and focusing on the vital work that remains to achieve an AIDS-free generation. Maternal and child health programs are a central part of CHAI’s work and include programs to increase access to pediatric AIDS medicines and diagnostics and Eliminate Mother-to-Child Transmission (EMTCT). Read how, in Nigeria, these programs are saving lives and strengthening Nigeria’s ability to fight AIDS.
Infants born to HIV infected mothers are exposed to the virus and if infected, have a 50 percent chance of dying before they reach the age of two. Early diagnosis of exposed infants within the first two months of life is therefore critical to ensure that babies infected with the virus are given timely intervention and have an increased chance of survival.
Nigeria's Early Infant Diagnosis (EID) program began in 2007 with two centralized testing laboratories and six facilities where infant samples were collected for testing. CHAI supported the Nigerian government in strengthening its EID services and rapidly increasing coverage – thereby ensuring that over 200,000 HIV-exposed babies annually are diagnosed and placed on the appropriate treatment intervention.
To increases access to diagnostics, CHAI had to overcome a critical systems barrier: the lack of an efficient way to send samples to the central labs and return results quickly to the facilities. CHAI worked closely with the Federal Ministry of Health (FMOH) and PEPFAR implementing partners to introduce the use of dried blood spots for the collection of samples, which are easier to transport than traditional blood samples. Additionally, through UNITAID, CHAI’s funding supported the FMOH in employing the services of a national courier service to handle the sample transport from all sites across the country and to all the testing labs and introduced the use of SMS printers for the accelerated return of EID results to the facilities and caregivers.
CHAI also helped the national government meet its requirements for testing commodities. With UNITAID funding, CHAI donated laboratory reagents and sample collection materials to the government of Nigeria from 2007 through 2011. These contributions led to a dramatic scale-up of EID services from 6 sites in 2007 to approximately 1,200 sites by 2012. Infant sample testing has grown by an estimated 9,000 percent – from a total of 745 samples tested in 2007 to more than 40,000 samples tested in the first six months of 2012. At the current rate, CHAI estimates that they will test 75,000 samples by the end of the year – an incredible achievement since the program was implemented.
There are now 23 centralized testing labs spread across Nigeria, and CHAI is currently exploring the introduction of Point-Of-Care technologies for EID to bring the service closer to those most in need, particularly in those primary healthcare centres located in the most remote areas.
Working closely with the government, Hewlett Packard Company and the Institute of Human Virology Nigeria, a Nigerian organization, CHAI is pursuing the use of information technology to further enhance data collection, reporting and analysis around EID testing. This project will enable the government and partners to improve program planning, monitoring and evaluation, and will ultimately accelerate the elimination of transmitting HIV between mothers and their children. Nigeria's elimination of mothers-to-child transmission (MTCT) program target is to ensure that by 2015, every infant born to an HIV-infected woman is HIV-free. CHAI believes in this vision and will continue to support all efforts by the government and people of Nigeria to ensure that the targets are met.