Testing

Before care and treatment can even begin, infected patients must be diagnosed and the progression of their disease staged to ensure appropriate treatment. Further, once on antiretroviral therapy (ART), patients must be routinely monitored through a variety of tests to check for treatment failure. Young children under 18 months require a separate test to diagnose and monitor them as they often carry their mothers’ antibodies for the first year of life. As a result, access to the appropriate testing technology is an essential part of high-quality HIV/AIDS care and treatment, yet is often lacking in resource-poor settings.

How CHAI Helps

CHAI’s Laboratory Services Team (LST) has entered into agreements with several suppliers to enable access to affordable diagnostics for HIV. We have lowered the cost of rapid testing by up to 50% from market prices in 2003, and in partnership with UNITAID, have negotiated price reductions of DNA PCR tests for early infant diagnosis ranging from 30% to 50%. LST’s negotiations with three suppliers of CD4 equipment and reagents have meanwhile achieved price reductions of up to 80% from 2003 market prices.

LST has negotiated deals with four viral load suppliers to help clinicians identify patients failing on treatment and in need of second-line drugs, and is currently working with suppliers to improve pricing for clinical chemistry and hematology programs which help physicians prevent harmful side effects and alert them to complications.

Beyond Price Reductions

Providing a network of advanced diagnostic technology remains a central challenge in scaling up access to ART, particularly in places where even the most basic infrastructure is still under development. Once laboratories are established, complex systems are required to monitor and maintain quality, to ensure an uninterrupted supply of reagents, to train and develop skilled laboratory technicians, and to repair instrument networks. Therefore, in addition to price reductions, LST also provides technical assistance to countries to support the development and implementation of such programs. This includes the creation of strategic and operational plans for laboratory development; improvement of procurement and supply chain systems; the design of instrument networks and sample transportation programs; and the promotion of training programs for laboratory workers and managers.

To date, CHAI’s Laboratory Services Team’s successes include:

Working with the government of Lesotho to develop a laboratory management training program to improve inventory management, quality assurance and human resource management throughout the country’s laboratories
Supporting the government of Ethiopia with the restructuring of the country’s national laboratory
Supporting the government of Liberia as it establishes a new Division of Laboratory Services
Supporting the governments of Botswana, Rwanda and Ethiopia to strengthen capacity for forecasting and quantification of laboratory supplies