Top HIV diagnostics for small labs in Africa

Report
Top HIV diagnostics for
small labs in Africa
Philippe Duneton
Deputy Executive Director
17 June 2013
Long term goal of the
Global Health Community
• HIV/AIDS
– GOAL: Reaching 15 million
people with ARVs by 2015
WHO New 2013 Guidelines
– CD4: 500 cells/mm3 from 350
– FDCs – 1 pill a day (Tenofovir based)
– Patient monitoring
2
Low access to HIV treatment: Only 9 million of 25 million
people in need are now on ART
1
CD4≤350
CD4≤500
0
5
10
15
# People (millions)
On ART
In need of ART
20
25
30
Monitoring diagnostics
CD4 Viral Load
Early Infant Diagnostics
• Large modern laboratories
• Sophisticated equipment
• Highly trained staff
Nyumbani, Karen, Kenya
• Benefit: High volume
• 4,500 tests a months
• Samples need to be
transported
• Result returned to patient
Pediatric University Hospital, Lusaka, Zambia
4
The reality of low
resource settings
• Limitation in health infrastructure
District Hospital, Meconta, Mozambique
– Crowded facilities
– Basic laboratory facilities
– Irregular power and water supply
• Limitation in human resources
– Few doctors
– Health workers with limited training
carry out most consultations
Kiboga Referral Hospital, Uganda
Quality, simple to use
diagnostic and medicines
are needed to assure rapid
effective treatment
5
Point of care testing
• Small devices
• Easy to use outside
central laboratories
• Rapid results
• Back up power supply
• HIV patient
monitoring
– CD4
– Viral Load
– Early Infant Diagnosis
1er maio, Maputo
Mozambique
Benefits to Patients
•
•
•
•
•
Ideal for resource limited
settings
– both urban and rural
Decreases turn-around time
– results available on same day
Improves patient outcomes
– prompt treatment
Reduces loss to follow up
– no need to return for results
Reduces workload of the central laboratory
Phebe Hospital, Liberia
7
UNITAID's new
Point of Care Projects
•
•
•
•
CHAI/UNICEF
Medecin Sans Frontiere
FEI –OPP-ERA
London School of Hygiene and Tropical
Medicines
AIM: Increase CD4 testing to 80% and Viral
load testing to 50% in low income countries
Good monitoring of patients =
better care and treatment
8
CD4
Product Pipeline*
BD FACSPresto™
BD Biosciences
Pima™ Analyser
Alere
PointCount NOW™
PointCare
Technologies
Visitect® CD4
Omega/Burnet
CyFlow® CD4 miniPOC
Partec
2010
2009
Instruments
MBio CD4 System
Zyomyx
CD4 Test
Daktari™
CD4 Counter
2014
2013
Disposable
*Estimated as of March 2013 - timeline and sequence may change.
Instruments
Disposable
Viral Load and EID Product Pipeline*
Liat™ Analyser
IQuum
Alere Q
Alere
EOSCAPE HIV™ Rapid
RNA Assay System
Wave 80 Biosciences
RT CPA HIV-1
Viral Load
Ustar
LYNX Viral Load
Platform
NWGHF
GeneRADAR®
Nanobiosym
SAMBA VL
DDU/Cambridge
LYNX HIV p24
Antigen
NWGHF
Truelab™ PCR
Molbio/bigTec
Gene Xpert®
System
Cepheid
2014
*Estimated as of March 2013 - timeline and sequence may change.
ALL
Cavidi AMP
Viral Load
Assay with
BART
Lumora
SAMBA EID
DDU/Cambridge
2013
Micronics
2015
No market launch date set by company.
BioHelix
2016
Call for LOIs
• UNITAID is pleased to
announce the first Call
for Letters of Intent
(LOI) of its new
strategic period
• Deadline: 22 Sep 2013
• http://www.unitaid.org
11

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