Overcoming barriers to equitable HIV testing

Eliminating barriers to HIV screening

Since its identification in the early 1980s, over 36 million people have died from AIDs related illnesses, and over 79 million people have been infected with HIV since the start of the pandemic. Close to 38 million people are living with HIV, two-thirds of whom live in Africa. Today, the tools exist to continue to work towards the elimination of HIV. In the past decade in particular, there has been incredible progress in expanding access to HIV diagnostics and treatment, especially in low and middle income countries which have been enduring the brunt of the disease.

People infected with HIV can live long, fulfilling lives with the diagnostics and treatments we have today. The challenge is ensuring that HIV positive people receive the help they need. In the countries hardest hit by the disease, access to the few healthcare centres that can diagnose, treat, and follow up HIV patient care has been extremely limited. Since 2002 and 2003, respectively, both the Global Fund and the United States President's Emergency Plan For AIDS Relief (PEPFAR), have invested heavily in providing the funds to supply quality testing and treatments to the people in need, along with building up the infrastructure needed.

Supporting HIV awareness and screening campaigns

To enable equitable access to HIV testing in resource-limited settings, and to support the UNAIDs 2020 (now 2030) targets, Roche created the Global Access Program in 2014. Through this program, Roche provides sustainable pricing to governments and funders, alongside working with partners to build the infrastructure and capabilities required to run diagnostic programmes. Recognising the unique challenges in resource-constrained countries, Roche also specifically developed solutions to address some of the critical challenges faced, such as reaching people in rural settings with limited ability to travel to testing clinics, along with loss of follow up with people not getting their test results in time. The aim is to ensure that all patients, even those in hard-to-reach locations, have access to quality diagnostic tests to either screen or diagnose viral diseases or monitor their treatment response.

For example, we have developed a plasma separation card, a simple device for viral load testing of people infected with HIV which is about the size of a credit card. It collects a small amount of blood from a fingertip that can then be easily transported for up to 28 days without refrigeration before being analysed. This test was designed for patients who are unable to access centralised testing locations, particularly those living in remote areas with extreme heat and humidity. Using this system, a blood sample can also be taken from a heel prick of a baby by the local healthcare centre and can be sent through the post for HIV testing. This helps overcome many hurdles preventing babies from being diagnosed with HIV.

In 2020, Roche launched iThemba Life, a mobile app that empowers people living with HIV in resource-limited settings to remain engaged in their healthcare. It can report test results, and provide educational content and disease-management solutions directly to a patient’s cellular device. By enabling people to check their disease status in privacy and offering treatment and appointment reminders, iThemba Life helps to ensure patient compliance. The platform is currently able to deliver viral load testing results for HIV-positive adults as well as results for early infant diagnosis of HIV-exposed infants.

Sharp increase in HIV testing

The Global Access Program for HIV testing has seen a four-fold increase in tests run since launch. It is estimated that in 2021, over 8 million people in Africa used our viral load testing to manage their HIV infection and to date over 11 million babies have been tested for HIV with Roche tests, giving more children the chance to live a healthy life.

In addition, from 2015 to 2021 we have been able to train over 8300 laboratory professionals, covering over 100 training courses and workshops, across 18 countries, through the Roche Scientific Campus in South Africa.

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In 2019, Roche expanded the Global Access Program beyond HIV to include diagnostic tests for screening for human papilloma virus (HPV) the causative agent of cervical cancer, along with testing for tuberculosis (TB) and hepatitis B and C virus infection.

In 2021, molecular testing for detecting SARS-COV-2 was added to help countries manage their COVID-19 response. Many countries, especially those across Africa have been enabled to be better equipped to respond to COVID-19 thanks to decades of investments for health system strengthening and HIV/AIDS programs. However, COVID-19 has also placed a tremendous strain on critical health services including the HIV/AIDS programs putting lives at risk. We will continue to support these global health investments and emphasise the importance of diagnostic testing in reducing the spread of COVID-19 and supporting disease management in order to end AIDS by 2030.

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