In developing countries, it is often difficult to gain access to diagnostic tools for prevention and treatment of disease. Limited access has led to the spread of preventable infectious diseases and even loss of life.
Access to screening, early detection and prevention of transmission reduces the spread of disease. E.g. tuberculosis is a major health crisis and is the leading cause of infectious disease deaths worldwide.
According to the World Health Organization (WHO), there are over 36 million people living with HIV around the world.
With over 356 million people infected with hepatitis, access to hepatitis diagnostic tests for HBV and HCV will improve the outlook of eliminating these chronic infections. And screening with HPV DNA testing can more accurately identify women at risk for cervical cancer than other screening methods1.
Our action
As the leading provider of HIV viral load testing, Roche created the Global Access Program. Since the start of the Global Access Program in 2014, access to HIV viral load tests and early infant diagnosis have improved in 82 countries with the highest disease burden. Now, in 2019, the Global Access Program includes a full portfolio with access to molecular diagnostics for HIV-1 viral load, HIV-1 and HIV-2 early infant diagnosis, the Plasma Separation Card - an innovative plasma collection device, MTB and MTB - RIF/INH, Hepatitis B and C, and Human Papillomavirus.
In collaboration with the Clinton Health Access Initiative and other partners, we provide accessible and reduced pricing for diagnostic solutions. To train healthcare workers, Roche also offers support programmes that help build healthcare system capacity, including participation in public-private partnerships (PPPs), for instance with the Centers for Disease Control and Prevention in the US. We also invest in developing countries by helping them equip laboratories with the newest technologies.
In August 2018, we formally launched our partnership with the Kenya Medical Research Institute by installing a cobas 8800 for HIV assays. Through the Global Access Program, the partnership aims to ensure that more people in Kenya have access to HIV/AIDS testing and viral load monitoring. Our PPP in Kenya and initiatives like the Roche Scientific Campus in South Africa demonstrate our ongoing commitment to Africa through capacity building and skills development, and go beyond the supply of instruments and sustainable pricing.
Our Goals
The Program aims to expand access to quality, sustainable diagnostic testing while contributing to the UNAIDS HIV 90-90-90 elimination goal. The aim is that by 2020, 90% of all people living with HIV will know their disease status, 90% of all those diagnosed with the HIV infection will receive sustained antiretroviral therapy, and 90% of all those receiving antiretroviral therapy will have viral suppression.
For hepatitis, the World Health Organization defined goals aiming at a 90% reduction in new chronic infections and a 65% reduction in mortality in 2030 as compared with the 2015 baseline2.
Cervical cancer is preventable with vaccination, screening, and treatment when necessary. The draft 2030 goals for cervical cancer elimination include 90% vaccination rate for HPV in girls by 15 years of age, 70% of women screened with a high-precision test at 35 and 45 years of age along with appropriate follow-up, and 90% of women identified with cervical disease receive treatment and care3.
The WHO have established goals to end Mycobacterium tuberculosis by 2035 which includes a 95% reduction in death, 90% reduction in incidence, and 0% catastrophic costs4.
Impact
In 2018, the number of HIV tests run was more than four times higher than when the programme was launched. The additional access to diagnostic test results for more disease areas means more patients being appropriately diagnosed and well treated, resulting in lives saved.
Redefining the reach of reliable testing
Roche continues to invest in innovative products and solutions to expand access. In 2018, we launched the cobas Plasma Separation Card, a stable and easy-to-use sample collection device for HIV plasma viral load testing. The size of a credit card, it fundamentally changes the way samples are taken and processed for HIV testing. Traditionally, viral load results required blood samples to be cooled during transport to the lab. With just a small amount of blood from the fingertip, the cobas Plasma Separation Card allows for reliable quantitative testing of patients with HIV living in remote areas—even in places that experience temperatures of 45°C and 85% humidity. The sample is protected on its journey to the lab for up to 28 days, even under such extreme conditions. As the samples can be sent by post, more viral load tests can be carried out. With up-to-date results, care can be personalised and adjusted as soon as necessary. Follow-up monitoring for people who are HIV-positive and who have achieved viral suppression helps them stay healthy
References
Wentzensen N, et al. HPV-based cervical cancer screening- facts, fiction, and misperceptions. Prev Med. 2017;98:33-5
WHO. GLOBAL HEALTH SECTOR STRATEGY ON VIRAL HEPATITIS 2016–2021. 2016
WHO draft global strategy towards the elimination of cervical cancer as a public health problem
https://www.who.int/docs/default-source/documents/cervical-cancer-elimination-draft-strategy.pdf. Accessed 11Jun2019.82http://www.who.int/tb/post2015_strategy/en/. Accessed 1 Nov2018