What are the health needs and challenges?

In resource-limited regions, the need for reliable and sustainable healthcare and its supporting infrastructure is crucial in the fight against disease and advancing human health. Unfortunately, according to a recent Lancet article (1), 47% of the world’s population have little or no access to diagnostics.

This is particularly problematic in low- and lower-middle-income countries which are also the hardest hit by diseases such as HIV/AIDS. In fact, of the 37 million people living with HIV, two thirds live in Africa (2).  And close to 95% of TB deaths occur in LMICs (3).

One of the greatest challenges in running effective diagnostic programs is having enough trained healthcare workers to manage diagnostic tools effectively. 50-70% of clinical decisions depend on accurate laboratory diagnosis, so having reliable diagnostic capabilities is critical.

Partnership activities and how they address needs and challenges

In 2014, Roche announced the Global Access Program in partnership with USAID, PEPFAR, CHAI and the Global Fund, to increase access to HIV viral load tests for monitoring anti-retroviral treatment efficacy and HIV tests for early infant diagnosis (EID).

In 2019, the program was expanded to include diagnostic tests for MTB, HBV, HCV and HPV/ cervical cancer, and more recently, COVID-19, to help mitigate the burden of these diseases where the need is highest.

Since its inception, the Global Access Program aims to provide increased access to diagnostic solutions in high-burden disease areas.  Roche provides affordable pricing to national governments, funders, international agencies, non-profit organisations and local healthcare facilities for use in the public sector in eligible countries, alongside working with partners to deliver comprehensive solutions along the patient pathway.

From the outset, the program was designed to provide end-to-end, sustainable solutions that would go beyond providing reduced pricing of diagnostic and monitoring tests.  This includes spanning the healthcare spectrum: from disease awareness and education, training healthcare workers and building health infrastructure, through to increasing access to diagnosis and linkage to treatment for improved disease management.

To address the shortage of trained healthcare workers, in 2012 Roche opened the Roche Scientific Campus in Soth Africa to provide training on the African continent such as:

• hands-on, certified training courses for lab technologists and engineers
• general lab management training for managers and policy makers
• education on health and scientific topics for healthcare professionals and scientists

The facility boasts five self-contained laboratories with the latest technological tools in chemistry, haematology, molecular biology, tissue diagnostics and sequencing. Training is conducted by certified trainers and experts, in collaboration with local and international organisations.

To address some of the wider access challenges, Roche has developed innovative tools specifically for LMICs. To address sample collection challenges, the cobas® Plasma Separation Card, which is the size of a credit card, requires only a small amount of blood from a fingertip and can be posted to the testing laboratory. This enables reliable testing of patients living in remote areas – even in areas of extreme heat and humidity.To address return of results to the patient, loss to follow up and treatment adherence challenges, iThemba Life, a mobile health application, delivers HIV viral load results, education, reminders, and clinical support directly to user’s smartphones, empowering people living with HIV to remain adherent to treatment and engaged in care.

We are now exploring how we can use our experience, knowledge, and networks to more holistically work across the various therapeutic silos.  For example, to utilise existing HIV programs to screen for Hepatitis, MTB, or HPV, as well as think more broadly around areas such as women’s health.

By working alongside the members of the global health community and with a continued focus on Public-Private Partnerships, Roche is committing its efforts to meet WHO’s various 2030 elimination goals.

References

1.  www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00673-5/fulltext

2. www.who.int/news-room/fact-sheets/detail/hiv-aids

3. www.stoptb.org/about-tuberculosis-0