What are the health needs and challenges?

Diagnosis and monitoring are as essential to effective HIV/AIDS treatment as medicines.  In infants born of HIV-positive mothers, early diagnosis is critical in determining HIV exposure. If found HIV positive, they can receive appropriate medical care before they develop significant illness, and can remain healthy despite their infection. If found HIV negative, the mother can get appropriate counselling to ensure their child maintains a HIV-free status. Doctors also need to monitor disease progression and efficacy of treatment in patients on anti-retroviral therapies so they can prescribe the most effective medicine and make adjustments if patients become resistant.

However, limited testing infrastructure, long travel distances and technological limitations often result in people not returning to collect their test results, or even being tested in the first place.

Partnership activities and how they address needs and challenges

The Global Access Program is a multi-faceted program to address barriers that prevent early diagnosis of infants born to HIV positive mothers along with monitoring HIV positive people on anti-retroviral therapies.

The program includes:

• Using Roche R&D expertise to re-design tests and delivery of test results to suit local conditions
• Building laboratory capacity and enhancing skills of lab technicians to support reliable testing
• Introducing differential pricing for HIV diagnostic tests in partnership with international health organisations.

To overcome some of the barriers, Roche re-designed its tests and developed a novel method for gathering and transporting blood samples. For example, by using dried blood spots which require only a small amount of blood and can be sent for testing via the post, early infant diagnosis is now more accessible.

The company also introduced text message (SMS) technology, making it easier to send test results back to rural healthcare facilities, saving people from having to return to the main testing site for their results.

The improved communication has several benefits:

• Test results are easily and quickly sent to rural locations
• Patient follow-up is improved by reducing logistical bottlenecks
• Patients don’t need to revisit the lab, which are often located only in major towns

The collection card has expanded access to HIV diagnosis throughout the remotest areas of southern Africa. Roche continues to work with other organisations in public-private partnerships to ensure subsequent medical care for babies with HIV.

An education program trains local doctors and nurses to carry out HIV testing with limited resources, and keeps them fully informed about the latest advances in HIV/AIDS care.