What are the health needs and challenges?

Infectious diseases are a challenge and great threat throughout Asia. For example in 2016, India had 80 000 (62 000 – 100 000) new HIV infections and 62 000 (43 000 – 91 000) AIDS-related deaths. There were 2 100 000 (1 700 000 – 2 600 000) people living with HIV in 2016, among whom 49% (40% – 61%) were accessing antiretroviral therapy.  India is committed to achieve country wide elimination of HCV in addition to reduce HBV infected population by 2030 and in 2018 India’s Ministry of Health and Family Welfare launched The National Viral Hepatitis Control Program.  Between 2019-2030, 5.3 million HCV patients in India are expected to be diagnosed & 4.7 million HCV patients are expected to be treated.  India has also been identified as the key country in the objective to eradicate tuberculosis by 2030 (per WHO).  Due to this, India is receiving the most implementation funding for TB diagnostics.  India is also a key focus country for WHO Cervical Cancer Elimination Strategy.  India is the highest burden country for cervical cancer and is expected to receive a significant portion of global funds

Breast and gastric cancer are also among the most common cancers in Asia. The incidence rates remain low, although they are increasing faster than in Western countries due to changes in lifestyle and diet. HER2-positive cancer is a particularly aggressive form that affects about one-in-five people with breast or gastric cancer.

Samples of a patient’s tumour must be tested for HER2 before treatment starts, in order to determine the most appropriate treatment option. The accuracy of the test is critical, requiring proficiency in tissue collection and processing, as well as laboratory procedures and interpretation of the test results.

Without reliable diagnostic testing, clinicians are unable to effectively screen for cancer, diagnose disease and develop care plans.

In Asia there is a critical shortage of reliable laboratories providing quality testing results, along with qualified pathologists and technical personal (histo-technologists).  This is compounded by the limited opportunities for professional education and training, and the more general lack of resources needed to strengthen healthcare systems. This contributes to the majority of cancers not being diagnosed until they reach an advanced stage of disease when it is often too late for a cure.

This highlights the need for educational programs to increase the number of pathologists and histo-technicians in the region, combined with programs to strengthen the skills of the current workforce.

Partnership activities and how they address needs and challenges

In 2014, Roche announced, the Global Access Program for increased access to HIV diagnostics. Roche partnered with national governments, local healthcare facilities, communities and international agencies, including UNAIDS, CHAI, Unitaid, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), Global Fund, and Center for Disease Control and Prevention (CDC), to establish programs that would go beyond providing diagnostic tests.

In 2010 Roche launched the SPHERE program (Scientific Partnership for HER2 Testing Excellence) in Asia-Pacific. The aim is to help integrate HER2 testing of breast and gastric cancer patients at the point of disease diagnosis.

Developed with experts, SPHERE is designed to improve pathologists and histo-technicians skills around all aspects of tissue testing processes, starting with HER2 driven disease. The training includes plenary presentations and workshops, with hands-on laboratory experience and interactive microscope sessions. The aim is to increase the reliability and reproducibility of HER2 testing by:

• Training surgeons on taking and handling tissue biopsies
• Establishing training and quality control procedures for lab technicians
• Assisting pathologists in scoring and interpreting results
• Educating oncologists on the need for reliable HER2 testing and the link to treatment decisions

In addition, the program aims to educate, share best practice and facilitate collaboration between all health workers in the management of cancer care – surgeons, technicians, pathologists, radiologists and oncologists – through the creation of multidisciplinary teams. The ultimate goal is for people to receive accurate, timely diagnosis of the disease and appropriate selection for treatment.