philippe duneton deputy executive director 17 june 2013 top hiv diagnostics for small labs in africa
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Philippe DunetonDeputy Executive Director
17 June 2013
Top HIV diagnostics for small labs in Africa
Long term goal of the Global Health Community
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• HIV/AIDS– GOAL: Reaching 15 million
people with ARVs by 2015
WHO New 2013 Guidelines – CD4: 500 cells/mm3 from 350– FDCs – 1 pill a day (Tenofovir based)– Patient monitoring
Low access to HIV treatment: Only 9 million of 25 million people in need are now on ART
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Monitoring diagnosticsCD4 Viral Load Early Infant Diagnostics
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• Large modern laboratories• Sophisticated equipment• Highly trained staff
• Benefit: High volume• 4,500 tests a months
• Samples need to be transported
• Result returned to patient
Nyumbani, Karen, Kenya
Pediatric University Hospital, Lusaka, Zambia
The reality of low resource settings• Limitation in health infrastructure
– Crowded facilities– Basic laboratory facilities– Irregular power and water supply
• Limitation in human resources– Few doctors– Health workers with limited training
carry out most consultations
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Quality, simple to usediagnostic and medicines are needed to assure rapid effective treatmentKiboga Referral Hospital, Uganda
District Hospital, Meconta, Mozambique
Point of care testing
• Small devices• Easy to use outside
central laboratories• Rapid results• Back up power supply• HIV patient
monitoring– CD4– Viral Load– Early Infant Diagnosis
1er maio, MaputoMozambique
Benefits to Patients
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Phebe Hospital, Liberia
• Ideal for resource limited settings
– both urban and rural• Decreases turn-around time
– results available on same day• Improves patient outcomes
– prompt treatment• Reduces loss to follow up
– no need to return for results• Reduces workload of the central laboratory
UNITAID's new Point of Care Projects
• CHAI/UNICEF• Medecin Sans Frontiere• FEI –OPP-ERA• London School of Hygiene and Tropical Medicines
AIM: Increase CD4 testing to 80% and Viral load testing to 50% in low income countries
Good monitoring of patients = better care and treatment
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2009 2010
PointCount NOW™PointCare
Technologies
CyFlow® CD4 miniPOCPartec Daktari™
CD4 Counter
Visitect® CD4Omega/Burnet MBio CD4 System
BD FACSPresto™BD Biosciences
ZyomyxCD4 Test
2014
Disposable Instruments
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Pima™ AnalyserAlere
DisposableInstruments
*Estimated as of March 2013 - timeline and sequence may change.
CD4 Product Pipeline*
2013 2014 2015 2016
Alere QAlere
LYNX Viral Load PlatformNWGHF
LYNX HIV p24 AntigenNWGHF
SAMBA VLDDU/Cambridge
Liat™ AnalyserIQuum
EOSCAPE HIV™ Rapid RNA Assay System
Wave 80 Biosciences
Gene Xpert® System Cepheid
Micronics
Cavidi AMP
*Estimated as of March 2013 - timeline and sequence may change. No market launch date set by company.
SAMBA EIDDDU/Cambridge
Viral Load Assay with
BART Lumora
Gene-RADAR®
Nanobiosym
RT CPA HIV-1 Viral Load
Ustar
BioHelix
ALL
Truelab™ PCRMolbio/bigTec
Viral Load and EID Product Pipeline*
Call for LOIs
• UNITAID is pleased to announce the first Call for Letters of Intent (LOI) of its new strategic period
• Deadline: 22 Sep 2013• http://www.unitaid.org
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