WHO warns of challenges posed by shortage of HIV testing
Experts from the World Health Organization (WHO) warn of the problems being presented by the shortage of HIV testing against global efforts to diagnose and treat people with the infection.
They looked at the responses to the annual surveys sent by the WHO to 127 countries between 2012 and 2014 asking about capacity and usage of blood tests that check HIV status and health. The experts found worrying gaps in provision.
They warn that, as a result, the targets for HIV by the United Nations (UN) could be missed.
The targets say that by 2020, 90% of all people living with HIV should know their HIV status, 90% of those diagnosed should receive antiretroviral therapy, and 90% of these treated patients should have “durable viral suppression”, which is a measure of effective treatment.
To meet and monitor these aims, laboratory testing is vital.
But according to Vincent Habiyambere and his colleagues in the journal PLoS Medicine, some low and middle-income countries, including African countries where the HIV burden is high, are not yet geared up for the challenge.
The surveys were sent to33 countries in the WHO Region of the Americas,all 47 countries in the WHO African Region, all 21 countries in the WHO Eastern Mediterranean Region, all 11 countries in the WHO South-East Asia Region, eight high-burden HIV countries in the WHO European Region, and seven high-burden HIV countries in the WHO Western Pacific Region.
Over the three survey years, 55 (43%) countries responded to all three surveys, 35 (28%) to two surveys, 25 (20%) to one survey, and nine (7%) responded to none of the three surveys.
Testing provision did improve over the years, but shortfalls remained in some parts of the world.
Lack of reagents, uninstalled or improperly maintained equipment, and inadequate or absent staff training are just some of the reasons for the gaps in the provision. In some laboratories, machines were not serviced regularly and in others, machines broke down and were not covered by contracts to be serviced or fixed.
Dr. Habiyambere and his team say: “A national laboratory strategic plan to strengthen services must be developed, implemented, and monitored by governments and their national and international partners.
“The focus of the international community, to ensure optimal use of laboratory technologies, should be on those countries where interventions for scaling up access to HIV diagnostic technologies are most needed.”
But they also acknowledged that they did not look at private sector testing and that some countries might rely more heavily on this than others.
HIV experts Peter Kilmarx and Raiva Simbi saidin an accompanying editorial that the findings show some programmes may have been “overly focused” on buying equipment without planning for how it would be used and maintained.
“Strong leadership, resources, planning, and management are needed to scale up laboratory services,” they conclude.
Category: Features, Health alert
