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Cheaper Tests Could Put an End to HIV Transmission by 2030

Global health experts say that reaching the United Nations’ goal of eliminating HIV transmission by 2030 is not possible without a less expensive way to monitor HIV patients — so the Clinton Health Access Initiative (CHAI) is aiming to create just that.

In partnership with other development agencies, the CHAI is working to make HIV viral load tests available for $12 each, which is more than 50% cheaper in some markets, according to NPR.

Viral load testing checks HIV patients who are on antiretroviral (ARV) drug therapy. This testing measures how effective ARV therapy is working for each individual patient.

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"Without viral load testing we will not be able to manage this epidemic," Michael Anderson, from MedAccess and a partner in the CHAI deal, told NPR.

He says increased access to quality HIV testing is essential in working towards eliminating AIDS.

Hologic, a private diagnostic company, will deliver all equipment and supplies for the tests through the CHAI deal. They will be paid for each analyzed sample.

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The aim is to make viral load testing more commonplace in countries with high HIV rates.

"At the moment, fewer than 50% of Africans on (HIV) treatment have access to viral load testing," Anderson told NPR. "Viral load testing needs to be escalated enormously if we're going to have any chance of tackling this epidemic."

In low- and middle-income countries, viral load testing is generally carried out in public laboratories with equipment that is owned by the government, according to NPR.

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This equipment can be expensive and is not available everywhere — and especially not in Africa, according to Nqobile Ndlovu, the acting head of the African Society for Laboratory Medicine.

"If you move across most of the African continent, we have got machines lying idle, lots of machines lying idle, because we can't maintain them," Ndlovu told NPR.

The UN aims to stop HIV transmission by 2030 with a three-part plan. First, people need to be tested; next, people with HIV need to be put on ARV treatment; and lastly, the viral loads of people with HIV need to be reduced to the point where they are essentially unable to transmit the virus to anyone else.

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Evidently, if people aren’t tested, the plan cannot work.

The reduced cost of the viral load machines being used by Hologic is significant. Catherine Barker Cantelmo, who studies health system costs with a private global consulting company called Palladium, told NPR that the CHAI deal provides equipment at a much lower cost than what most health ministries are currently paying.

But she cautions that it’s not just the equipment that cost money.

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"In the past, it was easy to point to cost as being the problem," she told NPR. "But even if the prices get to $12 per patient sample, you still need a lot of investment in the laboratory infrastructure, which is a huge cost."

This deal will initially target five sub-Saharan African countries and could be essential in reaching the goal of eliminating HIV/AIDS forever.