HIV effort let down by test shortages, says WHO

Neglected HIV

Experts from the World Health Organization warn that a scarcity of HIV testing could destabilize efforts globally to detect and cure people who are fallen prey to the infection. They went through the replies of the yearly surveys which the World Health Organization has delivered to 127 countries in the middle of 2012 and 2014 enquiring about the volume and practice of blood tests that can keep HIV status and health in check.

They found gaps of concern setting up. They cautioned the United Nations that as a result of this that target for HIV could be overlooked. The targets states that by the year 2020, about 90% of all those living with HIV, should be aware of their HIV status, 90% of those in which the infection has been detected should be given anti retroviral therapy and about 90% of those among these patients that are treated should have an amount of treatment which is effective or in their terms, ‘durable viral suppression.’ Laboratory testing is of utmost importance so as to meet and observe these aims.

But in the journal PLoS Medicine, Vincent Habiyambere and his team say that those countries where the people have low or moderate income, counting African countries where the infection strain is high, are not yet set up for the task. The reviews were sent to:

• The top 7 high stricken HIV countries in the WHO belonging to the Western Pacific Region 
• All 47 countries in the WHO belonging to African Region 
• 33 countries of the Region of the Americas in the WHO 
• All of 21 countries of the Eastern Mediterranean Region in the WHO 
• 8 countries in the European Region who very high driven by HIV 
• South-East Asia Region in the WHO comprising of all 11 countries.

Over the three years that the survey was conducted, a total of 55 countries answered back to all the three surveys (43%), 35 countries responded to two out of the three (28%), 25 countries replied back to only one survey (20%) and 9 countries reverted back to not a single survey. Over the years, testing facilities did improve, but what remained in few parts of the world were under performances and deficits.

Worrying gaps

The reasons that caused gaps in providing the facilities comprise of deficiency of reagents, installation and maintenance of tools not done properly and insufficient or lacking training of staff. In some labs, the machines were not sent for servicing regularly.

In the remaining, machines stopped functioning and could not be covered by warranty to be repaired or serviced. Dr Habiyambere and his colleagues say that a national lab tactical plan to reinforce services must be established, executed and examined by not only governments but also their international and nation partners. The goal of community internationally is to make sure that the prime use of technologies of laboratory should be for those countries where involvements for an increasing access to HIV investigative technology is of great need.

They do confess that they did not take a look at testing for private sectors and that some of the countries may depend a lot on this as compared to others. HIV specialists Raiva Simbi and Kilmarx say in an associated editorial that the results portray that some platforms could have possibly been focused at more than required on purchasing apparatus without planning for how to use it and maintain the devices.

For instance, in Zimbabwe, in 2015 only 5.6% of the patients that were infected by HIV that were on drug treatment received consistent blood checks to keep in check their viral burden – way far then their actual aim of 21%. They believe that this was greatly down to difficulties with the mobilisation of resources and the transportation of specimen as well as the procurement of the devices.

They concluded by saying that in order to up scale the laboratory services they will need strong leadership qualities, proper planning and management as well as resources. The testing should be carried on frequently or as required depending upon the amount of specimen test that need to be run and the availability of resources. Proper planning techniques should be implemented for which firstly staff need to be trained regarding the same.

No proper planning would not only cause a problem but would also lead to wastage of labour, resources and money. The procedures could be allotted and one task could be taken up so that it prompts maximum accuracy with minimized trial and errors.

The goal could be achieved if the procedures are conducted faithfully and with awareness. Machines and equipment should be handled delicately and be maintained from time to time to obtain longevity. Lastly, patients should receive time to time blood check-ups to observe the viral load or bulk within their system. This could help in speeding up tests.