Scaling up EID: Successes, Challenges & Potential Solutions

Shabnam ZavahirRoche Diagnostics

Vienna, IAS 2010, Special Session, 18th July

Roche Activities in EID

• HIV Qualitative Assay on Cobas Ampliprep-TaqMan (CAP-CTM)– Automation

• Increased daily output & simplified workflow• Robust & High Quality

– Migration of high volume countries to CAP-CTM (South Africa, Kenya,Uganda)

• Training Initiatives– ACILT/CDC/NHLS in Johannesburg

• Turn Key Labs– 7 new Laboratory Facilities across sSA

• Educational Material– Laboratory Tools – Workflow Charts– DBS DVD – English and French

Challenges

• Leadership– Focus the spotlight on the issues– Take EID from words to action– Where leadership is lacking, programmes fall down

• Policy – WHO Guidelines and National Guidelines

• Technology– Scaling-up requires automation

• Human Resources– High Staff attrition rates– Task shifting for clinic workers– Lay health care workers in short supply

Innovating Solutions

• Health Systems Strengthening through Turn Key Laboratory Concept• Establishment of high quality facilities for EID allows for growth

in other lab services– Bundled Procurement

• Consolidated Clinical & Laboratory Supplies reduces bottlenecks

• Technology– Cobas Ampliprep-Cobas TaqMan HIV Qualitative assay– In response to growing demand for “scaled-up” solution

• Increased daily output & simplified workflow• Robust & High Quality

• Mobile Solutions– Successful pilots of “SMS” solution at lab level– Automation at Lab level + “SMS” = > improvement in TAT– Further explore opportunities to link mother to EIC track via SMS

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