UNITAID and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) today launched an initiative that will dramatically scale up HIV diagnosis among newborns in nine African countries. In partnership with ministries of health, this initiative will make "point-of-care" testing more widely available to HIV-exposed infants early in their lives, when they are most at risk of dying, and enable those diagnosed with the virus to be put on lifesaving treatment more quickly. The project will also pilot point-of-care diagnosis in a variety of child-centered services, such as pediatric clinics, where HIV testing is frequently unavailable. Through this initiative, UNITAID and EGPAF intend to prove that point-of-care HIV testing and treatment can be successfully scaled up to create momentum for its adoption at the global level and bring the world closer to an AIDS-free future.
The four-year, U.S. $63 million project aims to significantly increase the number of children living with HIV whose status is known in the nine project countries. Improving early infant diagnosis is critical to initiating treatment promptly for HIV-infected infants and reducing mortality. Globally, more than 1.4 million babies are born to HIV-infected mothers. However, only half of those infants are tested in their first two months of life. Fifty percent of infants who are tested never receive their test results and therefore cannot be put on lifesaving treatment. Without treatment, 80 percent of all children living with HIV die before the age of 5.
"The world has set an ambitious target of identifying 90 percent of those living with HIV by 2020. This is achievable, but only if we continue to find innovative new ways to work," said Lelio Marmora, executive director at UNITAID. "Scaling up the use of new, better-performing diagnostic tools to find those infected before, during or after childbirth will make an important contribution to reaching this goal, and this is what UNITAID is focused on achieving."
Identifying and treating HIV-infected babies as soon as possible after diagnosis greatly improves their chances of long-term survival. Studies have shown that starting treatment within 12 weeks of birth reduces HIV-related mortality by 75 percent. The program will aim to reduce the time it takes to deliver test results to health workers in the field to no more than two days, significantly minimizing the risk of infants dying while they wait for a test result. Currently, across the nine project countries, the return of test results to rural caregivers can take as long as 100 days, well beyond the critical 12-week period.
"Every day, 600 children become newly infected with HIV. If we want these children to grow up and lead healthy, productive lives, we must put them on treatment as soon as possible. Being able to do that requires that infants, especially those in rural, underserved communities, have increased access to testing that is efficient, accurate, and most importantly, accessible," said Charles Lyons, EGPAF president and CEO. "Through our new partnership with UNITAID we can quickly identify and test infants who are at-risk as early as possible and reduce turnaround times for test results. A shorter window of time between testing and treatment means more infant lives will be saved."
The project will work with ministries of health to identify the most appropriate health facilities for placement of point of care platforms to address existing gaps in nine African countries: Cameroon, Côte d'Ivoire, Kenya, Lesotho, Mozambique, Rwanda, Swaziland, Zambia, and Zimbabwe. Through this project, more than 215,000 infants will be tested for HIV, reaching approximately 30 percent of unmet testing needs in these countries and saving as many as 27,000 lives.
New insights into the mechanisms of efavirenz-induced neurotoxicity