World AIDS Day 2013: Technology can help shift the HIV response to the community level

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Already moving HIV prevention and treatment to the community level has saved hundreds of millions of dollars in the countries that have made this move, avoided thousands of unnecessary hospitalisations and allowed much more rapid diagnosis and treatment for millions, said Dr Denis Broun, Executive Director of UNITAID.

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Our efforts to provide better quality of care at the community level – for affordable prices – are critical. It is essential that other donors target their investments in a similar way. (Dr Denis Broun, Executive Director of UNITAID.)

To cover most people living with HIV with full access to treatment within the amount of resources available today and with a fully funded Global Fund, it is essential that activities for appropriate prevention, detection, treatment and surveillance of HIV infection are performed at the community level, said Dr Denis Broun, Executive Director of UNITAID.

“Already moving HIV prevention and treatment to the community level has saved hundreds of millions of dollars in the countries that have made this move, avoided thousands of unnecessary hospitalisations and allowed much more rapid diagnosis and treatment for millions,” said Dr Broun. “Further cost-savings can be gained if we move laboratory-based diagnosis to communities by using technology adapted for the point of care.”

UNITAID has already invested $140 million in portable and easy-to-use HIV diagnostic technology. These tools can monitor a person’s immune system strength and also use molecular-based testing to measure the amount of HIV in the body, today’s standard for evaluating the efficacy of treatment.

“Community health workers can use these devices to manage a person’s response to HIV treatment, without having to refer anyone to distant urban hospitals,” said Dr Broun. “Importantly, they can determine if people are adhering to treatment correctly or if stronger medicines are required – an essential part of any chronic disease management.”

This World AIDS Day, UNITAID is announcing an additional $20 million in grants to diagnostics developers of these innovative new tools. This is the first time ever that UNITAID is providing direct subsidies to manufacturers to expedite the evaluation and registration of new machines. These grants will bring more products to market more quickly and will also increase the number of countries these technologies will be available in.

“The aim of these new grants is to create a sustainable and competitive market for these products,” added Dr Broun. “We want to make these technologies affordable, for high-burden countries.”

UNITAID funding is already allowing its implementers Médecins Sans Frontières, the Clinton Health Access Initiative and UNICEF to roll out new tools in the heart of the HIV/AIDS epidemic, notably in Eastern and Southern Africa where HIV prevalence rates are often above 10-20% of the population. In Mozambique, remote districts are receiving compact immune system monitoring devices that allow people to receive test results the same day instead of months later. In Malawi, new methods are being tested to provide monitoring services to remote communities, including the first “point-of-care” device in clinical use to measure the amount of HIV in the blood. Meanwhile, in West Africa, UNITAID is funding France Expertise Internationale to stimulate market entry of new HIV monitoring tools.

“Our efforts to provide better quality of care at the community level – for affordable prices – are critical. It is essential that other donors target their investments in a similar way,” concluded Dr Broun.

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