Access to Health Care in Africa : Laboratory Diagnostics Cape Town, April 16 –

2 Scaling up interventions against major diseases of poverty –HIV, tuberculosis, malaria identified as major killers Source: WHO, 2nd Stakeholders meeting on Prequalification Geneva, 10 January 2007 Challenges in Health Care in Africa Scaling up Diagnostics 75% of the world's unmet need 13% of the world's unmet need  Scaling up access to TREATMENT implies … –Access to safe appropriate and reliable diagnostics at country level

3 Diagnostic Services identified as a Priority Lab Infrastructure, Quality Systems and Skills

4 Source: FIND 2007 Laboratory Infrastructure at Country Level Diagnostic requirements differ according to level of lab

5 0 10,000 20,000 30,000 40,000 50,000 60,000 70,000 80,000 5 hours Hours from Laboratory 330,000: HIV infected 110,000: Commitment to treat 25%:3 or more hours from lab Lab Zone Access to Laboratory Diagnostics in Africa Botswana illustrates typical socio-geographic constraints

6 The Nature and Utility of Diagnostics’ Products Typically shorter shelf-life and stringent application

7 Provision of Laboratory Diagnostics Factors affecting access in Africa Funding unpredictable Poor logistics & supply Unreliable lab test results Undervalued IVD tests Skills shortage Inadequate transport systems Funding available Partnerships with Gov/NGOs Awareness Recognition of IVD’s Extensive training programs Innovative testing solutions DRIVING FACTORSRESTRAINING FACTORS Source: Frost & Sullivan, May 2007

8 Country-specific laboratory infrastructure: robust and high quality Dx systems; Service and maintenance contracts (funded by the donor); New sample collection methods and transportation; Capacity building initiatives: e.g. training academies; Point of Care Testing: healthcare professionals agreements on specs (compromise?) Provision of Lab Diagnostics in Africa Requirements for Increasing Access