1. Tools to Maximize a National Investment in the GeneXpert July 22, 2013

2. Abt Associates  GxAlert –Open source, dev in 2012 by Abt Associates using their own money –Incorporates diagnostics for TB and flu (GeneXpert) and HIV (PIMA) –Active in India and Nigeria; early stage in 5 countries  TBGxMonitor –Developed in 2011 by Univ. of Witwatersand in South Africa –Active in South Africa; early stage in 13 countries  XpertSMS –Open source, dev in 2011 by IRD Pakistan under one-time grant –Active in Pakistan, Nepal, Kenya, Zimbabwe; early stage in 5 countries  RemoteXpert –Being developed now by Cepheid, estimated launch December 2013 –Pilot tested in South Africa There Are Four Stable, Scaling-up Data Services Around the GeneXpert The first three were developed out of necessity… teams just wanted the data. It turns out, others wanted the data too. So these developed into software products. There is some overlap, but generally each tool fits a different set of needs. The first three were developed out of necessity… teams just wanted the data. It turns out, others wanted the data too. So these developed into software products. There is some overlap, but generally each tool fits a different set of needs.

3. Abt Associates What Does Each Software Do? Disease Management  Case+Population level Management  Indicator reporting  MDR treatment  Drug demand / supply  Integration into existing National Health Information Systems  MOH messaging  Clinic / lab messaging  Patient messaging Instrument Operations  Errors and error rate (by user, module, and machine)  External Quality Assurance (EQA)  Instrument Verification  Pre-analytical, analytical and post-analytical evaluation Supply Chain Management  Cartridge expirations  Stockout management  Utilization vs. disease load  Deployment planning  Procurement, warranty, and service planning

4. Abt Associates A Look Inside…GxAlert

5. Abt Associates Each is Relatively Inexpensive to Bring to National Scale  GxAlert ~$25,000 Yr1 to roll out nationwide and tech support existing software; Yr2 ~$10,000  XpertSMS ~$25,000 Yr1 to roll out nationwide and tech support existing software; Yr2 ~$10,000  TBGxMonitor available to complement NHLS/Wits DCS EQA program. Independent use cost TBD.  Cepheid’s RemoteXpert, cost TBD, Dec 2013 Organizations can pay for customizations if desired, but not necessary By leveraging these tools, you can: 1)Shorten diagnostic response time from months to seconds, getting patients into treatment faster 2)Reduce waste, operating costs, and stockouts 3)Dramatically improve data quality By leveraging these tools, you can: 1)Shorten diagnostic response time from months to seconds, getting patients into treatment faster 2)Reduce waste, operating costs, and stockouts 3)Dramatically improve data quality Each of these software is capable of communicating with the others so installing a mix of software is relatively easy and inexpensive

6. Abt Associates Why Include These Tools in Your GeneXpert Implementation? 1.Shorten diagnostic response time from months to seconds, getting patients into treatment faster 2.Reduce waste, operating costs, and stockouts 3.Dramatically improve data quality 4.Identify drug resistance patterns of TB strains 5.Measure program adherence to the TB algorithms 6.Order cartridges based on real-time demand forecasts 7.…

7. Better patient treatment Faster response to MDR-TB More efficient TB logistics Prepared by: Martha Benezet martha_benezet@abtassoc.commartha_benezet@abtassoc.com Jeff Takle jeff_takle@abtassoc.comjeff_takle@abtassoc.com Download slide deck @ www.GxAlert.comwww.GxAlert.com