New reduced costs of dual HIV/syphilis rapid tests to accelerate progress toward elimination of mother-to-child transmission of HIV

Each year, approximately 1.3 million women living with HIV become pregnant and just under 1 million pregnant women are infected with syphilis (1,2). Despite the availability of affordable diagnostics and treatment, undiagnosed and untreated HIV and active syphilis infections among pregnant women continue to adversely affect the lives of many mothers and their children. Simple-to-use dual HIV/syphilis rapid diagnostic tests (RDTs), which are recommended by WHO, can integrate and streamline services, and enable more countries to eliminate mother-to-child transmission (EMTCT) of HIV and syphilis.

Today, a new partnership between the Clinton Health Access Initiative (CHAI), MedAccess and SD Biosensor will make these dual tests available for under US$ 1 marking it as the lowest priced WHO prequalified dual HIV/syphilis test available. “The announcement of the new pricing is exciting,” said Meg Doherty, Director of WHO Global HIV, Hepatitis and STI Programmes. “It will help more countries adopt dual HIV/syphilis testing and accelerate progress toward EMTCT for both HIV and syphilis and deliver services for key populations, where both infections are common.”

WHO has recommended using dual HIV/syphilis RDTs for pregnant women since 2019, not only as the first test in antenatal care to help countries achieve EMTCT for both HIV and syphilis, but also as an important cost-saving measure (3). To date, WHO has prequalified three different dual HIV/syphilis RDTs.

Many countries have adopted WHO recommendations and are introducing dual HIV/syphilis RDTs in antenatal care, particularly in the WHO African Region. WHO estimates that major donors and governments procured more than 5 million dual HIV/syphilis RDTs in 2020, with volumes projected to increase (4). For example, Nigeria, which started a pilot programme in 2019, is now moving toward implementation at the national scale, with planned distribution of 4 million tests in the coming year.

Despite some important gains, global adoption of dual HIV/syphilis RDTs in antenatal care remains suboptimal with only 23% (n= 45/194) of all countries reporting a national policy (5). The newly negotiated price reduction is an opportunity for more countries to adopt the dual test, and to allow more pregnant women to be tested and treated for HIV and syphilis.


References

  1. UNAIDS. The gap report: children and pregnant women living with HIV. Geneva: Joint United Nations HIV/AIDS Programme; 2014.
  2. Korenromp et al., Global burden of maternal and congenital syphilis and associated adverse birth outcomes—Estimates for 2016 and progress since 2012 (plos.org); 2019.
  3. Rodriguez, Patricia J et al. Cost-effectiveness of dual maternal HIV and syphilis testing strategies in high and low HIV prevalence countries: a modelling study. Lancet Glob Health. 2021;9(1):e61 – e71. Accessed: https://doi.org/10.1016/S2214-109X(20)30395-8, 3 November 2021.
  4. WHO Diagnostics Forecasting Meeting, 2021–2025.
  5. WHO, UNAIDS, UNICEF. Global AIDS Monitoring. https://lawsandpolicies.unaids.org/, Accessed 3 November 2021.
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