1. To beat Coronavirus we must confront glaring inequities
2. New rapid CD4 test could be game-changer for people with advanced HIV disease
To beat Coronavirus we must confront glaring inequities
By Dr. Philippe Duneton, Unitaid Executive Director a.i.
Covid-19 has cut an uneven, unpredictable path across the globe, leaving some countries with thousands of people dead, while passing over others with relatively mild effects.
Dr. Philippe Duneton, Unitaid Executive Director a.i.
Many commentators portray Covid-19 as a great leveller, striking at rich and poor alike. They see powerful public figures who have fallen ill with the virus, including the UK prime minister and Hollywood film stars, as hard evidence that nobody is safe from contagion.
The disease has, however, exposed glaring inequities in access to medicine, tests and health tools.
The virus is having an impact on the whole global health system and we do not yet know what the long-term damage will be or how long COVID-19 will be with us. The world has never experienced a pandemic quite like this.
What is clear is that countries with lower incomes and fragile health systems may face an unsurmountable health and economic emergency as CVID-19 infections spread.
Bill Gates recently summed up the disparities in healthcare between rich and poor and their consequences. “Covid-19 overwhelmed cities like New York but the data suggest that even a single Manhattan hospital has more intensive-care beds than most African countries. Millions could die.”
The global health community can mitigate COVID-19’s destructive impact on the most vulnerable. To do so, Unitaid and many agencies and organizations are uniting under the leadership of the World Health Organization, each group bringing skills and insight to this unprecedented crisis.
Heads of state and global health leaders have committed to ensure everyone has access to all the necessary tools to prevent, detect, treat and defeat COVID-19, and launching a mechanism – known as the COVID-19 Tools (ACT) Accelerator -- that combines the efforts of many organizations to work speedily and at scale. We are already working with partners including the Bill & Melinda Gates Foundation, the Global Fund, GAVI, the World Bank and many others on the need to strengthen health systems to deal with the COVID-19 pandemic, and other possible pandemics.
A vaccine will provide a long-term solution, but it will not be the only weapon in our armoury to fight COVID-19. We also need to think about new diagnostics and treatments, not just vaccines, and we must act now.
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New rapid CD4 test could be game-changer for people with advanced HIV disease
While many rich countries struggle to cope with COVID-19, the global health community is racing against time to help contain the potentially devastating impact of the virus in resource-limited countries with weak health systems. The biggest fear is that over-stretched health facilities in the poorest countries could implode if COVID-19 spreads uncontrollably, putting at risk patients receiving treatment and care for other diseases such as HIV and tuberculosis. Unitaid and its partners are ramping up efforts to introduce solutions with potential to take pressure off over-burdened health systems. The latest is a rapid CD4 test, that holds out the promise to improve care for patients with advanced HIV disease. We talked to Robert Matiru, Director of Programme Management at Unitaid, about the initiative.
Robert Matiru, Director of Programme Management at Unitaid
Why does Unitaid seek wider access to rapid test kits for CD4 cell counts?
An easy-to-use portable test is now available that can quickly determine whether a person’s CD4 cell count – which measures the resilience of the immune system – has dropped to a critical level. Effective and widely available CD4 testing is vital for countries to be able offer the best possible treatment and outcomes to patients with advanced HIV disease. These are people whose immune system is dangerously weakened by the time they start antiretroviral therapy, or resume it after a break in treatment. We want to get many more of these tests carried out as close as possible to the point of care, including in villages and small towns, where more complex diagnostic tools are harder to access.
Will the new test make it easier to manage advanced HIV disease?
Yes, it will. The new test, known as the VISITECT CD4 Advanced Disease test, is more affordable than existing laboratory-based tests; requires no additional equipment; and can be used in all kinds of health facilities. It has the potential to identify more people with advanced HIV disease more rapidly so that they can receive the right treatment before they fall seriously ill.
What kind of CD4 testing has been on offer until now?
Conventional and point-of-care equipment-based tests are run on platforms, requiring investment in equipment and maintenance. Blood samples are taken from the patient at a health clinic and are then sent to a laboratory, which is sometimes outside the facility. This may require patients to return a week or two later to the clinic to get their results before follow-up treatment can begin. Omega’s CD4 diagnostic can test individual blood samples instantly, which will speed up case management and also alleviate the burden on healthcare systems.
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