TODAY -

Can innovation drive HIV responses to meet 90:90:90 targets by 2020?

Bobby Ramakant *

A painting exhibit during World AIDS Day 2013 observation at Imphal on December 01, 2013
A painting exhibit during World AIDS Day 2013 observation at Imphal on December 01, 2013 :: Pix - Ashok Ningthoujam



Joint United Nations programme on HIV/AIDS (UNAIDS) is mobilizing governments and other partners to achieve new set of targets, referred to as, 90:90:90 by 2020, but with current set of tools, approaches, funding commitments, and challenge that HIV poses to the world, the goal seems certainly a bold and ambitious one. Without innovation, at current pace of HIV responses on the ground, we are very likely to fail meeting the targets. We not only need to accelerate the search for better and effective technologies to help fight AIDS effectively but also need to improvise and innovate in rolling out evidence-based approaches.

Innovation can surely help provide more value for every dollar of investment. But then the dollars must be there to help innovation maximise the returns. Hence, besides innovative ways to do HIV programming more effectively we also need to increase HIV financing. The resources for the Global Fund to fight AIDS, Tuberculosis and Malaria (The Global Fund) and PEPFAR, among others, have almost flat-lined over the past 5 years or so. Without sufficient financial investment in HIV programming, it will be difficult to reach the new set of targets by 2020.

90:90:90 by 2020

Dr Michel Sidibe, Executive Director of UNAIDS said at 20th International AIDS Conference (AIDS 2014) that 90:90:90 by 2020 targets include increasing to 90% the proportion of people living with HIV who know their diagnosis, increasing to 90% the proportion of people living with HIV (PLHIV) receiving antiretroviral treatment and increasing to 90% the proportion of people on HIV treatment who have an undetectable viral load.

Is innovation the golden key?

One of the most respected organizations that has demonstrated its commitment to accelerate health responses by innovation and market solutions, is UNITAID. Robert H Matiru, Portfolio Grant Manager for HIV at UNITAID said to Citizen News Service (CNS): "UNITAID is very excited by new ambitious targets of 90:90:90 and it is going to actively support realisation of all three of these targets. In case of first '90' target, of helping 90% of those who are estimated to have HIV to get diagnosed and know their status, UNITAID is looking at new innovative projects to drive the current baseline which is less than 50%."

HIV self-testing a possibility

Robert Matiru added: "Less than 50% of people estimated to have HIV know their status currently. To reach 90% by 2020, requires real innovation. UNITAID is aiming to go beyond what exists already, that is, HIV rapid test which is well priced, and exploring how can we complement it further. One new area is HIV self testing, particularly oral self testing where testing is based on oral specimen such as saliva. It is a critical area to explore, it is a new area and it is an area which UNITAID is interested in potentially backing. So we are currently looking at potential partners to provide more evidence on suitability and feasibility of these new testing in resource limited settings. Currently such tests are only being rolled out in United States and Europe. There is one supplier, OraQuick for HIV self-testing. We want to look at if UNITAID can be a driver in shaping the market for these diagnostic technologies to get many more people tested and help them to know their status."

Regarding second target of ensuring that 90% of those who get diagnosed with HIV get antiretroviral therapy (ART) by 2020, UNITAID has been active in this area for many years. Robert Matiru said to CNS: "We heard in President Bill Clinton’s speech at AIDS 2014 that UNITAID has been instrumental in driving 75% of paediatric treatment for HIV in last 6-7 years, and we continue to be the leader in paediatric HIV treatment. Right now The Global Fund to fight AIDS, Tuberculosis and Malaria (The Global Fund) and PEPFAR have taken over the cause of providing HIV treatment to children and UNITAID is looking at new paediatric medicines that are better adapted, cheaper and better tolerated by children. We are doing important work with partners such as DNDi and generic manufacturers such as CIPLA. In future we may have an important role in making second line and third line ART treatment more affordable but right now our major focus in treatment space in on paediatrics."

Point of care viral load testing - a reality?

Regarding last target of ensuring that 90% of those who receive treatment have viral suppression (viral load is undetectable), UNITAID is responding to a critical gap in availability of viral load testing machines in many countries such as India. Robert said in this regard, "Just a year ago UNITAID began an important project in increasing access to viral load and infant testing as well as CD4 testing at the point of care. By that we mean products that can be used in district and rural health centres, that does not require skilled trainers and can be used by nurses, community volunteers etc. We have UNICEF on one hand to scale up infant and viral load testing, as well as MSF on another hand, to help generate evidence on what is the best placement of different diagnostic technologies that we have currently (right from the laboratory based diagnostic technologies to the point of care ones)."

Taufiqur Rahman, Head of Operations, UNITAID, told CNS: "We are aggressively supporting efforts to develop diagnostic tools that can reach rural and remote areas - diagnostic tools that are portable, rechargeable and can be taken to the remotest corner of the world and get the HIV testing done - because once the test is done treatment will be made available in most countries. Now 90:90:90 has been announced we are even more committed to see how can we accelerate the pace towards reaching these targets through innovative financing. We fund innovative products to come to the market, and will continue to build on that."

HIV, TB, Hepatitis C testing on one platform: a possibility?

Taufiqur Rahman added: "HIV-TB co-infection is a serious area for us to see how can we help on the diagnostic part as well as making sure that better multidrug-resistant TB (MDR-TB) drugs are made available to the countries at an affordable price. We also support the pre-qualification programme of the drugs and diagnostics, to make sure that developing countries receive quality assured products. UNITAID is different from all other donors as we focus on market shaping activities so that products are available in the market at an affordable price, and national programmes can take it to scale. When we talk about HIV financing, it can only happen when national programmes can afford the products. We fund medicines patent pool which gets patented drugs for generic production at country level. Large number of people can access generic products and this is major investment from our side in form of medicines patent pool to support generic drug production."

Robert said: "UNITAID is supporting integrated platforms what we call polyvalent platforms for diagnosis. One UNITAID grantee is looking at a possibility of having a platform at a central laboratory which is open, which can take its components and reagents from different suppliers, so that we are not tied to any one supplier, and it makes the platform that much more flexible and adaptable for countries. Particularly for countries where one type of reagent has been designed for a HIV genotype, so this enables you to combine it to include multiple genotypes. That is the open nature of the platform. Polyvalent nature is to see if we can then add TB, hepatitis C, or other assays to the platform which are possible. They are looking at the feasibility of doing that in a number of countries in Western Africa and then generalising their findings beyond that. So here we are looking through technology to promote integration of services and testing for HIV, TB and even hepatitis C. This is a possibility where technology and tools might help programmes to come together. This is in response to the needs expressed by healthcare providers on the frontlines such as nurses or community volunteers etc who wanted this kind of a platform so that with increasing task-shifting they may not have to deal with multiple point of care machines for HIV, TB, and hepatitis C, and rather have ‘multiplex’ platforms. Besides such platforms at central laboratory level, UNITAID is also exploring possibility of a point of care polyvalent platform to test for HIV, TB, and hepatitis C virus. It makes economic sense to do that, will be better for programmes and for horizontalizing the work."

There is no doubt that if we continue to do business as usual, it may be difficult to reach the 90:90:90 targets set for 2020. Innovation can potentially drive the pace of HIV responses on the ground.


* Bobby Ramakant, Citizen News Service – CNS wrote this article for e-pao.net
The writer can be reached at ramakantbobby(at)gmail(dot)com
This article was posted on August 08, 2014.


* Comments posted by users in this discussion thread and other parts of this site are opinions of the individuals posting them (whose user ID is displayed alongside) and not the views of e-pao.net. We strongly recommend that users exercise responsibility, sensitivity and caution over language while writing your opinions which will be seen and read by other users. Please read a complete Guideline on using comments on this website.




LATEST IN E-PAO.NET
  • Rajkumari Muktasana - Artiste : Gallery
  • Covid-19 Status 29 May : Govt of Manipur
  • A novitiating criminal lawyer's reflections
  • Childline Thoubal, frontlines during lockdown
  • Webinar on 'Dynamics of Online Education'
  • Share market as career options
  • The Beauty of It :: Poem
  • Countdown to May 31
  • Contemplating on the impending changes
  • Train @Jiri [May 28] #1 : Gallery
  • Covid-19 Status 28 May : Govt of Manipur
  • 'Fisabishiing Thabak Suhanbiyu'
  • Thoughts random: In times of coronavirus - V
  • Appeal to CM from Students in Delhi
  • Deadly Darkness :: Poem
  • 'Avoid stigmatization against Returnees'
  • Martin Ennals Award 2021 : Nominations
  • Make information come more freely
  • Need for greater aggression & sterner actions
  • Stuctures @ Willong Khullen, Maram : Gallery
  • Covid-19 Status 27 May : Govt of Manipur
  • Discussion with tribal leader- 27 May : Gallery
  • A walk to remember :: Poem
  • School at Senapati as quarantine center
  • Delhi Declaration- environmental conservation
  • Letter to Governor on Lhukhosei Zou's case
  • Increase of COVID-19 +ve cases in Nagaland
  • Dialogue: Inequality-Bridging the Divide
  • Learning to live with COVID-19
  • I Rise :: Film Synopsis & Biography
  • Covid-19 Status 26 May : Govt of Manipur
  • Legal framework behind Lockdown, Curfew
  • Furnishing of Fees Info from Private School
  • Curfew Violators - 26 May : Govt of Manipur
  • Continuing woes of people in Manipur
  • Increasing positive cases of COVID-19
  • Measures @ Imphal Airport - 25 May : Gallery
  • Covid-19 Status 25 May : Govt of Manipur
  • Modified SOP for Air Traveller- 25 May : GOM
  • Haoginlun, Chingdakoiba: eMing
  • Covid-19 : Impact in Manipur :: News Timeline
  • Drug Rehabilitation Centre in Manipur
  • COVID-19 & ecology, environment in Manipur
  • Vegetable flood at Wabagai during lock down
  • Technology to the rescue
  • M.K Binodini Devi's Sense of Beauty
  • Covid-19 Status 24 May : Govt of Manipur
  • Monkeys seen on the streets of Imphal
  • Id-Ul-Fitr :: Book
  • Make in Manipur, try Yu
  • SOP for Air Traveller- 24 May : Manipur Govt
  • Economic Relief package for small business
  • Manipur Muslims stranded in Gujarat
  • Bracing up for arrival by air
  • Motsillaba Mingsel : Film Synopsis
  • Covid-19 Status 23 May : Govt of Manipur
  • COVID-19 emergency response- observation
  • Ugly side of lockdown during COVID-19
  • International Day of Biodiversity 2020
  • Requests for Orders on 7th UGC Pay
  • Mother - A Deity :: Poem
  • Preparing for the inevitable change
  • Phisakol #3 :: eRang
  • Covid-19 Status 22 May : Govt of Manipur
  • Two students at 'Model Conference of Parties'
  • Eyek Tamba :: Learn Manipuri script
  • It's a cup of my Tea - International Tea Day
  • Govts' accountability in response to COVID-19
  • Online Faculty Development Program at RGU
  • Verse for Schoolchildren :: Poem
  • Growing number of positive cases
  • Tending to the trivialities in time
  • International Day for Biological Diversity
  • Covid-19 Status 21 May : Govt of Manipur
  • Issues of Manipuri nurses in Kolkata
  • Item Distribution to Quarantine centres
  • Orders/Memo - 21 May : Govt of Manipur
  • Workshop On Writing Research Paper
  • Appeal to all the Stranded Denizens
  • 'Reverify the lists of evacuees'
  • Helpline for Women Entrepreneurs of NE
  • Focus on quarantine centres
  • Counting on our collective responsibilities
  • Art has no gender & neither do Artists
  • Covid-19 Status 20 May : Govt of Manipur
  • Medical assistance to journalist awarded
  • 13th Manipur State Film Awards, 2020
  • Power loom weave intricately designed cloth
  • Dilemma after High School
  • Quarantine Centre- Negligence at Saitu, Kpi
  • 'This is no time to politicize the pandemic'
  • Highest spike on single day with 16
  • Foresight & vision - need of the hour
  • Distribution for Manipuri @ Blore: Gallery
  • Covid-19 Status 19 May : Govt of Manipur
  • Hand sanitizer to Journalists : Gallery
  • Manipur Migrants in Bengaluru's Safety Net
  • Orders/Memo [19 May] : Govt of Manipur
  • A Forbidden Love : Poem
  • Social advocacy as career choice
  • Total curfew : Confusing the people
  • Preparing for the long haul
  • Tungjoi Glory Day #2 : Gallery
  • Covid-19 Status 18 May : Govt of Manipur
  • Gandhi's talisman.. to reform public health
  • A view of the Thames
  • COVID-19 knocks our education system
  • Clarification from Mumbai Returnee [May 18]
  • Nagaland : Demand for Special Trains
  • Beating China on the tally
  • Turning threat into opportunity
  • How Lockdown impact Textile Industry
  • Covid-19 Status 17 May : Govt of Manipur
  • Fight COVID-19 !! :: Poem
  • Thoughts random: In times of coronavirus- IV
  • Webinar series with a focus on COVID-19
  • COVID-19 gi matangda suggestion khara
  • Urges to impose curfew on Eid-ul-Fitr
  • Hundreds and hundreds returning
  • Emotional reverberations during COVID-19
  • Covid-19 Status 16 May : Govt of Manipur
  • Ningombam Sunibala : NE Success Stories
  • Home Sweet Home vis-a-vis Lockdown Exodus
  • Issue of Curfew Pass [May 16]
  • e-Videos Learning should be made in English
  • The Old Man in the Evening :: Poem
  • The silver lining
  • Kabui Lai of Kakching
  • Covid-19 Status 15 May : Govt of Manipur
  • Have you ever sanitize your mind ?
  • Challenges in the new normal
  • We Real Brave :: Poem
  • Know our health care system
  • How about the 14 days quarantine ?
  • Psychological side of COVID-19 epidemic
  • Associates & Junior Associates at MaolKeki
  • Know our health care system & shortcomings
  • Quarantine Centre @Thangmeiband: Gallery
  • Covid-19 Status 14 May : Govt of Manipur
  • The Princess & The Political Agent : Preview
  • Self-Sufficiency: A Shibboleth ?
  • Running business not just to survive lockdown
  • A Symphony on Spring :: Poem
  • 'No concrete roadmap by Nagaland govt'
  • Coronavirus, lockdown, stranded people
  • Unattended struggle of Phige Weavers
  • Covid-19 Status 13 May : Govt of Manipur
  • Featured Front Page Photo 2020 #2: Gallery
  • Relief exchange- Moidangpok & Keikao, Tml
  • Unheeded Balance :: Poem
  • Arsenal's new home
  • Getting ready for lockdown 4.0
  • Preparing for the shifting battle line
  • Barak River, Tamenglong #1 :: Gallery
  • Covid-19 Status 12 May : Govt of Manipur
  • Bishnupur Dist. Orders / Memo [May 12]
  • Vaccination of cattle at Khumbong
  • Bus for Stranded Manipuris in Guwahati
  • Startups in the time of corona crisis
  • Naming children after pandemic
  • Growing number of infected
  • Adversity to opportunity
  • The Princess & the Political Agent : eBook
  • Covid-19 Status 11 May : Govt of Manipur
  • Huishu village, Chingai, Ukhrul Dist. : Gallery
  • Nurse unite to demand universal public health
  • Transport of stranded students from Shillong
  • Of kombirei and daffodil
  • Impact of lockdown on economy of Manipur
  • Opening the doors amid the lockdown
  • Preparing for the inevitable future
  • Naga Peace Process :: News Timeline
  • Quarantine Centre @Kwakeithel : Gallery
  • Covid-19 Status 10 May : Govt of Manipur
  • SOP : Returning by Train to Manipur
  • Foreign Nationals stranded in Northeast
  • The International Mother's Day 2020
  • Lonely Days at Home :: Poem
  • Keep helping the poor amid COVID-19
  • From chinky to coronavirus
  • Rajkumari Muktasana : Dance Artiste
  • Covid-19 Status 09 May : Govt of Manipur
  • Impact on children during lockdown
  • Movement Pass Register - Resident Govt
  • Mother, The Giver ! :: Poem
  • Improving English during lockdown
  • Nagaland Govt to bring back stranded citizen
  • Road to unity
  • Paoki Fest @ Purul, Senapati: Gallery
  • Taja mgidi ya_Aodbr :: Seireng
  • A view on soccer training
  • Covid-19 Status 08 May : Govt of Manipur
  • Wetlands of Manipur : Documentary Film
  • Contribution of AR in Empowerment of women
  • Understanding stranded persons
  • nuHsi K_waHceY :: Seireng
  • Covid-19 Status 07 May : Govt of Manipur
  • Vagabond :: Poem
  • Best materials for homemade mask
  • E-Learning during COVID-19 Lockdown
  • Our careers and COVID-19
  • Need to expand commercial centres
  • Normalizing the act of humanism
  • Landscape to Dzukou Valley #4 : Gallery
  • Covid-19 Status 06 May : Govt of Manipur
  • Our part in the coronavirus lockdown
  • Quick nutrition garden during COVID-19
  • Lockdown Order from 6 May: Manipur Govt
  • Relief material to families at Keibul Lamjao
  • What to foresee from a Free Haircut ?
  • May 6, 2020 : Yet another day of drama
  • For Manipur, it is not COVID-19 alone
  • Luira Phanit @Kamjong #2 : Gallery
  • Covid-19 Status 05 May : Govt of Manipur
  • San Marino is now World's Highest Infection
  • Women bear brunt of humanitarian disasters
  • Covid-19 Lockdown Violators - 05 May
  • Lockdown and livelihood
  • Singlup's response to COVID-19 relief
  • No lessons learnt from lockdown ?
  • Embracing the new Normal
  • Distribution @Benguluru -2 May : Gallery
  • Covid-19 Status 04 May : Govt of Manipur
  • Manipur Looks Flat - Hingminnasi Eikhoi
  • Conflicts between Individualism & Collectivism
  • Thoughts random: In times of coronavirus - III
  • Taking care of your hands during lockdown
  • SOP for Stranded Manipuri
  • Categorise the stranded folks
  • Helping a lame dog over a stile
  • MK Binodini Book Reading : Gallery
  • Europe zooms MK Binodini Devi's Literature
  • COVID-19 outbreak: Safety at work is must
  • The Finest Hour :: Poem
  • 27th Anniv of Pangal's Black Day
  • Tribal way of fortification against Covid-19
  • Manipur officially in Green Zone
  • Why not carve out a future in Chakhao #2
  • Covid-19 Status 02 May : Govt of Manipur
  • Advisory for Farmers during Lockdown period
  • Apply for Medical Financial Assistance
  • Drug users community response in COVID-19
  • L Shamungou : Listed in 25 best photos
  • A way to make Manipur the best
  • Bangladeshki Sana Tampha #2 :: eRang
  • Covid-19 Status 01 May : Govt of Manipur
  • Thang Ta - Sangai Fest 2018 #2 : Gallery
  • May Calendar for Year 2020 : Tools
  • Pallel & Kakching Keithel : Gallery
  • Tangkhul Forum vegetable for valley: Gallery
  • Items distributed to Tarao -Apr 23 #2: Gallery
  • Covid-19: Impact in Manipur :: Photos/News..
  • Language affinity betn Meiteis & Tangkhuls
  • Helpline Number for Students/ people from NE
  • SPONSORED ADS