Testing Is Missing Link in AIDS Fight, Experts Say

The world will not meet its goal of getting AIDS medicines to the many millions who need them unless testing is stepped up dramatically, experts said on Saturday.

The world will not meet its goal of getting AIDS medicines to the many millions who need them unless testing is stepped up dramatically, experts said on Saturday.A new public-private alliance to promote routine testing met for the first time in Bangkok, on the eve of the 15th international AIDS conference, and called for cheaper and better tests in developing countries.Cuts of more than 90 percent in drug prices have made widespread access to antiretrovirals feasible in even the poorest countries, but testing remains a significant barrier.More than 90 percent of people do not know whether they have HIV. As a result, most are severely ill before they are diagnosed, making them harder and more expensive to treat.”We need the same dramatic movement on price reductions for diagnostics, not only to see whether people are infected but also to maintain treatment, because that has become sometimes now more expensive than the actual drugs themselves,” UNAIDS executive director Peter Piot told reporters.The number of tests needed is daunting.For the World Health Organization to meet its target of treating three million people with HIV/AIDS in the developing world by 2005, some 5,000 people a day will need to be put on medication.That implies 500,000 tests a day will be needed, assuming that 50,000 will test positive in high-prevalence countries and that 10 percent of these will need drugs immediately.”If over 90 percent of those who are infected with HIV don’t know they are infected, global testing policy has failed. Testing is the missing link,” said Trevor Neilson, executive director of the Global Business Coalition on HIV/AIDS, representing 150 companies around the world.An alliance of WHO, UNAIDS, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Global Business Coalition and AIDS activists is calling for routine as opposed to voluntary testing.That is a strategy that led to a dramatic boost in diagnosis in Botswana, where nearly 40 percent of the population is estimated to be HIV positive, since it was introduced in January.Under the routine testing scheme, patients arriving at clinics and surgeries are offered HIV tests routinely, although they can still refuse — a right Piot said was essential.The Global Fund, the main provider of AIDS testing kits in the developing world, has funds for 52 million tests. Executive director Richard Feachem said this was not nearly enough.Diagnostic companies are already offering discounts for some tests, but Feachem hopes increased buying power as testing increases will drive prices down further. Now, a finger-prick test costs around 80 cents in Africa while oral tests cost $3.25. (Source: Reuters Health, July 2004)