Integrated Multi-disease Testing from Theory to Practice: Generating Efficiencies and Building Programmatic Bridges.
Sponsors: African Society for Laboratory Medicine, Clinton Health Access Initiative, Elizabeth Glaser Pediatric AIDS Foundation, UNICEF & Unitaid
Date: Tuesday, 11 December 2018
No invitations necessary; open to all conference registrants
Background: Optimising and efficiently utilising resources is key to effective laboratory services. Better placement of diagnostic instruments and efficient sample transport mechanisms have the effect of reduced turnaround times, better result utilisation and better outcomes. Use of polyvalent or multi-assay testing platforms that have the ability to conduct a number of different test types using a single device is identified as one way of increasing access to testing for Viral Load and EID testing to priority populations. While traditionally there is capability of testing for many diseases in conventional laboratories, integrated testing is now available also on the POC or near-POC devices such as the Cepheid GeneXpert, which can run assays related to HIV, TB, Hepatitis, Ebola and human papilloma virus (HPV), among others. The continuously increasing fleet of diagnostic instruments in national diagnostics systems call for innovative ways of getting the most out of the capabilities of the instruments. This session aims to provide evidence and lessons learned to support setting up systems, adoption, scale-up of processes for the optimal use of resources, efficiencies and mutual benefits of integrated multi disease testing in the context of an optimised laboratory testing network.
The session will begin with case studies highlighting HIV, TB, Hepatitis and HPV integrated testing across multiple countries, demonstrating the technical and operational feasibility of integrated testing on a single platform, how integration of decentralized POC/near-POC platforms can increase access to diagnostic services, and the potential financial savings to be generated through integration due to increased device utilization. The case studies will be followed by a panel discussion that aims to highlight the important ingredients to setting up systems and processes for the optimal use of resources, and increased efficiencies in the context of ongoing lab network optimization exercises. Setting up such integrated systems requires political will and collaboration among key stakeholders. The panel discussion will therefore round up by tackling the key barriers to integration of testing, from the perspective of integration across different issues, including equipment and sample transportation integration. Speakers from various regions and partner organizations across the continent will share pilot experiences and future plans for scaling-up integrated testing within laboratory networks. The session, co-organized by ASLM, CHAI, EGPAF, UNICEF, and Unitaid, will convene the laboratory medicine community, national HIV and TB diagnostics program managers, government officials / policy makers, funders and donors, implementing partners, non-governmental Organizations (NGOs), health care workers, manufacturers and diagnostic product suppliers.
- Integrated testing is cost-effective, operationally feasible and does not compromise healthcare service delivery or patient outcomes,
- Political will and collaboration among key stakeholders is a prerequisite for successful integrated testing.
- Integration of testing can expand access to diagnostic services when optimised in a lab network, with robust sample transport systems
- Multi-assay testing platforms provide opportunities for collaboration and integration across disease programs, which can produce system efficiencies and cost savings at a time of diminishing donor funding for global health without compromising patient outcomes.
Anafi Mataka, African Society for Laboratory Medicine