In the midst of the COVID-19 pandemic, when global disruptions reduced access to health facilities, including testing services for HIV, our evidence-backed strategies helped to increase access to self-testing kits for HIV and other associated services across target countries in Africa.
The Global Fund is a worldwide movement to defeat HIV, TB and malaria and ensure a healthier, safer, more equitable future for all. They raise and invest US$4 billion a year to fight the deadliest infectious diseases, challenge the injustice that fuels them and strengthen health systems in more than 100 of the hardest hit countries. A core element of the Fund’s strategy involves uniting world leaders, communities, civil society, health workers and the private sector to support new innovations in programming, delivery, and access, and to take them to scale through country-led strategies.
The role of self-testing for HIV is imperative in prevention of the transmission of the virus. HIV self-testing kits serve as a transmission-control measure, especially in regions where the virus is endemic. The kits help to improve testing rates, and, in turn, reduce HIV burden in these communities. The World Health Organization recommends HIV self-testing kits to accelerate epidemic control, as they are feasible to implement in diverse settings, and in some cases are more effective in reaching specific groups.
However, there has been little incentive for pharmacies to stock HIV self-testing kits because they are considered slow-moving goods. Pharmacies are often the first point of contact for most African citizens, particularly among those who value the private nature of these visits over public facilities. The kits aim to address barriers that prohibit health providers from reaching their patients to provide routine diagnostic services
Access to such tests further supports the use of prevention tools and behaviours for those who test negative. Yet, gaps in funding and the COVID-19 pandemic caused a large disruption in testing services and resulted in national responses that derailed progress towards meeting national HIV goals. For instance, the funding gap among the 25 highest burden countries remains more than 90% of what is needed to meet HIV strategic goals.
The Global Fund commissioned Market Access Africa to provide a total market approach to develop sustainable strategies that increase access to self-testing kits and the associated services across different market segments. Our work provided a critical assessment of the current and potential HIV self-testing markets and provided key insights on supply and demand and market incentives.
Our insights helped to explain why current go-to-market strategies for self-testing kits had not resulted in the expected uptake at the country level. We convened a team of experts whose analysis and experience helped to inform new potential pathways to bring the product to market. These were backed by evidence-based approaches which highlighted the importance of commercial attractiveness in order to gain stakeholder buy-in.
Market Access Africa delivered a report proposing a series of recommendations and interventions that allowed the client to prioritize and guide their internal strategic business case for catalytic funding, with a focus on 5 key countries in the African market. Based on our report, the client was able to signal to its partners and donors a variety of approaches to catalyse uptake of the HIV self-test. Some recommendations have directly led to accelerated uptake in some markets, particularly those that were prepared to combine the HIV self-test into other prevention strategies; the experience in these markets is already providing evidence for other markets to follow suit.
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