E-DRUG: Cost of Viral Load Test down by 60%
[Although not on essential drugs, I would propose that we allow messages about
essential diagnostics and essential supplies related to the use of essential
drugs. This case, VL use in Kenya, seems appropriate. Copied as fair use.
Crossposted from AFRO-NETS with thanks. WB]
African Woman and Child Feature Service (Nairobi)
October 28, 2004
Posted to the web October 28, 2004
By Arthur Okwemba
A new technology for measuring the amount of HIV in the body -
viral load count - has reduced the cost of the mandatory test by
60 per cent - from KSh 7,000 to KSh 2,500.
The new technology, now available in over 13 selected public and
mission health institutions across Kenya, is also able to show
if an individual on anti-retrovirals is developing resistance
and to what specific drug. In Kenya, resistance levels to at
least one drug are estimated to be between 15 and 20 per cent.
Viral load tests are required for HIV positive people and par-
ticularly for those on anti-retrovirals at least after every
three months to know the progression of their condition and the
patient's response to medication. At the moment, the test con-
stitutes the most expensive component in HIV/Aids management.
Manufactured in Sweden by Cavidi Tech Lab, the technology will
be supplied for one year at no charge in selected public and
mission health institutions, using funding from Swedish Interna-
tional Cooperation Development Agency (SIDA), within a public-
private partnership framework.
Five provincial hospitals in Nyanza, Coast, Rift Valley, Central
and Western and two mission hospitals - Nazareth and Maua, the
Forces Memorial and five district hospitals in Busia, Thika,
Homa Bay, Kajiado and Kapsabet, constitute the sites where the
one-year programme is to be implemented.
The first batch of the kit, Exavir Load, has already been sup-
plied to these hospitals, each receiving kits equivalent to the
number of Aids patients being attended to.
People living with HIV/Aids in provinces such as Coast and West-
ern who are at the moment forced to bring their blood samples to
Nairobi for viral load tests are among the biggest beneficiar-
Together with the kits, SIDA is also going to upgrade laborato-
ries in the 13 selected hospitals and equip those without blood
testing capacities with technologies to do so. So far, two labo-
ratory technicians from each of the selected hospitals have been
trained on how to use the new technology.
SIDA is putting over Sh60 million into the entire programme that
involves procuring of the kits, improvement and equipping of the
Private laboratories and hospitals wishing to buy the equipment
can get it at Sh 240,000 from local suppliers. Its capacity to
show when a person is developing resistance to ARVs and even
pick out the ineffective drug from the combination is expected
to improve the clinical management of HIV/Aids.
At the moment, many HIV-infected people are unable to do the vi-
ral load test due to its high costs and consequently, doctors
are realising the drug resistance when it is too late.
However, some HIV-positive people feel the Sh 2,500 is not low
enough. "The prices are still too high for the very poor. The
government should subsidize the tests further to increase acces-
sibility," says Michael Omondi, who is HIV-positive.
Omondi, who now depends on his family for support in managing
his condition, says because of the high costs of the viral load
test, he has been able to take only two tests in the seven years
he has been living with the virus. Others like him would prefer
the price brought down to about Sh 1,000.
Cavidi's marketing director, Mr Martyn Eales, says while they
appreciate these concerns, they hope the prices will go down as
and when demand for the technology increases. According to him,
this is likely to be possible as the equipment finds wider use
all over the country.
Launched in 2002 during the International Aids Conference in
Barcelona, the facility has been approved by European regulatory
authorities. In Kenya, the technology has undergone a three-
month evaluation process at three sites: Kenya Medical Research
Institute, Immuno Molecular Diagnostic Laboratories at Kenyatta
National Hospital, and Nyumbani Children's home in Karen.
Besides Kenya, the other two countries in Africa likely to use
the technology are Botswana, where the technology has gone
through the evaluation process and South Africa, where the
evaluation procedure is still going on.
Although some doctors have questioned whether the Cavidi tech-
nology has been validated to establish if the results it gives
vary from one laboratory technician to another, those who evalu-
ated it say there is nothing to fear.
Dr Omu Anzala, one of the leading researchers with the Kenya
Aids Vaccine Initiative and in whose laboratory the kit was
evaluated, says they did a robust validation tests with their
laboratory technicians, which confirmed the kit's soundness.
Other doctors have welcomed SIDA's move, saying it comes at a
time when anxiety is building up on the failure to do viral load
tests on patients on the government ARVs programme. It has been
feared that failure to monitor the resistance levels may result
in the development of HIV strains that are 10 times more expen-
sive to treat.
Of concern is that most of the hospitals where the government
ARVs programme is being implemented, including Kenyatta National
Hospital, viral load tests are not being done. Medics have to
rely on the clinical presentations of the patients to determine
whether or not they are responding to the drugs prescribed.
Meanwhile, it is emerging that Kenya has no formal system for
evaluating and registering medical equipment and reagents used
in disease analysis. Quacks are therefore having a field day
bringing into the country technologies whose quality and viabil-
ity in not verified. This in turn means it is impossible to au-
thenticate results derived from such technologies.
Copyright ) 2004 African Woman and Child Feature Service. All
Distributed by AllAfrica Global Media (allAfrica.com).