A Brief Colonial History Of Ceylon(SriLanka)
Sri Lanka: One Island Two Nations
A Brief Colonial History Of Ceylon(SriLanka)
Sri Lanka: One Island Two Nations
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Thiranjala Weerasinghe sj.- One Island Two Nations
?????????????????????????????????????????????????Thursday, August 25, 2016
HIV effort let down by test shortages, says WHO
A shortage of HIV testing could undermine global efforts to diagnose and
treat people with the infection, warn experts from the World Health
Organization.
They looked at responses to annual surveys that the WHO had sent to 127
countries between 2012 and 2014 asking about capacity and usage of blood
tests that check HIV status and health.
They found worrying gaps in provision.
They warn that United Nation targets for HIV could be missed as a result.
The targets say that by 2020, 90% of all people living with HIV should
know their HIV status, 90% of those diagnosed should receive
antiretroviral therapy and 90% of these treated patients should have
"durable viral suppression" (a measure of effective treatment).
Laboratory testing is vital to meet and monitor these aims.
But Vincent Habiyambere and his colleagues say in the journal PLoS
Medicine that some low and middle-income countries, including African
countries where the HIV burden is high, are not yet geared up for the
challenge.
The surveys were sent to:
• all 47 countries in the WHO African Region
• 33 countries in the WHO Region of the Americas
• all 21 countries in the WHO Eastern Mediterranean Region
• eight high-burden HIV countries in the WHO European Region
• all 11 countries in the WHO South-East Asia Region
• seven high-burden HIV countries in the WHO Western Pacific Region
Over the three survey years, 55 (43%) countries responded to all three
surveys, 35 (28%) to two surveys, 25 (20%) to one survey, and nine (7%)
responded to none of the three surveys.
Testing provision did improve over the years, but shortfalls remained in some parts of the world.
Worrying gaps
Reasons for the gaps in provision included lack of reagents, equipment
not being installed or maintained properly and inadequate or absent
staff training. In some laboratories, machines were not serviced
regularly. In others, machines broke down and were not covered by
contracts to be serviced or fixed.
Dr Habiyambere and his team say: "A national laboratory strategic plan
to strengthen services must be developed, implemented, and monitored by
governments and their national and international partners.
"The focus of the international community, to ensure optimal use of
laboratory technologies, should be on those countries where
interventions for scaling up access to HIV diagnostic technologies are
most needed."
They acknowledge that they did not look at private sector testing and
that some countries might rely more heavily on this than others.
In an accompanying editorial, HIV experts Peter Kilmarx and Raiva Simbi
say the findings show some programmes may have been "overly focused" on
buying equipment without planning for how it would be used and
maintained.
In Zimbabwe, for example, only 5.6% of HIV patients on drug treatment in
2015 received regular blood checks to monitor their viral load - far
fewer than the goal of 21%.
This was largely down to problems with resource mobilisation and specimen transport as well as equipment procurement, they say.
"Strong leadership, resources, planning, and management are needed to scale up laboratory services," they conclude.