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Equitable access to diagnostics: promises and challenges of translating research on use of rapid syphilis tests into policy and practice

Date: Thursday 1 November 10.45–12.15
Source: Forum 11
Authors: Rosanna Peeling, Manager, Special Programme for Research and Training in Tropical Diseases (TDR), Diagnostics Research and Development, World Health Organization, Geneva
with Adele Benzaken, John Changalucha, Xiang-Sheng Chen and Jean Pape

Abstract

The objective of this session is to explore the promises and challenges in health research that will lead to equitable access and improvement in maternal and child health.

Although many high-quality diagnostic tests for infectious diseases are available in the developed world, they are neither affordable nor accessible to patients in developing countries due to the lack of appropriate facilities and resources. Most of these infectious diseases are treatable, but without the tools to diagnose infections, many of those infected cannot benefit from therapy. An estimated 500 000 babies die in sub-Saharan Africa every year from congenital syphilis simply because many women lack access to a screening test for syphilis in pregnancy. Research to evaluate the performance and utility of rapid syphilis tests has shown that tests with acceptable performance can be used in primary health care settings to guide treatment and avert stillbirths and congenital syphilis. The translation of this research evidence into policy and practice to ensure equitable access offers many promises and challenges.

During the session, presentations will address the following: 1) Introducing syphilis screening into control programmes for ethnic minority populations and high-risk individuals present many challenges but may help avert a major HIV epidemic. 2) Currently 30% of pregnant women in Haiti have access to syphilis screening. Rapid tests can reach rural populations through the use of mobile clinics and village health workers, the challenge is to monitor access and evaluate the quality of testing performed in remote settings. 3) Lessons have been learnt in implementation research to make syphilis screening available for villages along the Amazon river and in the municipalities in the Upper Solimões region. 4) The challenge is how to introduce new tools into district and village levels, where there are already multiple vertical donor programmes and a scarcity of trained personnel.

The translation of research evidence on new tools into policy and practice to ensure equitable access must involve community engagement and integrated approaches.