Uganda’s Specimen Hub Transport System: Supporting the Scale-up of Viral Load Monitoring
Pangaea Global AIDS and Beckman Coulter
No invitations necessary; open to all conference registrants
Tuesday 6 December
CTICC room location: 2.4
- Laboratory scientists and professionals
- Policy makers and program managers
- Implementers and industry partners.
Viral load monitoring for treatment success and failure is now standard of care in both well-resource and resource limited countries. Many countries in Africa face challenges in ensuring that people have access to HIV laboratory services, particularly in hard-to-reach areas. A key enabler of access to essential complex diagnostics is an efficient and cost effective specimen transport system.
Uganda’s Specimen Hub System is providing nationwide transportation of specimens to the Central Public Health Laboratory (CPHL) in Kampala for complex diagnostics, including viral load monitoring, early infant diagnosis of HIV, oncology, multi-drug resistant tuberculosis, disease outbreak surveillance, etc., and rapid return of results. Pangaea Global AIDS has documented the Specimen Hub System as a best practice, and now the Laboratory, with international partners including Beckman Coulter and Pangaea, is working to expand the program in Uganda and to offer the approach as a model to other countries for adaptation and implementation. CPHL and Beckman Coulter have been piloting a regional coordination initiative within the Uganda Specimen Hub system to further reduce costs and increase key operational efficiencies that impact patient care outcomes in a dramatic way.
The Central Public Health Laboratory in Kampala, supported by an efficient HUB specimen transport system, is scaling-up viral load testing in the country. A Hub is a hospital laboratory that provides diagnostic services to lower level facilities within its catchment area of 40km radius and serves as a conduit for samples that need high-tech diagnostics like viral load (VL), EID, TB culture, oncology, viral cultures, and other diagnostics only attainable at national reference laboratories like CPHL. There are 100 hubs nationally that support over 3,000 health facilities (about 90% coverage across the country), each with a motorcycle rider who performs daily routes collecting specimens and returning results. The system currently transports 8,000 EID samples and 17,000 VL samples per week. TAT nationally for early infant diagnosis (EID) of HIV decreased from an average of 69 days, before the introduction of the Hub system, to 14 days and VL TAT decreased from 90 days to 21 days. The all-in cost of for transportation and return of results per VL test was USD1.58, bound to reduce further as numbers go to scale.
SESSION LEARNING OBJECTIVES:
- Understand the need for Specimen Hub Transport Systems in Sub-Saharan Africa
- Understand Uganda’s Specimen Hub Transport System
- Identify next steps to improve the Specimen Hub Transport System and expand it to other countries in the region
Charles Kiyaga, Laboratory Programs Director, Uganda National Health Laboratory Services, Ministry of Health, Uganda
Charles Kiyaga is a biomedical scientist who earned Bachelor’s Degree in Biomedical Laboratory Technology from Makerere University Kampala, and a Bachelor’s Degree in Health Systems Management from the University of Manchester UK. He also earned a Master’s Degree in Biomedical Science and Management from Makerere University Kampala, Uganda, and a Master of Philosophy degree in Medical Science (MPhil) from the University of Cambridge UK. He also holds a Diploma in Health Management from Galilee International Management Institute, Israel.
Charles holds a number of portfolios at the Central Public Health Laboratories as the National Early Infant Diagnosis (EID) Program Coordinator, the National Viral Load Coordinator, the National Sickle Cell Program Coordinator, and the National Sample Transport Coordinator. He initiated all these programs. Charles has worn several international awards for his outstanding performance, including the ASLM Best Practice Award 2012 and 2014.
Peter Ehrenkranz, MD, MPH, Senior Program Officer for HIV Treatment, Bill & Melinda Gates Foundation
Peter Ehrenkranz, MD, MPH, is the Senior Program Officer for HIV Treatment at the Bill & Melinda Gates Foundation. From 2009-2014 he worked in Swaziland with CDC, first as the PEPFAR Care and Treatment Lead, and later as the CDC Country Director. Prior to that, he spent two years in Liberia supporting the National AIDS Control Program as the medical director for CHAI-Liberia. He earned an undergraduate degree in history from Yale, medical and public health degrees from Emory, and both trained in internal medicine and completed the Robert Wood Johnson Clinical Scholars Program at the University of Pennsylvania.