The US President?s Emergency Plan for AIDS Relief (PEPFAR) has announced an additional $11 million to provide up to 150 Xpert MTB/RIF instruments and 450,000 test cartridges in 14 high-burden countries across sub-Saharan Africa and in Burma.
The Cepheid Xpert MTB/RIF assay is a new fully automated molecular diagnostic test for tuberculosis disease (TB). It can detect Mycobacterium tuberculosis DNA and mutations associated with rifampicin resistance directly from sputum specimens in less than 2 hours. The assay is more sensitive for detecting TB than sputum-smear microscopy while achieving accuracy akin to culture on solid media. The ability of the Xpert assay to detect smear-negative TB provides a significant advantage over smear microscopy, especially for persons with TB who are also HIV-infected, according to a press release published on the PEPFAR website.
This support, to be implemented through the USAID agency and the Centers for Disease Control and Prevention, will accelerate access to Xpert MTB/RIF in countries that have a high burden of TB/HIV co-infection. Part of this funding will train health workers on proper use of the device and support its integration into national laboratory strategies.
TB is the leading cause of death among people living with HIV in Africa. Increased access to this test offers a significant advance in the capacity of TB and HIV programs to diagnose TB quickly and help reduce TB transmission, the development of TB disease, and avoidable deaths.
The announcement comes on the heels of the November 29, 2012, launch of the PEPFAR Blueprint for an AIDS-free generation and in conjunction with the first meeting of the African Society of Laboratory Medicine in South Africa.
?The roll out of Xpert MTB/RIF has brought us to the cusp of a revolution in TB diagnosis," says U.S. Global AIDS Coordinator Ambassador Eric Goosby, who is quoted in the press release. "As a clinician, I am thrilled about the promise of this technology to bring a rapid diagnostic closer to patients.?
The additional resources bring PEPFAR?s investments to-date in Xpert MTB/RIF to more than 275 instruments in high-burden countries.
In August 2012, PEPFAR and USAID partnered with UNITAID and the Bill & Melinda Gates Foundation in a public-private partnership to reduce the cost of Xpert MTB/RIF cartridges by 40% (from $16.86 to $9.98). This partnership also significantly accelerates access to this technology.
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