The Clinton Foundation has secured a deal with five manufacturers of CD4 and viral load tests, which will cut the price for test kits, testing machines, staff training and machine maintenance for resource limited countries, according to a report in the January 14th edition of the Wall Street Journal.
According to the Wall Street Journal report the Clinton Foundation has reached agreement with Beckman Coulter and Becton Dickinson & Co. on CD4 cell counting machines, and Roche Diagnostics, Bayer Healthcare and bioMerieux on viral load test pricing. Under the deal the cost of a CD4 cell count will fall from $11 - 12 to between $3 - $5, with no up front payment for machines. Under the agreement, the cost of a viral load test is confidential, but is thought to have been reduced to around $20 a test. The machines for carrying out the tests will be maintained and serviced by the manufacturers, and they will also provide training in how to carry out the tests.
To make sure the deal is sustainable in the long-term, pricing will allow the five companies to continue to make a small profit.
Although media attention has been focused on attempts to reduce the cost of antiretroviral drugs for resource limited countries, having CD4 and viral load tests available are key to the successful delivery of HIV treatment programmes.
The deal will be implemented immediately in countries where the Clinton Foundation operates, including South Africa, Tanzania, Mozambique, Rwanda, Haiti, the Dominican Republic and a number of other Caribbean countries.
Further attempts to redice the cost and increase the scope for use of monitoring tests is likely to focus on the development of tests which are very simple to use. One of the drawbacks of the CD4 cell counters and viral load tests involved in the Clinton Foundation is that they require relatively large volumes of blood which must be refrigerated and then transported promptly to large laboratories, sometimes hundreds of miles away from clinics.
Instead, researchers have been investigating methods that will use dried blood samples or much cheaper and more portable machines that either require minimal training to operate or which don't depend on rapid dispatch of fragile blood samples. Only when these methods are perfected, and can be delivered at costs below $1 a test will it be possible to provide monitoring that can detect teratment failure before the development of resistance or identify patients who are likely to develop AIDS-related illness rapidly if not treated.
Further information on this website
Monitoring where resources are limited - a guide to lowering the costs of diagnostics and issues in the use of diagnostic tests in resource-limited settings
Alternative to viral load flops in West African field trial - news story November 2003
Total lymphocyte count predicts risk of death in children - news story November 2003
New CD4 counting method may lead to cheaper tests in developing world - news story, October 2003
p24 test works for HIV+ newborns with subtype C virus, but not cost-effective? - new story August 2003
HIV DNA levels predictive of disease progression, could provide cheaper viral load test - news story, December 2002