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The Problem

Thirty years after the first detection of HIV, and despite advances in battling the pandemic, 60% of all those infected by HIV/AIDS worldwide still have not been tested and remain unaware they carry the disease.i This problem is most severe in sub-Saharan Africa where 68% of all the undiagnosed cases in the world occur and the majority live in poverty in rural communities with millions beyond the reach of traditional healthcare services. The problem is so large that there are more people infected by HIV in sub-Saharan Africa who remain unaware they carry the disease than all the diagnosed HIV/AIDS cases worldwide. The
communities most in need of HIV/AIDS testing, prevention and treatment often have the least access to necessary medical services and commodities.

Problem Summary


 - There are 22.5 million people living with HIV/AIDS in sub-Saharan Africa.
 - There are more people infected with HIV in sub-Saharan Africa who remain unaware they carry the disease than all the diagnosed HIV/AIDS cases worldwide.
 - Women in rural sub-Saharan Africa often face unique obstacles in securing HIV/AIDS services and represent the regionís majority of cases.
 - Over half the regionís population lives in rural poverty.
 - Patients may have to walk a day or more to seek medical help.
 - People seldom have the funds or means of travel to obtain necessary testing and care.
 - The communities most in need of testing, prevention & treatment often have the least access to necessary medical services & commodities
 - These undiagnosed carriers unknowingly continue to spread and die from the disease.
 

HIV/AIDS prevalence in sub-Saharan Africa
 

Prevalence Among Children


Over the past decade, the number of people newly infected
with HIV/AIDS has slowly decreased, and yet the number of
children infected annually has steadily increased.

There are 3.4 million children under the age of 15 with HIV/AIDS
worldwide, and 90% of those children live in sub-Saharan Africa.

Because women make up half of all HIV/AIDS cases, the importance
of prevention and treatment counseling is paramount in decreasing
the mother-to-child spread of disease.

The Need for Universal Access


In many parts of the world, such as sub-Saharan Africa, basic HIV prevention, treatment and support services do not reach certain populations because of restrictive policies and laws, poor service design, and the inaccessibility of the effected populations. Despite an international commitment to a strong response in hardest hit areas like Africa, governments are constrained by inadequate resources and infrastructure. This, combined with widespread stigma and discrimination surrounding HIV, means that few people in these remote communities have access to basic HIV testing and diagnostic services. Many remain unaware of their HIV status, especially in impoverished, resource limited, remote areas. These people, who live far from an equipped hospital, have little or no access to testing, preventive or treatment services. This lack of services puts this group at high risk for contracting and continuing to spread HIV.

Studies show that HIV prevention programs are most effective when they are targeted at the most vulnerable and at-risk populations. Therefore, reaching these most-at-risk populations is the most efficient way to reduce the spread of HIV, while also rendering HIV prevention more cost effective. Currently, less than 5% of all funding for HIV prevention and intervention is reported to be allocated for the most-at-risk populations, indicating there is a large unmet need. For donors to be more certain that their funds are making a lasting difference in the fight against HIV-AIDS, this situation needs to change.

The World Initiative for Science and Healthcare, Inc. (WISH), under its endhivnow initiative, is a pioneering force in making available mobile "turn-key" HIV testing, diagnostics and treatment services to the most vulnerable and at-risk populations. These are communities found living on the margins in resource-limited urban and rural environments. Our program is aimed at removing barriers that prevent individuals in these communities from accessing diagnostic and treatment services. At WISH, we believe that every person, regardless of where they live or their economic status, should have access to these types of services because it is only in implementing these services that the world community can contain and rid itself of HIV / AIDS. By delivering a mobile HIV diagnostic platform in partnership with non-governmental organizations (NGOs), we are able to make a significant contribution to relieving suffering and improving the lives within these hard hit communities, while advancing the world community toward ending HIV.

WISH, through its endhivnow initiative, will work with experienced NGOs with demonstrated access to those populations living in these hard to reach environments to implement its unmatched wellness strategy. That strategy begins with screening for HIV using our comprehensive mobile HIV diagnostic platform. We consider HIV testing and counseling to be the gateway to treatment - without an accurate diagnosis, treatment cannot begin. Once started, there needs be a way to continue to reach these communities for ongoing counseling and treatment. Our mobile platforms are also designed to serve that need. Testing is also the gateway to supporting preventive behaviors, whether the person is HIV positive or negative. In such areas, our testing and counseling program will be able to change the mindset surrounding HIV from being thought of as a death sentence into being thought of as something with which people can live and manage.

Serving these remote areas requires completely self contained and simple-to-use equipment for testing and methods that eliminate the need for sophisticated infrastructure or highly skilled operators. Yet the system must also deliver results quickly, preferable with some result achieved at the time of the patient's visit. Through our program, people living in these remote communities will no longer have to walk long distances on treacherous journeys to access testing. Instead, testing will be brought to them by a mobile unit with the ability to deliver rapid HIV screening, CD4/CD4% diagnostics, preventative tools and counseling provided by an NGO counselor. The NGO clinician will have the ability to make on-the-spot appropriate clinical decisions, resulting in improved care for all. For HIV-infected patients, this means there is a potential for lives to be saved and for the quality of life of the infected patient to be improved. The mobile unites allow treatment resources to be deployed to maximum advantage and cost efficiency.

The initial priorities of our mobile HIV testing initiative are to identify the communities most affected by HIV and to identify and partner with NGOs best suited to serve these communities, particularly those located in remote geographic areas. We place high emphasis on measuring achievement towards our strategic goals and objectives as well as on ensuring accountability to donors that their dollars are making the greatest impact in the fight against HIV-AIDS. We will work closely with our partner NGOs to monitor the progress of our programs while working to constantly improve results. This will be done through the tracking and communication of clearly-defined metrics that score both the quality and efficiency of the mobile HIV testing and diagnostic platforms. In many instances the mobile units will be the first to actually define the number of HIV cases among more remote populations, thereby providing a baseline to begin to measure improvement including the reduction of spread of the disease. WISH's policies will ensure that commitments are kept to donors, and partner NGOs as we develop the mobile infrastructure dedicated to the achievement of universal access to HIV testing and diagnostic services to most-at-risk populations.

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