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.
- There are 22.5 million people living with HIV/AIDS in
- 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
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
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