Uganda Achieves Early UNAIDS 90-90-90 Targets
Africa Wellness

Uganda Achieves Early UNAIDS 90-90-90 Targets

Kampala, 09 April 2021 – A mid-term “Progress Report on Enhancing Laboratory Capacity to Combat HIV/AIDS, TB and Malaria” shows that substantial improvements in Uganda’s diagnostic services infrastructure in 2018 and 2019.

This is including the deployment of point-of-care (POC) diagnostics and increased mentorship and technical support – resulted in significant positive impacts on the health of Ugandans.

The progress was supported by a Public-Private Partnership (PPP) agreement between the Ministry of Health and Abbott.

Abbott is a global healthcare company. The program was jointly implemented by Uganda National Health Laboratory and Diagnostic Services (UNHLS) and Lifecare Diagnostics of Uganda through a network of highly trained Field Support Staff (FSS) who covered more than 1,700 healthcare facilities country-wide including Health Centers III and IV and District, Regional Referral and National Referral Hospitals.

The Progress Report cited three major health impacts:

  • By the end of 2019, Uganda became one of 14 countries in the world to score early attainment of UNAIDS 90-90-90 goals to eliminate new infections of HIV by 2030.
  • Widespread deployment of Abbott’s Determine TB LAM rapid POC test in people living with HIV with CD4 counts below 200 resulted in a 42% increase in the number of people diagnosed with tuberculosis (TB). Without the use of this test, almost half of TB cases would have been missed.
  • Continuous training and mentorship improved adherence to quality assurance (QA) and led to test results being presented to patients for earlier effective treatment, care and management.
  • The Progress Report also revealed a number of other important achievements:
  • Improved efficiency and cost-effectiveness of diagnostic services and better value for money were achieved through routine monitoring of inventory and stock utilization.
  • Sustained routine mentorship and supervision increased adherence to the national HIV testing algorithm from 96% to 99%, which drove a 77% reduction in the number of invalid tests for all HIV POC testing kits.
  • Technical support of scientific research led to the adoption of new diagnostic innovations and technologies in the fight against HIV/AIDS.
  • Interventions included the use of Abbott’s PIMA CD4 Analyser, m-PIMA Analyzer for Early Infant Diagnosis (EID) and HIV/Syphilis Duo for testing among pregnant women.
  • The National Tuberculosis and Leprosy program (NTLP) piloted the use of lateral flow urine lipoarabinomannan assay (LF-LAM) for the diagnosis and screening of active TB in people living with HIV in 14 Regional Referral Hospitals, which was scaled up to 109 facilities in 2018 and then rolled out to 658 facilities in 2019. Consequently, TB screening increased by 300% in one year.
  • Abbott supported the Ministry of Health National Malaria Control Program (NMCP) on an evaluation study of Abbott’s NxTek Eliminate Malaria Pf., a highly sensitive malaria rapid diagnostic test (HS-RDT) for the detection of low levels of the parasite in people.
  • The study demonstrated that NxTek Eliminate Malaria Pf. was superior to currently used conventional RDTs (cRDT), with a positivity rate of 13.3% for the HS-RDT vs. 6.4% for the cRDT for febrile patients at the Outpatient Department (OPD) in Mpigi district.
  • The HS-RDT also reported a 21.1% positivity rate among asymptomatic pregnant women despite the use of Intermittent Preventive Treatment in pregnancy (IPTp) and Long-Lasting Insecticide Treated Nets (LLINS). Malaria parasites can be difficult to detect in pregnant women and can result in miscarriages and low birth weights of newborn babies.
  • Monitoring and evaluation using the Lifecare Health Monitoring Artificial Intelligence System (LIHEMAIS) facilitated real-time data reporting, which strengthened coordination and accelerated decision-making for timely interventions.

Based on the significant progress shown in this report, the Ministry of Health has found the Public-Private Partnership to be beneficial in improving the quality of healthcare service delivery in Uganda and intends the program to continue and will expand its scope to include other innovations in diagnostics, increased coverage of the Mentorship program, pilot decentralization of POC HIV Viral Load testing and development of a comprehensive supply chain tracking mechanism.