On December 4, 2012, the United States President’s Emergency Plan for AIDS Relief (PEPFAR) 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 (TB). It can detect Mycobacterium tuberculosis DNA and mutations associated with rifampicin resistance directly from sputum specimens in less than two hours. The assay is more sensitive for detecting TB than sputum-smear microscopy with similar accuracy as 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.
This support, to be implemented through USAID and CDC, will accelerate access to Xpert® MTB/RIF in countries with a high burden of TB/HIV co-infection. Additionally, a portion of this funding will train health workers on proper application of the device and support ministries of health to integrate its usage into national laboratory strategies.
TB is the leading cause of death among people living with HIV in Africa and greater access to this test offers a significant advance in the capacity of TB and HIV programmes 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 launch of the PEPFAR Blueprint for an AIDS-free generation and in conjunction with the 1st annual meeting of the African Society of Laboratory Medicine in South Africa. The PEPFAR Blueprint, a document outlining America’s specific action steps toward creating an AIDS-free generation, highlights the importance of smart investments that save lives and using science to inform programming. PEPFAR’s ongoing support for roll out of Xpert® MTB/RIF is one such smart investment.
U.S. Global AIDS Coordinator Ambassador Eric Goosby said, “The roll out of Xpert® MTB/RIF has brought us to the cusp of a revolution in TB diagnosis. As a clinician, I am thrilled about the promise of this technology to bring a rapid diagnostic closer to patients. Tackling TB/HIV co-infection is a high priority for PEPFAR and this funding for Xpert® MTB/RIF reflects that commitment.”
These additional resources bring PEPFAR’s investments to date in Xpert® MTB/RIF to more than 275 instruments in high-burden countries. Additionally, in August 2012, PEPFAR and USAID partnered with UNITAID and the Bill & Melinda Gates Foundation in an innovative 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 cutting-edge technology.