Country Background
With a prevalence rate of 14.2 %, Mozambique presents both challenges and opportunities for success in turning around the HIV/AIDS threat. The Mozambique government declared HIV/AIDS a national emergency in 2004 and initiated the DBS testing program in 2007. Mozambique was one of the fifteen focus countries of the past President’s Emergency Plan for AIDS Relief.  However, a massive population remains under served in the current system:  it was estimated that at least 78% of at-risk infants do not currently receive diagnostic treatment.

  GHI in Mozambique

GHI in Mozambique
The GHI Kellogg team conducted Point of Care Infant Diagnostic Analysis in Mozambique in 2008. The field team visited healthcare facilities involved in infant HIV/AIDS diagnostics in the country, met with key stakeholders and thought leaders in HIV/AIDS programs, investigated the DBS process flow, and analyzed the constraints of the current DBS system. The GHI team also gathered information on the approval process of the HIV/AIDS diagnostic devices, the supply chain and the distribution of such devices in Mozambique.  Similar to the GHI Infant Diagnosis field studies conducted in other countries, the market size of infant HIV/AIDS testing was evaluated, and the new diagnosis product concept was tested in Mozambique.  

GHI future work in Mozambique
The current infrastructure in Mozambique limits the usage of the diagnosis devices and the consumables supply, and GHI team will continue to gain information on the infrastructure development. GHI will further analyze the research results, and select the appropriate device which provides the greatest benefit with the greatest likelihood of success. The feasibility will be evaluated in order to determine the best sites for the GHI pilot program. GHI will further engage with key stake holders and develop potential roll out partners. 

Preliminary Findings from Mozambique
In 2008 a group of Kellogg graduates met with key thought leaders in HIV/AIDS programs, in South Africa and Mozambique, and also visited a number of healthcare facilities involved in early infant diagnosis of HIV.

Concept Testing
The group concluded that the single sample test concept would be useful for mobile clinics and transient populations. Mobile clinics are used to providing routine healthcare in rural areas, but if a mother misses the appointment, the time to results are delayed an entire month until the next visit. With respect to transient populations, many women come from neighboring provinces to give birth and get first immunizations, but then return to their home province without waiting for test results. A point of care test would ensure delivery of test results the same day, and dramatically decrease the number of patients who are “lost” due to limited access to healthcare.
Given that the circumstances of different populations dictate dramatically different needs, the group felt that both the batch and single sample testing models should be explored further.