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Trip Start Jul 01, 2008 Trip End Aug 10, 2008 Next
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  Evanston, Illinois, United States
Wednesday, June 18, 2008

Sub-Saharan Africa is more heavily affected by HIV and AIDS than any other region of the world. An estimated 22.5 million people were living with HIV at the end of 2007 and approximately 1.7 million additional people were infected with HIV during that year. In just the past year, the AIDS epidemic in Africa has claimed the lives of an estimated 1.6 million people in this region. More than eleven million children have been orphaned by AIDS.

The extent of the AIDS crisis is only now becoming clear in many African countries, as increasing numbers of people with HIV are becoming ill. In the absence of massively expanded prevention, treatment and care efforts, it is expected that the AIDS death toll in sub-Saharan Africa will continue to rise. This means that impact of the AIDS epidemic on these societies will be felt most strongly in the course of the next ten years and beyond. Its social and economic consequences are already widely felt, not only in the health sector but also in education, industry, agriculture, transport, human resources and the economy in general.

Clearly, a key step in managing the HIV/AIDS epidemic is diagnosing and treating those who are infected. While some diagnostic tests are available for low-income countries in Africa and Asia, they can be improved to detect diseases earlier and more cost effectively. Better test systems also are needed for disease monitoring and to detect the emergence of infectious agents resistant to drugs. To succeed in developing countries, tests need to be easy to use and faster so patients can be diagnosed and treated in one visit to a clinic. Diagnostic tests and related instruments also need to be affordable and better designed for the environment in which they will be used and for the culture of the people who will use them.

As part of the $4.9 million grant received from the Bill and Melinda Gates Foundation in August 2006, Kellogg's Global Health Initiative (GHI) is researching and developing affordable diagnostic devices for testing and treating HIV. To date, the program has sent more than 250 Kellogg volunteers to collect information in about 30 developing countries around the world.

This summer, there will be 3 groups traveling to 5 different countries to conduct an in-depth exploration of the infant HIV testing. Infant testing is particularly tricky. Infants carry their mothers' antibodies for about 18 months, which means that adult HIV tests, which test for the HIV antibody, are not a reliable means for testing infants. A positive infant test can only determine for certain whether the mother has HIV. A second test called PCR is needed to look for the presence of the HIV virus in the infant's blood. The PCR test requires complicated lab machinery, of which most sub-Saharan African countries only have one. Often the PCR machine is located in a major city, making it extremely difficult for people in other cities or rural areas to get their results in a timely manner. A recent group of Kellogg students found that the average time from test to result in Tanzania is seventy days! Since infant immune systems are developing so rapidly, 70 days can be the difference between life and death for an infant with HIV. Furthermore, about 20% of the results never make it back to the patient for a variety of reasons, and some patients simply just do not return for their results. Clearly this system is not effective in getting medical attention to people in need.

Our goal for this summer is to collect information from key stakeholders - government officials, NGOs, product distributors, community-based organizations and health care providers - that will help our engineer counterparts develop a miniaturized version of the big PCR machine that can be utilized in more health care facilities in more rural settings. This will enable us to essentially bring the lab to the patient, instead of bringing the patient (or patient's blood sample) to the lab. Our hypothesis is that administering the test at the point of care - in the clinic while the patient waits - will enable more infants to be diagnosed on the spot, so that they can receive the treatment they need in a timely manner.

So that's the project in a nutshell. If you are interested in learning more, here are some links...

  - For general HIV and AIDS information, visit http://www.avert.org/

  - For information about HIV/AIDS in South Africa, visit http://www.pepfar.gov/press/81640.htm

  - For information about HIV/AIDS in Mozambique, visit http://www.pepfar.gov/press/81612.htm

  - For information about infant diagnostics, visit http://www.pepfar.gov/progress/76907.htm

  - For information about the Global Health Initiative, visit http://www.thinkglobalhealth.org/

  - For information about the Gates Foundation, visit http://www.gatesfoundation.org/ 

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