Attaining UNAIDS' 90–90–90 targets largely depends on the first 90 – correctly diagnosing 90 percent of all people living with HIV. Many people with HIV have already been diagnosed; an estimated 13 million people are on antiretroviral therapy worldwide. Although most technologies for HIV testing have high sensitivity and specificity and are highly accurate when used in a validated national algorithm, the volume of tests conducted (over 150 million tests were conducted in 2014 alone), could result in thousands of misdiagnosed cases, particularly if tests are not conducted correctly. Misdiagnosis of HIV has significant implications for individuals and for public health.
On October 13, 2016 from 9:00 a.m. – 10:30 a.m. EDT, AIDSFree hosted a webinar with Anita Sands of the World Health Organization, Khumbo Ng`ona of the Ministry of Health in Malawi, Leslie Shanks of the Inner City Health Associates, and Russell Dacombe of the Liverpool School of Tropical Medicine. The speakers highlighted the evidence collected on HIV misdiagnosis and discussed the ethical, legal, human rights, and public health implications.
Meet the Speakers
Anita Sands, World Health Organization
Anita Sands works at the World Health Organization (WHO) in the Prequalification Team – Diagnostics. She has spent 15 years working on all aspects of quality assurance for testing, including quality assessment of diagnostics that are most suited for use in resource-limited settings. Sands has authored WHO guidance on testing strategies and algorithms, procurement of diagnostics and post-market surveillance of diagnostics. She received a BSc (Hons) and MPH from the University of Melbourne, Australia.
Leslie Shanks, Inner City Health Associates
Leslie Shanks is the former Medical Director of Médecins Sans Frontières (MSF), Operational Centre Amsterdam. She joined MSF in 1994 as a family physician and has worked in a number of different countries. In Canada, she has worked with Aboriginal communities, in federal penitentiaries and with inner city populations. She completed her Master’s Degree in Public Health at Johns Hopkins University in Baltimore. Her research interests include HIV in resource-limited settings including HIV misdiagnosis, evaluation of mental health interventions in humanitarian contexts and prevention of malnutrition. She is currently the Medical Director of Inner City Health Associates in Toronto.
Russell Dacombe, Liverpool School of Tropical Medicine
Russell Dacombe has primarily worked in improving diagnostic capacity in developing countries for over 15 years, focusing on improving the quality of results at all levels of health care. As part of this work, he has been involved in determining the health system barriers to deploying diagnostic tests effectively, including HIV testing. He is currently involved in a project researching how to best regulate HIV self-tests in Africa and how to monitor the performance of intended users.
Khumbo Ng`ona works for the Department of HIV and AIDS at the Malawi Ministry of Health. She has worked in the field of HIV and AIDS for over 6 years focusing on policy development, quality improvement and provision of technical expertise. She was involved in the development of the 2016 Malawi HTS Guidelines policy document and is currently working as the HIV Testing Services Officer.