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Advancing point of care diagnostics for the control and prevention of STIs: the way forward
  1. Igor Toskin1,
  2. Karel Blondeel1,2,
  3. Rosanna W Peeling3,
  4. Carolyn Deal4,
  5. James Kiarie1
  1. 1 Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
  2. 2 Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
  3. 3 Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
  4. 4 Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, Rockville, USA
  1. Correspondence to Dr Igor Toskin, Department of Reproductive Health and Research, World Health Organization, Avenue Appia Geneva, CH 1211, Switzerland; toskini{at}who.int

Abstract

WHO recognises the global impact of sexually transmitted infections (STIs) on global public health and individual sexual and reproductive health and well-being. As a component of the WHO Global Health Sector Strategy for the control and prevention of STIs, there has been a growing recognition of the importance of integrating point-of-care tests (POCTs) into overall strategic planning. The process of integrating STI POCTs, in addition to providing a definitive diagnosis and appropriate treatment in a single visit, also includes innovative delivery options, such as on-site delivery, community-based testing (including screening), as well as self-testing at home after purchase of a test online or over-the-counter. WHO organised two technical consultations in May 2014 and July 2015. This article summarises the discussions of the meeting participants on advancing the use of POCTs to control and prevent STIs. The following priorities were identified: the need for pathogens’ target discovery; encouragement of multiplexing, miniaturisation, simplification and connectivity; promotion of standardisation of evaluation of new diagnostic platforms across all stages of the evaluation pipeline; the need for an investment case, modelling and scenarios to ensure buy-in among key stakeholders, including developers and the private sector; the need for norms and standards, including guidelines, to support introduction of STI POCTs in programmes; anticipating potential tensions between different parties at the implementation level; and leveraging on the global initiative, Sustainable Development Goals (SDGs)/global health sector STI strategy, to sustain investment in STI POCT programmes. There is a rich pipeline of diagnostic products, but some have stalled in development. An approach to accelerate the evaluation of new diagnostics is to set up a competent network of evaluation sites ahead of time, harmonise regulatory approval processes with development of models to estimate cost-effectiveness, informed by better STI data. This should result in accelerating policy development. Although it may be some time before good POCTs can be widely implemented in low resource settings, it is important to be a catalyst for continued development and use of these essential tools as an integral part of both the WHO Global Health Sector Strategy and the agenda for 2030.

  • point-of-care testing
  • sexually transmitted infections
  • preventive medicine
  • sexual health
  • public health
  • health policy

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors IT and KB designed the concept and methodology; IT, KB, CD, RWP and JK conducted the analysis and synthesis of the results. All authors contributed to the finalisation of the manuscript.

  • Disclaimer Disclaimer The authors are staff members of the World Health Organization. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the views, decisions or policies of the World Health Organization.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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