Table 6

 Key elements of a road map for the introduction of rapid STI tests

Key elementsEnabling activities
NGOs, non-governmental organisations; SDI, Sexually Transmitted Diseases Diagnostics Initiative; UN, United Nations; WHO, World Health Organization.
AdvocacyDefine disease burden, problems with status quo and what is needed to improve it, the attributable benefit of introducing new tool (such as a rapid test), eg, lives saved or morbidity prevented, cost-effectiveness of strategies for tool introduction
PolicyAccrue evidence needed for development or change of policy; determine fiscal and human resource implications of policy or policy change, feasibility of implementation
Testing algorithms and treatmentConvene expert group and stakeholders to review WHO guidelines for use of tests, and adapt as country or local guidelines and testing algorithms
Test selection and regulatory approvalReview data on test performance and operational characteristics available from the SDI website and peer-reviewed literature, compute costs based on volume of purchase, negotiated pricing available from the WHO Bulk Procurement Scheme; select tests and work with regulatory authorities on approval for sale in country
Procurement and logisticsUN member states can procure through the WHO or similar UN Bulk Procurement Schemes. Develop logistics for importation and distribution in country, in concert with the distribution of medicines to avoid stock-outs of either commodity at district level and remote settings
Training and supervisionDevelop or adapt training modules and develop a system for training the trainers at different levels of health care system
Quality assuranceDevelop a quality assurance scheme for ensuring validity of tests in remote settings, and proficiency of health workers at performing rapid tests
Monitoring and evaluationDevelop plans for monitoring and evaluating the effectiveness and impact of rapid test introduction
SurveillanceMonitor disease trends to assess benefit attributable to test introduction
Communications campaignDevelop and disseminate information on rapid tests to stakeholders and target populations
PartnershipsDevelop partnerships (donors, public and private sector, NGOs, civil societies) for test introduction and coordinate effort to ensure synergy and minimise duplication
Academic sensitisationOrganise workshops for professional societies and introduce new diagnostics into continuing medical education and medical curriculum