Our Experience:
Supporting One of Africa’s First Integrated Specimen Referral Network in Nigeria

2018 – ongoing

Supporting national efforts to achieve the 95-95-95 targets set forth by UNAIDS to end AIDS.

Situation

Health commodity supply chains are an essential element of a well-functioning health system. In the case of infectious diseases such as human immunodeficiency virus (HIV), a strong supply chain is integral in maximizing the availability, quality, and affordability of critical medicines as well as diagnostics, including testing supplies, viral load tests, and early infant diagnosis (EID) equipment. Resource-limited settings such as low- and middle-income countries may experience challenges in preventing, detecting, and effectively responding to public health concerns such as HIV/AIDS, tuberculosis (TB), and COVID-19 that may be alleviated in part by more organized and resilient supply chain systems.  

In Nigeria, 1.9 million people are living with HIV/AIDS (2021)[1] and the country ranks third among countries with the highest burden of HIV infection in the world.[2] To help address the burden of HIV/AIDS in Nigeria, in 2018, the Ministry of Health established the National Integrated Specimen Referral Network (NiSRN) to help remedy an uncoordinated sample transport system.

Solution 

With support from the U.S. Agency for International Development (USAID)-funded Global Health Supply Chain Program-Procurement Supply Management (GHSC-PSM), NiSRN has worked to ensure that patients can receive enhanced diagnostics, care and treatment for HIV/AIDS throughout all 36 of Nigeria’s states and the Federal Capital Territory. Specifically, NiSRN works to enhance access to clinical diagnosis, reduce operational costs and turnaround time for sample analysis, and provide secure specimen referral services.

To support the goals of NiSRN, Akesis was engaged by Chemonics International under GHSC-PSM to provide sample transport and result dispatch services for various states within the region spanning various institutions such as government health facilities, private hospitals, and pharmacies. A key tenant of Akesis’ biological sample management and transport service is comprehensive training for sample pick-up personnel (SPP) to ensure that SPPs are equipped with the skills needed to effectively maintain sample integrity throughout transit and ensure that the quality of results is not affected by sample transport conditions. Proper specimen handling, timely transportation of samples, and the immediate dispatch of corresponding test results help to reduce testing turnaround time and play an integral role in the treatment and care of HIV/TB and other infectious diseases.

Results 

As a member of the GHSC-PSM consortium, Akesis supports NiSRN in providing laboratory sample transport and result dispatch services across Nigeria. To date, the project has improved diagnosis turnaround time with 95% of results returned to the health facilities within 48 hours of result collection. Between March 2018 and June 2022, Akesis has supported 1,200+ facilities across 29 states by supporting the transport of over 1.2 million samples – ranging from HIV viral load, HIV EID, CD4, sputum/Tuberculosis, and COVID-19 – in partnership with Chemonics International. Not only have these efforts supported expeditated and more accurate diagnosis, but they have supported national efforts to achieve the 95-95-95 targets set forth by UNAIDS to end AIDS.[3]

[1] www.unaids.org/en/regionscountries/countries/nigeria

[2] www.unodc.org/nigeria/en/hiv-and-aids.html

[3] www.ncbi.nlm.nih.gov/pmc/articles/PMC9352102/#:~:text=In%20December%202020%2C%20UNAIDS%20released,have%20viral%20suppression%20by%202025