Analysis of procurement of rapid tests and test systems for HIV monitoring in Kyrgyzstan and the Republic of Moldova (2021-2022): challenges and recommendations

The Association “Partner Network” (Kyrgyzstan) and Public Association “Positive Initiative” (Moldova) with technical support of the Health Advocacy Coalition (hereinafter HAC) and “International Treatment Preparedness Coalition” (ITPC EECA) prepared analyses of procurement of rapid tests and test systems for HIV treatment monitoring in 2021-2022 in Kyrgyzstan and Moldova.

The analyses were developed within the framework of the Regional Project “Sustainability of Services for Key Populations in the Eastern Europe and Central Asia Region” (SoS_project 2.0), implemented by a consortium of organizations led by the Alliance for Public Health in partnership with ‘100% Life’ CO, with financial support from the Global Fund.

Let us review the key aspects of the documents presented below:

Kyrgyzstan:

In 2021-2022, 12,000 HIV monitoring test kits have been procured in Kyrgyzstan, but according to the report, this number is insufficient to fully cover PLHIV according to clinical standards. The analysis showed that in 2022 the number of people tested increased by 27.5%, reaching 720,570 people, compared to 2021.

With the change in the EAEU registration rules, the number of registered medical devices has decreased. There is a problem with the translation of previously registered dossiers to comply with the new requirements. Only one name of a test system for CD-4 detection is registered in the country. Rapid tests and tests for monitoring drug sensitivity require revision and expansion of registration.

General recommendations:

• Preservation of national rules for registration under the simplified procedure by the EAEU legislation.
• Revise the distribution plan for rapid tests with a focus on key groups.
• Reducing the price of alternative test 2 through negotiations with suppliers or searching for alternatives.
• Monitoring of rapid tests to optimize results and save resources.
• Consultation with stakeholders on opportunities to procure test systems with public funds.
• Promotion of self-testing and tracking of rapid test systems within the state program.

Republic of Moldova:

The Republic of Moldova has seen a 27.5% increase in HIV testing in 2022. Funding for procurement of rapid tests has increased and the volume of procurement has also increased by 27%. The total number of HIV ½ and syphilis antibody tests procured increased by 27%, indicating increased interest and efficient budget utilization. For 2021 and 2022, there were no reported disruptions in the provision of rapid tests.

General recommendations:

• Revise the test distribution plan, focusing on key populations.
• Monitor and optimize test expenditures to achieve better results.
• Collaborate with state and non-state organizations to discuss opportunities to expand access to tests.
• Supporting self-testing programs and further integrating rapid testing into state programs.
• These recommendations are aimed at improving the effectiveness of HIV monitoring and treatment, as well as optimizing costs in the procurement of test kits in both countries.

You can read the full text of the analyses below (in Russian):

• Analysis of procurement of rapid tests for HIV diagnosis in the Republic of Moldova
• Analysis of procurement of rapid tests for HIV diagnosis in Kyrgyzstan
• Analysis of procurement of test systems for monitoring HIV treatment in Kyrgyzstan

Also we recommend to read the following documents:

• Almaty: ECAT meeting on expanding access to treatment and diagnostics for HIV, viral hepatitis, and tuberculosis
• UN High-Level Meeting on Universal Health Coverage (UHC) 2023: A Call to Expand Our Ambition for Health and Well-being