At a glance
- CDC has improved access to HIV viral load and early infant diagnosis services in Kenya, enabling timely testing and treatment for HIV and other diseases.
- This program has strengthened the laboratory network, enhancing its capacity to manage outbreaks and bolstering America’s ability to detect and respond to global health threats before they reach U.S. shores.
Overcoming geographic barriers
Diseases, such as HIV, know no borders. With one of the largest HIV epidemics globally and an estimated 1.5 million people living with HIV, the need for timely and accurate HIV testing in Kenya is critical.
For children, early infant diagnosis (EID) tests can identify HIV in newborns as early as possible, allowing for timely treatment, which can prevent the progression of the disease. For adults living with HIV, regular viral load testing is important for healthcare providers to determine if the current treatment is working to lower the viral levels and prevent spreading the disease to others. Both EID and viral load tests need advanced molecular testing equipment in laboratories that meet high safety and quality standards.
However, only seven laboratories in Kenya could perform this testing, making it difficult for the population of 57 million to access these services. Over 80% of the tests were done in research laboratories, leading to delays in receiving test results, starting treatment, and increased costs for patients and healthcare providers. Additionally, transporting samples over long distances raised issues of safety and keeping the samples intact.
- Boniface Olale, Migori Country Laboratory Coordinator
Transforming health delivery
To address these challenges, CDC, through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), collaborated with the Kenya Ministry of Health (MOH), county governments, and the Kenya Medical Research Institute (KEMRI) to develop a strategy to decentralize HIV testing services. This strategy aims to make these services more accessible to the community. Through stakeholder engagement and leadership support, public health officials identified five public health service delivery laboratories for the expansion of HIV molecular testing capacity in the country.
CDC assisted the identified laboratories in upgrading their facilities, training staff in safe blood collection practices and sample transportation, improving laboratory testing, and ensuring accurate results interpretation. CDC also provided technical guidance on the installation of modern equipment, including advanced systems from American medical technology companies.
The decentralization of laboratory services greatly improved healthcare delivery in Kenya. For example:
- By December 2024, the first three newly established laboratories conducted 157,745 viral load tests and 8,077 EID tests. Previously, these laboratories were unable to perform these tests.
- The time to receive test results has significantly decreased within a two-year period. Viral load tests now take just 3 days, down from 14 days. EID tests results take just 2 days, reduced from 10 days.
- Efforts to improve laboratory efficiency led to potential savings of over $29,000 in transportation costs for one of the laboratories. Additionally, the Kenyan government, through local counties, covered savings in operational costs for staff salaries, overhead, and infrastructure.
The newly equipped laboratories have also increased their testing capabilities beyond HIV to include diseases like tuberculosis (TB), hepatitis, and human papillomavirus. This integrated approach simplifies laboratory processes, reduces the need for multiple separate tests, and saves costs by lowering transportation and operational expenses for performing individual tests for each disease.
CDC supports over 11 million HIV diagnostic tests, 1.2 million viral load tests, 120,000 EID tests, and 900,000 TB tests in Kenya annually. This support builds the capacity to identify, treat, and contain the international spread of HIV and TB.
A sustainable future
The lessons learned from the first phase of moving laboratory services closer to communities have informed the expansion of these services to more laboratories across the country. With CDC and PEPFAR support, the MOH developed a national integrated sample referral system, making it possible to transport samples for multiple diseases together. This has improved Kenya's ability to detect and respond to outbreaks closer to their source and strengthened global health security.
- Dr. Naomi Lucchi, CDC Kenya's Division of Global Health Protection Laboratory Associate Director
The successful decentralization of laboratory services in Kenya has led to improved access to essential testing, timely diagnosis, and treatment interventions for people living with HIV and others. The ability to test for multiple diseases on the same platform supports broader public health by enabling healthcare providers to efficiently diagnose and manage various health conditions simultaneously. It also enhances the overall effectiveness of disease tracking and response efforts. By consolidating testing capabilities, healthcare systems can allocate resources more effectively, ensuring that limited funding and staff are fully maximized. Through robust, adaptable laboratory networks and rapid response systems abroad, CDC is bolstering its ability to identify and contain infectious disease threats at their origin, well before they can spread globally and potentially impact communities and healthcare systems within the U.S.
As Kenya moves towards a model that prioritizes local partnerships and host government involvement, CDC has laid a strong foundation for a sustainable healthcare solution tailored to the unique needs of the country. This transition enhances the capacity of local health systems to manage HIV effectively and fosters greater accountability and responsiveness to emerging public health threats. By investing in local expertise and resources, Kenya is poised to achieve long-term success in addressing the HIV epidemic, ensuring that future generations, at home and abroad, benefit from a resilient and reliable healthcare framework.