POC Product Selection and Adoption for Use

As detailed in the national POC strategy document, as new POC diagnostics become available, competition should be encouraged to ensure that Cameroon does not become overly reliant on a single supplier for any one test and that multiple products are used that meet the needs of different types of settings. At the same time, it is important to maintain some standardization of equipment in order to avoid excessive complication of the supply chain. For example, in the POC product class, there are several products available and in development that have clear advantages and disadvantages for different types of facilities. One product may be ideal for higher volume health center settings, while another product may be ideal for sites with lower volumes and without consistent electricity. For CD4 testing, Cameroon’s goal will be to evaluate several products or review external evaluations and approve a limited number to adopt across different levels of the healthcare system, in order to provide the greatest patient impact and the most efficient and cost-effective provision of services. The number of products approved for use will need to be limited in order to minimize the cost and complexity of managing supply chain, service and maintenance, training, and monitoring and evaluation for a large number of testing sites. Implementation will be conducted in a phased manner at facilities where the technology is well suited. This strategy will ensure that there is immediate patient impact achieved from the currently available technologies, while allowing for new, more suitable technologies to be adopted as they become available.

Currently there are several POC technologies in the pipeline including PimaTM CD4 Analyzer and the CyFlowTM and CD4 miniPOC. Due to the differences in throughput, these devices are adapted to different levels of health facilities providing ART services. Among the three, the Pima CD4 analyzer has been recommended for use by WHO and evaluated in Cameroon and produced results that are in agreement with the conventional techniques. Data from this evaluation study have served as evidence to consider this POC device for introduction to appropriately selected health facilities, which are currently depending on specimen referral system for CD4 testing. In the event that Cameroon decides to adopt the other two technologies or any other technology in the pipeline, which becomes available in the market, based on the criteria specified in the national strategy document, detailed product specific implementation guidelines will be developed and added as appendices to this document.