Public health

The P. vivax malaria parasite caused an estimated 5.4 million cases of malaria in 2022. Complete treatment requires elimination of the parasite from the blood as well as the liver. This treatment is known a ‘radical cure’.

However, doctors are wary of prescribing the most effective treatments because the treatments can cause severe anaemia in patients who are deficient in the enzyme glucose-6 phosphate dehydrogenase (G6PD). This affects 400 million people worldwide.

The World Health Organization (WHO) recommends conducting a G6PD deficiency test prior to treatment of P. vivax malaria patients, to guide treatment decisions. But many countries have not adopted this recommendation meaning point of care G6PD tests are not widely available.

In places with no access to G6PD testing, patients are usually prescribed longer courses of primaquine with lower dosing. However, patients often stop taking the pills when they start to feel better and this can lead to reinfection because the parasite persists in their liver.

Market situation

G6PD testing is required for countries to be able to roll-out tafenoquine, a new, more effective treatment for P. vivax malaria.

However, widespread adoption of G6PD testing has been limited due to inconsistent supply, low affordability, and the absence of cost-effectiveness, operational, and feasibility studies. In turn, commercial sustainability of the product has been threatened by the relatively small market size, uncertain demand, and complexity of producing and commercialising testing equipment. This caused some suppliers to exit the market.

At the time, SD Biosensor’s STANDARD G6PD Test was the only quantitative point-of-care G6PD test on the market. Demand visibility was critical to sustaining production levels and supporting the commercial feasibility of the product, while high-burden priority countries finalised studies, and rolled-out G6PD testing in accordance with WHO recommendations.

Lives changed

Estimates for treatment eligibility were derived from projections by Watson et al. Estimates of treatment outcomes were derived from a 2020 meta-analysis by Rodrigo et al.

Money saved

Impact was based on actual price reductions for G6PD tests over the course of the volume guarantee.

Markets shaped

We work with partners, including donors, procurers and ministries of health, to track changes in health markets where our investments are supporting access to products. We monitor for changes to policy, procurement practices and supplier movement, all of which affect markets and contribute to the long-term sustainability of impact.

Public health

HIV causes AIDS, which is one of the leading causes of death by infectious disease. In 2022, more than 5 million people living with HIV did not know their HIV status, meaning they are not on treatment and are at risk of developing AIDS-related illnesses and unknowingly passing the virus on. Testing is the gateway to accessing HIV prevention, treatment, and care.

Current HIV testing strategies are not effectively reaching priority populations, such as people who use drugs, sex workers and LGBTI people. People from these groups often face stigma, discrimination, and even criminalisation if they seek an HIV test at a clinic. The World Health Organization (WHO) recommends countries implement self-testing as part of HIV testing services.

Market situation

WHO prequalified HIV self-tests have been available since 2016. They are not widely used in lower-income countries because of their historically higher costs compared to professional-use tests offered in health facilities.

Global health organisations have provided a lot of support to introduce and scale-up HIV self-testing, with six suppliers now providing WHO-prequalified tests. However, the market remains dominated by a single company, leading to higher prices and limited use as donors and countries face pressure on HIV budgets.

Lives changed

Estimates for test uptake and linkage to care are based on a meta-analysis by Njau et al. Average HIV positivity rates for Africa reported by UNAIDS were applied to estimate people living with HIV identified through testing.

Money saved

Impact is based on comparing the negotiated price to the expected lowest priced equivalent HIV self-test.

Markets shaped

We work with partners, including donors, procurers and ministries of health, to track changes in health markets where our investments are supporting access to products. We monitor for changes to policy, procurement practices and supplier movement, all of which affect markets and contribute to the long-term sustainability of impact.

Lives changed

Estimates for additional women receiving access to syphilis testing were based on 2020 antenatal testing coverage for syphilis in African countries. Downstream patient outcomes were estimated based on 2020 seroprevalence and treatment rates in African countries, and a meta-analysis of risk for adverse outcomes of pregnancy by Gomez et. al.

Money saved

Impact was based on comparing the negotiated price to the expected weighted average market price of HIV-syphilis dual tests, including expected distributor mark-up where relevant.

Markets shaped

We work with partners, including donors, procurers and ministries of health, to track changes in health markets where our investments are supporting access to products. We monitor for changes to policy, procurement practices and supplier movement, all of which affect markets and contribute to the long-term sustainability of impact.

Public health

HIV causes AIDS, which is one of the leading causes of death by infectious disease. HIV transmission can be reduced if patients start taking combinations of medicines – called antiretroviral therapy (ART) – soon after acquiring HIV. Effective ART regimens can suppress HIV viral load, which can prevent death and onward transmission and allow patients to live longer, healthier lives.

In 2014, UNAIDS launched the “90-90-90” targets, calling for 90% of people living with HIV to know their status, 90% of those diagnosed to receive treatment, and 90% of those on treatment to achieve viral suppression by 2020. Those targets were later updated to “95-95-95” by 2030. However, in 2017, the year before the MedAccess agreement, only 81% of people receiving antiretroviral therapy were virally suppressed, and millions of people with HIV lacked access to viral load testing.

Market situation

Hologic’s Panther^® platform can test for HIV and viral hepatitis viral load and provide diagnosis for COVID-19 and human papillomavirus (HPV), the leading cause of cervical cancer. The Panther^® platform obtained World Health Organization (WHO) pre-qualification in December 2017.

The total size of the viral load market was around $190 million a year. At the time, the two dominant suppliers in Africa offered HIV viral load testing at a wide range of prices. Procurement of products and services was fragmented, leading to untransparent pricing. As a result, access to regular viral load testing was often limited in sub-Saharan Africa. Countries that had purchased viral load testing equipment had many machines out of use due to inconsistent service and maintenance.

Lives changed

Impact was based on estimates of the total reach of guaranteed tests and the depth of impact on patients by those tests. The depth factor was derived from the proportion of people receiving a viral load test that will switch to second-line antiretroviral therapy and the HIV-related mortality and disability burdens in Africa.

Money saved

Impact was estimated based on actual price reductions achieved throughout the course of the volume guarantee.

Markets shaped

We work with partners, including donors, procurers and ministries of health, to track changes in health markets where our investments are supporting access to products. We monitor for changes to policy, procurement practices and supplier movement, all of which affect markets and contribute to the long-term sustainability of our investments. To quantify change against a baseline, we used publicly available indicators as proxies for market-wide change.

Public health

SCD is a genetic condition that affects red blood cells, causing them to become stiff and crescent-shaped. These misshapen cells can block blood vessels, leading to pain, organ damage, and serious complications like anaemia, strokes and infections.

Without proper care, children with SCD face high risks – especially in low-resource settings. Around 500,000 babies are born with SCD each year, mostly in Sub-Saharan Africa and India. In 2021, sickle cell disease caused more than 81,000 deaths among children under five, making it the 12th leading cause of death in this age group worldwide. The true toll is likely even higher, as many children die before ever receiving a diagnosis.

Early diagnosis through newborn screening can save lives by enabling timely treatment – such as antibiotics, malaria prevention and vaccinations – and non-medical interventions. Despite its global impact, access to screening and care remains limited in many countries, making SCD a major public health concern recognised by the UN and WHO.

Market situation

In high-resource countries, newborn screening and proper care have greatly improved life expectancy for people with SCD. But in low-resource settings, scaling up testing and treatment is difficult, meaning millions of children are not tested and therefore those with SCD do not start treatment early.

Standard tests used in many countries rely on expensive equipment and skilled staff, which many low-resource areas cannot afford or support.

Near point-of-care (POC) testing, which takes place where the patient would be treated rather than in a laboratory, offers a more practical alternative, especially in remote regions. Hemex’s Gazelle® device is portable, accurate, and designed for use in these settings, helping make early diagnosis and care more accessible and affordable.