{
  "abstract": "The COVID-19 Treatment QuickStart Consortium worked with governments in seven low- and middle-income countries (LMICs), Ghana, Laos, Malawi, Nigeria, Rwanda, Uganda and Zambia, to implement COVID-19 test-and-treat programmes at 776 health facilities, including training over 5000 staff and facilitating a donation of 11 300 courses of the oral antiviral nirmatrelvir/ritonavir for treatment. This paper describes the process of implementing COVID-19 test-and-treat programmes in each country, provides aggregate programme monitoring data on numbers tested and treated and analyzes programme enablers and challenges. Between country-level programme initiation (Ghana, May 2023; Laos and Malawi, July 2023; Nigeria, June 2023; Rwanda, March 2023; Uganda, September 2023; Zambia, December 2022) and June 2024, a total of 731 970 SARS-CoV-2 tests were conducted. Of 6724 positive tests, a subset were documented to meet eligibility criteria for nirmatrelvir/ritonavir initiation, and 3041 patients were prescribed nirmatrelvir/ritonavir. The largest number of prescriptions was in Zambia. Programme enablers included decentralisation of services; task-shifting from higher to lower health worker cadres; increased access to point of care antigen tests, including self-tests; and the integration of COVID-19 with other health services. Challenges included COVID-19 de-prioritisation at the time of programme rollout, test commodity stockouts and expiries, and dwindling national surveillance efforts. Learnings from rapid initiation and scale-up of COVID-19 test-and-treat programmes in these seven countries can be used to inform future pandemic preparedness strategies in LMICs.",
  "authors": [
    {
      "affiliations": [
        "Clinton Health Access Initiative, Boston, Massachusetts, USA"
      ],
      "name": "Caroline E Boeke"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Boston, Massachusetts, USA"
      ],
      "name": "Nervine Hamza"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Abuja, Nigeria"
      ],
      "name": "Chukwuemeka Agwuocha"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Boston, Massachusetts, USA"
      ],
      "name": "Okechukwu Amako"
    },
    {
      "affiliations": [
        "Mahosot Hospital, Vientiane City, Lao PDR, Vientiane, Lao People’s Democratic Republic"
      ],
      "name": "Khamsay Detleuxay"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Boston, Massachusetts, USA"
      ],
      "name": "Michelle Gao"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Boston, Massachusetts, USA"
      ],
      "name": "Bridget C Griffith"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Lilongwe, Malawi"
      ],
      "name": "Yamikani Gumulira"
    },
    {
      "affiliations": [
        "Duke Global Health Institute, Duke University, Durham, North Carolina, USA"
      ],
      "name": "Elina Urli Hodges"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Boston, Massachusetts, USA"
      ],
      "name": "Jessica Joseph"
    },
    {
      "affiliations": [
        "Acute Respiratory Illness Unit, Government of Malawi Ministry of Health, Lilongwe, Malawi"
      ],
      "name": "Norman Lufesi"
    },
    {
      "affiliations": [
        "Duke Global Health Institute, Duke University, Durham, North Carolina, USA"
      ],
      "name": "Emily Macharia"
    },
    {
      "affiliations": [
        "Zambia National Public Health Institute, Lusaka, Zambia"
      ],
      "name": "Nyuma Mbewe"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Boston, Massachusetts, USA"
      ],
      "name": "Elizabeth McCarthy"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Accra, Ghana"
      ],
      "name": "Faustina O Mintah"
    },
    {
      "affiliations": [
        "Quality Assurance, Uganda Ministry of Health Pharmacy Division, Kampala, Uganda"
      ],
      "name": "Moses Mukiibi"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Lusaka, Zambia"
      ],
      "name": "Mwaba Mulenga"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Kigali, Rwanda"
      ],
      "name": "Alida Ngwije"
    },
    {
      "affiliations": [
        "Institutional Care Division, Ghana Health Service, Accra, Greater Accra Region, Ghana"
      ],
      "name": "Lawrence Ofori-Boadu"
    },
    {
      "affiliations": [
        "Nigeria Federal Ministry of Health, Abuja, FCT, Nigeria"
      ],
      "name": "Ijeoma Uzondu Okoli"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Vientiane, Lao People’s Democratic Republic"
      ],
      "name": "Sompasong Phongphila"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Boston, Massachusetts, USA"
      ],
      "name": "Christian Ramers"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Boston, Massachusetts, USA"
      ],
      "name": "Sean Regan"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Kampala, Uganda"
      ],
      "name": "Evarist Twinomujuni"
    },
    {
      "affiliations": [
        "Rwanda Biomedical Center, Rwanda Ministry of Health, Kigali, Rwanda"
      ],
      "name": "Edison Rwagasore"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Boston, Massachusetts, USA"
      ],
      "name": "Jessica Tebor"
    },
    {
      "affiliations": [
        "Duke Global Health Institute, Duke University, Durham, North Carolina, USA"
      ],
      "name": "Krishna Udayakumar"
    },
    {
      "affiliations": [],
      "name": "COVID-19 Treatment QuickStart Consortium"
    }
  ],
  "title": "Rapid establishment of public sector COVID-19 test-and-treatment programmes across seven low- and middle-income countries: implementation strategies and program monitoring results",
  "uid": "1dff509b-f889-5ef1-a484-c829bd18fd85"
}