Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
South African Press Association (Johannesburg) - May 9, 2003
The PanLeucogated CD4 T-cell enumeration technique (PLG CD4) developed by pathologist Debbie Glencross of the SA National Health Laboratory Service (NHLS) is South Africa's first item of intellectual property related to Aids.
The NHLS recently licensed the technique to an American company -- Beckman Coulter Incorporated -- for global distribution. But the laboratory insisted the innovative technology be sold at an affordable price to developing countries.
The technique provides a simple and accurate measure of CD4 T-cells in the blood of Aids patients. CD4 T cells indicate the level of immunity in the system. By the time an Aids patient dies, there are few or no CD4 cells left in his or her blood.
CD4 tests also measure how well a patient is reacting to antiretroviral drugs. Glencross' technique, first published in April last year, has earned her accolades from the World Health Organisation (WHO) and others. The WHO plans to use the new technique across Africa.
PLG CD4 can reduce the cost of monitoring disease progression in HIV/Aids patients by more than 90 percent when compared to the cost of testing based on current international guidelines.
"Laboratory monitoring of HIV, if you do it according to international guidelines, can literally exceed the health budget of a small Third World country," Glencross told Sapa.
"If we treated every Aids sufferer (4,5-million people) in this country according to international guidelines, CD4 and viral load testing would cost us R17-billion a year.
"If you use PLG CD4, you can literally get the cost down to less than R2-billion a year."
The technique, which made counting CD4 T-cell levels cheaper and easier by changing the reference point from which the cells were measured, is set to be warmly welcomed by poor countries struggling to manage the cost of Aids monitoring.
"The first big obstacle for rolling out anti-retroviral (ARV) treatment to the population is the cost of the drugs themselves but that has largely been settled. There's been court cases and the prices have come down a lot.
"The next big hurdle (in ARV roll-out) however is the cost of administering the drugs. Laboratory monitoring is in fact more expensive than the drugs themselves and although PLG CD4 is not the whole answer, it's a very significant component," Glencross said.
CD4 T-tests, which have to be done every three months for patients on triple therapy, dramatically increase the cost of chronic treatment and are only one of a number of monitoring tests required by the patients.
The new technique is both cheaper than existing tests, and more accurate. Glencross proved this when she sent blood samples she had tested in her laboratory in Johannesburg to London where CD4 counts were obtained using two expensive and very accurate tests.
She compared the results of the "gold standard" tests done in London both with those of her new technique and with the method previously used in South Africa.
Her method turned out the same results as the gold standard tests 99 percent of the time, whereas the method previously used in South Africa turned out the same results as the gold standard in only 70 percent of cases.
"In Third World countries there's really a desperate need for innovation, there's no money, no chance of implementing the technologies available. With the new technique, at least there's a chance to bring down costs," Glencross said.
While her potentially life-saving innovation could save the government billions of rands, not to mention the millions the NHLS will receive in royalties from the patent, it is unlikely to affect Glencross' personal bank account. But for Glencross this is beside the point.
"It's a really gratifying feeling to know that we've done something that can really make an impact. If I wanted to make a lot of money I would have gone private years ago.
"I do what I do because I enjoy the research, because I enjoy the people I work with and because it's a pleasure to go to work every day."
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