NEW YORK – Yemaachi Biotechnology, a molecular diagnostics firm headquartered in Accra, Ghana, last week began shipping its recently launched Sheba-HPV test, enabling Ghanaian women to screen for cervical cancer at home.
Yemaachi is currently piloting its distribution model in Accra and Kumasi, with plans to expand its distribution network throughout the country over the coming months, before eventually bringing it to the wider East African region and possibly beyond.
The test consists of the Evalyn Brush, bought from Rovers Medical Devices, which is sent directly to customers, who send it back to Yemaachi via a company-distributed free drop box. The company then performs real-time qPCR analysis of that sample using the World Health Organization-recommended standard set of 15 medium- to high-risk HPV strains. These include HPV 16 and HPV 18, which together account for roughly 70 percent of all cervical cancer.
"The idea is that it's a convenient, discreet way for women to screen themselves for HPV," Yaw Bediako, founder and CEO of Yemaachi, said in an interview. With the kit at home, "[you] take your own sample, drop it in an envelope, drop it back at the pharmacy where you bought it, and you get your results … within 72 hours," he added.
The Evalyn Brush is considered by some experts to be one of the best-established and widely used self-collection HPV screening devices. Numerous studies have found its sensitivity comparable to clinician-collected samples, including during cases of long intervals between sample collection and preparation, suggesting that it may be an ideal tool for situations where extended delays cannot be avoided, such as may occur in remote and rural settings.
At the moment, Yemaachi is using Sansure HPV DNA diagnostic kits with a maximum specificity of 400 copies per mL, while working to develop an in-house lab-developed test.
Cervical cancer is Ghana's second most common female cancer among women between the ages of 15 to 44 and the second leading cause of cancer deaths in the country.
"The majority of the cervical cancer burden now is in low- and middle-income countries," Bediako said. "Countries like the US have got HPV screening and cervical cancer screening in general to be routine and when detected early [it] is one of the most treatable forms of cancer."
By coupling sample collection to a distribution strategy that enables easy sending and receiving, Yemaachi is leveraging Ghana's rising use of e-commerce to address the country's low HPV screening rate and the challenge that many women face in simply reaching a clinic.
"For some consumers, online purchasing is more convenient than going to a community pharmacy or a health clinic, so it's great that Yemaachi is offering this approach," Patrick Beattie, cofounder and CEO of Redbird, another Ghanaian diagnostics company, said via email. "Convenience is not a one-solution-fits-all."
Redbird supplies pharmacies with the necessary equipment, supplies, and software to make affordable tests available, including tests for anemia, blood sugar, blood pressure, body mass index, cholesterol, hepatitis B, malaria, typhoid, prostate cancer, and pregnancy.
Yemaachi's leveraging of Ghanaian e-commerce habits complements this strategy by easing the burden of having to reach a pharmacy in the first place. It also taps into what some experts believe to be one of the more effective strategies for boosting cervical cancer screening throughout sub-Saharan Africa, that being innovative service delivery solutions.
Strategies to this end typically fall into one of three categories: education interventions, economic incentivization programs, and service delivery solutions. Of these, a recent analysis published in BMC Public Health of 19 screening intervention studies determined that educational interventions were largely ineffective, while new ways to deliver screening services generally produced the greatest impact, both in terms of building community engagement and in finding ways to lower diverse barriers to in-person screening.
"The cost of the diagnostic test is just one part of the overall affordability calculation," Beattie explained. "To really affect affordability, one must also consider secondary costs such as travel and registration fees and opportunity costs like lost wages due to long wait times."
In this way, groups like Redbird and Yemaachi reduce hidden costs to consumers by creating more convenient options, something that Bediako describes as a necessary component of any African diagnostic or healthcare solution.
"An African solution doesn't forget about the rural [population] but also doesn't ignore that there's a growing population of people who are very cosmopolitan, with a growing ability to pay for certain services," Bediako said.
Sheba-HPV currently costs GH¢ 300, or approximately $50, or roughly equivalent to a three-course meal for two at a mid-range restaurant. As the project expands, the company expects the price to drop further, helping it reach more less-advantaged women, with a target price of between $10 or less.
"It's great to see this approach," Beattie said, "and I hope we start seeing even more approaches join the ecosystem."