HIVST

1-Policy uptake of WHO recommended HIV testing approaches 

No policy in Bhutan explicitly allows HIV self-testing and there is no policy under development either (June 2020, hivst.org). HIV testing services are available in Bhutan in out-patient department (OPD), in-patient department (IPD) and emergency wards.

However, on December 1, World AIDS Day 2020, the health ministry introduced HIVST as a part of the community-led HIV testing mechanism. This is an additional means of complementing the country’s existing HIV testing mechanism (facility-based and mobile HIV testing services), which is made available across all health care facilities till the BHU level including private clinics. 

Unlike in the past, health workers now initiate HIV tests depending on a person’s willingness. The ministry is also working towards providing comprehensive key population preventive services, where the range of services include mental health and counselling.

In Bhutan, mobile vans to conduct HIV tests have proven beneficial to the people and health workers and there are plans to enhance these services. Because contact tracing has proven beneficial in Bhutan, the ministry is also developing protocols to further strengthen it. The protocol would provide guidelines on the time frame of conducting contact tracing, which today is conducted by health workers on their own willingness and concern.

2-Implementation status

While no policy explicitly allows HIV self testing in Bhutan and there is no policy under development either (June 2020, hivst.org), on World AIDS Day 2020, the health ministry has introduced HIVST as a part of community-led HIV testing mechanism. 

Since July 2021, the HIVST initiative is rolling out in six priority dzongkhags of Thimphu, Paro, Phuentsholing, Gelephu, Samdrupjongkhar, and Samtse.

As a part of the initiative, the health ministry is pilot the HIV self-testing (HIVST) kits (testing through oral swaps) that are procured through the World Health Organisation (WHO) and the Global Fund support. The programme is supported by the Global Fund (National and Regional Grant) and the World Health Organisation and includes protocols developed by the Ministry that highlight the procedures and steps of conducting the tests and follow-up on patients, and other directives. Sample size, training of health officials and area of the pilot project are also to be determined according to the protocol. Trained members of CSOs like Lhak-Sam and self-help groups such as Rainbow Bhutan and Red Purse are able to conduct the HIV tests.

3-Product Registration and Costing of HIVST Kits 

Product registration is planned in Bhutan.

As a Least-developed Countriy (LDC), Bhutan is exempted from the obligation to grant pharmaceutical patents under the Trade-Related Intellecteual Property Rights agreement (TRIPS) until 2033 or until the country graduates from the LDC category. 

In the 2020 launch of HIVST as a part of the community testing model, the government recommends Oraquick. 

Amazon.com also delivers Oraquick to Bhutan. Pricing ranges from $ 19 – 51 with additional shipping charges.