Nigeria among high-volume markets for new $1 HIV, syphilis, hepatitis B testing bundle

Nigeria has been identified among high-volume markets where a new $1 testing package could help expand screening of pregnant women for HIV, syphilis and hepatitis B.

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The package, launched by Premier Medical Corporation and Impact Nexus Africa, combines two rapid diagnostic tests under a single commercial offer for use through existing antenatal care services.

The companies said their analysis identified Nigeria, Ethiopia, Tanzania, Uganda, Kenya, Mozambique and South Africa among the countries with the largest potential markets for antenatal hepatitis B screening.

Impact Nexus Africa estimates that the package could generate about $215 million in commodity savings across 74 low- and middle-income countries between 2026 and 2035, if adopted across antenatal care at the modelled volumes.

However, the estimate is based on modelling and does not represent confirmed savings for individual countries, including Nigeria.

How the package works

The Triple Elimination Testing Bundle costs $1 ex-works per woman screened and contains two separate rapid diagnostic tests.

One is the World Health Organisation’s (WHO)-prequalified First Response HIV 1+2/Syphilis Combo Card Test, which screens for HIV and syphilis simultaneously.

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The second is the First Response hepatitis B surface antigen (HBsAg) Card Test, which screens for a marker of hepatitis B infection.

The tests remain separate products but are supplied together as a single commercial offer.

The price also includes access to digital training, assessment and competency tools for end users.

The $1 price excludes freight, local distribution, taxes, regulatory costs and other programme or implementation expenses. Orders are subject to a minimum quantity of 100,000 bundles.

Potential savings

According to the companies, the package is between 22 per cent and 46 per cent cheaper in commodity terms than procuring equivalent HIV/syphilis and hepatitis B rapid diagnostic tests separately.

The analysis estimates an addressable market of about 37.8 million antenatal HBsAg tests annually across 74 low- and middle-income countries.

It projects that using the package instead of separately procured tests could generate about $215 million in commodity savings over 10 years.

The companies said annual savings could exceed $10 million in some high-volume markets, while they could remain below US$1 million in smaller markets.

Actual savings, however, would depend on countries’ existing procurement prices, testing volumes and the scale and pace of implementation, according to the analysis.

They also estimate that the modelled rollout could identify HBsAg-positive pregnancies in about 17.1 million women and contribute to averting approximately 2.7 million infant hepatitis B infections between 2026 and 2035.

It said the health impact projections depend on screening uptake, local hepatitis B prevalence and successful linkage of women who test positive to recommended maternal and infant interventions.

Why hepatitis B screening matters

The initiative is aimed at supporting the global effort to eliminate mother-to-child transmission of HIV, syphilis and hepatitis B.

The WHO recommends testing pregnant women for HIV, syphilis and hepatitis B at least once during pregnancy and as early as possible.

While HIV and syphilis screening have increasingly been incorporated into antenatal care, hepatitis B screening remains less consistently implemented across countries.

The companies said the new package could therefore serve both countries that already provide hepatitis B screening and those seeking to introduce or expand it.

They said the approach builds on existing antenatal care systems rather than requiring countries to establish a separate testing platform.

What the package could mean for Nigeria

For Nigeria, the significance of the package goes beyond its lower price.

A 2026 analysis of Nigeria Demographic and Health Survey data found that although 72 per cent of mothers attended antenatal care, only 12.3 per cent were tested for hepatitis B during pregnancy.

Earlier national data also highlighted the gap. An analysis of about 2.8 million pregnant women who received antenatal care across more than 6,000 facilities providing prevention of mother-to-child transmission services found that only 7.2 per cent were screened for hepatitis B.

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The Federal Ministry of Health and Social Welfare has also been working to strengthen hepatitis B screening as part of Nigeria’s triple-elimination response. In 2025, the ministry said it planned to introduce free hepatitis B testing, treatment and care for pregnant women who test positive.

Against this backdrop, the new bundle could offer Nigeria a lower-cost option for expanding hepatitis B screening through existing antenatal care services.

The companies said the package is available to public and private sector purchasers across all low and middle-income countries, subject to national registration, importation and procurement requirements.