June 29, 2023

Update (07/10/2023): Abbott Laboratories responded to the below open letter.

Abbott Laboratories
100 Abbott Park Road
Abbott Park, Illinois, USA 60064-3500

To: Robert B. Ford, Chairman and CEO



Olaf Such, Site Director ARDx, Jena GmbH, Abbott
Jenifer Healy, Senior Director, International Government Affairs, Abbott
Duncan Blair, Vice President, Global Health Initiatives, Abbott
Dr Tedros Adhanom Ghebreyesus and Dr Meg Doherty, WHO
Peter Sands, Global Fund to Fight AIDS, TB, and Malaria
Dr John Nkengasong  and Dr Mamadi Yilla, PEPFAR
Winnie Byanyima and Dr Angeli Achrekar, UNAIDS
Dr Jean Kaseyam and Dr Yenew Kebede Tebeje, African Union and Africa CDC
Mark Suzman and Dr Yogan Pillay, BMGF
Dr Philippe Duneton, Unitaid
Dr Bill Rodriguez, FIND
Nqobile Ndlovu, ASLM


29  June 2023

Open Letter to Abbott: People Living With HIV Need Your HIV Tests Time for a Course Correction on Pima

Dear all,

We are writing on behalf of the Fight AIDS Coalition, concerned civil society, clinicians, Ministries of Health, and other signatories to this letter.

We are writing out of deep concern regarding Abbott’s May 2022 announcement that it will no longer produce new PIMA instruments as of 25 May 2022, only the CD4 cartridges and services for existing instruments will remain available for the time being.

This decision will impact the ability of national HIV programs to prevent unnecessary loss of life.

CD4 testing at the point of care is crucial in diagnosing advanced HIV disease (AHD) in people living with HIV, due to the high and rapid rates of morbidity and mortality.  In 2021, an estimated 650,000 people died of AIDS-related illnesses. Advanced HIV is defined by WHO as a CD4 cell count below 200 cells/mm3 or a WHO clinical stage 3 or 4 of HIV in any adult, adolescent, or child aged 5 years and above.

Without the use of CD4 tests to identify AHD, up to 50% of asymptomatic AHD cases would be missed.2 It is estimated that up to 30% of people initiating HIV treatment have AHD with severe immunosuppression, putting them at a high risk of opportunistic infections and death. The PIMA instrument, manufactured by Abbott and prequalified by WHO, has been an essential tool in diagnosing AHD and providing accurate, rapid, quantitative CD4 cell counts, at the point of care, which is preferable to centralized alternatives, in terms of turnaround times and timely provision of the AHD care package, whereas getting CD4 results back from centralized facilities can take weeks and sometimes months.

Specifically, we call on Abbott to reverse this dangerous reckless course and change the decision to discontinue manufacturing the PIMA instruments. In addition, we are seeking specific clarification on several important issues regarding the discontinuation of the production of equipment and Abbott’s long-term strategies to mitigate harm. These questions are found on the pages in an annex accompanying this letter.

We ask that Abbott stays committed to the needs of people living with HIV including ensuring continued access to CD4 point-of-care testing. Therefore, we ask that Abbott provides in writing concrete steps for a long-term solution to sustainable access to point-of-care CD4 tests.

As civil society, communities, clinicians, and countries affected by Abbott’s decision, we commit to continued engagement with national ministries of health and HIV programs to optimally use existing CD4 testing capacity. We will also be requesting Ministries to map and provide data on used versus non-used machines in-country. We ask Abbott to revert the decision to discontinue manufacturing of point-of-care CD4 instruments.

Thank you for your attention to these matters, and we look forward to your prompt written  response within two weeks of receipt of this letter, and an opportunity to meet with you to discuss these issues at your earliest convenience.


Fight AIDS Coalition (FAC)

Diagnostics Equity Consortium (DEC)


Government and research entities:

amfAR – The Foundation for AIDS Research, USA

BC-Centre for Excellence in HIV/AIDS, Canada

Le Centre Régional de Recherche et de Formation à la Prise en Charge Clinique de Fann (CRCF CHU), Sénégal

City University of New York, Institute for Implementation Science in Population Health, United States

Drugs for Neglected Diseases initiative (DNDi), Switzerland

Mbarara University of Science and Technology, Uganda

Ministry of Health, AIDS Control Program, Uganda

Programme National de Lutte contre le VIH/SIDA et les Hépatites (PNLSH), Guinée


International and regional organizations:

AIDS Healthcare Foundation (AHF), USA

African Society for Laboratory Medicine (ASLM), South Africa

Asia Pacific Network of People Living with HIV (APN+), Thailand

Aurum Institute, South Africa

Children’s AIDS Fund International, USA

Diagnostics Equity Consortium (DEC), Zimbabwe

Frontline AIDS, South Africa

Global Action For Fungal Infections (GAFFI), Switzerland

The Global Network of People Living with HIV (GNP+), The Netherlands

Health Global Access Project (GAP), USA

International AIDS Society (IAS), Switzerland

International Association of Providers of AIDS Care (IAPAC), USA

International Community of Women Living with HIV Eastern Africa (ICW-EA), Uganda

International Treatment Preparedness Coalition Global (ITPC), South Africa

International Treatment Preparedness Coalition in Eastern Europe and Central Asia (ITPC-EECA)

International Treatment Preparedness Coalition in Guatemala/Latin America & Caribbean (ITPC-LATCA)

The International Community of Women Living with HIV (ICW), Argentina

Journalists Against AIDS (JAAIDS), Nigeria

Médecins Sans Frontières (MSF) Access Campaign, Switzerland

Partners in Health (PIH), USA

Prevention Access Campaign (global)


National organizations and entities:

Access Care Treatment and Support (ACTS), Ghana

Acción Ciudadana Contra el SIDA (ACCSI), Venezuela

Advocacy Core Team (ACT), Zimbabwe

AIDS Drug Assistance Program (ADAP) Advocacy Association, USA

Among Karsa, Indonesia

Anantha Network of Positives, India

Andrah Pradesh Drug Users Forum (APDUF), India

Assam Network of Positive People (ANP+), India

Association El Hayet des personnes vivant avec le VIH, Algérie

Association of People Living with HIV (APLHIV) Pakistan, Pakistan

Association of Positive People for Living Excellence, India

Association Tunisienne de Prévention Positive, Tunisie

Bangladesh NGOs Network for Radio and Communication, Bangladesh

Cancer Alliance, South Africa

Chasing Zero, UK

Child Way Uganda, Uganda

Coalition for Health Promotion and Social Development (HEPS), Uganda

Coalition of Women Living with HIV and AIDS (COWLHA), Malawi

Collaboration of Women In Development (CWID), Kenya

Comité de protection des personnes VIH (CPPVIH), Maroc

Community Access National Network, USA

Community Network for Empowerment (CoNE), India

Community of Women Living HIV Lesotho (ICW Lesotho), Lesotho

Dandora Community AIDS Support Association (DACASA), Kenya

Delhi Network of Positive People (DNP+), India

Dignity and Wellbeing for Women Living with HIV in Tanzania (DWWT), Tanzania

Educating Girls and Young Women for Development (EGYD), Zambia

Ex-Wenela Miners Association of Zimbabwe (EWMAZ), Zimbabwe

Facilitators of Community Transformation (FACT), Malawi

FHI 360, India

Five Horizons Health Services, United States

Gift of Hope Foundation, Tanzania

Global Alliance for Human Rights (GAHR), India

Haryana Drug Users Forum (HDUF), India

Heartland Alliance LTD/GTE (HALG), Nigeria

HIV i-Base, UK

Housing Works, Inc., USA

Initiative for Youth Development Change in Nigeria (IYDCN), Nigeria

Institute of HIV Research and Innovation (IHRI), Thailand

Jamaica Community of Positive Women-ICW, Jamaica

Jaringan Indonesia Positif (JIP), Indonesia

Joint Initiatives For Vulnerables Support (Mzeituni), Tanzania

Jointed Hands Welfare Organisation (JHWO), Zimbabwe

Just Treatment, UK

Kampala District Forum of PLHIV Networks, Uganda

Kamukunji Paralegal Trust (KAPLET), Republic of Kenya

Life Concern, Malawi

Life Health Education Development Foundation Trust, Zimbabwe

Live Alive Network (LIAN), Uganda

Médecins Sans Frontières (MSF) South Africa, South Africa

Meghalaya State Network of Positive People (MSNP+), India

Misbah Society, India

Mozambique Treatment Access Movement (MATRAM), Mozambique

Myanmar Positive Group National PLHIV Network (MPG), Myanmar

NAM aidsmap, United Kingdom

National Coalition of People living with HIV in India (NCPI+), India

National Councils of People Living with HIV (NACOPHA), Tanzania

National Minority AIDS Council (NMAC), USA

National Coalition of People Living with HIV in India (NCPI+), India

The National Organisation for People Living with Hepatitis B (NOPLHB), Uganda

Network in Thane by People living with HIV(NTP+), India

Network of African People Living with HIV West Africa (NAP+WA), Côte d’Ivoire

Om Prakash Network of People Living with HIV/AIDS (OPNP), India

ONG LES Batisseurs, Democratic Republic of the Congo

OurEquity NPC, South Africa

People PLUS, Belarus

Positive Women Network Mizoram (PWNM), India

Positively Aware magazine, USA

Public Citizen, USA

Red Ribbon Istanbul Association, Turkey

Sexual Minorities Uganda (SMUG), Uganda

South African Health and Technology Advocacy Coalition (SAHTAC), South Africa


Support on AIDS and Life Through Telephone Helpline (SALT), Uganda

Suruwat, Nepal

Swaziland Network of Young Positives (SNYP+), Eswatini

Tanzania Community Health and Environment Organization (TACHEO), Tanzania

Tanzania Community Health Information and Support (TaCHIS), Tanzania

Tanzania Health Summit, Tanzania

Tanzania Organisation of Serving Orphans and Vulnerable Children (TOSOVC), Tanzania

Tanzania Network of Women Living with HIV (TNW+),  Tanzania

Tanzania Youths Behavioral Change Organization (TAYOBECO), Tanzania

Thai Network of People Living with HIV/AIDS (TNP+), Thailand

Treatment Action Group (TAG), USA

Treatment Advocacy and Literacy Campaign (TALC), Zambia

Trust for Community Development (Trust4Code), Malawi

UK Community Advisory Board (UK-CAB), United Kingdom

Vietnam Network of People living with HIV (VNP+), Vietnam

Vihaan Care and Support Center (CSC), India

Vijana Na Children Foundation (VINACEF Uganda), Uganda

We Rise And Prosper (WRAP), Uganda

Wote Youth Development Projects, Kenya

Youth And Women Emancipation (YAWE), Tanzania

Y+ Global, Tanzania

Y+ Malawi, Malawi

Y.R. Gaitonde Centre for AIDS Research and Education (YRGCARE), India


Signatures in individual capacities:


Clinicians, professors, researchers, lab and government personnel:

Sunita Agarwalla, Associate Professor, Dispur College, India

Brook K. Baker, Professor, Northeastern U. School of Law, USA

Alexandra Calmy, Head of HIV/AIDS Unit,  University Hospitals of Geneva (HUG), Switzerland

Angelique Corthals, Associate Professor, USA

Masimba Dube, Program Pharmacist, AIDS & TB,  Ministry of Health and Child Care, Zimbabwe

Jayne Ellis, Clinical researcher, London School of Hygiene and Tropical Medicine (LSHTM), Uganda

Ngozi Erondu, Technical Director, UAE

Eudoxia Filipe, Advanced HIV Disease (AHD) Focal Point, Ministry of Health, Mozambique

Rebecca Gathercole, Global Health Operations Coordinator, St George’s University of London, UK

Deborah Goldstein, Dr., USA

J Carolyn Gomes, The Honourable Dr., Jamaica

Nelesh Govender, Professor, University of the Witwatersrand, South Africa

Leslye Heilig, M.D., USA

Petros Isaakidis, Operational Research Coordinator, Médecins Sans Frontières (MSF), Southern African

Hani Kim, Executive Director, RIGHT Foundation, South Korea

Nsangi Laura Joan, Clinical Trials Coordinator,  Infectious Diseases Institute, Uganda

David Lawrence, Associate Professor, London School of Hygiene and Tropical Medicine, United Kingdom

Thuy Le, Associate Professor of Medicine, Duke University School of Medicine, USA

Angela Loyse, Senior Lecturer, UK

Marybeth Cherono Maritim, Senior Lecturer and Consultant Physician, University of Nairobi, Kenya

Francois-Xavier Mbopi Keou, Professor of Laboratory Medicine, Infectious Diseases and Global Health, Cameroon

Graeme Meintjes, Professor of Medicine, University of Cape Town, South Africa

Calorine Noel Mekiedje, HIV – TB senior advisor, South Africa

David Meya, Associate Professor,  Infectious Diseases Institute, Makerere University, Uganda

Síle Molloy, Senior Lecturer in Epidemiology, St George’s, University of London (SGUL), United Kingdom

Julio Montaner, Killam Professor of Medicine, University of British Columbia, Canada

Andrew Mujugira, Senior Research Scientist, The Infectious Diseases Institute Limited, Uganda

Zee Ndlovu, Laboratory advisor, Médecins Sans Frontières (MSF), South Africa

Medical Unit (SAMU), South Africa

Tatu M. Nyange, Lecturer, Mwalimu Nyerere Memorial Academy (MNMA)

Madhukar Pai, Professor of Epidemiology & Global Health, McGill University, Canada

Nitika Pant Pai, Associate Professor, McGill University, Canada

Praphan Phanuphak, Professor Emeritus, Thailand

Stephanie L. Smith, Associate Professor, Virginia Tech, USA

Wendy Stevens, Professor, Wits Diagnostic Innovation Hub, National Priority Program, National Health Laboratory Service, South Africa

Boyer Chammard Timothee, Infectious Diseases Physician, France

Mugabi Timothy, Research Medical Officer, Infectious Diseases Institute, Uganda

Francois Venter, Executive Director, Ezintsha, University of the Witwatersrand, South Africa

Larry Westerman, CDC, USA

Kara Wools-Kaloustian, Director of Research IU Center for Global Health, U.S.A

William Worodria, Physician, Uganda


Civil society individual endorsements:

Ganesh Acharya, TB/HIV Activist, India

Oswald Andrade, India

Anita Autade, Ntp, India

Steven Bamford, UK

Aisuluu Bolotbaeva, Consultant, Kyrgyzstan

Juliet Bosa, United Kingdom

Sanjib Chakraborty, India

Ashmita Chetri, India

Trandan Chutia, India

Mohamed Dadsi, Member CCM/1st Representative of PLwHIV instance de coordination national, Morocco

Naba Kanta Deka, India

Rajesh Didiya, CEO, National TB Network, Nepal

Rajiv Dua, Executive Director, India HIV/AIDS Alliance, India

Rajesh Dutta, India

Maura Elaripe, CCM TB Community Representative, ACT AP, Papua New Guinea

Cindra Feuer, Senior Program Manager, AVAC, USA

Tia Francis, Co-Founder, It’s Possible, USA

Mundrika Gahlot, India

Suparna Gawade, India

Manitosh Ghildiyal, India

Birinchi Gogoi, India

Maurice Greenham, United Kingdom

Amit Singh Gusain, Uttarakhand Association for Positive People Living with HIV/AIDS (UKNP+), India

Haroun Habib, USA

Josephine Ijekhuemen, Executive Director, Center for Rights and Development (CRD)

Jo Josh, UK Community Advisory Board, UK

Kundan Kumar, India

Bandana Kumari, India

Raymond Kwesiga, AFROCAB

Jen Linson, Program Coordinator, USA

Esihle Lupindo, USA

Sharonann Lynch, Associate Director, Global Health Policy and Politics Initiative, O’Neill Institute, USA

Arturo Hernández Martínez, Counceil, Costa Rica

Dorina Mathayo, Advocacy Navigator, Advocacy Navigator Program by AVAC

Daisy Montero, USA

Sanjana Mukherjee, Professional Fellow, Global Health Policy, USA

Mercy Nangwale, UK Community Advisory Board (CAB), England

Rahul Narah, Indian

Puneswar Nath, India

Kim Nichols, Co-Executive Director (retired), African Services Committee

Ambrose Oduch, Chief Representative, Child Way Uganda, Uganda

Faith Onu, Young Persons Network for Sustainable Lifestyle and Health (YOUPEN4SLAH), Nigeria

Peter Owiti, Wote Youth Development Projects CBO, Kenya

Pranjal Pandey, India

Arda Karapınar Panosian, Activist, Türkiye

Fiona Pettitt, United Kingdom

Laltan Puia, Mizoram, India

Vikas Rathod, India

Shekinah Rose, HIV Advocate/Activist, Positively Trans National Advisory Board (NAB), USA

Ankit Sachan, India

Bhaskar Jyoti Saikia, India

Ranjib Saikia, India

Abdul-Fatawu Salifu, Hope For Future Generations (HFFG), Ghana

Fotios Saltaferis, UK

Manisha Salunke, India

Niharendra Sarma, India

Agrata Sharma, Fellow, O’Neill Institute for Global and National Health Law, USA

Rekha Sharma, India

Archna Sharma, India

Subha Sarmah, India

Hari Shankar Singh, India

Richard Stern, Costa Rica

Ch Subbareddy, India

Tracy Swan, Consultant/Activist, Spain

Sahil Tambe, India

Phumeza Tisile, South Africa

Ankita Tiwari, India

Milind V. Rajwade, India

Wim Vandevelde, Liaison Officer, GNP+, South Africa

Sachin Verma, India

Scholastica Williams, National Council for People Living with HIV/AIDS (NACOPHA), Tanzania

Henry Zohmingthanga, India Northeast, Aizawl, Mizoram


Annex: Questions and considerations for Abbott to mitigate harm due to PIMA device discontinuation

  1. Production challenges: We understand that Abbott claims the discontinuation is due to supply issues of a specific component(s) that facilitates production. We would like to know the component(s) causing the production challenge and the related supplier information, as well as the steps undertaken by Abbott with the supplier to mitigate this gap. We ask for Abbott’s strategies in the short term and especially in the long term and solutions for the supply of the components to make the instruments. We cannot allow that manufacturers of critical components of live-saving technologies stop production and put the millions of lives at risk.
  2. The supply of stock of PIMA instruments in Germany: It has come to our attention that there is a stock of PIMA instruments in the Jena facility in Germany. We would like to understand the size of this supply and your intentions and how it may impact existing instruments in terms of service, maintenance, and availability.
  3. Existing instruments in countries: Many countries already possess PIMA instruments, some of which may no longer be under warranty or in functioning condition. We request clarification on how Abbott plans to address these instruments and ensure their continued use and provision of support to countries. Are there any plans to work with countries and global health actors to conduct mapping exercises to assess dormant machines in various countries? If so, it would be highly beneficial for the data resulting from these exercises to be available to stakeholders, as it could inform actions needed to achieve optimal use of existing machines in countries.
  4. Honoring warranties: It has been noted in Abbott’s communications that current active warranties will be honored, and new warranties will be supported for new instruments purchased from the stockpile in Germany. However, we seek further clarity on how Abbott plans to handle instruments that are no longer under warranty but are still functional or require repair.
  5. Long-term solutions and support:  What long-term plans has Abbott put in place regarding the availability of cartridges and the provision of service and maintenance? What are the long-term plans from Abbott to guarantee access to point-of-care CD4 testing, beyond the lifetimes of the existing PIMA instruments in countries? Can Abbott commit to transfer the PIMA technology, IP, data and any relevant information royalty-free to local manufacturers (s) in low- and middle-income countries?

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