1 Supplementary Figure 1B. Interview guide for country-level experts
Overview of current gonorrhoea control
1. Current gonorrhoea case management guidelines:
a. Is any testing being done today in connection with screening or case management?
b. What are the recommended first line treatments? What is the approximate cost of these medications?
c. How does actual practice differ from the guidelines?
2. How do populations access STI care? At what level of health system? Who are the providers? Do you have any sense for the current coverage of STI services?
3. How is STI care funded in your country?
4. Who are the key populations that you are worried about when it comes to gonorrhoea?
Do you have any estimates of the size of these populations? Are there any specific activities for accessing them?
5. What do you consider to be the greatest gaps in gonorrhoea control in your country?
What are the programme’s main worries and priorities? (e.g. Need for tests and what type? Resistance surveillance? New medicines? Expanded coverage of STIs? Working with providers to increase STI case management?)
6. STI Program background: how is the STI programme organized at the MoH (what
department does it sit in? What linkages to other programmes, e.g. HIV, MCH, are there)?
a. How is it funded?
b. How are guidelines updated, what would the process for introducing a new diagnostic test?
Questions related to simplified TPPs
If available today, do you think your MoH would adopt any of these tests?
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• If yes, which ones would you prioritize and why?
• For what would it be most useful (target populations, settings, how would you use results?)
• How many tests could you envision being performed in a year?
• What is an acceptable price?
• What would drive decision making about adoption of the new test?
• What do you think would be the greatest obstacles to use of the test and to the test having its intended impact?
Scenario 1: new gonorrhoea treatments become available
New drugs for treating gonorrhoea are in development. It is not certain yet how much they will cost (but likely higher than existing drugs). Their intended use is not yet clear either, i.e. whether they would be good first line treatment, or reserved treatments, and this may differ by country.
• What factors would influence the MoH’s decision to adopt a new drug?
• How would your response to the previous questions about diagnostics change if a novel drug for gonorrhoea were available? How does the pricing of new drugs affect your response (e.g. if the new drug was much more expensive compared with existing drugs, or on par with existing prices)
Scenario 2: accelerated development of resistance to existing NG treatments.
If resistance to the treatments currently used in your country were to develop quickly, how might this change your preferences for diagnostic tests?
Linkages between new antibiotics and diagnostics
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• Could you envision a policy where a novel drug and diagnostic are linked, i.e. people could only access the drug if they had a confirmed diagnosis?
• What about if there were an economic incentive to test before treating, e.g. a voucher for discounted/free treatment upon receipt of a positive test?
