Issue brief |

Achieving undetectable: what questions remain in scaling-up HIV virologic treatment monitoring?

Helping people with HIV achieve ‘undetectable’ levels of the virus in their blood—‘undetectable viral load’— should be the goal of HIV treatment programmes. Although the majority of developing countries do not yet offer viral load testing on a routine basis, the use of HIV viral load monitoring is rapidly gathering pace in most developing countries. Which questions remain in further scaling up this gold standard for HIV treatment monitoring in these countries? Médecins Sans Frontières (MSF) is releasing Achieving Undetectable, the latest in a series of issue briefs and reports on access to viral load monitoring in resource-limited settings.

Achieving Undetectable identifies these questions – including recommendations and testing and suppression targets, the status of the roll-out of routine viral load monitoring across 55 countries, pricing, and more – and addresses the barriers that still remain to ensuring broad scale-up of viral load testing on the ground in developing countries. In highlighting these questions, MSF looks at the best practices and lessons learnt, including from its own implementation of viral load monitoring in MSF HIV treatment programmes. This includes an analysis of the results MSF has collected on implementing viral load monitoring in a survey of five key countries, and identifying the challenges those countries face. It is hoped that Achieving Undetectable will be a valuable tool and source of information for both policymakers and implementers of viral load monitoring today.   

Download the briefing document

Achieving undetectable:what questions remain in scaling-up HIV virologic treatment monitoring?

Download supplementary information to the briefing document

Supplementary Material 1: Supplementary material includes national recommendations on infant diagnosis, CD4 and viral load testing, across 55 low- and middle-income countries, sourced from the UNAIDS database.

Supplementary Material 2: Supplementary material includes prices for CD4 and viral load tests, sourced from the Global Fund’s PQR tool, across companies and countries.

Additional publications in the Undetectable report series are available here.

Learn more about MSF’s work to improve access to lifesaving HIV treatment.