From 2013-2016 the UNITAID-funded MSF HIV viral load initiative has supported the programmatic and/or laboratory scale-up of viral load testing in seven countries (DRC, Lesotho, Malawi, Mozambique, Swaziland, Uganda and Zimbabwe) performing almost 320,000 viral load tests. The three years of implementation have seen both laboratory and programmatic strategies developed to enhance the uptake of routine viral load. Success withstanding, significant challenges still remain.

Based on a survey performed across ten MSF supported ART sites and seven viral load testing laboratories in February 2016, “Making viral load routine” aims to share practical lessons from the field with Ministries of Health and implementing partners. The report reflects both on the programmatic strategies required within the clinic (for clinicians, counsellors and patients) and the realities of both setting up and keeping a viral load testing laboratory functional in such settings. National viral load scale up plans must link both programmatic and laboratory planning if viral load tests are to be taken, processed and results utilised.   

Our MSF field teams in collaboration with Ministries of Health have made great strides to begin the scale up of viral load testing, developing models of care that optimize the use and benefits of viral load. We hope that learning from the successes and failures documented in this report will result in more patients having access to viral load testing and have the test results acted upon. For the success of this scale up, sustainable funding must be assured, whilst Ministries of Health, donor agencies and implementing partners must develop a coordinated response. If they succeed we may truly make viral load monitoring routine.   

Viral Load Toolkit

Additional publications in the Undetectable report series are available here.

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

Making Viral Load Routine