With an estimated 19 million people living with HIV globally unaware they have the virus, UNITAID is investing $23 million to accelerate access to simple self-tests in three high burden African countries over the next two years.

Detecting infections is vital to be able to increase treatment coverage worldwide.  Following scale up in recent years of treatment availability, increasing testing has now become the priority to make further headway against the disease.

HIV self-tests which are effective, efficient and ethically sound, with adequate post-test support services, provide cost-effective solutions for expanding existing testing services. Self-testing can help reach those who are either not able to access or unlikely to use current HIV testing services due to privacy issues or lack of convenience. Additionally, it can encourage re-testing among those at high risk.

‘UNITAID continually seeks new ways to improve access to better products to fight HIV/AIDS, TB and malaria,” said Philippe Duneton, Deputy Executive Director of UNITAID. “For HIV, we’re at the point where we need to rapidly increase the number of people tested in order to expand appropriate treatment coverage.  New simple oral tests provide an option to broaden testing services, and help detect more people in need of care.”

Although the US Food and Drug Administration approved an HIV self-test product for the US market in 2012, HIV self-testing remains uncommon elsewhere. More evidence is urgently needed to inform policy and programming decisions at both global and national levels, particularly for high burden countries with an urgent need to increase testing.

With the support of UNITAID, Population Services International (PSI) and its partners, the London School for Hygiene and Tropical Medicine, the Liverpool School of Tropical Medicine, University College London and the World Health Organization, will conduct the world’s largest evaluation of HIV self-testing to date, in Malawi, Zambia, and Zimbabwe, with the view to paving the way for its scale up. PSI and partners will pilot HIV self-testing models among different populations and over the course of the two-year project will distribute nearly 750,000 HIV self-test kits and gather evidence to inform future investments.

These pilots will generate crucial information about how to distribute self-test products effectively, ethically and efficiently and answer key questions about the feasibility, acceptability and impact of this intervention. The project will use these results, and other emerging evidence, to support the establishment of appropriate policy and to encourage new manufacturers to enter the self-test market. At the end of two years, the self-test market will be poised to dramatically increase access to HIV testing and impact HIV prevention, care and treatment goals.