A report by Médecins Sans Frontières (MSF) provides invaluable guidance to countries seeking to make viral load testing routine for those on antiretroviral treatment, according to Unitaid Executive Director Lelio Marmora.

“Making Viral Load Routine” is based on lessons learned over the past four years in the course of a Unitaid-funded project, implemented by MSF, which established the feasibility of viral load testing in challenging environments. An advocacy toolkit emerging from the project can be used by civil societies looking to educate and advocate for routine viral load monitoring, and implementing agencies and countries looking to expand viral load testing can use the operational toolkit developed by MSF.

A viral load test quickly detects exactly how much HIV is in the blood. If treatment is not working, the virus will replicate. By monitoring how well antiretroviral therapy is controlling the virus, a viral load test can help prevent a treatment failure and avert a switch to more expensive and toxic second-line treatment regimens.

UNAIDS’ 90-90-90 targets call, among other things, for 90 per cent of all people receiving antiretroviral therapy (ART) by 2020 to have viral suppression, meaning that they have no detectable HIV in the blood. UNAIDS estimated in December 2015 that more than 17 million people are accessing ART – but less than 30 per cent of them have ever had a viral load test.

“[Though] viral load testing is the most important tool that we have to determine whether HIV treatment is having the desired effect […] it is not widely available,” writes Marmora in the foreword to the report.

In 2012, Unitaid funded its first grant with MSF to demonstrate the feasibility of monitoring HIV treatment using viral load testing. Almost four years on, this detailed report provides guidance on how we can make viral load testing routine for all those on antiretroviral therapy.

A key finding is that viral load diagnostic tools and approaches need to be adapted to the setting they will be used in. Another major factor contributing to success is to work with clinicians, health workers and people living with HIV in order to create awareness and stimulate demand.

Unitaid has invested more than US$180 million in the last three years in a range of projects that address the diagnostic needs of countries, assess innovative and adapted solutions, and generate essential evidence to inform countries and global stakeholders on how to invest more effectively in this vital area of the HIV response.

Read the report: “Making Viral Load Routine” 

Download the toolkit for implementers [PDF]

MSF will officially launch this report on Wednesday 20 July 2016 at the 21^st international AIDS conference in Durban, South Africa. Follow the launch using #undetectable on Twitter. 

For more on Unitaid’s HIV response, check out our HIV grant portfolio.