1. Introduction and current status of viral load access
ADVANCING THE LABORATORY PROFESSION AND NETWORKS IN AFRICA
Introduction and current status of viral load access
Anafi Mataka
ASLM
IAS 2019 Satellite Session, Mexico City, 22 July 2019

2. Momentum for VL scale-up
Fully implemented in 68% of LMIC and partially implemented in 20% of LMIC.
2013- strong recommendation
2015 – stayed with the
Routine HIV viral load monitoring is fully implemented in 68% of LMIC and partially implemented in 20% of LMIC.
Wca- partially-
Still some way to

3. Progress towards 90-90-90 79 % 62 % 53 %
Cascade: 79% know status, 62% on treatment, 53% are virally suppressed, of PLHIV
Key facts HIV – from

4. High viral suppression rates across countries

5. Population-wide global progress
4.3 Million
7.4 Million
7.7 Million
Cascade: 79% know status, 62% on treatment, 53% are virally suppressed, of PLHIV
79 %
62 %
53 %
Key facts HIV – from

6. Need is estimated using projected ART patient numbers and testing guidelines. Where national guidelines are unknown, the WHO’s recommendations of 2 tests for new patients and 1 test for existing patients is used.
Source: CHAI projections of 19 high-burden countries (81% of people on ART in LMICs), supplemented by linear extrapolations of “Rest of World” by Avenir Health.

7. Most molecular labs are in major urban centres…
Kenya
Zimbabwe
Uganda
Malawi
Note: this slide only reflects the PCR testing labs used for VL testing in the public sector. This excludes private PCR testing labs or those used for research purposes. Some circle represent multiple labs in the same city

8. … and so are the largest ART facilities where patients seek care
48% [33% -66%] of all patients1 are at facilities close to centralized labs and can transport samples within 24 hours
Can be accessed using EDTA blood
Require alternative strategy
1 Data based on facility level ART patient numbers from Kenya, Malawi, Uganda and Zimbabwe

11. Treatment failure management
8.85%
Not enough viral load results are being used clinically
6.89%
5.97%

12. Innovations for scaling up VL Access are key
Plasma viral load and alternative technologies pipeline: capabilities and market size
Multi-disease diagnostics integration
Alternative technologies performance and regulatory status
Tools to support viral load implementation
HIV molecular diagnostics toolkit

13. Thank You
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