​​​​​​​Fall 2017​

​​​Expanding testing capacity to help reach the WHO 90-90-90 HIV treatment targets​

Photo: A l​aboratorian in Zimbabwe o​pperates​ ​​a Cobas AmpliPrep to prepare samples for viral load testing

​APHL is boosting the World Health Organization's 90-90-90 HIV treatment targets by supporting five sub-Saharan countries to scale up HIV viral load monitoring. This new capability will allow Ghana, Kenya, Mozambique, Zambia and Zimbabwe to monitor patients on antiretroviral therapy and evaluate progress toward national HIV treatment goals.


In 2016 APHL launched the scale-up of viral load monitoring in Zimbabwe. After developing an implementation plan, the association partnered with the Ministry of Health and Child Care to set up viral load testing laboratories at six hospitals. This involved renovation and refurbishment of laboratory space, procurement and placement of high-throughput viral load equipment, and procurement of reagents and consumables, as well as guidance on specimen transport and quality management systems.

APHL collaborated with CDC to design and implement an interim data management system to help viral load testing laboratories handle the rapidly increasing volume of data. Using open source tools, the partners implemented a test system in only six weeks. Now running smoothly, the system will remain in use until the Ministry of Health and Child Care rolls out a national laboratory information system (LIS).

With work in Zimbabwe well underway, APHL is moving forward to scale up viral load monitoring in four other countries.


In collaboration with the Ministry of Health, Ghana Health Service and CDC-Ghana, APHL designed a national plan to implement viral-load testing across the country. Using a phased approach, the plan aims for completion by the close of 2020. As part of the design process, the association conducted a baseline assessment of existing viral load testing capacity and hosted a meeting of 69 stakeholders from all ten regions to provide input and build support for the initiative.


At the National HIV Reference Laboratory, APHL is collaborating with CDC to implement viral load remote login of specimens using an LIS system web interface. This feature will allow distant sites to log in specimens, monitor progress and view/retrieve results.


In conjunction with CDC-Mozambique and other PEPFAR partners, APHL is adding LIS capabilities at three viral load reference laboratories, for a total of nine nationwide. The LIS allows reference laboratories to track specimens, interface with equipment and store/forward results. APHL will also aid clinical partners with the installation of an LIS application at 80 referring facilities.


APHL has begun installation of alternative power back up systems (solar and industrial UPS power) at viral load testing laboratories and facilities processing specimens for viral load testing. These systems will provide a source of stable backup power for uninterrupted laboratory service. Installation has been completed at seven sites with 19 more scheduled for implementation this fiscal year. APHL also is strengthening the courier system used for viral load specimens, and assisting viral load monitoring laboratories to capture and manage patient/client information, laboratory processes and store/forward results.

​Learn More​

For more information about APHL's support for viral load scale-up in Africa, contact APHL's Director of Global Health, Lucy Maryogo-Robinson, MPH.​