Insufficient laboratory testing capacity may limit the ability for nations to achieve the ambitious targets the Joint United Nations Programme on HIV/AIDS (UNAIDS) has set for rates of HIV diagnosis, treatment and viral suppression.
The agency has called on nations to get 90 percent of their HIV population diagnosed, 90 percent of that group treated for the virus and 90 percent of that group virally suppressed by 2020, for a 73 percent overall viral suppression rate. These goals are known as the 90-90-90 targets; and if achieved, UNAIDS estimates they would set the HIV epidemic on a path to end as a public health threat by 2030.
Publishing their findings in PLOS, researchers analyzed annual surveys sent to the World Health Organization (WHO) from 127 countries between 2012 and 2014. The surveys included data on each nation’s capacity for CD4 testing, HIV viral load testing and early diagnosis of infants, as well as the actual use of such testing.
On the one hand, there were sufficient CD4 testing machines to meet the needs of people living with HIV in these countries. But when it came to viral load testing capacity, nations fell short. And even in nations where there were enough viral load testing machines, they were insufficiently used in most countries. In fact, in 2013 the nations surveyed were using just 13.7 percent of their CD4 testing capacity and 36.5 percent of their viral load testing capacity.
The findings of this study are limited by the fact that the survey responses concerned national programs and not testing capacity in the private sector. Additionally, some nations provided incomplete responses or no response at all to the survey, meaning that the available data had holes in it.
In the report, the researchers wrote: “With laboratory systems in reporting countries expanding, a national laboratory strategic plan to strengthen services must be developed, implemented, and monitored by governments and their national and international partners. The focus of international community, to ensure optimal use of laboratory technologies, should be on those countries where interventions for scaling up access to HIV diagnostic technologies are most needed.”
To read a press release about the study, click here.
To read the report, click here.