A key step to support the scale up of viral load testing toward the achievement of the ‘third 90’

Monitoring the continuum of viral load testing at the facility level is important to help identify potential bottlenecks that can limit the scale up of viral load testing for improved patient management, and delay the achievement of the ‘third 90’. The United States Centers for Disease Control and Prevention (CDC) has developed the ‘HIV Viral Load and Infant Virological Testing Scorecard’, a laboratory- and clinic-based tool, to help define, improve, and measure improvement of efficiencies across the viral load testing spectrum. Expanding the use of the scorecard has the potential to help improve the overall quality and efficiency of VL testing for improved patient management.

The Pan-African Consortium (PAC) is a joint collaboration between the Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formation/Cheikh Anta Diop University (IRESSEF/CADU), the Africa Centres for Disease Control and Prevention (Africa CDC) and the African Society for Laboratory Medicine (ASLM). The President’s Emergency Plan for AIDS Relief (PEPFAR) funds the PAC to assist supported countries to further advance and sustain access to quality-assured HIV laboratory services, and bridge the gaps towards the 90-90-90 targets. Under this umbrella, ASLM supports various activities for the scale up of viral load testing.

ASLM and the International Laboratory Branch of the United States CDC organized a training that took place 25-26 February 2019 to support the use of the HIV Viral Load and Infant Virological Testing Scorecard by laboratory staff and implementing partners from PEPFAR-supported countries. The training was conducted under the umbrella of the PAC, facilitated by Global Health System Solution (GHSS) and hosted by the Ethiopian Public Health Institute (EPHI).

Twenty-six staff from laboratory facilities and implementing organizations from 10 African countries participated in the two-day didactic and practical training. They learnt how to use the scorecard for auditing viral load and infant virological testing laboratories.

Dr Peter Fonjungo from CDC Atlanta’s International Laboratory Branch brought his expertise to this training by explaining that auditors should conduct a reassessment of laboratories conducting viral load and infant virological testing after 6 months to monitor and evaluate improvements in resolving gaps that they see in their baseline audit.

Practical exercises were conducted at EPHI’s HIV reference laboratory, Addis Ababa’s regional laboratory and the ALERT Hospital laboratory. The training was the first step towards a broader phase: the 26 trainees will now be closely mentored and followed up with to ensure that their skills are put to good use at home in their respective countries. It is expected that in the next 12 months, measurable improvements in the viral load testing cascade will be demonstrated in the PEPFAR-supported laboratories that are implementing the scorecard. This training illustrates how ASLM continuously works to improve the laboratory workforce within highly relevant, regional collaborations.

Author: Anafi Mataka

Editor: Mrs Bethanie Rammer

About ASLM
Established in 2011, the African Society for Laboratory Medicine (ASLM) is a pan-African professional body focused on improving healthcare by strengthening all aspects of laboratories including workforce strengthening, quality improvement and accreditation, harmonization of regulations, strengthening of networks, and strengthening advocacy and communications. Laboratory testing is pivotal for disease diagnosis, epidemiological surveillance, outbreak investigation, and initiation and monitoring of treatment, as well as research and development. ASLM addresses these challenges by working collaboratively with governments; national, regional and international organizations; implementing partners, the private sector and other agencies to achieve its Strategic Vision goals. ASLM is endorsed by the African Union with support from the World Health Organization, Africa CDC, the United States (US) Centers for Disease Control and Prevention, the US President’s Emergency Plan for AIDS Relief, the World Bank, the Clinton Foundation, UNAIDS, and others.

Become a member of ASLM here.