HIV Viral Load Testing

Accurate monitoring of HIV viral load (VL) in a patient is essential for assessing the effectiveness of antiretroviral therapy (ART) and preventing unnecessary switches to costly second-line drug therapy. Unfortunately, VL testing is not widely available due to limited laboratory capacity and cost considerations, so many countries are exploring ways to expand access to this test. This includes investigating more feasible testing and sample collection like dried blood spots (DBS) and point-of-care (POC) technologies, and transport options.

With the continued need for rapid scale-up of ART and an increasing emphasis on VL for ART monitoring, there is an urgent need to expand VL testing capacity within Africa. ASLM recognises that the complexity of scaling-up VL testing is not only a laboratory issue, but it also relates to clinicians and programme managers. Through the Laboratory Systems Strengthening Community of Practice (LabCoP), ASLM provides a venue for sharing information, tools and resources that will support clinical, policy, programmatic, technical and scientific aspects of the implementation of VL testing.

Who We Are
LabCoP is led by the African Society for Laboratory Medicine, with funding from the Bill & Melinda Gates Foundation, and the technical support from ICAP at Columbia University, and Project ECHO at the University of New Mexico.
What We Do
LabCoP fosters a knowledge exchange and joint learning by linking together country teams and global experts, and sharing the knowledge and best practices of viral load scale up and lab systems strengthening amongst ministries of health.
How To Join
Any African country can join LabCoP by submitting a letter of support from the Ministry of Health and identifying a team that includes laboratorians, clinicians, program managers, and any representatives of individuals living with HIV.

Sharing and co-creation of knowledge and best practices

Tools and Resources

Please visit ASLM’s YouTube page to view past LabCoP ECHO sessions about viral load, waste management sessions, and COVID-19 sessions
Here you can find upcoming LabCoP and partner events supporting laboratory medicine. Please check back often to make sure you don’t miss out!
Introducing LabCoP’s Cookbook, a downloadable set of considerations and best practice recipes shared by member country teams from across Africa.
Read the latest issue or back issues of LabCoP Quarterly, LabCoP’s newsletter for connected country teams, ECHO Session summaries, and events.
Explore LabCoP resources to help your country scale up your viral load capabilities and learn best practices from neighboring countries and global health organisations.

Frequently Asked Questions

+ - What is LabCoP?

LabCoP is an abbreviation for Laboratory Systems Strengthening Community of Practice. It is a collaborative learning network of multidisciplinary and multi-stakeholder country teams working together to create knowledge and to share information, experiences and best practices. LabCoP is funded by the Bill & Melinda Gates Foundation, and supported by ICAP at Columbia University and Project ECHO™ (Extension for Community Healthcare Outcomes) at the University of New Mexico Health Sciences Center. ASLM’s LabCoP will initially focus on supporting country teams to scale up high-quality HIV viral load monitoring for improved patient outcomes through the strengthening of laboratory system functions. Overtime, LabCoP will strive to address health system issues beyond HIV.

+ - Why LabCop?

Most countries have adopted routine HIV viral load monitoring of antiretroviral therapy (ART), as recommended by the World Health Organization (WHO). However, the scale up of HIV viral load testing faces many challenges limiting the clinical benefit of viral load monitoring and the achievement of the third 90 in the UNAIDS 90-90-90 targets, which stipulate that 90% of people on ART should reach viral suppression by 2020.

Some countries are making more rapid progress with HIV viral load scale up, suggesting that they might have identified, adapted, and are implementing best practices to meet the needs of their local context. What works in one country could be adapted and applied in another. Additionally, the challenges of viral load scale up not only concerns laboratorians, but also clinicians, communities, patients and policy makers, who ensure that appropriate demand for testing, the correct utilisation of test results, and the implementation of enabling policies. Creating, exchanging and disseminating best practices among multi-country working groups through LabCoP can accelerate the scale up of viral load testing for improved patient outcomes.

+ - What does LabCoP aim to achieve?

To provide a platform fostering peer-to-peer exchange amongst laboratorians, clinicians, policy makers and communities, leveraging expertise across Africa and beyond.

  • LabCoP activities will be articulated around:
    • Knowledge creation facilitated by country teams engaged in collaborative problem solving along the entire HIV viral load testing cascade to identify best practices (from creating patient and provider demand, to test requisition, specimen collection, transportation, viral load testing, the return of results, and finally, to the effective utilisation of test results to guide patient management). LabCoP knowledge creation will follow the model proposed by C-QUIN, a community of practice on differentiated care convened by ICAP.
    • Knowledge dissemination of identified solutions regarding key challenges in the HIV viral load testing cascade will leverage programmatic case-based learning, to promote the adoption of locally derived best practices. Knowledge dissemination will be supported by the ECHO™ education and collaborative problem solving model and platform developed by the University of New Mexico.
+ - What will LabCoP do?

Activities in LabCoP include:

  • a series of online seminars, workshops, interactive working groups, webinars and video teleconferencing sessions to facilitate the creation, sharing and adoption of laboratory best practices or lessons learned. All virtual sessions will be moderated by an experienced facilitator.
  • a yearly face to face meeting to maintain country engagement and evaluate the achievement of LabCoP
  • an opportunity for continuous asynchronous interaction through use of the Slack online communication and collaboration platform to promote sharing of knowledge, experience, and resources across the LabCoP community around viral load scale up.
  • In addition, LabCoP will support countries to conduct baseline and follow up self-assessment of the country level viral load cascade. This information will contribute to populating a dashboard highlighting and identifying gaps and strengths as well as monitoring the advancement of the viral load scale up in participating countries.
+ - How to become a LabCoP member?

LabCoP membership is based on country teams rather than individual membership. Membership is voluntary, free of charge and is open for any country in sub-Saharan Africa.

  • Countries that are interested in becoming a member of LabCoP are advised to take the following steps to register with ASLM:
    • Ensure that a country team (working group) including representatives of HIV laboratory services, clinical care and the civil society can be constituted
    • Obtain the support of the Ministry of Health in your country for participation in LabCoP. The LabCoP team can provide templates for letters of interest.
    • Send a letter of interest signed by a senior official at the Ministry of Health to ASLM using the contact address described in #10 below;
    • Once your country has become a member, the country working team will have immediate access to participation in a series of online best practice sharing webinars and video teleconferencing sessions.
+ - What is a country working group?

Members of the country working team should be volunteers chosen based on merit, and should be comprised of, but are not restricted to laboratorians, clinicians, strategic information officers, pharmacists, representatives from the Ministry of Health, people living with HIV, community activists, program people and delegates from local and international implementing partners. About 8-10 people are adequate for the establishment of a country working team.

+ - What does it mean to be a LabCoP member country?

Being a LabCoP member gives the country the opportunity to share and highlight its successes and challenges, and to learn from other countries. Member countries will have the opportunity to receive technical assistance to design viral load capacity strengthening interventions based on identified best practices.

LabCoP country working teams are expected to engage in online and offline work sessions with other countries to identify, validate, and prioritize best practices along the entire HIV viral load testing cascade. We anticipate that online work sessions will be organized at least once a month and that preparatory work might take a maximum of half a day per week.

+ - Are there any financial incentives for member countries?

There are no financial incentives foreseen. Cost for internet or communication will be supported by the project. Support for procurement of video conferencing equipment can be negotiated if need be. LabCoP will support identification, dissemination and adoption of best practices, but will not fund their implementation.

+ - When did LabCoP project start?

ASLM’s LabCoP was launched on 24 October 2017 during an African regional viral load scale-up conference held in Addis Ababa, Ethiopia.

+ - Whom to contact?

Should you require additional information about LabCoP, or for queries related to membership, please contact the project leadership team.

  • Dr Collins Otieno Odhiambo, LabCoP Project Lead, email
Read More FAQs
George Alemnji
PhD, MPH
Heather Alexander
PhD
Solange Baptiste
ScM
Smiljka de Lussigny
MPharm, MPH
Peter Ehrenkranz
MD, MPH
Fausta Mosha
MD, PhD, MSc
Zibusiso Ndlovu
MSc, BSc
John Nkengasong
PhD
Rituparna Pati
MD, MPH
Trevor Peter
PhD, MPH
Lara Vojnov
PhD
Jason Williams
MPH
Dalila Zachary
MD
Pascale Ondoa, MD, PhD

Director of Science and New Initiatives, ASLM

Collins Otieno Odhiambo, PhD

Project Lead, ASLM

Anafi Mataka, MPH

Program Manager, LabCoP, ASLM

David Lewin

Communications Manager

Dr Miriam Rabkin, MD, MPH

Director for Health Systems Strategies, ICAP at Columbia University

Associate Professor of Medicine and Epidemiology, Columbia University’s

Mailman School of Public Health

Getachew Kassa, DrBA, MSc, MPH

Quality Improvement Advisor, ICAP at Columbia University

Bruce Baird Struminger, MD, MA, FACP

Associate Director of ECHO Institute

Associate Professor of Medicine, Division of Infectious Diseases, University of New Mexico Health Sciences Center

Jutta Lehmer, BA

Program Planning Manager at Project ECHO, University of New Mexico

Fitsum Abebe

Information Technology and Web Specialist, ASLM

The Democratic Republic of Congo (DRC)
Dr Nadine Yongui Massok Abiola – Team Lead
Ethiopia
Adisu Kebede – Team Lead
Eswatini
Sindisiwe Dlamini
Kenya
Nancy Bowen – Team Lead
Malawi
James Kandulu – Team Lead
Sierra Leone
Dr Sartie M. Kenneh – Team Lead
South Africa
Leigh Berrie – Team Lead
South Sudan
Dr Achut Victoria Anib Majur – Team Lead
Tanzania
Mr Victor Muchunguzi – Team Lead
Uganda
Dr Susan Nabadda – Team Lead
Zambia
Dr Aaron L. Shibemba – Team Lead
Zimbabwe
Norah Vere – Team Lead

Partners

To request an invitation to join LabCoP’s communication hub please fill out the form below.