In October 2015, the World Health Organization issued guidance on what it calls the treat-all approach – or Test & Start – recommending antiretroviral therapy (ART), for everyone living with HIV at any CD4 cell count. Commonly known as Test and Start, this approach begins patients on ART immediately after an HIV-positive diagnosis in an effort to improve health outcomes. Study evidence shows that the earlier patients initiate ART, the better they do.

The U.S. Agency for International Development (USAID) uses the Test and Start approach as a strategy to achieve the UNAIDS 90-90-90 targets.  To reach the targets of the second and third 90, USAID’s Office of HIV/AIDS is taking a leading role in innovative service delivery models and in advancing antiretroviral drugs that are more effective and less expensive.

Costs are a significant barrier to providing ART to those who need it most. In order to reduce costs and improve impact, USAID works with implementing partners such as EQUIP to provide these tailored services, such as Technical Assistance, Multi Month Scripting and Dispensing, and more. This ensures that Ministries of Health and local implementation partners are able to reduce the burden on local health facilities while increasing treatment initiation, patient retention, and disease suppression.