Viral load scale-up involves increasing the viral load testing capacity of labs in a specific country across health facilities. Improving viral load testing and scale-up supports the third of the UNAIDS 90-90-90 targets by enabling viral suppression through effective viral load monitoring.

By applying their expertise in the management of large-scale HIV and TB programs in South Africa, the National Priority Programs division of the National Health Laboratory Service (NHLS) and Wits Health Consortium (WHC), have supported EQUIP partners in offering cross-cutting viral load scale-up solutions and innovative technologies to improve viral load testing and monitoring across the entire value chain.

The team has developed a Rapid Laboratory Assessment Tool to identify gaps and rapidly produce solutions for HIV viral load including sample transportation, results delivery and turn-around time. The tool is used in conjunction with GIS mapping of laboratories/clinics (performed by Right to Care) as well as a health economics analysis (HE2RO) to a) determine the optimal specimen logistics routes for a country, and b) determine the optimal placement of viral load analysers and labs, taking into consideration the options of centralized and Point-of-Care testing. These tools are currently being used in Zambia to assist the Ministry of Health with viral load scale-up.

The most recent work involves the development of an EQUIP-specific innovation, called eLABS.  This is an eHealth and mHealth innovation designed to strengthen the “clinical-laboratory-patient” interface. It is an automated workflow solution that holistically encompasses the entire viral load value chain. Its capabilities include sample tracking and tracing, cold chain monitoring, electronic test requisition at facility level, alternative Laboratory Information System (LIS) options, result reporting and alert triggering to facilities and patients as well as program monitoring through dashboards. eLABS is currently in Phase 1 of its development and is soon to be piloted in Zambia.