The Joint United Nations Programme on HIV/AIDS (UNAIDS) and the African Society for Laboratory Medicine (ASLM) have joined with global partners to launch the Diagnostics Access Initiative which calls for improving laboratory capacity to ensure that all people living with HIV can be linked to effective, high-quality HIV treatment services.

Partners in the initiative include UNAIDS, the World Health Organization (WHO), the Clinton Health Access Initiative (CHAI), UNICEF, the US President’s Emergency Plan for AIDS Relief (PEPFAR) and ASLM.

“Around 19 million of the 35 million people living with HIV don’t know they have the virus. If they don’t find out, they will die,” said Michel Sidibé, UNAIDS executive director. “This is why we have to make it simpler for people to test for HIV to be able to start lifesaving treatment when they need it.”

The Diagnostics Access Initiative specifically focuses on ensuring that at least 90 per cent of all people living with HIV know their HIV status. It also aims to ensure that all people accessing HIV treatment have ready access to tests that monitor the levels of the virus in their bodies.

For treatment to be optimally effective, it is essential that all people accessing HIV treatment monitor their viral load frequently. Currently very few high-burden countries routinely offer viral load testing to people receiving HIV treatment. New viral load testing technologies which are made available when people first come in for care, offer promise for expanding access to viral load testing. However they will need to be affordable, appropriately deployed and used effectively.

“To achieve control of the HIV/AIDS epidemic, it’s essential that all people have access to high-quality HIV laboratory services, both for accurate HIV diagnosis and treatment monitoring. Building a country’s capacity for virologic testing is critical for early identification of virologic failure, drug resistance and overall improved impact of the country’s HIV care and treatment programs,” said Ambassador Deborah Birx, US Global AIDS Coordinator. “The Diagnostic Access Initiative represents an important step in ensuring the close collaboration among all donors and stakeholders to expand access and enable strategic scale-up of HIV laboratory services.”

To ensure early diagnosis of HIV, laboratory procedures need to be simplified and multiple testing tools and strategies made available. These also need to be integrated into community-centred health campaigns that focus on multiple diseases.

“It is essential that people know whether they have HIV infection, and that people who take treatment know whether their medicines are controlling the virus,” said Dr Hiroki Nakatani, Assistant Director-General, WHO. “As diagnostic technology changes rapidly, and our Member States need guidance on how to use it, WHO will play a key role in this initiative.”

HIV treatment is effective in reducing HIV-related illness and AIDS-related deaths. It also helps to prevent new HIV infections, by sharply suppressing viral load and decreasing the risk of HIV transmission.

“The Diagnostic Access Initiative focuses urgent attention on the importance of developing new, affordable viral load and infant diagnosis technologies and effectively using the laboratory capacity we currently have,” said Dr. Tsehaynesh Messele, chief executive officer of ASLM. “Effectively using existing and emerging viral load and infant diagnosis technologies will demand substantially stronger laboratory capacity as well as strategic planning to ensure that all technologies are optimally used.”

Partners in the initiative will advocate for greater funding for laboratory services and for the development of new diagnostic tools. They will also strengthen efforts to ensure that diagnostic services are of the highest quality and forge well-coordinated partnerships to close diagnostic access gaps.

The African Society for Laboratory Medicine (ASLM) is a pan-African professional body working to advocate for the critical role and needs of laboratory medicine and networks throughout Africa.