Zimbabwe HIV Viral Load Testing Overview

Zimbabwe's plan to scale up HIV viral load testing from 2018 to 2020 is outlined, with targets set for each year. The country has made significant progress in expanding its viral load testing capacity, going from targeted testing to near-universal coverage by 2018. Various testing laboratories in Zimbabwe are equipped with different types of instruments to meet the demand. The performance of viral load testing against set targets for 2018 and 2019 is also highlighted, showing achievements and areas for improvement.

• Zimbabwe
• HIV
• Viral Load Testing
• Scale-Up
• Laboratories

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1. Norah Sukutayi Vere HIV VIRAL LOAD TESTING OVERVIEW

2. OUTLINE HIV Viral Load scale up plan Viral Load testing Labs distribution HIV viral load testing capacity conventional machines HIV testing performance 2018 HIV Testing Performance 2019 Challenges

3. ZIMBABWE VIRAL LOAD SCALE UP PLAN Revised Viral Load Testing Scale-Up Plan 2018-2020 Target for 2018 was to cover 60 % of ART cohort with a VL test. Target for 2019 is to cover 80% of the ART Cohort with a VL test

4. VL TESTING LABORATORIES Zimbabwe started with targeted Viral load testing and moved towards universal coverage in 2016. Started off with one testing lab and has expanded to 14 conventional and 25 POC sites between 2016 and 2018 Near POC TESTING SITES CONVENTIONAL TESTING SITES

5. VL testing Lab Instrument Type Total number of instrumentCapacity/ instrument Total capacity Beat AIDS Roche Cobas CAP/CTM96 1 44,352 44,352 Beatrice Road Infectious Disease Hospital BM NucliSens Easy Q HIV-1 v 2.0 1 39,600 39,600 Roche Cobas CAP/CTM96 1 44,352 44,352 Chinhoyi Provincial Roche Cobas CAP/CTM96 1 44,352 44,352 Chitungwiza (PSI) Abbott m2000 1 31,680 31,680 Gweru Provincial Hospital Roche Cobas CAP/CTM96 1 44,352 44,352 Masvingo Provincial Hosp. Roche Cobas CAP/CTM 96 1 44,352 44,352 Mpilo Central Hospital Roche Cobas CAP/CTM96 1 44,352 44,352 Abbott m2000 2 31,680 63,360 Mutare Provincial Hospital Roche Cobas CAP/CTM96 1 44,352 44,352 Abbott m2000 BM NucliSens Easy Q HIV-1 v 2.0 2 1 31,680 39,600 63,360 39,600 NMRL Abbott m2000 3 31,680 95,040 Gwanda and St. Luke s Hospitals Abbott m2000 2 31,680 63,360 Bindura, Kadoma, Marondera Hologic Panther 3 66000 198000 Various districts Total Annual 8 hr capacity Samba 100 79200 983,664

6. 2018 VL QUARTERLY TEST PERFORMANCE AGAINST SCALE UP TARGETS 700000 700000 84% 84% 78% 78% 83% 83% 83% 83% 600000 600000 82% 82% 82% 82% 500000 500000 81% 81% 80% 80% 400000 400000 80% 80% 79% 79% 300000 300000 78% 78% 200000 200000 77% 77% 100000 100000 76% 76% 0 0 75% 75% Q1 Q1 Q2 Q2 Q3 Q3 Q4 Q4 Achievement Achievement Target Target % Achievement % Achievement

7. 2019 QUARTERLY VL AGAINST SCALE UP TARGETS 500000 500000 66% 66% 66% 66% 450000 450000 65% 65% 400000 400000 350000 350000 64% 64% 300000 300000 # tests done # tests done Target Target % Achievement % Achievement 250000 250000 63% 63% 200000 200000 62% 62% 62% 62% 150000 150000 100000 100000 61% 61% 50000 50000 0 0 60% 60% Q1 2019 Q2 2019

8. CHALLENGES IN LABORATORIES Understaffing Power interruptions- Working hours and capacity reduced because of power availability Reagent and consumables stock outs Suboptimal LIMS- challenges with data management and TAT

9. THANK YOU!