The World Health Organization consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection recommends quantitative viral load testing as the preferred monitoring tool for diagnosing and confirming the failure of antiretroviral therapy.
Qualitative viral load is also the recommended approach to early infant diagnosis of HIV. It is necessary to consider planning and procurement jointly as testing for viral load and early infant diagnosis can use the same technologies, albeit with different reagents and consumables.
The purchase of viral load and/or early infant diagnosis machines can cost more than US$150,000. Reagents and other consumables needed to produce a test results may vary significantly in price, with a range of US$10-85 per test for the reagents alone.
We know there are significant challenges that limit the impact of investments in viral load and early infant diagnosis testing, including high and variable costs for testing technologies, low utilization of machines, and frequent test malfunctions. Expanding viral load and early infant diagnosis testing can be complex and requires, in addition to the cost of the products, significant investments in infrastructure, transport networks and people.
A 2015 Global Fund tender established framework agreements with diagnostic manufacturers with the aim to bring more transparency and competition to the HIV viral load market.
The Global Fund’s procurement strategy for viral load and early infant diagnosis focuses on both optimizing existing equipment and investments as well as supporting scale-up. The prime focus is to achieve simple, transparent and affordable pricing with optimal contracting models for analyzers and/or reagents for both existing and new investments. The strategy emphasizes maintaining a sustainable, competitive market through:
Our interactive HIV Viral Load and Early Infant Diagnosis Selection and Procurement Information tool provides guidance and clarity for partners procuring these technologies.
The tool is continually updated and covers high-level topics including:
Additional resources are available below to download and access.