Global efforts to accomplish targets set against HIV/AIDS could be seriously undermined because of shortfalls in testing, officials from the World Health Organization (WHO) warned in a new report published Tuesday, Aug. 23.

One of the Joint United Nations Program on HIV and AIDS (UNAIDS) targets is for at least 90 percent of all people with HIV/AIDS to become aware of the status of their condition. The targets also include the following: that 90 percent of patients receive antiretroviral therapy (ART), and that 90 percent of those who receive ART achieve lasting viral suppression by 2020. All these targets are connected to the UN's goal of eradicating the HIV/AIDS epidemic by 2030.

However, in a new study, a team of researchers from WHO found that inadequate capacity to perform lab tests that monitor HIV infection, as well as underuse of current testing capacity can seriously limit the ability to reach the UNAIDS targets.

Led by Vincent Habiyambere, WHO experts analyzed responses to annual surveys sent to the organization from 127 countries between 2012 to 2014.

Respondents of the surveys reported on the usage and capacity of CD4 testing, a lab test that counts the number of CD4 cells in a blood sample, HIV viral load (VL) testing and early diagnosis for infants in their respective countries.

Habiyambere and his colleagues found that the capacity of available CD4 instruments were enough to meet the demand irrespective of treatment status. But when it came to the VL capacity to cover needs, it was inadequate.

Even when capacity was sufficient, only 13.7 percent of current CD4 testing and 36.5 percent of current VL testing are used around the world, the report said.

What's more, low-income and middle-income countries, including African countries where HIV prevalent is high, are not ready to tackle the challenge of testing, researchers found.

The study said reasons for the worrying gaps in testing could be the following: lack of reagents, lack of equipment, equipment not being properly maintained, absent or inadequate staff training and machines that are not serviced regularly.

Because of this, Habiyambere and his colleagues urge the formulation of a national laboratory strategic plan to improve services and make them more efficient. Governments and international partners should implement and monitor the strategic plan.

"Strong leadership, resources, planning, and management are needed to scale up laboratory services," the authors wrote in the report.

Details of the new WHO research are published in the journal PLOS Medicine.

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