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Forecasting the global demand for HIV monitoring and diagnostic tests: A 2016-2021 analysis

Author

Listed:
  • V Habiyambere
  • B Dongmo Nguimfack
  • L Vojnov
  • N Ford
  • J Stover
  • L Hasek
  • P Maggiore
  • D Low-Beer
  • M Pérez Gonzàlez
  • D Edgil
  • J Williams
  • J Kuritsky
  • S Hargreaves
  • T NeSmith

Abstract

Introduction: Despite considerable progress, just over half of the 37 million people eligible to start antiretroviral therapy (ART) have accessed treatment and millions of HIV-positive people still do not know their status. With demand for ART continuing to grow, meeting the ambitious 90-90-90 HIV treatment targets will depend on improved access to high-quality diagnostics to both diagnose infection and monitor treatment adherence in low and middle-income countries (LMICs). Robust projections of future demand for CD4, viral load (VL), HIV early-infant-diagnosis (EID) tests and HIV rapid diagnostic tests (RDTs) are needed as scale-up continues. Methods: We estimate the current coverage for HIV diagnostics and project future demand to 2021 using a consolidated forecast using data on past coverage and current demand from a number of sources, from 130 predominantly LMIC countries. Results: We forecast that the overall number of CD4 tests is expected to decline between now and 2021 as more countries adopt test-and-treat and shift to VL testing for patient monitoring. Our consolidated forecast projects a gradual decline in demand for CD4 tests to 16.6 million by 2021. We anticipate that demand for VL tests will increase to 28.5 million by 2021, reflecting the increasing number of people who will receive ART and the adoption of VL testing for patient monitoring. We expect that the demand for EID tests will grow more rapidly than in past years, driven by the implementation of testing at birth in programmes globally, in line with WHO guideline recommendations, doubling to 2.1 million tests by 2021. Demand for rapid diagnostic tests is also likely to increase, reaching 509 million tests by 2021. Discussion: In order to achieve the ambitious 90-90-90 targets, it will be essential to maintain and improve access to CD4, VL, EID tests and RDTs. These projections provide insight into the global demand we can expect to see for these HIV monitoring and diagnostic tests, both in relation to historical trends, and the 90-90-90 targets. Our projections will better enable producers to ensure adequate supply, and to support procurement organisations in planning future funding and purchase plans to meet the anticipated demand. The findings highlight the ongoing need for governments and international funding bodies to prioritise improving capacity and access to HIV diagnostic and monitoring technologies in line with demand.

Suggested Citation

  • V Habiyambere & B Dongmo Nguimfack & L Vojnov & N Ford & J Stover & L Hasek & P Maggiore & D Low-Beer & M Pérez Gonzàlez & D Edgil & J Williams & J Kuritsky & S Hargreaves & T NeSmith, 2018. "Forecasting the global demand for HIV monitoring and diagnostic tests: A 2016-2021 analysis," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-14, September.
  • Handle: RePEc:plo:pone00:0201341
    DOI: 10.1371/journal.pone.0201341
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    References listed on IDEAS

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    1. Aastha Gupta & Sandeep Juneja & Marco Vitoria & Vincent Habiyambere & Boniface Dongmo Nguimfack & Meg Doherty & Daniel Low-Beer, 2016. "Projected Uptake of New Antiretroviral (ARV) Medicines in Adults in Low- and Middle-Income Countries: A Forecast Analysis 2015-2025," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-18, October.
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    Cited by:

    1. Robert Luo & Jessica Markby & Jilian Sacks & Lara Vojnov, 2019. "Systematic review of the accuracy of plasma preparation tubes for HIV viral load testing," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-10, November.
    2. Sarah J Girdwood & Brooke E Nichols & Crispin Moyo & Thomas Crompton & Dorman Chimhamhiwa & Sydney Rosen, 2019. "Optimizing viral load testing access for the last mile: Geospatial cost model for point of care instrument placement," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-13, August.

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