VN019 A capable team to implement a pilot project on integration of HCV and HIV viral load testing using existing GenExpert system in district health centre

Background

Vietnam is home for nearly one million people living with HCV and 230,000 people living with HIV. The burden of HCV and HIV infection remains an important public health issue in Vietnam. HCV and HBV are the main causes of cirrhosis, liver cancer and liver-related death in Vietnam. Hepatitis is also one of the main causes of death among people living with HIV despite effective antiretroviral therapy. To achieve the goal of the national strategy to end the AIDS epidemic by 2030, Vietnam needs to achieve the 95-95-95 target by 2030, which means that the HIV viral load coverage rate must be at 95%. Currently, HIV viral load testing in Vietnam is centralized at national and regional laboratories. Therefore, specimen transportation from primary health care facilities to these laboratories for testing leads to long turnaround time and delays in clinical management. In addition, there are additional costs for specimen transportation. In addition, reimbursement of viral load testing through centralized testing faces a lot of difficulties. Similarly, HCV viral load testing is not available in all district health facilities and in many provincial hospitals which limit the access to HCV diagnosis and treatment for people in need.

 Vietnam's national TB program has a very good GenExpert system, mainly for the diagnosis of tuberculosis and multidrug-resistant tuberculosis. Currently, with the support of the Global Fund, Vietnam has 231 GenExpert systems located in 155 medical facilities in 63 provinces. The GenExpert system is a point-of-care testing machine operated by trained district health personnel. In recent years, along with the development of technology, the GenExpert system has become a widely used HIV and HCV load testing platform and has been pre-qualified by WHO. Decentralizing viral testing, enhancing laboratory capacity centralization and integrating implementation of HCV and HIV viral load testing on the existing GenExpert system at district health facilities will contribute to increasing the access to HIV and HCV viral load testing, shorten the turnaround time and thereby improving the access to HCV treatment and monitoring HIV treatment.

This pilot on integration of HCV and HIV viral load testing using existing Expert machines is expected to address the current barriers of accessing HIV and HCV viral load testing.  Experiences and lessons earn from this project will provide important evidence to advocate for decentralization and integration of HCV and HIV viral load testing into the existing GenExpert system at district health facilities. 

WHO is calling for 02 capable teams to carry out this pilot project and to document the results as well as lessons learnt from the integration of implementation of HCV and HIV viral load testing on the existing GenExpert system at two district health centre/hospital, one in Hanoi and one in Can Tho.

Address for applications:

Administrative Officer

World Health Organization

UN Building, 304 Kim Ma Street, Hanoi, Viet Nam

Or by email at:

wpvnmdc@who.int