HIV diagnostic tests in low- and middle-income countries: forecasts of global demand for 2021–2025

Overview

This report provides projections of the future demand for HIV diagnostic tests through 2025. The projections will  enable efficient planning by manufacturers and procurement organizations in securing and ensuring funding for production and supply security.  

The projections are based on country reports to the Global AIDS Monitoring system, purchases reported to the Global Price Reporting Mechanism, and forecasts and historical testing volumes of high burden countries. 

The main results are: 

• Rapid diagnostic tests. Demand for rapid diagnostic tests may be nearing saturation. The market may still grow over the next 6 years but at a slow rate. 
• HIV self-testing is likely to have a larger role in determining the need for treatment (and prevention) interventions. 
• Viral load. Demand for viral load tests continues to grow rapidly and could reach nearly 30 million by 2024 as more countries adopt viral load testing for routine monitoring that may be further enabled by the use of viral load point-of-care technologies and dried blood spots.
• CD4 tests. Conversely, demand for CD4 tests for routine monitoring is declining since most countries have adopted routine viral load testing for treatment monitoring. However, there will continue to be a need for everyone starting treatment to receive CD4 testing to identify people with advanced HIV disease. Additionally, CD4 for routine monitoring will be needed for people with limited access to viral load testing 
• Early infant diagnosis tests: Demand for early infant diagnosis tests will likely grow as point of care testing continues to scale up, and countries adopt nucleic acid testing at 9 months per the WHO’s guidelines.