Summary

Routine viral load testing is the WHO-recommended method for monitoring HIV-infected patients on ART and many countries are rapidly scaling up testing capacity at centralized laboratories. Providing testing access to the most remote populations and facilities (the “last mile”) is especially challenging. Using a geospatial optimization model, this research estimated the incremental costs of accessing the most remote 20% of patients in Zambia by expanding the transportation network required to bring blood samples from ART clinics to centralized laboratories and return results to clinics.