WHO Urges Shift to Low-Cost HIV Tests to Safeguard Life-Saving Services

As global health systems grapple with mounting financial pressures, the World Health Organization (WHO) is calling on countries to adopt low-cost, quality-assured HIV testing methods to ensure continued access to critical prevention and treatment services.

HIV testing remains the essential gateway to both care and prevention. However, with many countries facing economic uncertainty, WHO warns that the global HIV response is at risk unless swift, pragmatic measures are taken to reduce costs without compromising quality.

“The global HIV response and epidemic control is at risk,” said Dr. Meg Doherty, Director of WHO’s Global HIV, Hepatitis and STI Programmes. “We must continue to do everything we can to support countries in delivering life-saving HIV services. Providing countries flexibility and shifting to low-cost, quality-assured HIV rapid tests, dual HIV/syphilis tests, and self-tests will ensure impact, quality, and allow more resources to reach people living with HIV and prevent new infections.”

WHO is recommending that countries revise their national HIV testing algorithms to incorporate low-cost, WHO-prequalified rapid diagnostic tests (RDTs) as the initial screening tool. This applies not only to standard HIV testing but also to dual HIV/syphilis tests used in antenatal care.

“Adopting a high-quality, low-cost first test in national HIV testing strategies can lead to immediate and substantial cost reductions,” WHO noted in its latest guidance. To support this transition, WHO offers a detailed Toolkit to Optimize HIV Testing Algorithms, enabling countries to rapidly integrate cost-effective options into their national programs.

To further expand coverage and reach populations with limited access to health facilities, WHO is also urging the adoption of low-cost, quality-assured HIV self-tests—available in both oral and blood-based formats. These self-tests are especially recommended in settings with a shortage of healthcare workers or where traditional testing services are difficult to maintain.

The recently released 2024 WHO Consolidated Guidelines on Differentiated HIV Testing Services include a new recommendation on facility-based self-testing. The guidelines emphasize flexibility and sustainability, particularly in resource-constrained settings.

To help countries implement these changes swiftly, WHO is offering support in expediting product availability through regulatory waivers and existing national fast-track mechanisms for product approval. A wide selection of WHO-prequalified tests is available, and countries can consult the WHO Diagnostic Catalogue and Product Selection Tool to review their options and customize strategies based on local needs.

“This guidance is only possible thanks to WHO’s Prequalification Programme,” said Dr. Rogerio Gaspar, Director of WHO’s Department of Regulation and Prequalification. “It ensures that quality-assured diagnostics are accessible and affordable for all low- and middle-income countries.”

The Prequalification (PQ) Programme plays a crucial role in assessing HIV diagnostic tools for quality, safety, and performance according to international standards. It ensures that reliable, cost-effective diagnostic solutions reach the frontlines of healthcare, enabling accurate diagnosis, timely treatment, and effective prevention efforts.

With global HIV gains hanging in the balance, WHO’s latest push for cost-effective testing solutions aims to secure the continuity of life-saving services. By shifting to low-cost, prequalified diagnostics, countries can stretch limited resources further—ensuring that people living with HIV remain on treatment, new infections are prevented, and decades of public health progress are preserved.