“APHN has demonstrated strong capacity to expand equitable access to essential laboratory diagnostics by embedding testing, result return, and utilization within integrated community–health facility service delivery models. As a predominantly community-based partner with strong linkages to public health facilities, APHN operates at the interface between communities and the formal health system, ensuring that diagnostic services reach priority populations and directly inform timely case management and treatment outcomes. Across Africa CDC– and PEPFAR/USAID–funded programs, and more recently U.S. Department of State–supported activities in Namibia and Malawi, APHN has strengthened access to HIV testing services (HTS), early infant diagnosis (EID), viral load (VL) monitoring, sexually transmitted infections (STI) screening, and COVID-19 testing for vulnerable populations.
Under the REACH I activity in Namibia (2023–2025), APHN contributed to progress toward the UNAIDS 95-95-95 targets across 13 districts through programming for orphans and vulnerable children (OVC). Ninety-seven percent of OVC had a documented HIV status, and VL suppression among children and adolescents living with HIV (CALHIV) reached approximately 96% (VL <1,000 copies/mL), exceeding national pediatric suppression estimates. APHN addressed barriers to VL testing in remote settings through coordinated community outreach, specimen referral, and collaboration with multisectoral stakeholders to ensure continuity between testing and clinical action. APHN also strengthened syndromic management of STI for adolescent girls and young women (AGYW) through combined community and facility-based platforms and strengthened point-of-care syphilis testing within antenatal care services.
APHN’s capacity to support diagnostic access at scale was further demonstrated through its role in the COVID-19 response in Namibia. During the pandemic, APHN supported the Government of the Republic of Namibia (GRN) to expand access to SARS-CoV-2 testing through community-based screening, referral, and linkage to public laboratories for confirmatory testing. APHN contributed to risk communication and demand creation, supported specimen referral and result dissemination, and strengthened infection prevention and control practices at both community and facility levels, demonstrating the ability to adapt diagnostic delivery systems in emergency contexts.
In Malawi, APHN’s Ana ndi Achinyamata Patsogolo (ANAPA), means Children and Youth First, project further illustrates its strength to expand access to laboratory services. By the end of FY25, APHN supported communities within the catchment areas of 142 health facilities, reaching 55,862 program participants with lifesaving HIV services. Among 10,420 children living with HIV enrolled in ANAPA, 99% of those eligible received VL testing, and 77% achieved viral suppression, despite the intentional enrolment of CALHIV with high baseline VL. APHN also facilitated EID for 6,933 HIV-exposed infants, achieving a vertical transmission rate of 0.29%, well below the national average of 6.7% and within global eMTCT targets.
APHN’s model explicitly links diagnostics to last-mile service delivery and follow-up. Community care workers, social workers, and healthcare professionals facilitate transportation support, specimen referral, appointment reminders, result tracking, and intensified follow-up for clients with actionable or clinically significant laboratory results. In Malawi, this approach included 1,558 multisectoral case conferences for children with high VL and the successful tracing and return to care of 82% of children experiencing treatment interruption, demonstrating effective use of laboratory data to guide clinical escalation, adherence support, and retention in care.
In addition, APHN has demonstrated readiness to support diagnostic innovation and health system strengthening. Prior to the PEPFAR stop-work order, APHN was collaborating with the GRN to pilot a demonstration project assessing the feasibility of leveraging GeneXpert platforms for molecular STI diagnostics, addressing limitations associated with syndromic management. Across both Namibia and Malawi programs, APHN strengthened laboratory data integration within project information systems, improving documentation, turnaround time monitoring, and data use for case management and clinical decision-making, while working closely with ministries of health to support sustainable, government-led scale-up of diagnostic services.