Evaluation summary – EVAMAD project: strengthening access to, demand for and quality of HIV care in Madagascar

The EVAMAD project aimed to improve the quality of viral load monitoring for people living with HIV across Madagascar, and thus contribute to strengthening the Malagasy health system, notably by expanding routine access to HIV viral load testing. EVAMAD laid essential foundations for access to HIV viral load testing and early infant diagnosis in Madagascar, drawing on the Charles Mérieux Infectiology Centre and national logistics chains.
Despite significant obstacles — the impact of Covid-19, changes in the national laboratory strategy and limited coverage of emergency diagnostics — the project helped create sustained demand for virological testing, establish quality standards and transfer skills to the national laboratory.
The evaluation highlights the relevance and technical quality of the activities carried out, while also pointing to limitations in strategic alignment and sustainability. The gains now serve as a foundation for defining a national roadmap and guiding funding priorities to expand and stabilise access to viral load testing and early diagnosis for HIV-exposed infants.