HIV prevalence in Malawi is high and has for the past five years stabilised at a high level of 14.6% with women being more infected than men and urban areas having HIV prevalence as high as 22.8%. HIV/AIDS continues to unleash severe impact on individuals, households and communities through high morbidity and mortality1. The National HIV/AIDS Action Framework [2005-2009] has put in place intensive efforts to bring down HIV prevalence and to scale-up treatment and care of people living with HIV. HIV Testing and Counselling is part of a comprehensive package of HIV prevention, care and treatment and a critical entry to accessing ARVs, treatment of opportunistic infections and prophylactic treatment to prevent vertical transmission from mother to child.

This 5 year HIV Testing and Counselling Scale Up Plan [2006-2010] is a planning tool setting out the framework and strategies within which HIV testing and counselling services will be scaled up. This plan has formulated eight strategies that if realised, could lead to over four million Malawians being tested for HIV from 2006 to 2010. The eight strategies are: 1. Enhancing equitable access to HIV Testing and Counselling by all Malawians

1. Scale Up Provision of HIV Testing and Counselling services

2. Strengthen Quality of HIV Testing and Counselling Services

3. Development of Human Resource Capacity for delivery of HIV Testing Services

4. Creation of Demand for HIV Testing Services

5. Development and Dissemination of HIV Testing and Counselling Resource Materials

6. Operational Research

7. Exchange of Experiences

There is a huge potential to scale up HIV Testing services in the health sector through integrating HIV Testing in all health care facilities. There is a further huge potential for NGOs and CBOs to introduce HIV testing and counselling either as a stand alone activity or integrated in their current HIV prevention and mitigation interventions. Workplace HIV/AIDS programmes, including government ministries as well as large private corporate organisations will be encouraged and supported to develop HIV testing services.

This plan is setting a target of 55% of all health facilities integrating HIV testing services by the end of 2007, and by 2010, 94% of all health facilities will have integrated HIV Testing services. As HIV Testing services are introduced in all health facilities, all patients will be offered and provided with HIV testing and counselling to facilitate their immediate referral for ARVs and treatment of opportunistic infections, etc.

Mobile and Outreach HIV Testing services will be introduced and it is planned that each DHO will have at least one Mobile HIV Testing Unit that will provide HIV Testing Services to communities that find it difficult to access HIV Testing provided by health care institutions or other NGOs.

The promotion and marketing of HIV Testing will be strengthened through introducing HIV Testing days in the annual calendar. During these days, there will be intense social marketing and promotion of HIV Testing through electronic and print media, drama and involvement of traditional authorities at community level. Printing of posters, pamphlets and drama will continue to inform members of the public and specific vulnerable groups on the benefits of HIV Testing.