Summary of process for CD4 and viral load testing. The patient goes to the SCS (solid arrow) to have blood drawn. The specimen is shipped under the cold chain to the central laboratory (CNDR) for CD4 and viral load testing (double-line arrow). Results are communicated (dotted arrow) back to the originating local healthcare department (SILAIS). The SILAIS then communicates the results back to the pertinent ART multidisciplinary team. The SCS, ART multidisciplinary team and ART case management site (gray shading) may or may not reside at the same healthcare facility.