This evaluation of the viral load (VL) monitoring system was commissioned in order to more fully understand the experience and outcomes of the introduction and scale-up of VL in one district of Zimbabwe but also undertaken with a view to the national scale-up of VL monitoring, and the general issue of VL monitoring in sub-Saharan Africa in light of the UNAIDS 90-90-90 targets. The report details five clear recommendations to reach undetectable viral load.