TRACnet is an mHealth system that has been supporting the national HIV/AIDS program of Rwanda since 2004 with funding and technical support from the US Centers for Disease Control. The longest continuously operating national mHealth system in Africa, TRACnet was built by Voxiva for and with the Government of Rwanda and the Center for Treatment and Research on AIDS, Malaria, Tuberculosis and Other Epidemic diseases (TRAC Plus). Today, more than 350 facilities offering ART, VCT and PMTCT submit monthly program indicators and receive lab results using the web or mobile phones. 91% of routine reports use mobile phones to report; the rest use the Internet. Using Rwanda's burgeoning mobile infrastructure, TRACnet has achieved 67 months of continuous nationwide routine reporting of data on ART care since 2004. In addition, more than 100 000 patients on care and treatment have been registered. The system includes >8000 reports submitted, >98% reporting rate, 1200 users, >100 000 patients registered The Ministry of Health and TRACPlus are also extending the system to incorporate integrated disease surveillance and response. Voxiva has an active partnership with MTN which is providing a national toll-free line to TRACnet, GPRS SIM cards and free access for users. Data collected by TRACnet is used for a variety of purposes, for example: to monitor program expansion and progress; drive performance-based incentive payments to health center; deliver lab results to facilitate early infant diagnosis; and provide donor reporting. Sustainability is a major focus of the TRACnet program. An innovative framework that addresses all components of operating and maintaining a national enterprise system guides capacity building efforts in collaboration with Rwanda's School of Public Health. This abstracts presents the experience of 6 years of continuous operation of an mHealth solution at national scale.