Supporting National TB Reference Laboratories and surveys in Africa – Supra-National TB Reference Laboratory

The CTB has recently been successfully evaluated for its reference laboratory potential, resulting in it being awarded the responsibility to function as the 3^rd Supra-National Reference Laboratory of the WHO on the African continent. As part of this function, it provides technical support to two national reference laboratories in Africa, namely those in Malawi and Namibia. Progressive missions to improve quality management systems for laboratory testing, as well as programme initiatives towards TB surveillance activities, have been performed in these countries. In addition, the Centre provided reference laboratory support to the Malawi Prevalence Survey and the Namibia Drug Resistance Survey for both quality assurance and second-line DST. An expanded approach, aiming to assess the proficiency of nine of the 22 highest burden TB national reference laboratories in Africa on culture identification and DST, has been recently initiated through WHO-AFRO. Although the performance of countries in the first round was sub-optimal for several countries, feedback and further provision of quality-related support has resulted in an overall improvement in the quality of results generated by these laboratories. These developments have been important and have shown the great value of the support functions conducted by CTB.