Mission and strategic priorities
To serve as a platform of coordination and communication, providing the required infrastructure, focused on TB laboratory strengthening, in the areas of:
- Global policy guidance on appropriate laboratory technology and best practices
- Laboratory capacity development
- Interface with other laboratory networks to ensure appropriate integration
- Standardized laboratory quality assurance
- Coordination of technical assistance
- Effective knowledge sharing
- Advocacy and resource mobilization
GLI strategic priorities 2009 - 2011:
Development of laboratory norms and standards, including specifications for TB laboratory equipment, laboratory biosafety, standard operating procedures for TB laboratories, policy guidance and technical manuals for first- and second-line drug susceptibility testing, and assessment of evidence for WHO policy recommendations on the use of new TB and MDR-TB diagnostics.
Acceleration of country laboratory strengthening, guided by a GLI Roadmap for country specific strategic plans on TB laboratory strengthening. This generic Roadmap or template for TB laboratory strengthening aims to provide a structured framework for TB laboratory strengthening based on WHO-recommended norms and standards, documented country best-practices and growing lessons learnt from field experiences that can be used to develop a strategic plan for providing reliable TB laboratory services within national laboratory strategic plans.
Prioritization of human resource development and training, including development of comprehensive training and retention strategies, and proposals to train different cadres of laboratory consultants from developing countries:
- Senior TB laboratory consultants who will assist countries with development of National Laboratory Strengthening plans;
- Programmatic TB laboratory consultants who will ensure long-term assistance to laboratory capacity strengthening at country level;
- TB laboratory technicians who will perform day to day routine laboratory investigations.
Partner organizations with an active interest and involvement include the Association of Public Health Laboratories (APHL), the Netherlands Tuberculosis Foundation (KNCV), the US Centers for Disease Control and Prevention (CDC), the International Union Against Tuberculosis and Lung Disease (Union), MSH and WHO.
Laboratory accreditation, involving a task force consisting of international experts and key partners, to develop a consensus strategy and approach to voluntary laboratory accreditation programme for national TB reference laboratories.
Laboratory biosafety, involving a task force to achieve consensus on appropriate biosafety standards for TB laboratories in resource-constrained settings, develop appropriate biosafety manuals, and design a comprehensive training plan and training materials.
Expansion of the Supranational Reference Laboratory Network, to fill existing geographical gaps, to enable SRLs to assume broader laboratory strengthening responsibilities and to meet the demand for expanded global drug resistance surveillance capacity.
Gaps and needs
Assuming universal access to TB culture and drug susceptibility testing (DST), as called for by the World Health Assembly in 2009, estimates based on epidemiological modelling indicate that 60 million culture investigations and five million DST investigations are required annually to meet the diagnostic goals of drug-resistant and HIV-associated TB by 2015, resulting in a current gap of 50 million cultures and 4.5 million DSTs per annum in addition to the almost 120 million microscopy investigations needed annually. Meeting the estimated gap will require at least 5 000 new microscopy laboratories and 2,000 new culture and DST laboratories to be established and more than 20,000 new laboratory technicians to be trained at an estimated minimum investment of USD 6.1 billion up to 2015.