The MSPP/National public Health Laboratory (NPHL) remains committed to development and strengthening of laboratory networks related to quality assurance, training, testing expansion, and technical assistance. The development and strengthening of laboratory infrastructure collectively address the following 8 objectives: 1) lab capacity building; 2) specimen referral system, 3) cold chain and inventory management, 4) training and workforce development, 5) accreditation, 6) laboratory information system and health management information system, 7) quality management system, and 8) bio-safety and waste management. In FY12, the NPHL will reinforce the capacity of departmental laboratories to assume the role of regional reference public health lab and work toward regional and international accreditation. We will increase technical capacity, fully implement SOPs and biosafety measures, and provide personnel with the capacity to conduct EQA. Fully accredited regional public health lab in the North and the South will improve cost efficiency over time and ease geographical access to high quality laboratory services. It will specifically balance the geographical coverage of diagnostic centers and ensure timely access to accurate and preliminary results at the regional levels, especially in areas of dense rural populations. We are also working at enhancing the ownership of lab activities by local partner institutions, including Ministry of Health (HIV, Malaria, and TB national control programs), Global Fund, universities, and non-governmental organizations (GHESKIO, NASTAD, I-TECH, PIH).

Global Fund / Programmatic Engagement Questions

1. Is the Prime Partner of this mechanism also a Global Fund principal or sub-recipient, and/or does this mechanism support Global Fund grant implementation? Yes2. Is this partner also a Global Fund principal or sub-recipient? Sub Recipient3. What activities does this partner undertake to support global fund implementation or governance?(No data provided.)

Specific activities include the continuation of efforts to strengthen facilities to support HIV/AIDS-related activities at regional/department level such as providing training support in clinical testing (i.e. chemistry, hematology, and CD4, phlebotomy). This will target all existing 86 care and treatment sites, and include equipment set-up and maintenance on FacsCount, Sysmex, Reflotron, Vitros, and basic small equipment. We will also provide for quality assurance programs on HIV & syphilis rapid tests (159 sites); malaria microscopy and RDT (40 sites).During the last fiscal year, the implementation of an efficient specimen referral network to support HIV care and treatment and the laboratory surveillance system was initiated and Technical assistance for specimen transport for CD4 and TB testing provided. During FY 2012, The National Public Health Laboratory (NPHL), through collaboration with other stakeholders will ensure that all 86 HIV care and treatment sites are linked to centers with automated testing capacity for CD4.In collaboration with ASM, the NPHL will provide training support to implement TB Fluorescent Microscopy at 20 sites. Also, over the next 18 to 24 months, we will work with ASCP to strengthen our technical capacity to meet regional and international requirements for a public health laboratory accreditation process. In addition two departmental laboratories, HIC (Les Cayes) and HUJ (Cap Haitien), will be strengthened and capacitated to function as Regional Laboratories or Tier 3 laboratories.The NPHL will reinforce its collaboration with the supply chain management system to assist laboratories supported through PEPFAR in supply chain management.Another major line of activities will consist of strengthening the National Lab at the central level to support HIV/AIDS-related activities. This effort will include: 1) TB permanent lab BSL-3 renovations; 2) training of 6 TB staff on culture and DST, and 2 new TB techs hires; 3) implementation of TB culture and DST; 4) increase of service testing menu with viral load testing; 5) provision of tools and resources to establish and operate a specimen referral network; provision of microbiology professorship courses to 25 medical students and post-docs; 6) strengthening of data management capacity; 7) TB technician training for TB culture and DST lab with Massachusetts Supranational TB Reference laboratory; and 8) the implementation of surveillance activities for TB drug resistance in the West department (30 sites).

This effort is aimed building institutional capacity for laboratory-based surveillance in order to establish a national system at the central level (National Lab and DELR) as related to laboratory data analyses and surveillance. The operational objectives of this program are: 1) to conduct field and laboratory surveillance on human infectious diseases with empahsis on V. cholerae, Salmonella and Shigella sp diarheal diseases, respiratory infection diseases, and acute febrile illness; and 2) to incorporate the resutls of surveillance into disease prevention and national control programs and build into program monitoring system.Actvities will seek to expand central capacity (National Lab and DELR) for implementation of laboratory-based surveillance in specimen collection, laboratory testing and data analysis, and surveillance and monitoring information. The system should be be web-based to ease integration/interface with existing data collection and management sources. This will include support for additional technicians, national and international training, lab reagents and supplies, and equipment. Data management training will be provided to develop standards for data collection, data base, data linkage, analysis, and dissimination. Support for surveillance transport logistics of team members and specimens will also be covered. At the regional level, support will be provided for on-site surveillance coordinators, training workshops, and laboratory supplies in an effort to set up and strengthen 4 health centres in the Ouest Department.