Plus-up: The main component of this activity is to support the MoH in efforts to provide adequate, safe and quality laboratory services for the diagnosis of TB. Technical assistance will be provided in the specific technical areas of the renovation of the National TB reference laboratory, training of laboratory personnel (20) on TB laboratory practice and safety as well as assisting MoH in establishing and maintaining a relationship with a routine quality control syetm with an external body for routine quality control assessments and interventions. In addition funding will be given to hire a data manager to strengthen M&E initiatives at the National Reference Laboratory.

Original COP: This activity is related to activity number 8540, and responds to the strengthening of microbiology and TB laboratory units to improve the quality of services offered for diagnosis of opportunistic infections, including TB, in health settings.

Using the recently completed training curriculum developed jointly by WHO/CDC/APHL/IUATLD, APHL will work with the relevant officers within the TB department of the Ministry of Health (MoH), and with CDC and USAID to adapt the training material to Mozambique needs (translation to Portuguese and other modifications as needed). APHL will work with MoH to present training workshops for instructors selected by MoH so as to develop a pool of local trainers for roll-out of this training.

APHL will also identify equipment and related supply needs for the training program and provide these items to designated training laboratories, which may be specially designated rooms, existing laboratories with appropriate space or other appropriate locations. Using the experience from the instructors training program, APHL in consultation with CDC and USAID will assist MOH in developing a training schedule, presenting trainings, evaluating the training program and certifying the proficiency of technicians who are trained in the program.

Finally, APHL will provide technical assistance if needed to develop and implement quality control and an EQA program for the TB laboratories.

Through this assistance, 100 laboratory personnel will be trained through this program.

This activity is related to activity number 8540, 8546 and 9254 as well as treatment activities: 8545, 8593, 8547 and 9160.

The main components of this activity are to support the Mozambique Ministry of Health (MoH) in its efforts to provide adequate capacity of quality laboratory testing services for HIV/AIDS diagnosis and ARV treatment by providing technical assistance and support in the following areas:

1) Rental-Reagent Contracts: Manage reagent rental contracts for instruments and essential laboratory reagents for CD4, hematology and biochemistry testing for treatment sites at all levels of the MoH laboratory system (includes all Emergency Plan partner supported laboratories). Plan and implement transition of reagent rental contracts to the Supply Chain management System (SCMS) efficiently to assure uninterrupted availability of reagents. This will include providing technical assistance to SCMS to assure the effectiveness and efficiency of the system for providing essential reagents and instruments to laboratories to support quality testing at all levels of the health care system.

APHL will also provide specific support for the Military and Police services in Mozambique in collaboration with the US Department of Defense and procure 2 hematology analyzers and 1 CD4 instrument including reagents needed for ARV treatment facilities in the Military and police services.

2) Laboratory training centers: Provide technical assistance and coordinate planning, development and implementation of in-service and pre-service training; integrate training activities with those being implemented by the Federal university of Rio de Janeiro and other groups for laboratory technician mentoring program; provide assistance to CDC-Mozambique in identifying laboratory partners (APHL, American Society of Clinical Pathology-ASCP, American Society for Microbiology-ASM, and Clinical and Laboratory Standards Institute-CLSI) to provide curriculum development, training center renovation and equipping and faculty to support laboratory technician training.

3) National Specimen Referral System: Provide technical assistance for the planning and development of a coordinated national specimen referral and transport system that incorporates existing partner transport systems, standardizes specimen identification, tracks specimens, provides timely delivery of specimens to referral laboratory services, and provides access to testing to all levels of the health care system.

4) Rapid testing site deployment. Provide start-up technical assistance to new laboratory sites to assure rapid initiation of quality testing, identify training needs and assure communication link to technical assistance.

5) Laboratory information system (LIS): Implement the LIS developed in FY06 to all laboratories providing ARV testing support including purchase of hardware, installation of the LIS, user training, and maintenance, help desk support and training centers

7) Strategic Planning: Provide technical assistance for development and implementation of strategic and implementation plans: The strategic plan will be developed for each tier of laboratory and describes minimal requirements needed to effectively support programs. Support will include provision of technical assistance to the MoH for the development of a strategic plan that incorporates the national objectives and strategies and defines what and how activities will be implemented to develop a national laboratory network. Senior laboratory directors will also work with the MoH to support national planning and implementation activities.

7) QA/QC and Safety Training in lab sites: Provide laboratory management, QA/QC and safety training for laboratories. Provide training to improve laboratory management skills and practices including laboratory facility infrastructure improvement and equipment validation, operation and maintenance, supply management within the laboratory, quality control including SOPs, and safety practices.

8) Support QA centrally: APHL will provide sub grant to the National Institute of Health in the MoH to support Implementation of Laboratory Quality Assurance through; a) training of six Mozambican technical staff at the National immunology reference laboratory and

HIV serology reference laboratory to oversee and provide supervision of the CD4 T cell and HIV serology quality assurance programs respectively b) Procurement and distribution of proficiency panels for the quality assurance programs c) provision of continuous training of laboratory staff in participating laboratories and d) perform DNA PCR for infant diagnosis of HIV, conduct viral load testing and resistance monitoring.

9) Lab coordination: Participate in project meetings, provide regular reports and communication and participate in CDC/GAP Laboratory Consortium. Attend CDC-Mozambique laboratory meetings; participate in laboratory workgroup conference calls with CDC-Mozambique and CDC/GAP Atlanta; and participate in laboratory consortium conference calls and meetings. Provide reports of activities as required for the CDC agreement and frequently to inform CDC and partners of activities.