These funds will be provided to the International Laboratory Branch Partners Consortium in order to

continue the American Society of Microbiologists' (ASM) technical assistance to the Namibia Institute of

Pathology (NIP) to improve TB laboratory capacity. ASM has provided short- and long-term technical

advisors to work alongside NIP staff at the main laboratory in Windhoek to improve their proficiency with TB

diagnostic testing, including on-the-job training on TB-related laboratory equipment and infection control

practices. In 2008, ASM will expand their support to peripheral NIP laboratories and will work alongside

NIP managers and technologists to secure accreditation for NIP's TB laboratory. ASM has worked to

strengthen the TB laboratory at NIP since 2007; these funds were previously reflected in the "Laboratory

Services" program area. These activities leverage ongoing TB expertise and resources from the MoHSS,

the Global Fund, the TB Control Assistance Program (TBCAP), and other organizations.

This is an ongoing activity in FY08. The CDC GAP International Laboratory Branch has established a

consortium consisting of four US partners with laboratory expertise. The partners include the Association of

Public Health Laboratories (APHL), American Society of Clinical Pathology (ASCP), the American Society

for Microbiology (ASM) and the Clinical Laboratory Standards Institute (CLSI). ASM's efforts are reflected

under the HVTB program area as primary areas of focus are tuberculosis smear microscopy, culture and

drug susceptibility testing.

An NIP laboratory training needs assessment was completed in FY06, and recommended workshops and

consultations started during FY07. In FY07, an in-service training Lab Unit was established within NIP to

provide training on new technologies as well as refresher trainings. The ILB partners will continue to provide

assistance to fill the remaining training gaps identified as well play a key role in training the trainers (TOT).

The presenting partner was selected depending on the following priorities that were identified during the

laboratory assessment and continue to be challenges. Priority areas for training and consultation in FY08

are laboratory and leadership management including strategic planning for the national laboratory system

(APHL); training on bio-monitoring assays such as CD4 methods and instrumentation, chemistry and

hematology, development of training resource center (ASCP); preparation for laboratory accreditation,

assessment of the NIP's quality management system practices through an active gap analysis and

effectiveness assessment program, and standardized laboratory methodology and quality assurance

(CLSI). The ILB consortium partners will provide the technical trainings while ITECH manages the logistics

of the trainings to be conducted. Equipments and reagents procurement for the trainings will be covered by

NIP through their cooperative agreement with USG. In FY07, in collaboration with the CDC Office of Global

Health (OGH) Field Epidemiology and Laboratory Training Program (FELTP) and the South African National

Health Laboratory System (SA-NHLS), the GAP International Laboratory Branch (ILB) and TB/OI/HIV

Program Team (T/HP) proposes to establish a TB/HIV/OI Regional Laboratory Training Center in South

Africa with the explicit mission of training and certifying personnel in standardized techniques and promoting

EQA for:TB AFB smear microscopy (for both light and fluorescent microscopy), Establishment of EQA

programs for TB AFB smear microscopy, Mycobacterium culture (using both manual and automated

methods) , First-line drug susceptibility testing (DST), OI/STI diagnosis, HIV Diagnosis and monitoring and

EQA. This regional laboratory training center will be used as appropriate to complement Namibia training

needs.