The Laboratory Branch Consortium includes a group of international organizations with expertise in various

aspects of laboratory capacity development. FY 2009 funds were temporarily placed in the CDC,

International Laboratory Branch Consortium pending the identification of appropriate implementing partners.

This action will re-program funds from the Laboratory Branch Consortium to one of the partners, Clinical

and Laboratory Standards Institute (CLSI), to carry out activities that will improve laboratory practices in

Vietnam.

The International Laboratory Branch Consortium activity narrative that refers directly to CLSI remains the

same.

This is a continuing activity from FY 2008.

The Laboratory Coalition is a loosely-knit group of international organizations with expertise in various

aspects of laboratory capacity development. The coalition members include the Association of Public Health

Laboratories (APHL), the American Society for Clinical Pathology (ASCP), the American Society for

Microbiology (ASM), and the Clinical and Laboratory Standards Institute (CLSI). All have worked closely in

various PEPFAR-supported countries over the past five years. This activity narrative explains projects and

activities planned for ASCP, ASM, and CLSI; an explanation of the activities can be found in the APHL

narrative. In FY09, laboratory coalition partners will support curriculum development, provide technical

assistance (TA) for the development of a national laboratory accreditation program, and will assess and

make recommendations for improvements to TB culture practices.

ASCP is focused on improving global health by exploring, identifying, and implementing innovative methods

and partnerships that improve laboratory practices. ASCP staff and volunteers provide technical assistance

and build laboratory infrastructure in countries affected by HIV/AIDS. Over the past five years, ASCP has

developed modular, five-day training packages for CD4 determination, clinical chemistry, and hematology.

Training packages consist of lectures (Power Point presentations), a participant's manual, participant

supplementary materials (i.e., procedures, atlases, job aids), an instructor's manual, an instructor's guide

with support notes, and an electronic copy of the training package (CD-ROM). Hands-on instrument training

is coordinated by ASCP through in-country vendors. Packages have been extensively field tested in various

countries by a cadre of skilled trainers. In FY08, ASCP will conduct a review of the current training curricula

in these three areas and will adapt their training packages to the Vietnam setting. In FY09, ASCP will deliver

the training curriculum to a targeted audience, who will serve as future master trainers and disseminate the

training to sites where care and treatment monitoring is currently provided.

In FY09, ASCP will also work towards improving the quality of training provided to students attending

medical laboratory degree programs in Vietnam through a program known as Pre-Service Curriculum

Development. The ASCP Pre-Service Work Group is comprised of educators from seven universities and

schools of medical technology. This is a 24-month, two-phase program. The first phase includes the

assessment of current training materials, a curriculum development workshop to be attended by key faculty

members and school deans, 700 hours of professional curriculum development by U.S.-based university

partners, and a curriculum finalization workshop attended by key stakeholders, faculty, and school directors.

The second phase includes a monitoring and evaluation activity (observing new materials being taught), an

additional 300 hours of professional curriculum development/finalization by the ASCP, and a two-month

mentorship with ASCP consultants.

The American Society for Microbiology is the world's largest and oldest scientific society of individuals

interested in the microbiological sciences. The Society's mission is to advance microbiological sciences

through the pursuit of scientific knowledge and dissemination of the results of fundamental and applied

research. ASM has more than 43,000 members worldwide (more than 5,000 of these are clinical

microbiologists); the members represent 26 disciplines of microbiological specialization, including a division

for microbiology educators. ASM, via its International Laboratory Capacity Building Program, supports

global health programs by ensuring that laboratories possess the necessary organizational and technical

infrastructure to provide quality laboratory testing and results in support of infectious disease prevention,

care, and treatment. Since 2006, ASM has worked closely with the CDC Global AIDS Program and

PEPFAR by providing onsite technical assistance and training through carefully chosen experts from their

membership roles. ASM's activities specifically include improving the quality and capacity of infectious

disease diagnosis by training and mentoring local laboratorians on implementing newer technologies and

optimizing quality-assured laboratory testing procedures. ASM is currently supporting: PEPFAR programs in

Botswana, Côte d'Ivoire, Haiti, Kenya, Mozambique, Namibia, Nigeria, and Zambia; CDC International

Emerging Infections programs in Guatemala, Thailand, Kenya, and China; and workshops for the African

Centre for Integrated Laboratory Training in South Africa .

In FY09, ASM will provide TA to improve the following diagnostic training programs: Bach Mai Hospital in

Hanoi for opportunistic infections (OI), the National Institute for Dermatology and Venereology (NIDV) for

sexually transmitted infections, and the National TB Hospital for TB. ASM will conduct initial assessments of

current diagnostic testing capacities and training programs. To update the AFB smear microscopy training

package, ASM will use the recently published WHO/CDC generic package as a resource. For distribution of

new packages, ASM will develop master trainers from the existing facility staff. To ensure TB liquid culture

is conducted in Vietnam at an internationally accepted standard, ASM will conduct assessments of the

culture laboratory at the National TB Hospital and Pham Ngoc Thach Hospital. These will be used to make

recommendations to ensure liquid culture is conducted in a way that is safe for both the laboratory staff and

the environment. This might include training, infrastructure improvements, and/or procurement of new

equipment.

The Clinical and Laboratory Standards Institute is a global, nonprofit, standards-developing organization

that identifies best practices, voluntary consensus standards, and guidelines through a unique consensus

process that balances the viewpoints of government, industry, and health professions. CLSI documents

"best practices", which are used in over 55 countries worldwide, and are translated into several languages.

Good laboratory practices prove to be cost-effective, promote reliable and accurate results, contribute to

Activity Narrative: good patient care, and promote a positive attitude towards testing from a patient's perspective. Guided by

our membership and accepted clinical and laboratory standards and guidelines, CLSI is committed to

facilitating the development of quality systems in the laboratory and providing on-going advisement to

sustain quality improvements. CLSI will build capacity through the provision of laboratory standards and

guidelines, and provide technical assistance, training, and technology transfer to individuals and

organizations. CLSI is currently involved in building laboratory capacity in Namibia, Nigeria, Ethiopia, Cote

D'Ivoire, and Tanzania.

One objective of the PEPFAR laboratory program is to enhance the overall quality of laboratory testing in

health care and public health laboratories across Vietnam. In FY09, CLSI will provide technical assistance

to Vietnam's Ministry of Health's Department of Medical Administration (DMA) to develop a national

program for laboratory accreditation. This program does not currently exist in Vietnam, but will be clearly

outlined in the National Laboratory Strategic Plan (NLSP), currently under development with PEPFAR

support.

New/Continuing Activity: New Activity

Continuing Activity:

Table 3.3.16: