The African Institute of Biomedical Science and Technology (AiBST) is a non for profit organization dedicated to biomedical research and development in HIV, TB and Malaria. Its core business also includes capacity building for laboratories with cutting edge biomedical technologies and the training of healthcare professionals.

The objectives of the project are: 1) To train private sector health care professionals (medical doctors, nurses, pharmacists and laboratory technologist) on the effective management of HIV, TB and sexually transmitted infections (STIs). 2) To establish a network of private sector health institutions for effective monitoring and evaluation of HIV&AIDS management.

For FY10 expansion of these objectives include: 1) To take diagnostics to the people in the diagnosis, treatment and monitoring of HIV/AIDS, tuberculosis and malaria. 2) To strengthen the Blood Transfusion Services of Zimbabwe (NBSZ) with laboratory capacity to screen for HIV, HCV, and HBV using nucleic acid tests (NAT). 3) To support the roll out of Early Infant diagnosis throughout the country.

The activities that AiBST implements support the HIV/AIDS National Strategy and Plan through: 1) Ensuring that more HIV positive people get access to laboratory diagnostic and monitoring services. 2) Training of health care professionals, especially from the private sector, in updated ART guidelines for adults and pediatrics. 3) Training of laboratory technologist on Molecular Diagnostic methods. 4) Supporting the National Blood Service Zimbabwe in setting up NAT tests for screening blood and training of its technical staff in running such tests and ensuring that the screening services meets international quality assurance.

Our activities will have a nationwide coverage and target mainly rural populations and Health Care Workers that do not have access to continuous training.

The key contributions of the program to health systems strengthening is in the area of labs where AIBST will be increasing access to lab services to the general population, especially to those in rural areas. Capacity building will be achieved through the training of lab personnel on molecular techniques which is helpful in early infant diagnosis and in the screening of blood.transfusions. Other health care cadres will also be trained on diagnosis, treatment and monitoring of HIV/AIDS in Zimbabwe.

Our activities contribute to the cross-cutting areas of Human Resources for Health as we provide training to private medical personnel, doctors, pharmacists, nurses and laboratory technologists. This is a critical area in Zimbabwe for the provision of HIV/AIDS services as any expansion of activities need sufficient and skilled human resources in place. Among this group, laboratory technologists are a key cadre mainly in the area of Molecular diagnostics as the University of Zimbabwe does not have the equipment or expert tutors to train their students in this area.

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Other activities covered under the program include TB and Malaria as we will be providing microscopic and molecular diagnosis for these two diseases within the mobile services.

Our strategy for cost-efficiency is based on an integrated approach to training, biomedical research and provision of healthcare services within the execution of our project. Our team of experts at the mobile laboratories will also provide training to local clinical and laboratory staff on latest ART and diagnostics guidelines and technologies. The combined trip and use of the same team to achieve two key objectives will translate into significant savings. Simultaneous availability of a wide range of diagnostics and monitoring tests for HIV/AIDS, TB and Malaria cost-free for the patient will be highly cost-effective for our beneficiaries and for the health care delivery system. For the diagnostic services, the project has identified equipment which is relatively affordable and sourced for reagents that are also cost effective. This will go a long way in providing the service to more patients within the given budget. Procurement of reagents and consumables in bulk will be an additional strategy of cost-efficiency.

Monitoring and Evaluation of our activities is going to be done through quarterly progress reports based on a detailed implementation plan that outlines clear deliverables. The mobile laboratory services will be captured through a lab information system: InfCare, that will allow us detailed information on the services provided and characteristics of the patients served. This information will also be shared with the Ministry of Health and Child Welfare. Training of healthcare professionals will be captured through training reports. For laboratory technologists, indicators of the success will be the number of new diagnostic methods set up at the National Microbiology Reference lab, National Blood Service Zimbabwe and other beneficiary labs.

With FY09 Supplemental Funds, AIBST will provide Rapid HIV testing, CD4, Viral loads, HIV DR tests, chemistry and hematological tests, for monitoring of patients on ART through a mobile laboratory that will serve the 10 provinces of Zimbabwe. Additional diagnostics services will cover TB and Malaria. This will be made possible through the procurement of a flow cytometer for CD4 and CD4% testing; a PCR machine for viral load determinations and drug resistance testing; a microscope for TB and Malaria diagnosis; chemistry and hematology automatic analyzers for glucose, creatinine, ALT, AST and FBC among others. Samples for HIV/TB drug resistance testing will be shipped to AiBST Laboratories in Harare where Real Time - PCR and direct sequencing will be used to genotype for known drug resistance mutations. We expect to be able to offer these services to at least 5,000 patients countrywide in the first year after commissioning of the mobile labs.

In FY2010 we will continue and increase the coverage of the mobile lab activities started with the supplemental funds of FY09 and target to reach at least 12,000 patients with these activities.

In addition AIBST will continue the training of health professionals on OI/ART care and monitoring in the 10 provinces of Zimbabwe as previously done with special focus on strengthening the confidence of health care workers in the clinical and laboratory monitoring to identify at early stage patients failing the first line regimen. A series of updated lectures on current and future trends in diagnosis, treatment and monitoring in HIV/AIDS will be given to key medical associations like the Zimbabwe Medical Association (ZIMA), Pharmacist Association of Zimbabwe, Nurses Association, and the Zimbabwean Institute of Medical Laboratory Sciences (ZIMLS).

With FY09 Supplemental Funds, AIBST will provide CD4%, Viral loads, HIV DR tests, chemistry and hematological tests, for monitoring of pediatric patients on ART through a mobile laboratory that will serve the 10 provinces of Zimbabwe. Additional diagnostics services will cover TB and Malaria. This will be made possible through the procurement of a flow cytometer for CD4 and CD4% testing; a PCR machine for viral load determinations and drug resistance testing; a microscope for TB and Malaria diagnosis; chemistry and hematology automatic analyzers for glucose, creatinine, ALT, AST and FBC among others. Samples for HIV/TB drug resistance testing will be shipped to AiBST Laboratories in Harare where Real Time - PCR and direct sequencing will be used to genotype for known drug resistance mutations. We expect to be able to offer these services to at least 1,000 children countrywide In the first year after commissioning of the mobile lab units.

In addition we will do special workshops for health care practitioners in updated ART guidelines for pediatrics strengthening the confidence of clinicians in the initiation of pediatric patients and switch to second line.

In FY2010 we will continue and increase the coverage of the mobile lab activities started with the supplemental funds of FY09 and target to reach at least 2,400 children with these activities.

In addition AIBST will continue the training of health professionals, mainly from the private sector, on OI/ART pediatric care and monitoring in the 10 provinces of Zimbabwe as previously done.

With FY09 Supplemental Funds, AIBST will assist NBSZ to acquire NAT testing technology through the procurement of one RT-PCR machine that will increase the number of units screened from 40 to 80 and reduce the window period for detecting HIV from 22 to 11 days, detection of Hepatitis C Virus (HCV) from 82 to 23 days and detection of Hepatitis B Virus (HBV) from 59 to 34 days; procurement of accessory equipment to implement the new technology; training of laboratory scientists on the new management of the new equipment; revising Standard Operating Procedures (SOP) according to the new testing technology and provision of External Quality Assurance. This activity will be implemented with the goal of getting safer blood at lower prices for the final user.

In FY2010, AIBST will provide operational support services to the National Blood Service Zimbabwe as they scale up the screening of blood and most of the resources will be used in bringing down the cost of blood to the final users through major support in the procurement of test kits and the implementation of other activities that could contribute to this goal.

With FY09 Supplemental Funds, AIBST will set up two mobile laboratory units which will be equipped with a flow cytometer, a centrifuge, a microscope, a chemistry and haematology automatic analyzers and a PCR machine each. The mobile laboratory units will be equipped with Laboratory Information Management Systems (LIMS) for patient data management and to facilitate the consolidation of results for reporting. The mobile laboratory concept will enable AiBST to reach out HIV patients in remote areas where laboratories do not have the capacity to provide adequate diagnostic and monitoring services enabling clinicians at district and rural levels to provide the best care to their patients. The maximum capacity of each mobile laboratory unit is around 10, 000 patients per year based on the fact that each of them will be operating 2 weeks per month in the field while the other 2 weeks they will be at the base for maintenance and re-stock. This schedule will be reassessed after an initial 6 month period of operations.

In FY2010, AIBST will continue and increase the coverage of the mobile laboratory services through higher procurement of reagents. A major addition to the AiBST laboratory will be a DNA Sequencer which will enable AiBST to detect a broader range of drug resistance mutations associated with first line and second line therapy failure. At the same time, the project will support on-site training of laboratory technologists at provincial and district level so that they can optimally utilize the equipment which is being installed at their laboratories by various funding agents.

AIBST will additionally continue the short course training for lab scientists on molecular techniques at the AiBST laboratory minimum 3 times per year. .

With FY09 Supplemental Funds, AIBST will provide direct sputum microscopy and PCR testing for Tuberculosis diagnosis among HIV positive patients through the mobile laboratory units already mentioned. Services will be provided to the 10 provinces of Zimbabwe.

In FY2010, AIBST will continue and expand the activities initiated with FY09 supplemental funding.