National Institute for Hygiene and Epidemiology (NIHE) supports HIV/AIDS programs through quality HIV surveillance and capacity development activities for epidemiologic studies. Through its HIV Reference Lab, NIHE also supports expanded and improved HIV diagnostic testing. This activity is referenced in the Partnership Framework Implementation Plan (Goal #2: Supporting the provision of sustainable HIV/AIDS Services through strengthening systems; Objective 2.1 c: Improve Lab Systems through improved strategic planning and management).With a focus on quality data, NIHE will monitor HIV prevalence, incidence and behavioral trends among MARPs nationwide and transfer epidemiologic skills to provincial HIV/AIDS centers. NIHEs HIV EQA and IQC services support all confirmatory labs in Vietnam. Support for the development of testing guidelines by MOH also has a national impact.NIHE is a Ministry of Health institution with a well established GVN funding stream. Through capacity development within the national systems, key biologic and behavioral indicators are captured using more resource intensive, PEPFAR-funded surveys that may eventually be replaced by government-owned HIV surveillance systems. NIHE will lead a national surveillance and survey technical working group (TWG) to identify where surveillance is most needed; consolidate efforts among government, donor, and research bodies to limit redundant studies and achieve cost-savings.The cooperative agreement monitoring plan for NIHE includes quarterly partner monitoring visits and bi-annual meetings to review project progress and outcomes. With regard to lab activities, NIHEs HIV serology EQA and IQC programs are ideal monitoring and evaluation tools and will continue to be used to determine areas that need improvement.

The National Institute of Hygiene and Epidemiology (NIHE) is a national level MOH institute and home to the Vietnam HIV Reference Laboratory. The mandate of this laboratory is to support HIV-associated surveillance and diagnostic testing. NIHE provides training on HIV testing, administers an HIV serology EQA program (120 participating labs) and certifies/monitors laboratories to perform confirmatory testing. More recently, NIHE has started to build an associated national IQC program. NIHE will have a key role in development and dissemination of a new national HIV diagnostic algorithm offering same day results (using rapid tests). An extensive HIV test kit evaluation was completed in summer of 2011. The test panel was challenging and representative of clinical specimens; the results indicate that several algorithms with high sensitivity and specificity can be constructed. NIHE is also a resource for Vietnams Ministry of Health (MOH) in setting policy and developing national testing guidelines.

COP12 funding will be used to support the following activities:1. Development of a national HIV testing training package in collaboration with Pasteur Institute in Ho Chi Minh City. This will be built around the new rapid test algorithm.2. Expansion of EQA program to include HIV screening labs, as the current EQA program only supports confirmatory labs but there is a need for all HIV testing sites to participate.3. Full implementation and monitoring of an IQC program for HIV serology testing in HIV laboratories in the northern region of Vietnam.

As the Vietnam HIV/AIDS Surveillance Committee Chair, NIHE will coordinate and conduct surveillance, surveys, and other epidemiologic studies to provide critical data for effective monitoring and responses to the HIV epidemic in Vietnam. Specific activities include:1. Strengthening the national sentinel surveillance system (HSS) through continued training, quality assurance, and widespread use of surveillance data. NIHE has recently completed a pilot integrating behavioral markers into HSS. The integration provides data on injecting and sexual risk behaviors and preventive practices at limited additional cost. Funds will be used to cover the additional costs of collecting behavioral data.2. Size estimation of most at risk populations. NIHE is testing different methodologies and will support and guide up to 10 Provincial AIDS Centers (PACs) in applying appropriate methodologies. NIHE will subcontract with the PACs for data collection in the field.3. Conducting incidence surveillance to obtain new HIV infection rates among most at risk groups. In collaboration with the Ho Chi Minh City Pasteur Institute, CDC GAP Atlanta, and CDC Vietnam, NIHE will conduct incidence surveillance to obtain incidence rates among most at risk groups for measuring the extent to which HIV transmission is occurring and provide evidence of intervention impact. CDC recently supported the validation of two tests for recent infection (TRI) and will apply these assays on stored blood specimens of multiple, existing cross-sectional studies in Vietnam. Funds will be used for specimen collection and training, quality assurance visits, and consumables for laboratory testing.4. Capacity development, in collaboration with the Ho Chi Minh City Pasteur Institute, around second generation surveillance in building technical capacity for all regional institutes and fundamental skills building for PACs, including basic epidemiology courses. Funds will be used for holding workshops to apply epidemiological principles for collecting and interpreting provincial data and for attendance at surveillance workshops and conferences with accepted abstracts.