Stop TB Partnership Global Laboratory Initiative Karin Weyer

Stop TB Partnership Global Laboratory Initiative Karin Weyer WHO Stop TB Department

Background • Health systems weaknesses one of the greatest challenges in TB control • Laboratory services one of the weakest links • Lack of diagnostic capacity a crucial barrier preventing an effective response to the challenges of HIV-associated TB and drugresistant TB

Strengthening TB laboratories ‘From unimaginable…to indispensable’

To reach MDG targets, a global capacity need of 120 million smears, 60 mlllion cultures and 6 million DST investigations must be met by 2015, requiring at least 1 billion USD investment in laboratory infrastructure and annual variable cost # of tests required (mln) USD funding required (mln) 200 150 n sio 100 ac ap ed Re ir qu an exp Re d ex quire 2008 on of pansi : from acity e cap r Cultu 2010 0 2500 60 10 to 2012 mln p 2000 1500 1000 a Urgent 50 c ar e m of S 8 20 a MDG Target om fr ity: o 0 t p mln 2015 500

STP-Global Laboratory Initiative • WHA call for universal access to culture and drug susceptibility testing, May 2007 • Critical lack of TB laboratory capacity a global crisis • Paradigm shift required in laboratory policy guidance, coordination, quality management and knowledge creation • STP-GLI endorsed by CB October 2007

STP-GLI components • • Integration of SLCS and SRLN Global policy guidance Laboratory advocacy and resource mobilization Laboratory capacity development and coordination Uniform standards, procedures, specifications Multi-sectoral and disease cross-cutting approach Coordination of technical assistance Effective knowledge sharing

STP-GLI as an active facilitator of communication and provider of global infrastructure services synchronized to be a coherent network service Key STP-GLI activities ~100. 000 smear lab centers 200. 000 -300. 000 personnel ~8. 000 advanced diagnostic centers 40. 000 – 50. 000 personnel Guidance - Laboratory policies - Laboratory manuals - Training materials - Resource mobilization - National roadmap advice 150 National Reference Labs 70 GLI Members Knowledge Sharing - Coordinating TA, training - Communication technologies - Online knowledge resource network WHO GLI Office 7 STP WGs Assurance activities - Coordination of EQA - Equipment specifications - Global accreditation system - Monitoring/evaluation Technical Agencies Other Laboratory Networks Other Diseases Interface Connection - Matchmaking projects between countries and implementing partners - National “roadmaps” - Advocacy - Other disease networks Capacity building (expanding SRLN, building diverse and flexible national, regional, international consultants base, systematic and structured training)

Integrated systems approach Training/Retention CROSSCUTTING STREAMS Strengthen Laboratory Capacity Linked Referral Services Logistics and Commodities Management Facility & Equipment Maintenance Quality Assurance Malaria H I V T B Immunization INTEGRATED SERVICE DELIVERY TIERED LABORATORY SERVICES

Achievements • GLI Core Group* expanded • Technical guidance transitioned from volunteer efforts to structured process of expert review and consensus • Increase in technical working groups • Draft GLI Business Plan • Laboratory resources − SLD-DST Policy Guidance and Technical Manual − Laboratory equipment specifications − Laboratory standard operating procedures − Biosafety Manual • Expansion of WHO Laboratory Team, GLI secretariat * WHO, Union, FIND, CDC, Patient Community, National TB Programmes, Supranational & National TB Reference Laboratories Observers, Liaisons with other Working Groups

Next Steps/Priorities • Refinement of estimates for escalating laboratory capacity under different epidemiological and resource scenarios • Modeling of anticipated impact of new technologies • Finalization of Business Plan priorities, supported by appropriate resource mobilization plan • Prioritization and costing of key activities – Standard-setting – Building laboratory management capacity – Creating conditions for accelerated laboratory strengthening, including private-sector involvement • Joint GLI-Fondation Merieux meeting, 11 -12 April 2008