Global Laboratory Initiative (GLI)

background

Mrs Eman Lottfi preparing DST (Egypt)

Lack of diagnostic capacity is a crucial barrier preventing an effective response to the challenges of TB-HIV and drug-resistant TB, with less than 5% of the estimated burden of MDR-TB patients currently being detected. Gap analyses, using estimation models and projections based on a variety of epidemiological and programmatic assumptions, all confirmed that an effective response to the diagnostic challenges of TB-HIV and MDR-TB requires urgent and massive scale-up of laboratory services. Stop TB Partnership Working Groups, technical expert bodies, and international research and donor agencies also agree that the critical lack of TB laboratory capacity constitutes a global crisis, requiring a paradigm shift in providing laboratory policy guidance, quality assurance and knowledge creation within a global and integrated laboratory network.

In 2002, recognizing the pressing need for improved TB laboratory services, the DOTS Expansion Working Group (DEWG) of the Stop TB Partnership (STP) established a Subgroup on Laboratory Capacity Strengthening (SLCS), comprising mainly of the directors of the Supranational Reference Laboratory Network (SRLN), heads of National TB Reference Laboratories (NRLs) and STP representatives. In January 2007, the SLCS established a Core Group (CG) of international TB laboratory experts to accelerate activities and set the strategic direction for laboratory capacity strengthening. Over subsequent months, the CG worked on a draft business plan, estimating the projected needs in scaling up TB laboratory services and outlining current resource gaps.

Global Laboratory Initiative (GLI)

In order to reach universal access to quality-assured TB diagnostic services by 2015, a strategic plan and roadmap to guide the massive scale-up of laboratory services is an essential first step in effectively addressing the diagnostic challenges of TB, notably HIV-associated and drug-resistant TB.

To maximize the activities of the SLCS and the SRLN, and optimize the network of Stop TB partners involved in laboratory strengthening, a Global Laboratory Initiative (GLI) was proposed to and endorsed by the STP Coordinating Board in October 2007. The GLI provides a focus for TB within the framework of a multi-faceted yet integrated approach to laboratory capacity strengthening through a network of partners.

The GLI Secretariat is hosted in the Stop TB Department at the World Health Organization (WHO) in Geneva, Switzerland and works closely with National TB Programmes, nongovernmental organizations, technical and financial partners, and WHO offices at country and regional levels, in strengthening TB laboratory services.

Components of the GLI include:

• Global policy guidance on appropriate laboratory technology and best practices
• Laboratory advocacy and resource mobilization
• Laboratory capacity development and coordination
• Interface design with other laboratory networks to ensure appropriate integration
• Standardized laboratory quality assurance
• Coordination of technical assistance
• Effective knowledge sharing