Laboratory Technical Assistance Service Providers

The Global Fund 2023-2028 Strategy, entitled “Fighting Pandemics and Building a Healthier and More Equitable World” includes four mutually reinforcing contributory objectives which underpin the Global Fund’s Goal to end AIDS, TB and Malaria:

1. Maximizing people-centered systems for health to deliver impact, resilience and sustainability
2. Maximizing the engagement and leadership of most affected communities to leave no one behind
3. Maximizing health equity, gender equality and human rights
4. Mobilizing increased resources

These objectives are complemented by an additional evolving objective: contribute to pandemic preparedness and response. To maximize impact of these investment areas at country level, the Global Fund is committed to maximizing impact of investments and supporting countries to eliminate implementation bottlenecks. Supporting efficient and reliable health laboratory services traverses all five of these contributory and evolving objectives, with resilient, integrated laboratory systems forming the foundation of health systems in all countries.

Laboratory services are an essential component of any resilient health system and are central to achieving the core mission of the Global Fund. Laboratory diagnostic and monitoring capacity is critical towards achieving the global targets for Human Immuno-Deficiency Virus (HIV), Tuberculosis (TB) and Malaria control. Global Fund is investing significantly in laboratory services -approximately 11.5% of total grants in the last funding cycle with a significant proportion of this investment dedicated to laboratory equipment.

However, much of this investment in laboratory equipment has not been optimal with low equipment utilization rates, high cost per test, limited or no maintenance of equipment, limited access to and poor quality of testing. Improving utilization is crucial to a cost-effective system as the cost per test decreases with higher testing volume. Additionally, with the introduction of newer innovations like point of care technology, there is a need to understand how best to maximize and optimize their use within the entire laboratory network. In order to address these challenges, multiple countries have sought to address the root causes of many of these barriers from a broader, systems-wide approach, known as laboratory network optimization.

Gaps in laboratory systems and inadequate diagnostic capacities present some of the most intractable and complex barriers to achieving disease-specific targets for HTM. Inefficiencies in laboratory operations and systems are multi-factorial, arising from weaknesses at all levels of governance/leadership, management, infrastructure and operations. To date, there has been limited involvement of national laboratory leadership in grant development and the life-cycle of global fund country allocations, which may lead to poor alignment between interventions and NLSPs and exacerbate the already limited visibility and limited domestic investments for lab systems and services.