AFENET Laboratory Strengthening
Overview
This report provides an expanded summary of laboratory strengthening achievements implemented by the African Field Epidemiology Network (AFENET) under CDC/PEPFAR support. The content is synthesized from submitted Annual Performance Reports and organized by year for publication on the AFENET website and use by partners and stakeholders.
During this foundational period, AFENET launched the AFENET-Lab initiative to support HIV-related laboratory networks and partnerships in PEPFAR-supported countries. The focus was on introducing innovative approaches to capacity building, mentorship, and continuous quality improvement.
Key achievements included:
- Introduction of Project ECHO® to strengthen HIV Rapid Test Quality Improvement (RTCQI) through virtual mentorship and peer learning platforms in Uganda, Malawi, and Tanzania.
- Implementation of TB diagnostic Continuous Quality Improvement (CQI) initiatives aimed at improving clinic–laboratory interfaces and strengthening the TB diagnostic cascade.
- Development of electronic laboratory equipment tracking tools to monitor equipment location, functionality, calibration status, and maintenance needs.
- Strengthening of laboratory workforce capacity through structured trainings, mentorship, and remote technical assistance models.
This phase laid the groundwork for scalable laboratory strengthening interventions across multiple regions.
Download pdf: Annual performance report 2019
In this phase, AFENET expanded laboratory strengthening activities to the Caribbean region, while continuing support in Africa. The emphasis was on viral load scale-up, laboratory quality management systems, and accreditation readiness.
Key achievements included:
- Support for HIV Viral Load (VL) and Early Infant Diagnosis (EID) scale-up through improved sample referral systems, procurement of laboratory supplies, and targeted mentorship at testing and referral laboratories.
- Expansion of Laboratory Information Systems (LIS) in Jamaica and initiation of LIS integration activities in Trinidad and Tobago to improve result turnaround times and data visibility.
- Implementation of External Quality Assessment (EQA) and Proficiency Testing (PT) programs for HIV VL, EID, TB diagnostics, and HIV rapid testing.
- Provision of LQMS-SIP assessments and mentorship toward ISO 15189 accreditation, including follow-up on corrective actions.
- Strengthening of biosafety, waste management, and equipment maintenance practices to support quality diagnostic services.
This period marked AFENET’s transition from pilot interventions to broader regional laboratory system strengthening.
Download pdf: Annual performance report 2020
During this period, AFENET focused on optimizing diagnostic networks, expanding point-of-care testing, and strengthening laboratory information systems to support data-driven decision-making.
Key achievements included:
- Expansion of Point-of-Care (POC) testing for HIV Viral Load, Early Infant Diagnosis, and TB diagnostics using mPIMA and GeneXpert platforms, particularly in Angola.
- Implementation of Laboratory Information Systems (LIS) at referral laboratories and support for development of viral load and EID dashboards for performance monitoring and visualization.
- Strengthening of sample transport networks and referral systems, contributing to reduced turnaround times for test results.
- Implementation of SLMTA and SLIPTA mentorship programs, supporting laboratories progressing toward national and international accreditation.
- Launch and support of TB Clinic–Laboratory Interface CQI (CLICQ!) ECHO programs, improving coordination between clinicians and laboratories and strengthening TB diagnostic performance.
These efforts enhanced system efficiency, quality management, and accreditation readiness.
Download pdf: Annual performance report 2021 – 2022
In this most recent period, AFENET emphasized innovation, sustainability, and national ownership of laboratory systems, aligning laboratory services with evolving PEPFAR priorities.
Key achievements included:
- Support for HIV Recency Testing initiatives, including assay validation, proficiency testing, and implementation at PEPFAR-supported sites.
- Continued strengthening of viral load and EID systems through quality improvement activities, workforce training, and laboratory equipment support.
- Expansion of open-source laboratory information and data management solutions, improving interoperability, reporting, and sustainability.
- Implementation of Population-Based HIV Impact Assessment (PHIA) Laboratory Fellowship programs, building regional laboratory leadership and advanced technical capacity.
- Strengthening of laboratory networks, including sample transport systems, laboratory document repositories, and continuous quality improvement initiatives for HIV and TB diagnostics.
This phase focused on long-term sustainability and integration of laboratory services within national health systems.
Overall Impact
Across all reporting periods, AFENET has:
- Strengthened national laboratory systems and diagnostic networks
- Improved access to quality HIV and TB diagnostics
- Enhanced laboratory data systems and use of real-time information
- Built sustainable laboratory workforce capacity
- Supported progress toward accredited, resilient laboratory services
These efforts have contributed to improved patient outcomes, reduced turnaround times, and stronger health system performance in PEPFAR-supported countries.
Download pdf: Annual performance report 2024 – 2025