Turning evidence into policy and policy into practice
The steps to building Lesotho's modern TB central laboratory
October 2006 - Global attention on XDR-TB in South Africa
WHO convenes the first Global Task Force on XDR-TB in Geneva. FIND (Foundation for innovative new diagnostics) is at the meeting presenting their plans for new diagnostics. The Task Force concludes with eight recommendations including the urgent need to strengthen laboratory services. News reports continue to highlight concern over drug-resistant TB cases in South Africa.
November 2006 - funding announcement on TB by George Soros
Philanthropist George Soros, founder of the Open Society Institute, announces a $3million two-year grant to Boston-based NGO Partners in Health to immediately strengthen TB control in Lesotho, a country devastated by the dual TB/HIV epidemic. WHO invites FIND to collaborate with Partners In Health in Lesotho to begin work on transforming TB diagnosis services.
December 2006 - Lesotho identified for TB laboratory project
FIND commits to supporting an in-loco TB laboratory expert for several months in Lesotho to build TB laboratory capacity through a demonstration project exploring introduction of rapid culture and drug susceptibility testing.
January 2007 - Lesotho Minister of Health prioritizes TB control
A WHO TB expert is appointed to work with Lesotho's Ministry of Health to help facilitate establishment of a renewed programme and a brand new TB central laboratory. The Ministry of Health underlines priority action on TB control by strengthening the National TB Control Programme team with an additional TB expert.
February 2007 - WHO XDR-TB Task Force progress report
The report underlines need for a strategic, budgeted plan for strengthening laboratory services in all affected countries through support from the Laboratory Strengthening Subgroup. In the four months since the task force met, a draft business plan has been prepared; WHO has committed funds for additional staff to work on laboratory issues; and provided assistance to countries to apply to the Global Fund to fight AIDS, TB and Malaria for laboratory strengthening projects.
March 2007 - WHO Global TB Control Report
WHO's Global TB Control Report highlights the challenges around laboratory strengthening: "Prompt diagnosis and effective treatment require fully functioning laboratories and reliable drug supplies. Despite some improvements, National TB Programmes in all WHO regions reported drug stockouts, too few laboratories, weak quality control and limited facilities to carry out culture and drug susceptibility testing."
April 2007 - construction work begins on Lesotho central laboratory
Initial design and development work begins on the floor plan for the new National TB reference in Lesotho. Renovation work commences, plus preparations underway for guidelines specifically for use by Lesotho laboratory staff.
May 2007 - World Health Assembly passes TB resolution
The World Health Assembly passes TB resolution which urges Member States to develop and implement long-term plans for TB prevention and control, and enhance "laboratory capacity in order or provide for rapid drug susceptibility testing or isolates obtained from all persons with culture-positive TB."
June 2007 - Global MDR-TB and XDR-TB Response Plan
Lesotho laboratory staff undergo full training, and guidelines are finalized with the national TB programme. Renovation work on the new laboratory is on target.
In Geneva, WHO releases the Global MDR-TB and XDR-TB Response Plan 2007-2008 calling for US$ 2 billion investment by countries and donors. The document lays out a strategy for sufficiently increasing the number of fully-equipped TB laboratories in countries to ensure a ten-fold increase in detection of MDR-TB cases.
The WHO's TB Strategic and Technical Advisory Group endorses recommendations for the use of rapid liquid culture and species identification in order to accelerate diagnosis of TB and MDR-TB and XDR-TB.
July 2007 - new laboratory recommendations issued
Leading TB laboratory specialists meet at WHO and issue recommendations to guide national TB programmes on second-line drug susceptibility testing.
August 2007 - new equipment ordered for installation
Orders placed for additional equipment: centrifuge, autoclave, incubators and water distillation unit.
September 2007 - MDR-TB Working Group meets in Tbilisi, Georgia
Impressive results in demonstration sites for new TB diagnostic tools presented by FIND and the National TB control Programme of Lesotho at the working group meeting.
October 2007 - Final renovation work is completed
With the renovations finished, the laboratory's validation of the Quality Control indicator for culture in high HIV settings is approved and the processing of 100 smear negative TB suspects for culture begins.
November 2007 - opening of Lesotho's new Central TB Laboratory
Official opening of the TB Central Laboratory by the Minister of Health for Lesotho, WHO, FIND and Partners in Health.