Is awarded by The Global Fund to Fight AIDS, Tuberculosis and Malaria.

The East, Central and Southern Africa Health Community (ECSA-HC) is a regional inter-governmental health organisation established in 1974 to foster regional cooperation in health among member states. With over 43 years of experience, ECSA-HC is the largest health-specific organisation in the region outside the UN system, occupying a unique position to provide leadership on regional health sector issues.

In April 2013, through support from the ECSA-led East African Public Health Laboratory Networking Project (EAPHLNP), the Uganda National TB Reference Laboratory (NTRL) received WHO-designated status as a Supranational Reference Laboratory (SRL): the third SRL in Africa, and one of only 29 worldwide. Building on this recognition, ECSA-HC in collaboration with Uganda SRL was awarded a Global Fund grant to strengthen TB laboratory diagnostic capacity across the region.

The project supported 21 countries formally linked to Uganda SRL through Memoranda of Understanding, working toward a regional network of 21 National TB Reference Laboratories. A Mid-Term Review was conducted in December 2017 to assess progress against project outputs and guide the remaining implementation period.

• Build a regional network of NTRLs for inter-state laboratory quality assurance and management across ECSA countries
• Improve laboratory service provision for quality-assured 1st and 2nd line Drug Susceptibility Testing accessible to people in need
• Enhance impact of rapid molecular TB diagnostic testing and build NRL capacity for epidemiological surveillance including Drug Resistance Surveys

• All 21 NTRLs signed Memoranda of Understanding and enrolled in the Proficiency Testing Scheme (PTS)
• Project exceeded its targets for Proficiency Testing in TB microscopy across the network
• All NTRLs achieved capability to use GeneXpert, with high achievement scores in Proficiency Testing
• Four NTRLs began performing second-line Drug Susceptibility Testing as a direct result of project support
• Eleven of 21 countries acquired Line Probe Assay (LPA) machines, enabling second-line DST through Uganda SRL technical assistance
• Out of 14 countries enrolled in the 2016 EQA cycle, 10 reported results; with 8 scoring above the 87.5% pass mark
• Swaziland and Rwanda established TB Specimen Referral Systems covering 100% of their primary health care facilities

Is awarded by The KOFIH.

The KOFIH funds aimed to strengthen the bilateral cooperation through ODA and supported Uganda SRL with technical assistance in the field of tuberculosis diagnosis and management.

In July 2017, through support from the KOFIH, the Uganda National TB Reference Laboratory (NTRL) was funded to capacitate the Control Capacity Building in Uganda, continued to focus on building and strengthening of human resource technical capacity. This was to support the technical capacity growth of laboratory staff from peripheral facilities in Masaka, Bukomansimbi, Kalungu, and Kyotera district, contributed to DST technological enhancement and adoption through accreditation of the MKIT technology and infrastructural and technological development at the National TB Laboratory / SRL Uganda.

The project was to run from April 2017, to ’19, but was extended to 2022 due to COVID 19 pandemic.

• Improved capacity of TB management control and contribute to reducing TB incidence rate
• To build and strengthen human resource technical capacity at SRL/NTRL Uganda
• To strengthen the technical capacity of laboratory staff from peripheral facilities in Masaka, and Bukomansimbi districts
• To support DST technological enhancement through accreditation of the MKIT technology
• To support infrastructural and technological development of the National TB Reference Laboratory / SRL Uganda

• (1) Improvement of the diagnostic capacity of Multi-Drug Resistant Tuberculosis:
  • Operational Research training workshop
  • Laboratory Logistics and quantification training workshop
  • Procurement of Uninterrupted Power Supply (UPS)
  • Procurement of Online training Platform
  • Procurement of Laptops
  • SRL/NTRL Operational Costs
  • Blinded recheck Support supervision visits for each of the four districts within the greater Masaka region (including Masaka, Bukomansimbi, Kalungu and Kyotera)
  • EQA network (ZN, AFB Microscopy, GeneXpert) refresher training targeting Masaka and Bukomansimbi Districts peripheral lab staff
  • EQA network (ZN, AFB Microscopy, GeneXpert) refresher training targeting Masaka and Bukomansimbi Districts peripheral lab staff from 6 additional districts of Greater Masaka Region including Sembabule, Rakai, Lyantonde, Lwengo, Kalungu and Kyotera districts
  • To support DST technological adoption through accreditation of the MKIT technology (Certification of the MKIT technology)
• (2) Strengthened self-sufficiency capacity of Tuberculosis diagnosis in National TB Laboratory:
  • Curriculum development workshop, e.g. finalization of training materials and relevant training documentation [8 training modules], PT training modules, hence IACET standard requirements
  • Facility and Equipment maintenance at SRL/NTRL
  • Review and Finalization of curriculum training
  • SRL Operational Costs
  • Biosafety and Biosecurity Training in Masaka and Bukomansimbi

Itwas awarded by Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH , as commissioned by the German Federal Ministry for Economic Cooperation and Development (BMZ) and co-financed by the UK Foreign, Commonwealth & Development Office (FCDO).

BACKUP Health is a GIZ-managed initiative supporting countries to strengthen institutions of the health sector; improving organisational competencies for managing global health financing, human resource capacity, and technical systems required for effective health service delivery, including laboratory infrastructure.

Uganda continues to carry a high TB burden, categorised by WHO among the 30 high TB and TB/HIV burden countries globally, with an estimated incidence of 200 per 100,000 population. TB control services are managed under the National TB and Leprosy Control Program (NTLP), with the National Health Laboratories and Diagnostic Services (NHLDS); housing the National TB Reference Laboratory (NTRL) – overseeing all laboratory diagnostics.

While Uganda’s TB diagnostic network expanded from 303 facilities in 2006 to 1,669 by 2020, significant quality gaps remained: only 14% of health regions had decentralised TB External Quality Assurance (EQA) services, just 73% of diagnostic facilities were enrolled in any form of TB EQA, and GeneXpert proficiency testing lacked adequate funding. This project was designed to close those gaps.

• Expand TB EQA coverage from 58% (2020) to 90% by 2025
• Increase decentralised TB EQA regions from 14% (2020) to 100% by 2025
• Support provision of proficiency testing panels for GeneXpert TB testing at 100% of GeneXpert sites nationally
• Ensure 100% of new laboratory staff receive induction training and 50% of TB facilities receive regular supervision by 2025
• Reduce laboratories reporting EQA errors from 5% to less than 1% by 2025

• Update, print and distribute revised TB diagnostic manuals; stakeholder workshops to revise the outdated 2012 TB diagnostic network manual, incorporating new tools like GeneXpert Ultra, LF-LAM and TB LAMP; printing and distribution of 5,000 copies to laboratories nationwide
• Decentralise TB EQA to selected regions; two-week training for regional TB focal persons, district laboratory focal persons and DTLS; procurement of computers for data management; targeted support supervision and mentorship; routine quarterly regional review meetings
• Preparation of Proficiency Tests for MTB diagnostics; biannual preparation and distribution of GeneXpert PT materials to all 250+ GeneXpert sites nationally; targeted support supervision and corrective action follow-up; central performance review workshops

The project was coordinated at NTRL/SRL in collaboration with NHLDS as the principal recipient of funds, with a dedicated focal person overseeing implementation. Technical collaboration extended to the National TB and Leprosy Control Program (NTLP), regional referral hospitals, and district health offices across the country.