Mozambique

Mozambique is the newest addition to Ciheb's country portfolio. The work is supporting the Mozambique Ministry of Health in strengthening the laboratory systems for the diagnosis of HIV and tuberculosis (TB) and expanding COVID-19 testing to the sub-national level using the GeneXpert platform. The country operations based in Maputo are being established with a team of three technical advisors and one administrative assistant.

The US Centers for Disease Control and Prevention (CDC) has provided supplemental funding to develop related testing capacity in Mozambique to support the government’s COVID-19 efforts. Fortunately, the real-time PCR platforms to test for HIV are the same for SARS-CoV-2, the virus that causes COVID-19, thereby expanding the capabilities of the already developed molecular laboratories and HIV proficient staff. The automated machines are capable of completing about 400 COVID-19 tests per day.

Ciheb has worked with the Ministry of Health to ensure country-level support for capacity development and policies for the management of high-quality lab services, thereby building strong country ownership that is further strengthened by south-to-south mentorship and collaboration among regional African laboratory networks for sustainability.

Projects

Laboratory Systems Enhancement for AIDS Pandemic Control (LAPSEC). This project supports CDC Mozambique by providing direct technical assistance and support to enhance laboratory capacity and competencies for HIV services. LAPSEC is focused on improving individual and facility performance in patient diagnosis, care monitoring, and related services in order to reach the WHO’s 95-95-95 goals.

Specific areas of focus include:

1. Implementing a quality management system in PEPFAR-supported labs and testing sites.
2. Supporting the rapid testing continuous quality improvement (RTCQI) initiative.
3. Expanding internal and external quality assessments to support testing of HIV, early infant diagnosis (EID), viral load, and tuberculosis (TB).
4. Improving access to TB diagnostics and the utilization of GeneXpert.
5. Supporting the implementation of EID POC and multiplexing of mPima.
6. Providing guidance to support biosafety and waste management.
7. Supporting the expansion of COVID-19 testing to provincial levels.
8. Supporting the implementation of the specimen referral guidelines.

Ciheb began activities with LAPSEC in April 2020, but plans have been altered because of COVID-19. Despite the challenges, Ciheb Mozambique has continued making progress toward its goals and establishing operations. Achievements thus far include 1) evaluating Nampula’s IPAC assessment report and providing recommendations to close nonconformities; 2) meeting with the developer of the EQA database to discuss a timeline for implementation; 3) developing a list of potential quality indicators to measure TB laboratory performance via GxAlert connectivity; and 4) attending monthly waste management ECHO sessions.