Strengthening High Quality Laboratory Services Scale up for HIV diagnosis, Care, Treatment and Monitoring in Malawi under PEPFAR

Of the 19 million people in Malawi, approximately 1 million – or 9.2 percent – live with HIV. To meet the UNAIDS 90-90-90 goals, Malawi is working to strengthen its laboratory system so all Malawians can know their status and have access to treatment.

With PEPFAR funding from the Centers for Disease Control and Prevention, a URC-led project is supporting the Malawi Ministry of Health to strengthen the National Reference Laboratory and its network by providing mentorship and training to facilitate the development and implementation of the National Lab Strategic Plan, quality improvement, and accreditation programs.

The main goals of the project – known as the Strengthening High Quality Laboratory Services Scale up for HIV Diagnosis, Care, Treatment and Monitoring in Malawi under PEPFAR – include increasing quality and access to HIV laboratory services through strengthening quality management, control, assurance systems, and capacity. The project also is strengthening the collection and use of laboratory strategic information to improve organizational performance in Malawi, increasing training human resources, and improving the National Transportation System.


Mentorship towards Lab Accreditation

The project has embedded seven mentors in 48 facilities to work directly with laboratory technicians and clerks on quality improvement projects. Through this mentorship program, the project is working to achieve laboratory accreditation through the African Society of Laboratory Medicine (ASLM).

Mentors train lab technicians to conduct internal audits to find and fix nonconformities such as outdated SOPs or equipment that needs servicing. Once most of the nonconformities are addressed, the project will have ASLM do an external audit to accredit each laboratory.

Other project achievements include:

  • 309,409 Viral Load samples tested in project year three, representing 103 percent of the annual goal. This is a substantial increase since the project’s first year, which ended with 146,199 tests performed;
  • Established a National Transportation System network through Riders for Health, one of the project’s sub-recipients. Riders for Health connects 658 health facilities across the country to offer quality sample transportation services replacing the previous segmented sample transportation system. In the project’s third year, 311,360 samples and 302,298 results were transported;
  • The project renovated Nsanje Molecular Laboratory in July 2017 to increase the country’s viral load testing capacity; and
  • The project supports 107 students at two Malawi universities toward their goal of receiving diplomas in biomedical sciences. These students will then matriculate into government labs throughout the country to help alleviate the shortage of trained healthcare workers.


2015 to present
US Centers for Disease Control and Prevention (CDC)
Blantyre Health Research & Training Trust - Johns Hopkins
Network of Excellence in People-Centered Testing and Treatment (NEXT)
Riders for Health
Regions/ Countries