At a glance
- Laboratories are the backbone of public health, identifying infectious diseases like HIV and TB, guiding effective treatment, preventing drug resistance, and enabling outbreak surveillance.
- As the lead implementing agency for the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), CDC builds sustainable health systems to protect Americans from emerging health threats.
Overview
Laboratory systems lay the groundwork for effective HIV and TB detection, prevention, and treatment programs, and as a result, build systems and infrastructure used for outbreak response globally. In partnership with host country governments, CDC works to establish state-of-the-art laboratories, develop world-class laboratory-based surveillance systems, and strengthen local capacity. This partnership enhances local abilities to accurately, efficiently, and safely diagnose and monitor treatment for HIV and TB. It also allows countries to detect, quickly respond, and stop deadly outbreaks of various pathogens before they reach the U.S.
Strengthening laboratory capacity around the world improves CDC's ability to protect Americans—ensuring outbreaks never threaten American lives or harm our economy.
Read more about the impact of CDC's investments in global laboratory capacity.
Building resilience through robust laboratory networks
With over four decades of global HIV and TB expertise and relationships, CDC works with countries to build efficient, integrated, and adaptable national laboratory systems and networks.
Strong laboratory systems, combined with highly skilled laboratory staff, are essential for rapidly identifying and monitoring outbreaks. CDC's workforce provides outstanding leadership and unparalleled expertise in laboratory, data, and surveillance systems to develop public health capacity and quickly stop outbreaks at their source before they impact the United States.
CDC maximizes resource efficiency and increases global health security, using platforms developed for HIV and TB to successfully respond to and protect Americans from recent outbreaks, such as Marburg, malaria, Ebola, and mpox.
By the numbers
Molecular testing
CDC-supported laboratories and point-of-care sites with molecular testing capacity for HIV, TB, and other pathogens
Quality improvement
Lab information systems
International accreditation
Outbreak response
Overcoming drug resistance
HIV and TB drug resistance threaten to undermine decades of U.S. progress and investments. Drug resistance makes infections harder to treat, increases transmission, and drives up healthcare costs, illness, and death in the U.S.
CDC is a leader in detecting and preventing the spread of HIV and TB drug resistance across Africa, Asia, the Caribbean, and Latin America. Effective management of HIV and TB drug resistance safeguards Americans by ensuring the continued effectiveness of first-line treatments used to treat and control HIV and TB in the U.S. CDC contributes innovative methods and tools to detect drug resistance. Notably, CDC has:
- Supported 30 countries to establish or strengthen HIV drug resistance (HIVDR) genotyping capacity, with 10 countries recognized as regional or national HIVDR genotyping facilities.
- Developed and launched the first dried blood spot proficiency testing program in 2023, enabling global monitoring of HIVDR testing performance.
- Successfully validated four new commercially available HIV genotyping tests, expanding global capacity for multi-pathogen genotyping and drug resistance monitoring.
- Assisted , Nigeria, and South Africa to establish drug-resistant TB sequencing capacity and analyzed over 5,500 TB samples to mitigate outbreaks and improve the effectiveness of national TB programs.
Connecting care: Sample transport networks
CDC provides technical assistance for designing, monitoring, and sustaining national integrated specimen referral systems between testing facilities. CDC’s approach promotes efficient, scalable, and sustainable transport systems for improving patient outcomes and reducing transmission. For example:
- Kenya: CDC helped Kenya transition from a fragmented, donor-dependent specimen referral system to a unified, country-owned model. An integrated national sample referral system was launched in 2024, transporting samples for HIV, TB, cholera, measles, and mpox.
- Uganda: CDC established a sample transport system in 2007 and expanded from eight facilities to over 2,000 by 2018, covering 90% of HIV facilities. The locally owned system is leveraged during public health emergencies, such as the Ebola and mpox outbreaks in 2025.
- Zimbabwe: CDC supported a nationwide integrated sample transport system. Fully managed by the Ministry of Health and Child Care, the system handles over 1 million samples each year. It is recognized as a global best-practice model for its state-of-the-art tracking platform, optimizing efficiency, and ensuring transparency.
Innovative solutions
CDC develops, evaluates, and refines laboratory and point-of-care tests to fill gaps in diagnostic and surveillance programs and ensure accuracy of test results:
- Low-cost HIV genotyping test: CDC created a test that determines the drug resistance profile of HIV strains in the body. This improves population-level surveillance of HIV drug resistance patterns and informs treatment algorithms.
- New tests for HIV infection: CDC and new laboratory-based and point-of-care tests for surveillance of recent versus long-term HIV infection. This tool helps target interventions and allocate resources effectively in areas with ongoing transmission.
- Dried tube specimen technology: CDC developed the dried tube specimen technology to produce safe and cost-efficient proficiency testing materials for HIV rapid testing. This technology has been adapted for HIV viral load, TB, and tests for other diseases, and is used in 55+ countries to confirm the accuracy of test results.
Raising standards: International accreditation
CDC has assisted 405 laboratories in low- and middle-income countries achieve accreditation to international quality standards since 2013. This has been achieved through CDC/PEPFAR's flagship laboratory quality improvement mentorship program, Strengthening Laboratory Management Toward Accreditation ().
Achieving accreditation is crucial for ensuring laboratory systems deliver accurate and timely diagnosis and treatment while maintaining quality, sustaining improvements, reducing laboratory costs, and strengthening health systems' resilience to outbreaks.
Partnerships for sustainability: Public-private collaborations
Since 2008, CDC and PEPFAR have formed public-private partnerships with three companies to enhance laboratory capabilities. These strategic collaborations leverage the strengths of both sectors to foster innovation and support the transition to locally led laboratory programs in sub-Saharan Africa, Latin America, and Asia.
The transition to locally owned programs improves the countries' ability to protect the health of their nations with their own resources, reducing dependence on donor support. By combining public and private resources, these partnerships create a long-lasting impact and a sustainable country-owned response to HIV, TB, and future epidemics.
CDC in action
