Rwanda's implementation of IDSR began in 2000 with a national assessment of the country's communicable disease surveillance program. The results of the assessment were used to develop a strategic plan for improving the country's surveillance, laboratory and response capacities. The WHO/AFRO IDSR technical guidelines were adapted to ensure that Rwandan disease priorities would be emphasized in the streamlined system. Training of health workers on IDSR approaches began in 2001. Additional training in laboratory and data management was provided for relevant staff through national and regional training workshops. The initial IDSR strategy in Rwanda targeted 19 priority diseases and syndromes (Table 1 ) recommended by WHO-AFRO because they are among the leading causes of illness, death and disability in African countries and are relevant to Rwanda based on epidemiologic criteria [3] . Implementation of the full IDSR program within the Ministry of Health is still under development; the focus of this review is on the laboratory component.