The laboratory capacity for the isolation and identification of bacterial pathogens has been established at the NRL. Specimens for bacteria such as Vibrio cholerae, Salmonella typhi, Shigella species, Neisseria meningitidis and Haemophilus influenzae are collected from the peripheral levels and transported to the NRL where they are analyzed. The results are fed back to the districts and also shared with WHO/AFRO on a monthly basis. Decentralization of services was also implicated in expansion of access to antiretroviral treatment (ART) at the national level. Following the Rwanda National Paediatric Conference in 2004, there was recognition that early infant diagnosis of mother-to-child transmission (PMTCT) and ART sites should be expanded at all levels of the health system. In July 2005, with support from CDC, three paediatric diagnostic sites were established for early infant diagnosis using either dried blood spots (DBS) or whole blood methods. By April 2008, the number of rapid diagnostic sites had expanded to 126.