Masanza et al. BMC Public Health 2010, 10(Suppl 1):S8 http://www.biomedcentral.com/1471-2458/10/S1/S8 Developed countries with well-organized routine labora- tory services can easily meet this core capacity through existing systems. However, resource-limited countries, especially those in sub-Saharan Africa, need considerable capacity building. Attaining adequate capacities will require functional community, sub-national and national systems. Therefore, laboratory capacity building for IHR core capacity 8 must by necessity focus on strengthening the routine systems within which events are detected and reported. For a long time, laboratory services were not considered a priority for most resource-limited health care systems in Africa, resulting in poor infrastructure, low human resource capacity and inappropriate technologies [2]. The need for building laboratory diagnostic capacity in Africa has been well articulated over the recent past [2-6]. Consequently, there have been eﬀorts to enhance labora- tory capacity over the past ﬁve years in many sub-Saharan countries. These eﬀorts have largely been driven by the need for improved laboratory support to surveillance and treatment programs for speciﬁc diseases such as HIV/ AIDS, malaria, tuberculosis (TB) and avian inﬂuenza [7] at national and a few regional centers. Indeed, a recent review by Olmsted et al (2010) suggests a general improvement in infrastructure and service provision [8]. However, more challenges still exist, including the lack of suﬃcient numbers of well-trained laboratory scientists in public health service and inadequate laboratory manage- ment and leadership skills. There is no or limited distri- bution of available national laboratory guidelines and a lack of internal and external quality assurance systems, which is usually accompanied by low appreciation of quality control. No eﬀorts have been made towards assisting laboratories to attain international standards such as ISO 15189 and hence slow progress to accredi- tation. Other challenges have been the poor quality, limited analysis and utilization of laboratory data; incon- sistent and inadequate reagent supply chains; and lack of equipment maintenance [9]. The African Field Epidemiology Network (AFENET) is a coalition of Field Epidemiology Training Programs (FETPs) in Africa, initiated in 2005 out of a need to network and facilitate the strengthening of disease sur- veillance and public health responses to epidemics in the region. Since then, AFENET has grown in membership from four to ten countries. AFENET is organized around a networking and service concept, operating mainly through cooperation with other agencies, host country health ministries, universities, non-governmental organi- zations (NGOs), the private sector and an extensive network of professionals. Currently, the organization’s activities are focused on six strategic priorities, namely: 1) ﬁeld epidemiology capacity development; 2) public health laboratory capacity development; 3) public health Page 2 of 7 disease surveillance and eﬀective response; 4) networking and collaboration; 5) AFENET’s institutional development; and 6) information and publications. In this paper, we discuss some of AFENET’s experiences in building laboratory capacity in the region. AFENET’s laboratory capacity building efforts Human resource development The capacity to plan and implement an eﬀective public health laboratory system that meets the IHR core capacity requirements depends on the availability of highly- trained and motivated personnel that are not only tech- nically competent, but also possess strong leadership and managerial skills. For years, there has been a lack of advanced-level training programs for laboratory scien- tists, and this has contributed to the poor state of the laboratory sector in the region. While laboratory staﬀ could be imparted with technical skills, the ﬁeld has been short of leadership since laboratory staﬀ are rarely included in the decision-making process of health service planning [10]. Since 1993, AFENET founding member countries have been running a graduate-level program in public health, the Field Epidemiology Training Program (FETP), to build a critical mass of public health leaders who are available to respond to public health challenges in the region. Recognizing the eﬀectiveness of this approach in providing competent and motivated staﬀ, a proposal was made to leverage the curriculum by adding a laboratory component (known as the Laboratory Track). This was piloted in Kenya in 2004 as a Field Epidemiology and Laboratory Training Program (FELTP); laying the frame- work on which similar programs have been founded in other countries. The generic curriculum for the laboratory track was developed with input from the Kenyan Ministry of Health, universities, and the American Society for Laboratory Medicine, and has since been adapted by other countries. Admission requires a bachelor’s degree in medicine or other related sciences. Although detailed content may diﬀer slightly from program to program, they generally aim at developing a similar set of basic competencies, as detailed by Kariuki et al (2008) [10]. The program combines short didactic courses and laboratory bench work to impart skills in advanced laboratory science; the use of computers in public health; basic and ﬁeld epidemiology, biostatistics, and public health surveillance; the epidemiology and diagnosis of communicable and non-communicable disease; and management and leadership. This is a two year program with residents spending 65-75% of this time in ﬁeld placement. Table 1 summaries the current status of resi- dents enrolled or graduated from the Laboratory Track program.