1. World Health Organization, Western Pacific Regional Office Session 2 Laboratory strengthening Dr Cornelia Hennig Stop TB and Leprosy Elimination World Health Organization Regional Office for the Western Pacific Manila, Philippines 9-12 December 2014 The Ninth Technical Advisory Group and National TB Programme Managers Meeting Manila Philippines, 9-11 December 2014

2. World Health Organization, Western Pacific Regional Office Laboratory questionnaire LED/FM implementation Xpert MTB/Rif introduction and roll-out, impact NRL/SRL: Strengthening and coordinating technical assistance LED/FM implementation Xpert MTB/Rif introduction and roll-out, impact NRL/SRL: Strengthening and coordinating technical assistance Methodology: structured questions / inviting comments CAM, CHN, LAO PDR, MAL, MNG, PHL, PNG, VTN

3. World Health Organization, Western Pacific Regional Office LED FM WHO policy recommendation 2011 LED microscopy more sensitive than conventional ZN light microscopy Qualitative, operational and cost advantages Phase in LED FM as an alternative

4. World Health Organization, Western Pacific Regional Office Laboratory confirmation Global TB report 2014 Country notified pulmonary bacteriologically confirmed notified pulmonary clinically confirmed Total % bacteriologically confirmed Cambodia 14,082 9,069 23,151 60.8 China 275,915 512,469 788,384 35.0 LaoPDR 3,004 541 3,545 84.7 Malaysia 13,641 5,640 19,281 70.7 Mongolia 1,622 733 2,355 68.9 Papua New Guinea 3,150 9,390 12,540 25.1 Philippines 97,353 123,510 220,863 44.1 VietNam 50,067 24,403 74,470 67.2 HBC WPR 458,834 685,755 1,144,589 40.1

5. World Health Organization, Western Pacific Regional Office Status LED FM 2014 8 countries Validation: CHN, Lao PDR, VTN WPR – only gradual switch to LED 17 % of microscopy centers (range: 0 to 30 %) No further expansion in 5/8 Further expansion in 2/8 with focus on only high workload laboratories

6. World Health Organization, Western Pacific Regional Office Role of WHO Preparing and disseminating –Technical specifications for the purchase –Standard operating procedures for LED microscopy –Programmes for internal quality control and external quality assurance (EQA) for LED microscopy Facilitate a coordinated approach for standardized training on LED microscopy on country level

7. World Health Organization, Western Pacific Regional Office Identified issues / obstacles towards expansion Training duration –5 days (5), 3 days (2), NA (1) –training modules Staining solution –Commercial kits (5/8) vs in-house preparation (2/8) –Expiry of staining solution EQA: –3/8 no EQA –restaining / re-reading Maintenance

8. World Health Organization, Western Pacific Regional Office LED FM Comments from –TAG focal persons –Other SRL / observers