The arrival of free or affordable antiretroviral medications to South Africa appears imminent in many sectors. Laboratory diagnosis and monitoring methodologies for HIV are of crucial importance in the care of these patients. Most of these are highly expensive, require significant skill, infrastructure and are laborious to perform. It is of vital importance to develop better methodologies that are more user friendly in the resource poor areas of the globe yet that are proven of value in comparison to standard methodologies. The mission of this core laboratory group is to provide state of the art diagnostics to complement the management of HIV/AIDS and to make these investigations affordable and accessible. In the adult population this involves increasing access to monitoring and to reduce the cost of monitoring. In the pediatric population this would include increasing the access to molecular diagnosis. An additional aspect would be to define diagnostic and monitoring protocols appropriate for the local setting/resource poor setting The role of the core laboratory group for the CIPRA grant will include the following: 1) providing routine standardized diagnostic and monitoring investigations for HIV using existing technologies, 2) safety bloods for monitoring of patients on antiretroviral therapy,)evaluation of innovative assays developed within the laboratory projects for wider implementation, 4) infrastructures for the laboratory projects (project 5) and 5) assistance in development of local laboratory capacity. The treatment project (proj ects 2 and 3) and the prevention project (VCT) (project 1) will thus provide the clinical backbone of the laboratory core and laboratory projects by providing accurate clinical data and specimens. Core laboratory staff will also be involved in training of CIPRA staff in conjunction with the training core in 1) basic laboratory practices, 2) laboratory safety, 3) establishment of a quality system, 4) techniques courses with particular emphasis on molecular techniques used in the setting of HIV and 5) interpretation of laboratory investigations. The program will be applicable to many similar settings in South Africa and throughout the developing world.
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