Laboratory (lab) services form an essential component of HIV services. Laboratory Services division functions at the crosscutting interface of all the other divisions. It is recognized that work related to laboratory services are not just confined to HIV testing, but have an impact on other interventions included those under prevention, care, support and treatment, STI management, blood safety, procurement and supply chain management. Emphasis on quality assured laboratory service delivery is important for the success of the National AIDS Control Programme (NACP). Access to quality assured HIV related laboratory services is ensured in all service delivery points through this division. In NACP IV, laboratory services have been positioned as an independent division at the state level as well. The assurance of quality in HIV testing services through the implementation of External Quality Assessment Scheme (EQAS) for HIV and CD4 testing has been addressed in NACP with special focus.
Technical support is provided to testing laboratories through the existing three-tiered network of HIV reference laboratories at the apex (1), National (13), and State level (117) through a cascade of mentoring and monitoring system and EQA programme.
Quality of testing under NACP is ensured through laboratory services through State reference laboratory. Besides, there are laboratories to monitor CD4 level among PLHIV in the programme. Moreover, at National level, the routine viral load (VL) testing for all PLHIV on ART has been outsourced to a private firm. The firm is responsible for sample collection, VL testing and delivery of reports. Early Infant Diagnosis is provided through 6 National Laboratories.
EXTERNAL QUALITY ASSURANCE SCHEME (EQAS):The External Quality Assurance Scheme (EQAS) was set up to ensure high reliability and validity to the HIV and CD4 tests under the programme and higher levels of proficiency in the participating laboratories. The diagnostic services provided through ICTCs across the country are strictly monitored by a strong Internal and External Quality Assurance Scheme (EQAS).NEQAS categorized the laboratories into four tiers, as follows:
- Apex Laboratory (first tier) - National AIDS Research Institute, Pune
- National level: 13 (NRLs) (second tier).
- State level: 117 State Reference Laboratories (SRLs) (third tier)
- Districts-level: all standalone ICTC