The purpose of this funding opportunity announcement (FOA) in the United Republic of Tanzania is to continue strengthening of the quality and reach of national laboratory services. The program objectives are to: • Expand access to and equity of laboratory services to support HIV care and treatment, opportunistic infections including TB, malaria, and reportable infectious diseases. • Achieve accreditation of all zonal, regional, and district laboratories to national and/or international standards. • Strengthen laboratory information systems (LIS) to support early and correct diagnosis, prompt management of patients, laboratory logistics, supplies, and operational research. • Strengthen management of the National Health Laboratory Services The Government of Tanzania's Ministry of Health and Social Welfare (MOHSW) is uniquely positioned, in terms of legal authority, ability, track record, infrastructure and credibility to develop and support HIV/AIDS activities throughout the country as stated within the Application Instructions of this FOA. Furthermore, the MOHSW has the mandate to coordinate the health-sector response for all health issues, including HIV/AIDS, in Tanzania. It is the only organization on the Tanzania mainland with this mandate. It also has the mandate to provide technical support and coordination to the regional and district health management teams. The health laboratory system in Tanzania is multi-tiered, and the test menus, complexity of testing and personnel expertise decrease from the national level to dispensary levels. There are currently a total of 6,217 laboratories consisting of one national reference, four zonal referral, 23 regional, 90 district and 577 health center and 5,522 dispensary laboratories. Some of these facilities are under the management of faith-based organizations but fall within the classification of public health facilities. The National Health Laboratory Standard Guidelines prescribes the allocation of test menus, equipment placement and expertise requirements at different tiers. Key activity areas that will be supported through this funding include but are not limited to: • Expanding access and equity of laboratory services to support HIV care and treatment and opportunistic infections including TB and Malaria. • Implementing Laboratory Quality Management System through the National Health Laboratory Quality Assurance and Training Center (NHL-QATC) including facilitating accreditation of all zonal, regional, and district laboratories to national and/or international standards. • Strengthening laboratory information systems (LIS) to support early and correct diagnosis, prompt management of patients, laboratory logistics, supplies, and operational research. • Strengthening coordination and management of the National Health Laboratory Services At the end of the 5 years project period, the MOHSW is expected to achieve the following outcomes: • Increased access to quality laboratory services • Increased in number of laboratories that are accredited to international standards • Enhanced utilization of accurate laboratory data for program management including forecasting and quantification of laboratory commodities. • Increased management of the National Health Laboratory Services • Enhanced capacity to conduct disease surveillance. • Increased in quality of the National Health Laboratory Services • Increased coordination and management of the National Health Laboratory Services