The most efficient and cheapest mean for diagnosis of TB is sputum smear microscopy. Well functioning laboratories with quality control is fundamental requirement for any TB control programme.

The Nepal National Tuberculosis Control Programme operates a network of laboratories with a well established quality control system throughout the country. The NTP laboratory network is comprised of a well-functioning laboratory at the National Tuberculosis Centre and 315 laboratories at the peripheral level, all of these integrated with the government General Health Services laboratories or those run by NGO/INGOs. This Quality Assurance system has been established in order to maintain and improve the standard of laboratories. On a quarterly basis, all positive and 10% of the negative sputum slides are sent for cross checking to the Regional Quality Control Centres. Regular training and supervision has also supported the quality assurance programme to maintain the standard of laboratory activities.

The concept of Regional Quality Control Centers was developed in 1996, with the establishment of 5 Regional Quality Control Centers. The quality control centers were established with cooperation of BNMT, NATA, INF, and NLR.

NTP is aiming to up grade the status of the Central Laboratory at NTC to becoming National Reference Laboratory which should be linked to a Supra National Reference Laboratory (SNRL). NRL should be able to provide culture and drug sensitivity testing under internationally acceptable quality assurance by SNRL. NTP has taken steps for establishment of the NRL and it is envisaged that within 2007 or lasted by 2008 central laboratory at NTC will assume this much needed role.