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Delivery of diagnostic services that serve the population well depends upon the availability of high quality diagnostic tests and of laboratory systems that are able to prioritise efforts in regions of particular need and respond to changes in the distribution of that need. South Africa has pioneered widespread introduction of a new test for tuberculosis (TB) called Xpert MTB/RIF which runs on a platform called Genexpert that has capability both for connectivity to a central laboratory facility and for testing for things other than just TB. This means that the National Health Laboratory Service is able to identify where there are increases in people being diagnosed with TB, and potentially also follow trends in other infectious diseases such as HIV. In addition, this network provides the opportunity to test the performance of new and improved tests for infectious diseases, including TB, with the ultimate goal of improving patient care.