High quality testing is an essential component in responding to health threats such as TB, HIV, Malaria, Ebola and many other diseases. In order to produce high quality results and have a proactive response to health threats we need to identify what the gaps are in laboratories that would create a barrier to effective responses. At the ASLM meeting in December 2016 there was a very informative discussion eluding to some of the gaps particularly in developing countries. These ranged from facility, staff, equipment and effective quality management. I would like to explore the experience of colleagues in responding to health threats.