CD4 and tuberculosis: Automation in CD4 testing completely replaced manual CD4 by the end of 2013 to increase laboratory access to reach 99% of people living with HIV/AIDS through a spoke-and-hub specimen referral system by 2014 (Figure 2); before 2013, an average of only 20% of health-care facilities had access to CD4 testing.15 Automation in chemistry and hematology testing expanded until 2013 and stabilized to provide better quality of testing services and GeneXpert platforms became available at 17 geographically distributed laboratories by 2015 to strengthen TB diagnostics (Figure 2).