Laboratories are a fundamental part of health systems, essential for the detection, diagnosis, treatment and control of diseases. A national laboratory system is one of the technical areas that should be assessed and strengthened for implementation of the International Health Regulations (2005). Reliable laboratory services continue, however, to be rare in many low- and middle-income countries. Although there have been examples of effective laboratory responses to outbreaks, experience has shown that lack of a robust laboratory system can impede disease control and prevention. Able personnel are required to manage laboratories in complex environments and to build strong, collaborative national laboratory networks and strengthen preparedness for public health events. In many countries, laboratory directors and senior laboratory managers often lack sufficient training in leadership and management to develop and lead a laboratory system for surveillance and response.