This manual describes some of the strategic, managerial, financial, technical and scientific aspects to be considered in establishing a national EQA programme for clinical laboratories and 14 other testing services at all health care levels. The manual has been prepared by the World Health Organization (WHO) and partners to fill perceived gaps, and the scope is limited to EQA programmes that deliver proficiency testing. However, it is important to note that other EQA activities as well as internal quality control (process control) measures and other quality elements are an integral part of the quality laboratory management process as defined in ISO 15189:2013 (13). The scope of the manual is all WHO Member States, with a focus on developing countries as the principal target audience. The intended audience includes ministries of health, programme managers, laboratory managers, testing personnel and other implementing partners and EQA providers.