The availability of an Ov16 serology-based rapid test has highlighted important issues around uptake and appropriate use. The commercial availability of a rapid test does not guarantee high-quality results will be obtained when used by a program. There are many steps involved in selecting a test, how and when testing will occur, performing the test, reporting results, and how the results are used to inform control and elimination programs. At each step of the process, there is the potential that something can go wrong. Confidence in the testing process, including test quality, performance and accurate results, is important to consider when national onchocerciasis control and elimination programs (NOCPs) use test results for action. A quality assurance (QA) program will help assure NOCPs that the tests are functioning as intended, results are of high quality, and additionally provide an opportunity for feedback to the test manufacturer.