Lab Matters Fall 2016 | Page 10

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Kenya LIMS transition meeting

Echoing that thought, Diallo said,“ It is important that we develop a sustainable [ laboratory ] infrastructure, and the only infrastructure that is sustainable is a national network of reference laboratories.” His job today is to support the development of exactly that, so Guinea need not depend so heavily on external assistance.

Overall, the GHSA aims to assure that all 53 participating countries( as of August 2016) implement the revised WHO International Health Regulations( IHR) so they are able to prevent, detect and respond to disease outbreaks in near real-time. Among other things, those regulations( adopted by the World Health Assembly in 2005) require governments to assess all reports of“ urgent events” within 48 hours and to notify WHO immediately; to rapidly determine the control measures needed to prevent disease spread; to develop a national public health emergency response plan; to assure linkage among hospitals, laboratories, clinics, health officials and other key entities“ by the most efficient means of communication available”; and to provide support for laboratory analysis of patient specimens. As of 2012, fewer than 20 % of WHO member states reported full compliance.

As Ebola virus disease cases dwindled, the [ mobile, international ] laboratories closed. And as they closed, they left nothing behind them.... Somebody said,‘ Everybody came in a tank, like a war zone. And after the war, they took their tanks back

In 2015, APHL was awarded its first CDC / GHSA cooperative agreement funds for $ 4.5 million, to help grow national laboratory systems capable of real-time biosurveillance— the focus of one of 11 GHSA“ action packages” developed to accelerate progress toward specific goals. Part of that funding was dedicated to work in Vietnam. In September 2016, the association was awarded a new, five year CDC / GHSA cooperative agreement with over $ 8 million in Year 1 funding.

In addition to Guinea, APHL is carrying out GHSA-related work in eight other countries: Ethiopia, India, Indonesia, Kenya, Sierra Leone, Tanzania, Uganda and Vietnam.

One crucial, cross-national project is the creation of an International Public Health Service Fellowship that can be customized to address regional or national laboratory workforce gaps. APHL has already drafted a preliminary curriculum, and a pilot program will likely be implemented in Africa.

Said Samantha Dittrich, MPH, APHL’ s GHSA manager,“ In our interconnected world, an infectious disease threat in one place can pose a threat everywhere. APHL is the only organization that has both the depth and breadth of knowledge and experience to provide the training and technical assistance needed to strengthen public health laboratories, which is integral to improving health security across the globe.”

The association’ s GHSA work will build on past successes providing laboratory expertise under the US President’ s Emergency Plan for AIDS Relief( PEPFAR), a multibillion-dollar initiative begun in 2004 to drastically reduce cases of HIV / AIDS across the world. Now, as then, APHL’ s focus is on building sustainable laboratory infrastructures, assisting with national laboratory strategic plans, training scientist-managers and instituting quality management systems.

However, while PEPFAR was geared towards HIV / AIDS testing, the GHSA goal is for participating countries to develop capacity for ten core assays: influenza PCR, poliovirus culture, HIV serology, TB microscopy, rapid diagnostic testing for Plasmodium spp., Salmonella enteritidis culture and four additional tests selected by each country to address its national public health priorities.

Guinea—“ People are sober”

Diallo returned to Guinea December 29, 2015— the day President Alpha Condé announced the country Ebola-free, after 90 days with no new patients.“ But a month later, another case emerged,” said Diallo.“ Plus one more case after that.” As of August 31, Guinea is again Ebola-free, but, Diallo said,“ People are sober. They are not as festive as when I arrived.”