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 .”