Lab Matters Spring 2018 | Seite 4

president’s & executive director’s message Springtime in Europe: Lessons From Across the Pond APHL has always recognized the importance of partnerships to advance the field of laboratory practice to meet public health needs. Along these lines, one of the association’s current strategic objectives is to “expand international engagement and learn from established laboratory systems.” Most of APHL’s global outreach targets laboratory system development and support. Historically, our outreach in the developed world has been narrow. We have a longstanding relationship with the Canadian Public Health Laboratory Network and have had limited interactions with Japan. This spring, we focused attention on Europe, where we found much to learn. The initial purpose of our April trip to Stockholm was to review the curriculum framework for the Global Laboratory Leadership Program (GLLP)—a multinational effort to define laboratory leadership competencies—based on APHL and the US Centers for Disease Control and Preveition (CDC) competency guidelines. Following the GLLP session, we met with officials from the Microbiology Coordination Section of the European Centre for Disease Prevention and Control (ECDC) and then, in Bochum, Germany, with Drs. Holger Koch and Marike Kolossa, key leaders of the European Union’s (EU’s) human biomonitoring network, HBM4EU. The purpose of these latter two meetings was simply to listen, learn and lay the groundwork for future collaboration. So what did we discover? First, there are many similarities between US and EU lab networks. Like US states, EU member states differ significantly in technical capabilities and funding. 2 LAB MATTERS Spring 2018 Like our public health laboratories, EU national reference laboratories seek to fully exploit the capabilities of whole genome sequencing (WGS) for disease surveillance and outbreak investigations. As reported in Frontiers in Public Health, by mid-2016, half of EU/European Economic Area (EEA) countries were using WGS analysis as a first- or second-line typing method to track EU priority pathogens and antibiotic resistance, using Illumina and Ion Torrent technology primarily. Future ECDC goals will look familiar to any US public health laboratory official: optimization and broader use of rapid diagnostics, further integration of WGS in surveillance, and electronic linkage of laboratory and public health systems. However, there are important differences between US and EU laboratory systems. Unlike CDC, ECDC does not directly operate laboratories, relying on the network of national laboratories instead. The EULabCap monitoring program, launched in 2014, mirrors APHL’s work to assess member laboratory capabilities and capacities, identify priorities for improvement and gauge the impact of support activities. But while APHL focuses on process measures and summary data, EULabCap measures specific target indicators—such as C. difficile test rate and Ebola virus diagnostic capability—and produces detailed, visually compelling reports for each individual reference APHL staff and members at EUCDC EU national public health reference labs and US public health laboratories also share a strong interest in fully exploiting the capabilities of whole genome sequencing (WGS) for disease surveillance and outbreak investigations.” laboratory. ECDC uses these reports for technical assistance and policy work. As impressive as this work is, we were equally excited by discussions about EU human biomonitoring efforts and the German biomonitoring program PublicHealthLabs @APHL APHL.org