GLOBAL HEALTH
A Global Response to COVID-19:
Mozambique, Zambia and Zimbabwe
By Sarah Snyder, specialist, Global Health and Lucy Maryogo-Robinson, director, Global Health
APHL was the first US laboratory partner
that the US Centers for Disease Control
and Prevention (CDC) turned to for
technical assistance support at the
launch of the President’s Emergency
Plan for AIDS Relief (PEPFAR). APHL
began implementation of PEPFAR
activities in 2004 working to strengthen
laboratories across Africa, the Caribbean,
Europe and Asia. While activities under
PEPFAR focused on HIV/TB epidemic
response, APHL has been unwavering in
its commitment to building laboratory
systems globally. This emphasis on
laboratory system strengthening has
proven invaluable to COVID-19 response
efforts.
Zimbabwe
In 2013 APHL began a partnership with
the Ministry of Health of Zimbabwe
to improve the quality of laboratory
testing within the country. Over the
next six years, APHL worked with
local stakeholders to identify six
major laboratories across the nation
to support their journey towards
international accreditation. Thanks to
APHL mentorship, procurement, training,
internal assessments and continuous
quality improvement projects all six
laboratories received ISO accreditation
in January 2020. This major achievement
could not have happened without the
dedicated APHL staff in Zimbabwe who,
despite economic turmoil and political
unrest, continued to ensure APHL success
on the ground. Today all six accredited
laboratories are testing for COVID-19 as
the current pandemic rages on.
Mozambique
Mozambique was a pioneer in
standardizing laboratory data
management. Even though they began in
2006 with an initial focus on paper-based
A technician inputs test results into a reporting program
systems, strengthening their paper-based
tools and logbooks laid a foundation
for deploying electronic laboratory
information systems at central and
provincial laboratories throughout the
country. To reduce turnaround time,
APHL also supported implementation of
an electronic sample referral system for
remote test order and results receiving
at over 150 locations. All these data are
pushed to a laboratory data repository
hosted at the Ministry of Health that
can be used to provide key performance
indicator data for one or multiple
laboratories. This robust structure has
been essential in enabling the Ministry
of Health to be prepared for a public
health emergency. These networks
and systems have been successfully
repurposed for the COVID-19 response,
empowering health facilities to submit
test requests electronically for COVID-19
testing, utilizing previously implemented
automation in testing laboratories and
rapidly developing data visualization
options utilizing the laboratory data
repository. APHL has been recognized
as a trusted laboratory partner for the
Mozambique Ministry of Health.
Zambia
APHL has supported Zambia’s Ministry of
Health laboratory services unit through
the implementation of efficient, cost
effective and high-quality clinical and
public health laboratory services:
• Implementation of power backup
systems in the wake of increasingly
inconsistent grid power supply
• Capacity building in testing at hub
laboratories
• Strengthening courier systems for
specimen transportation
• Electronic laboratory information
management systems implementation/
support
• Remote electronic specimen
registration/results receipt
• Overall laboratory data management.
Key COVID-19 testing laboratories—
including the main COVID-19 testing
laboratory, University Teaching Hospital—
have benefited from this support while
scaling up pandemic response. APHL’s
work continues as efforts expand to
ensure the safe disposal of laboratory
waste through waste management
training and the installation of modern
incineration systems in laboratories
across the country.
The COVID-19 pandemic has illuminated
the significance of global health to
domestic health security and underscored
the need to implement a “One Health”
approach. APHL’s consistent focus on
strengthening laboratory systems globally
has helped countries better prepare for
outbreaks. This work must continue to be
a priority–the future of US public health
and US health security are inextricably
tied to global health.•
20 LAB MATTERS Summer 2020
PublicHealthLabs
@APHL APHL.org