Lab Matters Winter 2020 | Page 19

GLOBAL HEALTH done before,” Reisdorf said. The lab was able to share viruses with WHO and CDC and started surveillance for non-influenza respiratory pathogens. the world helps provide WHO with better data for vaccine strain selection. PCR’s rapid detection of novel influenza viruses also offers a sort of early warning system. The importance of such global surveillance became painfully evident during the 2009 influenza pandemic, which “kind of caught everyone by surprise. It seemed to emerge from nowhere and suddenly was a global pandemic,” Reisdorf said. “The aim is to be able to detect these strains earlier and perhaps put in place some mitigation measures.” Lasting Change Building Global Laboratory Capacity In more recent years, Reisdorf has provided mentorship for public health laboratories in southeastern Europe and western Africa through a WHO/CDC/ APHL collaborative training program aimed at increasing laboratory quality and technical expertise in influenza testing. Countries lacking in laboratory capacity can lead to data reporting gaps, he said. Through the mentoring program, Reisdorf worked closely with Bosnia and Herzegovina’s two public health labs for two years, helping the staff develop laboratory quality procedures and influenza diagnostic testing capacity. “The labs did all of the work,” he said. “We were just providing the support and guidance.” Some of the participating labs in Southeast Europe even received National Influenza Center designation from WHO, “a really key achievement of that mentorship program,” he said. Such programs show the lasting impact of global health partnerships based on sharing knowledge and building regional laboratory capacity. Many programs that purport to boost global health efforts fail to account for the local environment, resources and needs of recipient laboratories, Diallo said. Donations of equipment, reagents or other supplies, no matter how well intentioned, may be of limited utility if the lab lacks reliable electricity or refrigeration. For meaningful and sustainable change, Diallo lauds APHL’s long-term vision and efforts such as its “Foundations of Laboratory Leadership and Management” course, originally developed more than a dozen years ago with PEPFAR support to improve organizational structure and management skills in African public health laboratories. Another example is APHL’s laboratory twinning program, which matches a laboratory with particular needs from an under-resourced country with an established laboratory with expertise relevant to those needs. While director of the public health laboratory in Washington, DC, Diallo oversaw a twinning relationship with the national health and quality assurance laboratory in Tanzania to help set up virology training programs and an ELISA system. Blevins has also seen first-hand the impact of sharing knowledge and good laboratory practices. During a two-year mentorship in Rwanda, she learned that pipette calibration was a hurdle. She connected the laboratorians with a colleague in her San Antonio lab, who taught them how to test and calibrate their pipettes in-house. “Now they can be self-sufficient,” she said. “Even such a small thing affects testing and helped overall with their program.” “It’s been wonderful to work with people who share the same goals. It doesn’t matter what lab, what country you work in,” Reisdorf said. “We’re all trying to achieve the same outcomes.” n When the program expanded to Africa in 2017, Reisdorf became a mentor to Sierra Leone’s public health laboratory, which faced severe resource shortages and was not able to perform influenza testing. “At the end of the program in 2019, the test system was working, they were able to report test results and characterize influenza viruses. And, very importantly, they had begun reporting their data to WHO every week. That was a huge accomplishment because that hadn’t been Kim Lewis and Frances Downes work with public health laboratory stakeholders in Jakarta, Indonesia to develop plans to implement the public health network strategic plan. Photo: Frances Downes PublicHealthLabs @APHL Winter 2020 LAB MATTERS 17