GLOBAL HEALTH
Spanning Borders for a Cohesive
Public Health Approach
By Jill Sakai, PhD, writer
On his desk at Health and Education
Quality System Strengthening, the
international health systems NGO he
started in Guinea, Alpha Diallo, PhD,
HCLD (ABB), displays an APHL statement
about the importance of high-performing
public health laboratories for all countries.
With more than 40 years’ experience in
public health in the United States and
in Africa, Diallo has seen repeatedly
the value of strategic investments
that build the capacity, resilience and
interconnectedness of laboratory systems,
regardless of where the labs are located.
“There is a parallel to be drawn about
all the issues of public health laboratory
systems. They are more acute in resource-
limited settings, but they are the same in
America—or, for that matter, in Europe,”
Diallo said. “Diseases have no borders,
especially emerging and reemerging
infections, so the effective control of
diseases rests on the strength of a global
public health laboratory system.” That
includes non-communicable diseases as
well, such as high blood pressure, stroke
and diabetes.
As an international leader in public health
laboratory systems and practices, APHL
brings critical perspective and experience
to its efforts to strengthen global
networks to improve public health testing,
surveillance and disease control efforts
worldwide.
“We are a global participant in public
health, whether we want to be or not,
so it makes sense to take an active role,”
said Patricia Blevins, MPH, a laboratory
coordinator in the San Antonio Metro
Health District Laboratory who has been
active in APHL’s global programs. “We’re
trying to build and enhance this network
globally, so we can ultimately protect
people domestically.”
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LAB MATTERS Winter 2020
Public health network planning and development required visits to participating laboratories in Indonesia. Photo: Frances Downes
Preparedness Through Awareness
Efforts conducted outside the US are
linked to the APHL’s organizational
priorities, said Frances Pouch Downes,
DrPH, a professor of public health and
clinical microbiology at Michigan State
University and current chair of the APHL
Global Health Committee. After all,
pathogens don’t respect international
borders. “Any disease that arises
anywhere in the world can end up on
our doorstep. We saw that with Ebola,
SARS, MERS,” Downes said. “They may
be starting somewhere else, but they
don’t stay somewhere else. People travel,
vectors travel, food travels—and if we are
being very myopic in our vision of health,
we’re leaving ourselves vulnerable.”
The public health laboratory’s approach
to disease monitoring changed with the
launch of the Global Health Security
Agenda in 2014, shifting from a focus on
known diseases such as polio and yellow
fever toward “a realization that now there
are new diseases emerging, and what you
really need to have is a system that can
recognize the emergence of a new disease,
monitor it and control it,” Downes said.
As part of that framework, Downes is
assisting laboratory officials in Indonesia
with strategic planning for a cohesive
national laboratory network. Indonesia’s
position on an archipelago brings unique
geographic challenges. “We’re working
with them to connect public health
laboratories in an organized way that will
assure that emerging health threats are
recognized,” she said.
Influenza vaccine development also relies
on a strong global network, said Erik
Reisdorf, MPH, M(ASCP)CM, surveillance
and virology team lead at the Wisconsin
State Laboratory of Hygiene. Through
a collaboration between APHL and
the CDC to enhance global influenza
diagnostic capacity, Reisdorf has trained
international laboratory staff to use real-
time PCR for faster and more sensitive
influenza testing and characterization.
Enhancing this capacity at labs around
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