Health laboratory strengthening: Better Labs for Better Health supports early warning

surveillance and response systems and implementation of the International Health Regulations (IHR) (2005)

Dr Caroline Brown, Programme Manager, Influenza and Other Respiratory PathogensThomas Hofmann, IHR Area Coordinator

Communicable Diseases and Health Security

Presentation overview• The role of laboratories in IHR implementation and

emergencies• Capacity-building and partnership: Better Labs for Better

Health – Rationale and goals– Strategic directions

• Topics for the panel

IHR: laboratories 1 of 8 areas of work

National capacity to:• DETECT public health events• ASSESS public health events• REPORT public health events

Legislation and Policy

CoordinationSurveillance

ResponsePreparedness

Risk CommunicationsHuman Resources

Laboratories

Photo: WUR laboratory of virology/Jelke Fros

National laboratory network

Specimen referral and

transport system

Effective modern point of care and laboratory-based

diagnostics

Laboratory testing for

detection of priority diseases

Laboratory quality system

Photo: WHO

Photo: WHO

Photo: Research Institute of Influenza/Kirill Sirotyuk

Examples of laboratory response to emergencies

• National capacity to detect high-threat pathogens or

• Arrangements to ship

specimens to international reference laboratories with WHO support

WHO and EU networks for rapid response

Rapid provision of assays, proficiency panels for quality assurance, shipment of specimens, data management, deployments and mobile labs

WHO and EU networks for rapid response

200 technical institutions and networks; 600 partners

Examples of preparedness activities in partnership with Member States

Laboratory preparedness for emerging respiratory pathogens

Biorisk management

On-the-job training on influenza

Training

Photos: WHO

Capacity-building: Better Labs for Better Health

What is Better Labs for Better Health? o Guided by Health 2020 and the IHR,

an intersectoral approach to improve laboratory capacity up to international standards

o The first initiative aimed at improving the laboratory system as a whole rather than disease-specific programmes

o Builds national policies and strategic plans

o Platform for coordinating partner and donor activities

Goal

Improve health by providing timely and accurate laboratory results

from accredited laboratories that are trusted by the user

Why is Better Labs for Better Health needed?

• To assist countries where laboratory services are fragmented, lack oversight and investment and have poor quality and safety, develop quality-assured services

• Quality-assured laboratories create trust and contribute to the IHR

Upgraded HIV laboratory/ Neglected bacteriology laboratory

in central Asia

Few countries in eastern and south-eastern Europe regularly share influenza virus samples with WHO

Photos: WHO

Strategic directions• National policies, strategies and

operational plans• Establish quality-assured laboratories

through training and mentoring in laboratory quality implementation

• Advocacy, partnership and coordination

National policies, strategies and operational plans

Policy and strategy finalized March 2016; budgeted proposal on “Licensing, certification and accreditation of Kyrgyz laboratories” finalized July 2016

National laboratory working groups

Methodology

Photo: WHO

Training and mentoring programme for laboratory quality implementation

• First step: train people in laboratory quality and use of the WHO tool for laboratory quality systems implementation

• Second step: train mentors• Third step: mentor

laboratories

Photos: WHO

Rationale for mentoring and progress• Effective and efficient strengthening of medical laboratories

through the implementation of a quality management system based on the international quality standard ISO 15189:2012 • 135 experts from 100

laboratories trained• 20 mentors from 10

countries trained • 11 visits to 6 laboratories

Advocacy, partnership and coordination

Partners’ meeting 2014 and 2016 (1–2 December, Georgia)

Just published!

Partnership: support from Member States and centres of excellence

2674%

926%

ILAC signatories for ISO 15189

EU/EEA countriesplus Israel and SwitzerlandOther countries

Most western European countries have the capacity to accredit laboratories according to ISO as well as legislation;Example: France – legislation requires all medical testing laboratories to beISO 15189 accredited by 2020

2674%

926%

International Laboratory Accreditation Cooperation signatories for ISO 15189

EU/EEA countriesplus Israel and SwitzerlandOther countries

Most WHO collaborating centres (WHO CCs) that are laboratories are in western European countries (WEU)

Topics for panel discussion• What issues/gaps still exist with regard to laboratory capacity?

• What support do Member States require from WHO to close the gaps in laboratory capacity?

• What key elements should be included in a framework for laboratory capacity development for the WHO European Region?

AcknowledgementsKYRGYZSTAN

TAJIKISTANREPUBLIC OF MOLDOVA

UZBEKISTAN

Royal Tropical Institute

ECDC, US CDC, Global Fund/UNDP, USAID, Project HOPE, Fondation Mérieux, Public Health England, Robert Koch Institute, Gauting Supranational Reference Laboratory for TB

Photos: WHO

Thank you for your attentionThis work is supported by the European Union (European Commission's Directorate-General for International Cooperation and Development) as part of the project on strengthening health laboratories to minimize potential biological risks (contract IFS/2013/332312)

Funding was also received under:

• Deutsche Gesellschaft für Internationale Zusammenarbeit (GiZ)• The Netherlands partnership programme on antimicrobial resistance • The Pandemic Influenza Preparedness Framework • The Russian Federation funding on the implementation of the IHR• The United States Centers for Disease Control and Prevention