Pacific nations continue to strengthen laboratory capacities to save lives

21 May 2023

The COVID-19 pandemic has shone a spotlight on the integral role laboratories play in disease detection and control by providing accurate and timely test results. As the world moves past the emergency phase of the pandemic, recent investments in laboratory diagnostics need to be sustained to ensure public health systems are able to detect and identify a wide array of priority diseases.

“The emergency phase of COVID-19 is over, but there is still a public health threat out there from COVID-19 and other infectious diseases. Laboratory testing remains one of the critical tools that countries must use to understand their epidemiological situation and inform an appropriate response, link positive cases to early care and treatment, and ultimately save lives,” explained Dr Nuha Mahmoud, Team Lead for Pacific Health Security and Communicable Diseases at the World Health Organization Division of Pacific Technical Support.

Laboratory capacity in Pacific island countries and areas has long been uneven. Some countries have had enough resources to establish and maintain well-functioning national public health laboratories. However, many countries have faced a lack of funding, insufficient equipment and supplies, and limited qualified staff.

Driven by the heightened demand during the pandemic, ministries of health across the Pacific have spent the past few years strengthening their laboratory services with support from partners such as the World Health Organization (WHO). By the end of the pandemic, all Pacific island countries had capacity for laboratory testing of COVID-19. This capacity now needs to be maintained and further built upon, including to expand the scope of diseases able to be tested. WHO is supporting Pacific island countries to implement testing for influenza-like illness/severe acute respiratory illness, and to test for diseases like measles and rubella. But the combined efforts of Pacific governments and other partners will be needed to ensure that the entire Pacific can benefit from expanded testing capacity in future.

Scroll through the photos below to see how Pacific nations continue to strengthen their laboratory health services and testing, with support from WHO and partners.

WHO gratefully acknowledges the European Union, the Governments of Australia, India, Japan, New Zealand, and the United States, for their financial contribution and the Pacific Island Health Officers Association (PIHOA) and the Pacific Community (SPC) for partnering with us towards laboratory strengthening across the Pacific.

WHO/Jason Chute
WHO Representative to the South Pacific Dr Mark Jacobs (left) and WHO team-member Adrian Chand (right) inspect the boxes of rapid antigen tests stored in WFP’s cold storage warehouse in Nadi, Fiji, ready for delivery to neighbouring Pacific nations.

Delivery of lab equipment and supplies

Since 2020, WHO has delivered over 1.6 million items of laboratory equipment and supplies worth US$12 million to American Samoa, Cook Islands, Fiji, Guam, Kiribati, Marshall Islands, Federated States of Micronesia, Nauru, Niue, Northern Mariana Islands, Papua New Guinea, Samoa, Solomon Islands, Tokelau, Tonga, Tuvalu, Vanuatu and Wallis and Futuna.

The Division of Pacific Technical Support (DPS), WHO’s Fiji-based subregional office, has provided laboratory equipment and supplies ranging from polymerase chain reaction (PCR) testing machines to testing reagents and rapid antigen tests. DPS is closely coordinating with the logistics team in the Western Pacific Regional Office and the World Food Programme (WFP) Pacific to ensure the prompt delivery of this lab equipment and supplies when and where needed.

In this photo, WHO Representative to the South Pacific and Director of Pacific Technical Support Dr Mark Jacobs (left) and WHO team-member Adrian Chand (right) inspect the boxes of rapid antigen tests stored in WFP’s cold storage warehouse in Nadi, Fiji, ready for delivery to neighbouring Pacific nations.

WHO/Neil Nuia
Laboratory technicians conduct COVID-19 RT-PCR testing at the National Referral Hospital Molecular Laboratory in Honiara, Solomon Islands.

Tailored lab support to the Pacific

There was some laboratory capacity available in the Pacific prior to the pandemic, but this existing capacity was well and truly exceeded by the increased demand for testing for COVID-19.

WHO provided tailored assistance based on each country’s needs. In the Solomon Islands, WHO helped boost the country’s COVID-19 reverse-transcription polymerase chain reaction (RT-PCR) testing capacity by providing PCR machines, reagents and consumables, and other critical equipment and supplies to ensure biosafety. WHO also supported training with provincial laboratory teams on new diagnostic methods.

In this photo, laboratory technicians conduct COVID-19 RT-PCR testing at the National Referral Hospital Molecular Laboratory in Honiara, Solomon Islands.

WHO Samoa Country Office
WHO Representative to Samoa, Dr Kim Eva Dickson (centre), meets with lab technicians during a visit at the Malietoa Tanumafili II Hospital in Tuasivi, Samoa.

Capacity building for the lab workforce

WHO supported Pacific island countries and areas by training laboratory technicians in testing techniques using the new PCR machines and providing one-on-one technical advice. Even when faced with movement restrictions, ministries of health and WHO found ways to deliver these capacity-building efforts remotely.

In Samoa, for example, the Ministry of Health and WHO worked closely in organising virtual trainings with medical laboratory scientists and lab technicians on the use of the PCR machine and helped procure additional testing machines, cartridges, and other supplies.

In this photo, WHO Representative to Samoa, Dr Kim Eva Dickson (centre), meets with lab technicians during a visit at the Malietoa Tanumafili II Hospital in Tuasivi, Samoa.

WHO/Mesake 'Isileli Taukolo
Tonga Ministry of Health's former Chief Executive Officer, Dr Siale 'Akau'ola, and High Commissioner of India to Fiji, Kiribati, Tonga and Tuvalu, P.S. Karthigeyan, are inside the container laboratory that was opened in Vaiola Hospital in December 2022.

Set-up of fully functioning container laboratories

WHO supported Fiji, Niue and Tonga to set up fully functioning laboratories to boost existing in-country capacities. These laboratories were rapidly established to support testing needs in these countries, thanks to the innovative use of pre-fitted shipping containers. Aside from the laboratory infrastructure, the assistance provided by WHO also included testing machines, PCR kits and other supplies, staffing and operational support, a quality assurance programme and training.

In this photo, Tonga Ministry of Health's former Chief Executive Officer, Dr Siale 'Akau'ola, and High Commissioner of India to Fiji, Kiribati, Tonga and Tuvalu, P.S. Karthigeyan, are inside the container laboratory that was opened in Vaiola Hospital in December 2022. WHO supported the establishment of this new lab with funding from the Government of India through the United Nations Office for South-South Cooperation. The lab has the capacity to test for COVID-19 and other diseases.

WHO/Quennie Amor-Go
The Chuuk Department of Health Services and Department of Education conduct a training with school principals on how to use self-test kits, with support from WHO.

Self-testing capacity support

Rapid antigen tests may not be as sensitive as RT-PCR tests, but they are a practical and useful alternative for detecting COVID-19 cases. Access to affordable or free COVID-19 self-tests should be integrated into a country’s COVID-19 testing strategy, including strategies for reporting from self-testing. WHO has previously issued a guidance on self-testing.

WHO has been working alongside ministries of health across the Pacific to increase access and capacity to self-testing. In this photo, Myisha Mori (left) and Marmelyn Rhaym (right) from the Chuuk Department of Health Services and Department of Education in the Federated States of Micronesia (FSM) are conducting a training with school principals on how to use self-test kits, with support from WHO.

With limited health workers and widely dispersed islands in FSM, working with schools and school administrators is a critical intervention to ensure early detection of COVID-19 and proper case management. In Chuuk State, close collaboration between the Department of Health Services and Department of Education paved the way towards the safe reopening of schools in the State.

WHO/Darwin Operario
Members of LabNet, at an event co-sponsored by WHO and SPC, meet for the first time since the start of the pandemic in Nadi, Fiji.

Coordinating laboratory networks

The pandemic emphasized the significance of a robust laboratory network for timely coordination of urgent needs and available resources in the Pacific. For example, countries lacking the laboratory capability to characterize circulating variants can use the network to quickly coordinate and send samples to reference laboratory partners in other countries who can then perform this complex testing.

Coordination mechanisms like the Pacific Joint Incident Management Team (JIMT) and the LabNet under the Pacific Public Health Surveillance Network (PPHSN) were instrumental in the successful collaboration of laboratories across the Pacific especially for COVID-19. Throughout the pandemic, WHO supported the shipment of samples from PICs to advanced reference laboratories in Australia and New Zealand for genomic sequencing to characterize circulating viral variants.

In this photo, members of LabNet, at an event co-sponsored by WHO and SPC, meet for the first time since the start of the pandemic in Nadi, Fiji. LabNet members discussed lessons learned by laboratories during the pandemic, as well as future plans for influenza surveillance and training on the use of laboratory data to inform public health responses.

WHO/Lieke Visser
WHO’s Division of Pacific Technical Support Officer in Charge Dr Nuha Mahmoud talks with the Vanuatu Ministry of Health Laboratory Manager George Pakoa Junior during a visit at the National Reference Laboratory in Port Vila, Vanuatu.

Expanding capacities beyond COVID-19

Appropriately, government authorities are looking at how they can make the most of the laboratory capacity put in place during the pandemic to also tackle other diseases, such as influenza and measles. This work is being supported by WHO and other development partners in the region.

In Vanuatu, the National Reference Laboratory in Vila Central Hospital had existing capacity pre-pandemic to test for diseases like tuberculosis and HIV/AIDS. Since 2020, WHO has worked to support the lab to test for COVID-19 through the provision of equipment and supplies as well as relevant training. Now, WHO is working to support the Ministry of Health as they plan to further strengthen the laboratory to test for other diseases.

In this photo, WHO’s Division of Pacific Technical Support Officer in Charge Dr Nuha Mahmoud talks with the Vanuatu Ministry of Health Laboratory Manager George Pakoa Junior during a visit at the National Reference Laboratory in Port Vila, Vanuatu.

WHO/Jason Chute
Ministry of Health and WHO representatives discuss ongoing plans inside the lab room in Fiji CDC where the genomic sequencing equipment will be set up.

Genomic sequencing in the Pacific

Genomic sequencing helps to assess the evolution of SARS-CoV-2 variants and subvariants as they circulate. Currently, Pacific island countries send their samples for genomic sequencing to the Victorian Infectious Diseases Reference Laboratory in Australia or the Institute of Environmental Science and Research in New Zealand.

The Fiji Centre for Disease Control (CDC) is leading the way towards having the capacity for genomic sequencing in the Pacific. WHO is supporting this initiative through the procurement of equipment and reagents related to genomic sequencing.

In this photo (left to right), Fiji CDC Senior Scientific Officer, Shalini Singh, Ministry of Health and Medical Services Head of Health Protection, Dr Aalisha Sahukhan, WHO’s Director for Pacific Technical Support, Dr Mark Jacobs, and Pacific Health Security Team Coordinator, Dr Nuha Mahmoud, discuss ongoing plans inside the lab room in Fiji CDC where the genomic sequencing equipment will be set up.

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