Informal consultation for the development of a Regional Laboratory Network to augment national laboratory capacity for public health emergencies

20 August 2019
Departmental update
Ulaanbaatar, Mongolia
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The Countries of the  Southeast Asia are vulnerable to public health emergencies and have suffered from such situations in recent years (https://apps.who.int/iris/handle/10665/258766). High threat pathogens with epidemic and pandemic potential could cause devastating biological events and pose major challenges to the global health security. Hence, timely and safe diagnosis of any pathogen with an epidemic/pandemic potential is essential to activate immediate and effective response for controlling and mitigating their health impacts. Though laboratory diagnosis is an inseparable area for an effective response to such events, the Public Health Laboratories in SEAR region have several challenges in supporting optimal disease surveillance systems and sustaining national laboratory network capacities for timely diagnosis of high threat pathogens.  Also required   for immediate response to any health emergency by Public Health Laboratories   are timely resource mobilization, information sharing and technical support. This will be better achieved and effectively coordinated   through an effective

Regional Laboratory Network.  

With a view to envisioning such an effective Regional Laboratory Network to better handle any public health emergency in WHO’s South East Asia Region (SEAR), the Infectious Hazards Management (IHM) unit of the WHO’s Health Emergency Programme (WHE) at SEARO organized an informal consultation of laboratory focal points of National Public Health Laboratories in SEAR countries on 19-20, August 2019 at Ulaanbaatar, Mongolia. The Informal consultation was titled “The development of a Regional Laboratory Network to augment national laboratory capacity for Public Health Emergencies” and was conducted in integration with the 13th Bi-regional meeting of the National Influenza Centres and Influenza surveillance in WHO’s Southeast Asia and Western Pacific Regions.

Principle objectives of the informal consultation were;

  1. To obtain ideas on existing national laboratory capacities and network(s)/systems for high threat pathogens.

  2. To sensitize the importance of a Regional Laboratory Network, especially during emergencies in terms of knowledge sharing, personnel deployment and national laboratory capacity building.

  3. To obtain ideas of participants from the Member States to develop a sustainable Regional Laboratory Network for Public Health Emergencies in SEAR countries.

  4. To obtain ideas for development of laboratory capacity for multi-hazard health emergencies with specific focus on deployable laboratories in health emergency affected areas.

To achieve these objectives, the informal consultation began with brief presentations on

  1. the International Health Regulations (IHR 2005) and its role of improving laboratories as a core component of IHR.  
  2. Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies (APSED) III (2017) with specific focus on its laboratory component.

Further, laboratory focal points from the Member States presented the structure and function of their national public health laboratory systems, existing capacities and networks. They also shared experiences on the role of Public Health Laboratories during recent public health emergencies (including diseases outbreaks) in their respective countries. Other presentations included:

  • WHO Collaborating Centers (WHO CCs) for Emerging Infectious Diseases: Their Terms of References (TORs), inter and intra regional capacities and how they could support Regional Laboratory Networks

  • Deployable laboratories

  • Networks of priority emerging diseases: requirements, ToRs and mechanism and Step-by-step approach to operationalize networks

The facilitated discussion during the meeting paved the way for identifying points for a roadmap for involvement of Public Health Laboratories for high thereat pathogens in   Member States, WHO and WHO CC to address existing challenges and gaps for functionality of an effective regional network of laboratories for public health emergencies and the expectations of  SEAR  laboratory focal points  from The Regional Public Health Laboratory Network.  The suggested recommendations of the participants included:

Focus areas

Strategic interventions

Existing networks

  1. Identify the existing network in SEARO - explore the opportunities to strengthen the existing network and work towards using it for responding to public health emergencies.

  2. Strengthen /establish the network for high threat pathogens

Communications

  1. Create email, WhatsApp, viber group for effective communications

Lab testing for detection of priority high threat pathogens
  1. Identify a list of high threat pathogens in the region

  2. Assess the laboratory capacity of Member States in detection of prioritize high threat pathogens

  3. Identify Reference laboratory for prioritize high threat pathogens

  4. Share information in real-time about the circulating high threat pathogens, outbreaks or any other

  5. Establish a roster of laboratory experts, laboratory technicians within the region

  6. Develop tools, guidance for trainings, deployments and transfer of technology

  7. Train in-house preparation of reagents

  8. Prepare directories of institutions, entities based on the technology availabilities expertise etc..

  9. Facilitate quality assurance during technology transfer

  10. Strengthen activities based on the laboratory performance (EQAP)

  11. Establish external affiliations for effective laboratory activities

Specimen referral and transport system

 

  1. Prepare a directory of laboratories within and outside region for high threat pathogens

  2. Establish mechanisms for swift sample shipment and response for unidentifiable pathogens

  3. Support exploring mechanisms for shipment of specimens to different countries in the region and develop guidelines (Courier services within country, in the region)

Effective national Network

 

  1. Augment the national network through information and experiences shared from countries with existing/well established networks

  2. Establish and operationalize enhanced communication and co-ordination mechanisms

Laboratory quality systems

 

  1. System development for activities such as accreditation; laboratory quality management systems - knowledge sharing, support towards documentations