Countries in the South-East Asia Region are vulnerable to a wide range of emergencies and natural disasters that are becoming more frequent because of seismic activity, climate change and changes in human development.
(WHO’s publication, Roots for Resilience: A health emergency risk profile for South-East Asia Region).
COVID-19 has made it amply clear to the world as to how high threat pathogens with epidemic and pandemic potential can devastate biological events and pose major challenges to global health security. Hence, timely and safe diagnosis of any pathogen with epidemic and pandemic potential will activate immediate and effective response for controlling and mitigating its health impacts.
Though laboratory diagnosis is an inseparable area for an effective response to such events, Public Health Laboratories in SEAR have several challenges in supporting optimal disease surveillance systems and sustaining national laboratory network capacities for timely diagnosis of high threat pathogens. What is required for immediate response to any health emergency by Public Health Laboratories is timely resource mobilization, information sharing and technical support. This goal will be better achieved and effectively coordinated through an effective Regional Laboratory Network.
Informal consultation of laboratory focal points of National Public Health Laboratories
With a view to envisioning such an effective Regional Laboratory Network that has the potential to handle public health emergencies in the region, 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 on 19–20, August 2019 at Ulaanbaatar, Mongolia. The interaction coincided with the 13th Bi-regional meeting of the National Influenza Centres and the Influenza surveillance unit in WHO’s SEA and Western Pacific Regions. The consultation aimed to:
- Brainstorm ideas on existing national laboratory capacities and networks/systems for high threat pathogens.
- Build consensus on the importance of a Regional Laboratory Network, especially during emergencies, in terms of knowledge sharing, personnel deployment and national laboratory capacity building.
- Seek inputs on developing a sustainable Regional Laboratory Network for Public Health Emergencies in SEAR countries.
- Finalize a template for development of laboratory capacity for multi-hazard health emergencies with specific focus on deployable laboratories in health emergency affected areas.
The laboratory focal points of Member Countries in WHO‘s South-East Asia region who participated in this meeting shared their views on the International Health Regulations (IHR 2005) and its role in improving laboratories as a core component of IHR. They threw light on the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies (APSED) III (2017) with specific focus on its laboratory component. The group presented a broad structure along with primary functions of their national public health laboratory systems and cited the role that existing capacities and networks were playing in this area. WHO Collaborating Centers (WHO CCs) for Emerging Infectious Diseases shared their terms of reference, inter and intra- regional capacities and how they could support the Regional Laboratory Networks. They reviewed the status of deployable laboratories and networks of priority emerging diseases.
The meeting paved the way for identifying key strategic areas and action points for developing a roadmap for the involvement of Public Health Laboratories for diagnosing high threat pathogens in Member States with the support of WHO and WHO CCs. This would help 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. Suggested recommendations covered all six themes related to the network.
Review existing networks
- Identify the existing network in SEARO and explore opportunities to strengthen existing networks and find ways of using it for responding to public health emergencies.
- Strengthen /establish the network for identifying high threat pathogens
Undertake laboratory testing for detection of priority high threat pathogens
- Identify a list of high threat pathogens in the WHO’s South east Asia region
- Assess laboratory capacity of Member States to detect and prioritize high threat pathogens
- Identify a reference laboratory for diagnosing and prioritizing high threat pathogens
- Share information in real-time about circulating high threat pathogens and outbreaks due to these pathogens.
- Establish a roster of laboratory experts and technicians within the WHO’s South East Asia region
- Develop tools, guidance for trainings, deployments and transfer of technology for laboratory diagnosis
- Train in-house preparation of reagents
- Prepare directories of institutions and entities based on available technologies and expertise
- Facilitate quality assurance during technology transfer
- Strengthen activities to assess laboratory performance such as EQAP
- Establish external affiliations for effective laboratory activities
Organize the specimen referral and transport system
- Prepare a directory of laboratories within and outside WHO’s South East Asia region for high threat pathogens
- Establish mechanisms for swift sample shipment and response for unidentifiable pathogens
- Support exploring mechanisms for shipment of specimens to different countries in the region and develop guidelines (courier services within country, within the WHO’s South East Asia region)
Operationalize an effective national network
- Augment national networks through information and experiences shared from countries with existing/well established networks
- Establish and operationalize enhanced communication and coordination mechanisms
Ensure laboratory quality systems at all times
- Strengthen laboratory system development process with activities such as building s accreditation and laboratory quality management systems (knowledge sharing, support towards documentation), amongst others
Upgrade communication systems
Create email, WhatsApp, viber groups or and any other means for effective and speedy communication. Efforts must be made to share verified information and not spread any sensational and false information so as not to create panic or fear.