Global Laboratory Initiative for the African Region

(GLI-AFR)

Tsehaynesh Messele, PhD

ASLM, Chief Executive Officer

6th Global Laboratory Initiative (GLI) Partners Meeting

30 April - 2 May 2014

Geneva, Switzerland

Laboratory capacity gaps in Africa

1. Workforce: Less than 1 laboratory professional per 10,000

people.

2. Quality: Less than 500 laboratories accredited to international

standards and 90% are in South Africa.

3. Regulatory: No countries with stringent IVD regulatory

standards (as defined by the Global Harmonization Taskforce)

and no diagnostic regulatory harmonization by economic zone.

4. Lab Networks: Few fully functional national public health

reference laboratories and networks.

Key Facts

Over 1 billion people and growing

�Increased Access

����Quality service

Key healthcare commitments, documents, and

declarations in Africa

• Abuja +12: Shaping the future of health in Africa, 2012

(African Union)

• Delivering results toward ending AIDS, TB, and Malaria

in Africa (African Union accountability report on Africa)

• Work of the WHO in the African Region 2012-2013

(WHO-AFRO)

• Sixty-Second and Sixty-Third Sessions of the WHO AFRO

Programme and Statement of Strategic Objectives, 2012

(WHO-AFRO)

• The Brazzaville Declaration on Noncommunicable

Diseases Prevention and Control in the WHO African

Region, 2011 (WHO-AFRO)

• Libreville Declaration on Health and Environment in

Africa, 2008 (WHO-AFRO)

African healthcare priorities

Improved diagnostics is essential to meet healthcare goals

2008 Maputo

Declaration

2008-2009 Yaoundé

Resolutions

• Strengthen public health laboratories in

the African region

• Establish laboratory centers of excellence

2009 Kigali Stepwise

Accreditation

• Launch of WHO-AFRO Stepwise Laboratory Accreditation program

2010 Kampala

Statement

• Called for integrated laboratory support for major diseases

• Called on governments to develop and implement national laboratory strategic plans

• Called for creation of

the African Society

for Laboratory Medicine

2011 ASLM

Launched

• Support from MOHs, WHO, African Union, PEPFAR, World Bank, Clinton Foundation, UNAIDS, and others

-MINISTERIAL CALL FOR ACTION-STRENGHTENING LABORAOTRY SERVICES IN AFRICA

“We, the undersigned Ministers of Health from African countries, attending

and meeting at the 1st International Conference of the African Society for

Laboratory Medicine (ASLM), Cape Town, South Africa, December 1st-7th,

2012 under the theme ‘Accurate Laboratory Diagnostics – A Pillar of Quality

Health Care’”

ASLM MISSION

To advance professional laboratory medicine practice, science, systems and networks in Africa needed to support preventive medicine, quality care of patients and disease control through partnership with governments and relevant organizations.

ADVANCING THE LABORATORY PROFESSION & NETWORK IN AFRICA

ASLM proposes development of the Blueprint for

Laboratory Strengthening in Africa

GOAL 2020 TARGETS

�Train 30,000 laboratory professionals and clinicians

� 250 labs to achieve accreditation by international standards

� Raise regulatory standards for diagnostics products to international standards in 25 countries

� Establish harmonized regulation for new diagnostics across Africa’s 8 RECs

� Establish African Network of Public Health Reference Laboratories, with at least 30 member countries.

Workforce

Accreditation

Regulatory

Lab networks

Goals for Laboratory Strengthening

Laboratory accreditation

Niger

Chad

Sudan

Tunisia

Algeria

Mali

LibyaEgypt

Mauritania

Morocco

Western

Sahara

NigeriaB

enin

Togo

CI

Guinea

Senegal

Liberia

Sierra

Leone

Gambia

Guinea

BissauEthiopia

Djibouti

Eritrea

Ugand

a

Somalia

Kenya

Cameroo

n

CAR

CongoEquatorial

Guinea DRC

Tanzania

ZambiaAngola

Mozambique

MadagascarZimbabwe

BotswanaNamibia

Swaziland

LesothoSouth

Africa

Malawi

Burundi

Rwanda

South

Sudan

SLIPTA: A stepwise Lab Performance

Improvement Programme

SLIPTA: A framework to encourage, support and recognize the

implementation of QMS in medical laboratories in a stepwise manner

TB Diagnostic capacity

• Over 25% of the global TB burden is in Africa.

• No diagnostic capacity for effective TB control:

– Inadequate human resource quality and quantity.

– Poor laboratory infrastructure.

– Inadequate quality management systems (QMS).

– Lack of appropriate equipment and their maintenance.

– Lack of proper planning and management.

– Low political commitment.

– Weak partner coordination.

– Weak supply chain management systems.

– Lack of appropriate guidance.

– Poor absorption of new technologies.

State of TB Laboratories in Africa region, 20101

• 8,547 laboratories are linked to national TB programmes for

microscopy services

– 123 provide culture; 48 provide drug susceptibility testing (DST).

• Laboratory-to-population ratio:

– 1 microscopy laboratory to 93,000 population

– 1 culture laboratory to 7.2 million population

– 1 DST laboratory to an average of 18 million population

Source: WHO AFRO Strategic Plan for Control of TB, 2013-17

Launch of GLI-AFR in Addis Ababa, November

2013

• Included representatives from WHO/AFRO, ASLM, GLI Secretariat, and SRL Uganda.

• Outcomes:

– Creation of a working group called “Global Laboratory Initiative for Africa (GLI-AFR).”

– GLI-AFR Secretariat housed at ASLM.

– Establishment of interim GLI-AFR Core Group members.

– Priorities of the interim GLI-AFR Core Group members:

• Development of regional framework to strengthen TB laboratory services in Africa.

• Development of governance and operating procedures.

• Call for nominations of the GLI-AFR Core Group members.

• Alignment of the GLI-AFR priorities to GLI Secretariat.

GLI-AFR: Objectives

Support accreditation of the NRLs and the network.2

Support development of human resources to support activities.3

Introduction and implementation of WHO-approved technologies and

policies.

4

Facilitate establishment of functional NRLs and SRLs to support the

network.

5

To support African countries to achieve quality-assured, accessible and

sustainable TB laboratory services for TB control.

Develop TB laboratory framework for Africa.

.

1

GLI-AFR: Structure / responsibilities

GLI Secretariat �Provides technical support to GLI-AFR.

GLI-AFR Secretariat: ASLM Provides overall coordination of GLI-AFR activities.

GLI-AFR Core Group

�

�Provides overall leadership and guidance for GLI-AFR

initiative.

�Evaluates, approves and guides project implementation.

Advises GLI-AFR Secretariat.

GLI-AFR Partners

�Provides implementation support to GLI-AFR network.

�Collaborate in implementation of activities.

�Monitors project progress.

Proposed GLI-AFR strategic activities

• Develop framework for laboratory strengthening in Africa.

• Support accreditation of NRLs and the microscopy network.

• Facilitate harmonization of tools ( GLI, SLIPTA..)

• Facilitate human resource development.

• Assist with introduction/implementation of WHO approved

technologies/policies.

• Support external quality assurance (EQA) programmes.

• Harmonise regulatory mechanisms for TB laboratory equipment &

suppliers.

• Support the expansion of SRLN in the African region.

• Review performance of all 10 SRLs supporting African states.

• Promote the advancement of the 2 candidate SRLs in Africa: Benin, South

Africa.

• Ensure the implementation of biosafety & infection control policies.

• Assist in improvement of supply chain management to laboratories.

• Facilitate improved technical assistance to underserved regions of Africa.

GLI-AFR Core Group - Interim

• Chair: Tsehaynesh Messele , ASLM

• Vice-Chair: Jean Bosco Ndihokubwayo, WHO AFRO

• Secretariat: – Philip Onyebujoh, WHO

– Heather Alexander, CDC

– Jean Iragena, GLI Secretariat liaison

– TBD, USAID representative

– TBD, ASLM technical representative

– Moses Joloba, SRL Kampala representative

– NRL Benin representative

– NRL Mozambique representative

– SRL Algeria representative

– NTP manager representative

– NRL South Africa representative

– AUC

– funding representatives: Global Fund, AU, World Bank

Countries with SRL Supporting Africa

• Algeria

• Australia

• Belgium

• Benin

• Denmark

• Germany

• Italy

• South Africa

• Sweden

• Uganda

Partnership

���� Consolidate fragmented efforts

���� Scale up by pooling limited resources

���� Promote result oriented collaborative efforts

���� Engage partners outside the lab health sector

Thank you.