Public health microbiology

partnerships:

“Better Labs for Better

Health”

Caroline Brown & Pamela Hepple Influenza and other Respiratory Pathogens

Program

Developed in collaboration with Royal Tropical Institute, Amsterdam WHO CC Laboratory Strengthening

Presentation overview

• Lab partnerships in the WHO European Region

• WHO laboratory capacity requirements under the IHR

• Better Labs for Better Health:

– Rationale and approach

– Activities and achievements so far

– Tools and training

– Next steps

Lab partnerships in the WHO European Region

• Include EU and non-EU countries, disease specific networks polio, MR, HIV, TB, influenza, AMR

• Emerging diseases: WHO EDPLN, EMERGE, ENIVD, EMLab Consortium (EDV, H7N9, MERS-CoV, ZIKV)

• CBRN centres of excellence

• Joint activities between WHO/Europe, EC, ECDC: surveillance, training, EQA, guidance, preparedness and response

IHR core capacities - laboratories

• Countries should detect, investigate and report to the international community through WHO, potential public health emergencies of international concern

• A credible and accessible laboratory service capable of producing reliable results in a timely manner is a cornerstone of any country's capacity to investigate such events

• In many countries reliable confirmation of outbreaks is hindered by a lack of standardized methods, funds, trained staff and laboratory supplies.

• Main WHO activities in this area:

Strengthen national laboratory systems

Support implementation of laboratory quality management systems

Enhance networking between public health laboratories

Support laboratory workforce development

Better labs for Better Health: Why a new initiative was needed in the European Region

o Public health laboratory

services weak and

fragmented in some

countries:

o Lack standards and oversight

o Poor quality and safety

o Fragmented, duplication

o No initiatives targeting

improvements to the system

as a whole

o No WHO training programs in

lab quality

Benefitting all labs in a country: develop national laboratory policies and strategic plans

Standardized methodology – participatory approach led by intersectoral national

laboratory working groups*

*Brown, C et al (2015). New policy formulation methodology paves the way for sustainable laboratory systems in Europe. Public Health Panorama, 1(1)

Benefitting all labs in a country: develop national laboratory policies and strategic plans

Standardized methodology – participatory approach led by intersectoral national

laboratory working groups*

*Brown, C et al (2015). New policy formulation methodology paves the way for sustainable laboratory systems in Europe. Public Health Panorama, 1(1)

Laboratory policy development workshop, Uzbekistan

Improve national training programs and implement quality management systems based on ISO standards

o Quality assured labs produce

timely and accurate results

o This creates trust among

users and increases country

capacities to comply with IHR

Training in lab quality and implementation of LQMS

• Better Labs for Better Health developed a 5 day course in lab quality (based on the WHO LQMS training toolkit) and use of the WHO tool for the stepwise implementation of LQMS towards ISO 15189 accreditation (LQSI tool)

• LQSI divides LQMS implementation into phases to allow for systematic improvement of laboratory functioning –starting with the primary processes (e.g. SOP management), ending with continuous improvement and preparation for accreditation

http://www.who.int/ihr/training/laboratory_quality/en/

http://www.who.int/ihr/lyon/hls_lqsi/en/

Mentoring program to support use of the LQSI tool

• 110 laboratory managers from 23 countries in eastern and south eastern Europe trained since August 2014

• LQSI tool makes LQMS easier to implement, but requires mentoring for optimal implementation towards ISO 15189 accreditation

• During visits mentors can answer questions, help develop action plans, perform external audits and provide training

First mentoring mission, St. Petersburg

Mentors

• Mentors are laboratory quality officers from ISO 15189-accredited laboratories who support national laboratories via in-country visits and regular communication to ensure follow-up of plans

• They have been trained by WHO and are active in Kyrgyzstan, Russian Federation, Tajikistan and Turkmenistan

• We may be able to provide mentors for one additional lab!

Mentor training workshop, Copenhagen

Next steps

• Support countries to implement their national laboratory strategies

– Identify resources

– Partner with other initiatives (CBRN CoE projects)

– Develop good practice (legalframeworks and PHL networks)

• Continue to roll out the mentor program and lab quality training

• Suggestions welcome

Consultation on lab policy in Kyrgyzstan

Find out more information on our Laboratory Services website

Acknowledgements

The National Laboratory Working Groups

KYRGYZSTAN

TAJIKISTANMOLDOVA

Partners: UNDP, GF, USAID, Project HOPE, Gauting SRL for TB, US CDC, Fondation Merieux etc.

The WHO Country Offices and DCH Lab Coordination Group

Royal Tropical Institute (KIT), Amsterdam

Joanna Zwetyenga and Olga Slobodskaya, WHO consultants