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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.