Steven Specter, PhD, Chair of the ASM International Laboratory Capacity Building Committee (Lab Cap)

International Laboratory Capacity Building (Lab Cap)

American Society for Microbiology

American Society for Microbiology

The oldest & largest life science organization in the world -1899-2006

Membership >42,000 worldwide (30% reside outside the United States)

ASM members represent 26 disciplines of microbiological specialization plus a division for microbiology educators

Publications and journals Translated books 11 journals covering the spectrum of microbiology Microbe – the News Magazine of ASM

Meetings and conference ASM General Meeting Interscience Conference on Antimicrobial Agents & Chemotherapy

(ICAAC)

International Affairs

Ensuring that ASM's products & services effectively serve its international membership & the broader international microbiological community;

Establishing collaborative relationships with international societies & organizations;

Fostering access to microbiological knowledge worldwide;

Developing programs that address issues of global concern.

International Affairs

The International Affairs Department is under the following structure:

International Committee International Membership Committee International Education Committee International Laboratory Capacity Building (Lab

Cap) Committee

International Laboratory Capacity Building (Lab Cap) Program

Capacity Building of Global Clinical Microbiology Laboratories

Cooperative agreement with Centers for Disease Control and Prevention (CDC) – signed in Fall 2005

Technical support to the CDC’s Global AIDS Program (GAP) & U.S. Presidents Emergency Plan for AIDS Relief (PEPFAR) initiatives – activities initiated in Fall 2006

Technical support to the CDC’s Global Disease Detection Program for five sites of the International Emerging Infections Programs (IEIP) – activities to commence Fall 2007

American Society for Microbiology – Comparative Advantage

ASM’s main strength is its more than 42,000 members, >5,000 of which are clinical microbiologists. ASM is rapidly able to engage numerous experts as volunteers to provide clinical microbiological technical assistance.

Other key points:

• Many ASM clinical microbiologists are nearing retirement and/or have the capacity to travel in their current positions; and

• Many ASM clinical microbiologists have spent years developing quality assurance/quality control (QA/QC) programs, managing labs, instituting good laboratory practices (GLPs), and training on and designing diagnostic tools/procedures.

American Society for Microbiology – Comparative Advantage

Upon requests for technical assistance, ASM sends out calls to its massive membership to quickly mobilize world renown experts.

Examples include:

• October 2006 request for TB diagnostic experts – database of 200 qualified individuals compiled in 1 month

• August 2007 request for TB lab infrastructure design and renovation experts – current database includes 52 qualified individuals, compiled in 2 weeks

PEPFAR-funded Countries Currently Requesting Technical Assistance (TA) from ASM

Botswana – OIs/TB Cote d’Ivoire - TB Kenya - OIs Mozambique – OIs Namibia – TB Nigeria – TB/OIs Zambia – TB/OIs Zimbabwe - SOPs

OI/TB Diagnostic Capacity Building

BotswanaASM to provide technical support for strengthening

clinical laboratory diagnostics for common OIs, as well as to the National Tuberculosis Reference

Laboratory (NTRL) for TB diagnostics.

TB Diagnostic Capacity Building

Côte d’IvoireASM to provide technical assistance to the national TB laboratory network for infrastructure design and renovation of labs to support TB culture and drug susceptibility testing (DST); support for training in Lowenstein-Jensen and liquid (MGIT 960) culture,

DST, and identification.

OI/TB Diagnostic Capacity Building

KenyaASM is working with CDC-Kenya and the Kenyan

National Public Health Laboratories (NPHL) to establish a central microbiology laboratory at the

NPHL to serve as a reference microbiology laboratory. This will strengthen the organizational

structure of the NPHL to establish and offer clinical microbiology services to HIV/AIDS patients

countrywide. Kenya is also interested in expanding their TB culture

capacity with the BD MGIT 960 at multiple sites, which ASM may help support.

OI Diagnostic Capacity Building

MozambiqueASM to provide technical assistance to its laboratory

system, specifically for the strengthening of diagnostics for common OIs through laboratory

infrastructure improvement and training of laboratory personnel.

TB Diagnostic Capacity Building

Namibia Since Fall 2006, ASM is assisting the Namibia Institute of Pathology (NIP) to:Renovate central TB lab for efficient and

quality testing and establishing a safe work environment

Strengthen TB lab staff at central and peripheral labs

Improve quality of testing for TB smear microscopy, culture, & drug susceptibility testing (DST)

OI/TB Diagnostic Capacity Building

NigeriaASM to develop a comprehensive QA/QC system

for TB; suggest improvements to the AFB Microscopy training curriculum currently used in

Nigeria; provide technical expertise on the structural design of new and existing labs for TB culture/DST; and improve training for simple OI

diagnostics (emphasis on microscopy).

OI/TB Diagnostic Capacity Building

Zambia

Since Fall 2006, ASM has offered support with strengthening basic bacteriology and the

implementation of new technologies for AFB microscopy, blood culture, TB culture, and

DST.

SOP Writing Capacity Building

ZimbabweDuring a 2-week TA mission, ASM assisted CDC-Zimbabwe & ZINQAP to:

Review the National Clinical SOPs for accuracy & content Develop & include procedural details required by the

International Organization for Standardization (ISO) that were not in the original SOPs

Transcribe SOPs into the ISO format Develop QC procedures that would meet minimum ISO

standards.

ASM Lab Cap Successes

Large pool of technical experts to select from ASM membership >42,000

Providing timely advice on laboratory renovations, equipment and supply needs Detailed lists on lab renovation requirements, equipment and supply

needs have enabled countries to better allocate their funds Mentoring that has enabled visible, immediate results in

improving laboratory diagnosis of TB and OIs Maintenance of relationships with in-country laboratorians

ASM consultants’ expertise has lead to constant requests from in-country laboratorians to have them return and ongoing, even remote relationships have been maintained

ASM Lab Cap Successes

Collaborations with key individuals from international agencies such as CDC, WHO, International TB Union, Merieux Foundation, FIND, leading to development of experience-based best practices

Pulling from strong international collaborators to gain information on activities already ongoing in-country and harmonizing our efforts accordingly

Developing and harmonizing international training tools for TB and OIs

Developing specific national strategic plans and scopes of work for each consultant

Shorter term contracts leading to more frequent monitoring and evaluation of deliverables

ASM Lab Cap Challenges

Limited comprehension of TB/OIs and the long-term commitment needed to build capacity Underestimation of the amount of TA needed to

implement TB and OI procedures Limited resources (i.e. training materials, SOPs,

etc) available for OI diagnosis in low-income settings

Misunderstanding of technical consultancy vs. implementing partner roles

Inconsistencies in ability to communicate with in-country USG contacts

Lapses in three-way communication between CDC-ATL, CDC-country staff, and CoAg partner

Most Successful Operating Environments

Supportive Ministry of Health and National Programs

Good working relationships between National Reference Lab and corresponding National Programs

Collaboration between National AIDS Program and Microbiology-related Programs (i.e. NTP)

TB Expert and/or Microbiologist within USG team Facilitates proper planning; creates continuity in

activities; enables knowledge sharing

ASM International Affairs Staff

Lily Schuermann, Director

Lynee Galley, Manager Mah-Sere Keita Sow, Manager Todd Peterson, Manager Alexis Greenan, Coordinator Jessica McLean, Coordinator Jennifer Sanwogou, Coordinator

American Society for Microbiology

Visit the ASM Website atwww.asm.org

American Society for Microbiology1752 N Street, NW

Washington, DC 20036Phone - 202-737-3600

Fax - 202-942-9328E-Mail - international@asmusa.org