Seminar #39

Strengthening Diagnostic Networks in Africa

Global Laboratory Initiative for Africa (GLI Africa)

No invitations necessary; open to all conference registrants

Wednesday, 7 December
15:30-16:15
CTICC room location: 2.6

TARGET AUDIENCE:

Medical technicians, scientists, Ministry of Health officials, program managers, implementing partners, donors.

SEMINAR DESCRIPTION:

Considerable strides have been realized in the fight against Tuberculosis(TB) globally. The WHO reports a 47% reduction in TB mortality since 1990 and a fall in TB incidence by average 1.5% per year since the year 2000. Through the implementation of current TB interventions an estimated 43 million lives between 2000 and 2014 have been saved. Despite these tremendous results TB continues to take a major toll on human health globally, causing 1.5 million deaths and 9 million new cases annually. The African Region had 28% of the world’s cases in 2014, but the most severe burden relative to population: 281 cases for every 100 000 people, more than double the global average of 133. Effective new strategies are required in prevention, diagnosis and treatment to reach the EndTB strategy goals and stem this tide. This new strategy has set ambitious goals of reducing TB incidence by 90% in 2035.

Sub-optimal diagnostic capacity is a key barrier preventing an effective response to the challenges of TB. Only 63% of the estimated 9.6 million new cases were reported in 2014. This meant that worldwide, 37% of new cases went undiagnosed or were not reported. Newer diagnostics with better accuracy than the age old smear microscopy have been used extensively in last few years. However, it has become apparent that higher accuracy does not necessarily translate into improved patient care, policy makers have become cognizant of the need for improved strategic interventions that positively affect health or other outcomes that matter to patients.

Laboratory networks are plagued by an array of challenges from, poor coordination resulting in duplication of efforts and resource wastage, Lack of proper planning at national level, inadequate human and financial resources, absence or weak biosafety and biosecurity protocols, lack of infrastructure and unreliable supply chain management systems. Strong diagnostic networks are urgently required to improve TB case detection and successful treatment, and to attain global and regional targets.

The Global laboratory initiative for Africa (GLI Africa) is a regional partnership established to provide a mechanism for the regional coordination of partners and activities focused on TB laboratory diagnostic networks. GLI Africa through country consultation has a regional framework that seeks the development and strengthening of the TB diagnostic services that will be required to improve TB case detection and treatment outcomes in the African Region. GLI-Africa supports countries to develop and effectively implement national TB laboratory strategic plans, customize and adopt global guidance and best practices at country level, promote and support accreditation of national TB reference laboratories, and expand the role of the WHO TB Supranational Reference Laboratory Network in the African Region in provision of support to national TB diagnostic networks.
This seminar aims to discuss what the role of the laboratory network is in meeting the endTB goals. How can TB programs leverage new connectivity solutions to building strong networks? What is required to attain universal drug susceptibility testing? How can countries develop strong quality management systems that demonstrate continuous quality improvement for TB networks?

SESSION LEARNING OBJECTIVES:

  • To provide attendees with key priorities for strengthening diagnostic networks
  • To give guidance to countries on the role of the laboratory in attaining the endTB strategy targets.
  • To provide guidance on continuous quality improvement in laboratory diagnostic networks

SESSION SPEAKERS:

Amy Piatek, GLI Africa, Welcome and introduction to session
Amy Piatek is the GLI Africa Chair.

Obert Kachuwaire, African Society for Laboratory Medicine: Challenges of TB diagnostic services in Africa and opportunities for improvement
Obert Kachuwaire is the Tuberculosis Point of Contact for ASLM. Prior to this he was laboratory director for the Centre for Infectious Disease Research in Zambia (CIDRZ). He has previously worked in Botswana as the Quality Manager of the Botswana National TB Reference Laboratory (BNTRL) and supported expansion of the External Quality Assurance program in Botswana’s TB Laboratory Network. In 2009 he joined the KNCV Tuberculosis Foundation and served as the Country Director for the Botswana TB CARE I mechanism where he was responsible for project management and co-ordination of technical assistance to the National Tuberculosis Program. Obert led the efforts that resulted in the successful ISO 15189 Accreditation with the South African National Accreditation System (SANAS), of the BNTRL. He has experience in laboratory capacity-building in Zimbabwe, Namibia, Lesotho, South Africa, Swaziland, Uganda, Benin, Nigeria, Peru and Zambia with various organisations including Partners in Health, KNCV TB Foundation and Medical Research Council of South Africa. He is also a trained laboratory technical assessor and is on the Technical Expert roster for SANAS.

Wayne van Germet, World Health Organisation Geneva: GLI framework for assessing diagnostics connectivity systems
Wayne van Gemert is a technical officer in the Laboratories, Diagnostics, and Drug Resistance Unit of the WHO Global TB Programme in Geneva. Wayne serves as the secretariat of the Global Laboratory Initiative (GLI), a network of international partners dedicated to accelerating and expanding access to quality assured TB laboratory services and one of the Working Groups of the Stop TB Partnership. Based in the WHO Geneva office since 2009, Wayne’s current area of work focuses on uptake and implementation of WHO policies on diagnostics and laboratory strengthening. Wayne also managed the UNITAID-funded TBXpert project (2013-2016) and previously worked on the Global Project on Anti-TB Drug Resistance Surveillance. Prior to Geneva, Wayne was based in the WHO Moscow office in 2006-2009. He holds an MPH from University of California Berkeley and a BS Biology from Cornell University.

Heidi Albert, FIND South Africa: Essential “standards” for a TB diagnostic network

Heidi Albert is the Head of FIND South Africa and the Principal Investigator for FIND’s CDC-funded (PEPFAR) programme in diagnostics implementation and laboratory strengthening, working in 12 countries in Africa, Asia and the Caribbean, with a focus on TB and HIV diagnostics implementation and quality improvement. Heidi has more than 15 years’ experience in diagnostics research and development and implementation in low and middle income countries. Heidi trained in Pharmacy at the University of Bath, UK and later completed her PhD at the same institution in pharmaceutical microbiology. She started working in the field of TB diagnostics in 1997 in South Africa, working on the development and evaluation of rapid phage-based technology for diagnosis and drug susceptibility testing of TB. She completed a Masters in Public Health specialising in health economics at the University of Cape Town in 2008.

She joined FIND in 2007 to oversee the line probe assay demonstration study in South Africa, in collaboration with National and provincial Departments of Health, NHLS and Medical Research Council. She was based in Kampala, Uganda between 2008 and 2010, where she established and led the FIND TB Research Laboratory at the National TB Reference Laboratory and worked on a number of diagnostic research and evaluation studies and technology transfer of WHO-approved TB diagnostic technologies to the national programme. She led the development of the TB-specific SLMTA programme, a training and mentoring programme to strengthen TB laboratory systems, now being rolled out in 10 countries. She currently serves as a core group member of the Global Laboratory Initiative (GLI) and GLI Africa.

 

Wayne van Germet, World Health Organisation Geneva: GLI framework for assessing diagnostics connectivity systems

Wayne van Gemert is a technical officer in the Laboratories, Diagnostics, and Drug Resistance Unit of the WHO Global TB Programme in Geneva. Wayne serves as the secretariat of the Global Laboratory Initiative (GLI), a network of international partners dedicated to accelerating and expanding access to quality assured TB laboratory services and one of the Working Groups of the Stop TB Partnership. Based in the WHO Geneva office since 2009, Wayne’s current area of work focuses on uptake and implementation of WHO policies on diagnostics and laboratory strengthening. Wayne also managed the UNITAID-funded TBXpert project (2013-2016) and previously worked on the Global Project on Anti-TB Drug Resistance Surveillance. Prior to Geneva, Wayne was based in the WHO Moscow office in 2006-2009. He holds an MPH from University of California Berkeley and a BS Biology from Cornell University.

Nazir Ismail, National National Institute of Communicable Diseases/NHLS: External Quality Assurance: how can it contribute to strengthening TB diagnostic networks?

Nazir Ismail is the Head of the Centre for Tuberculosis incorporating the WHO supranational TB Reference Laboratory at the National Institute of Communicable Diseases/NHLS. He is a medical doctor that specialized in micriobiological pathology passing his fellowship with distinction. He also has 2 diplomas – one in tropical medicine and another a post graduate diploma infection control passing that cum laude. His passion is the study of TB including HIV-TB interactions and the epidemiology of TB. He is a councilor for the Colleges of Medicine South Africa and is a member of several international professional bodies and is a member expert groups both locally and internationally. He has authored and co-authored many peer-reviewed articles.

Welile Sikhondze, Swaziland National TB Control Program (NTCP) Opportunities and challenges for diminishing the case detection-clinical management gap within National programmes