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
Key Facts
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.
Over 1 billion people and growing
Increased Access
Quality service
African healthcare priorities
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)
Improved diagnostics is essential to meet healthcare goals
2008
Maputo
Declaration
• Called for integrated laboratory support for major diseases
• Called on governments to develop and implement national
laboratory strategic plans
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
2011 ASLM
Launched
• Called for creation of
the African Society
for Laboratory Medicine
• Support from MOHs, WHO, African Union, PEPFAR, World
Bank, Clinton Foundation, UNAIDS, and others
-MINISTERIAL
CALL FOR ACTIONSTRENGHTENING 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
Goals for Laboratory Strengthening
Laboratory Strengthening in Africa
GOAL
Workforce
Accreditation
Regulatory
Lab networks
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.
Laboratory accreditation
SLIPTA: A framework to encourage, support and recognize the
SLIPTA:
A stepwise Labof
Performance
implementation
QMS in medical laboratories in a stepwise manner
Improvement Programme
Tunisia
Morocco
Algeria
Western
Sahara
Mauritania
Egypt
Niger
Eritrea
Chad
Djibouti
Sudan
Benin
Senegal
Gambia
Guinea Guinea
Bissau
CI
Sierra
Leone
Liberia
Mali
Libya
Nigeria
South
Sudan
CAR
Ethiopia
Cameroo
Somalia
n
Ugand
Equatorial
Congo
DRC Rwanda
aKenya
Guinea
Togo
Burundi
Tanzania
Malawi
Angola
Zambia
Zimbabwe
Madagascar
Namibia
Mozambique
Botswana
South
Africa
Swaziland
Lesotho
TB Diagnostic capacity
• Over 25% of the global TB burden is in Africa.
• No diagnostic capacity for effective TB control:
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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, 2010
1
• 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
To support African countries to achieve quality-assured, accessible and
sustainable TB laboratory services for TB control.
1
Develop TB laboratory framework for Africa.
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Support accreditation of the NRLs and the network.
3
Support development of human resources to support activities.
4
Introduction and implementation of WHO-approved technologies and
policies.
5
Facilitate establishment of functional NRLs and SRLs to support the
network.
GLI-AFR: Structure / responsibilities
GLI Secretariat
GLI-AFR Secretariat: ASLM
GLI-AFR Core Group
GLI-AFR Partners
Provides technical support to GLI-AFR.
Provides overall coordination of GLI-AFR activities.
Provides overall leadership and guidance for GLI-AFR
initiative.
Evaluates, approves and guides project implementation.
Advises GLI-AFR Secretariat.
Provides implementation support to GLI-AFR network.
Collaborate in implementation of activities.
Monitors project progress.
Proposed GLI-AFR strategic activities
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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:
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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
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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.