ASLM Building laboratory capacity in Africa in a sustainable way

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SGCEP SCIE 1121 Environmental Science Spring 2012 Section Steve Thompson:

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ASLM Building laboratory capacity in Africa in a sustainable way Tsehaynesh Messele, PhD ASLM, Chief Executive Officer Annual AMDS meeting September 29-30, 2014 Geneva

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.

THE DEVELOPMENT AND CREATION OF THE AFRICAN SOCIETY FOR LABORATORY MEDICINE 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 Called for creation of the African Society for Laboratory Medicine

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 2020 TARGETS Workforce Train 30,000 laboratory professionals and clinicians Accreditation 2500 SLIPTA enrolled 250 labs to achieve accreditation by international standards Regulatory Raise regulatory standards for diagnostics products to international standards in 25 countries Establish harmonized regulation for new diagnostics across Africa s 8 RECs Lab networks Establish African Network of Public Health Reference Laboratories, with at least 30 member countries.

Laboratory workforce Development Establish national laboratory professional councils Improve regional standards for pre-service training, retention, and certification Facilitate cross-border certification

SLIPTA: A framework to encourage, support and recognize the implementation of QMS in medical laboratories in a stepwise manner Star Levels No Stars (0 142 pts) < 55% 1 Star (143 165 pts) 55 64% 2 Stars (166 191 pts) 65 74% 3 Stars (192 217 pts) 75 84% 4 Stars (218 243 pts) 85 94% 5 Stars (244 258 pts) 95% 3 Star 4 Star 5 Star 95 % End Point Link to Accreditation Body 2 Star 85-94 % 1 Star 75-84 % 0 Star 55-64 % 65-74 % Stepwise Process ADVANCING THE LABORATORY PROFESSION AND NETWORKS IN AFRICA

SLIPTA Governance

SLIPTA Auditor Training Developed a Standardized Training Curriculum - In collaboration with US-CDC, CLSI and Vijay Consulting Content includes, but not limited to: SLMTA and SLIPTA Introduction to accreditation and ISO 15189:2007 Standards Audit techniques WHO/AFRO SLIPTA Checklist Identification of Nonconformities (Major/Minor) Reporting Professional Ethics Five days Program 3 days for lectures & 2 days on lab audit practicum Post training practicum of 3-5 shadowed audits ADVANCING THE LABORATORY PROFESSION AND NETWORKS IN AFRICA

Laboratory quality improvement towards accreditation ASLM is an implementing partner in the WHO AFRO SLIPTA (Stepwise Laboratory Quality Improvement Toward Accreditation) Programme Auditor training Auditing Certification 2020 Targets Enroll 2,500 labs in the WHO SLIPTA quality improvement program Enable 250 labs to achieve accreditation

Guidance for the WHO/AFRO SLIPTA Implementation Guidelines and Policy for implementation of WHO/AFRO SLIPTA was finalized and approved in July 2011 in Nairobi, Kenya. Has catalytic effect to enable countries develop their national laboratory strategic and operational plans Established to bring laboratory quality improvement process in a stepwise manner Country owned program ADVANCING THE LABORATORY PROFESSION AND NETWORKS IN AFRICA

WHO/AFRO SLIPTA Checklist WHO/AFRO SLIPTA Checklist is based on ISO 15189:2007 and CLSI Quality Management System: Approved Guideline (GP26-A4: 2011) Developed to monitor the progress and improvement of laboratory quality system Directly applicable to all laboratory settings and disciplines Based on 12 sections of Quality System Essentials (QSE) ADVANCING THE LABORATORY PROFESSION AND NETWORKS IN AFRICA

The reach and spread of SLIPTA in Africa Morocco Tunisia Western Sahara Algeria Libya Egypt Mauritania Senegal Gambia Guinea Guinea Bissau Sierra Leone Liberia CI Mali Benin Togo Equatorial Guinea Niger Nigeria Chad CAR Cameroo n Congo DRC Sudan South Sudan Eritrea Ethiopia Ugand Rwanda a Kenya Djibouti Somalia Burundi Tanzania Angola Zambia Malawi Zimbabwe Madagascar Namibia Botswana Mozambique South Africa Swaziland Lesotho

Regulatory Strengthening WHO Pre-qualification Strengthening National Regulation of Diagnostics Product Registration and Post-Market Surveillance

Establishing functional laboratory Networks Regional Network of National Public Health Reference Laboratories Improved south-south collaboration, research and training BENIN Improved surveillance and early disease detection High quality data to inform policy and technology selection/deployment

STRENGTHENING THE CULTURE OF LABORATORY COMMUNICATION Development of quarterly newsletter Inform stakeholders and the public health laboratory network of ASLM activities, accomplishments, partnerships, opportunities Inform members of new and innovative ventures in the field of laboratory medicine Promote Laboratory Medicines success stories and best practices December 2011 ADVANCING THE LABORATORY PROFESSION & NETWORK IN AFRICA

African Journal of Laboratory Medicine ( AJLM ) December 2011 ADVANCING THE LABORATORY PROFESSION & NETWORK IN AFRICA

ASLM 1 st International conference Accurate Laboratory Diagnostics, A Pillar of Quality Health Care Cape Town, South Africa December 1-7, 2012 Seven Ministers of Health Over 1000 attendees Over 60 countries Over 500 high quality scientific presentation 85% of which were form Africa

-MINISTERIAL CALL FOR ACTION- STRENGHTENING LABORAOTRY SERVICES IN AFRICA We, the undersigned Ministers of Health from African countries, attending and meeting at the 1 st International Conference of the African Society for Laboratory Medicine (ASLM), Cape Town, South Africa, December 1 st -7 th, 2012 under the theme Accurate Laboratory Diagnostics A Pillar of Quality Health Care

Country specific plan development for viral load implementation Sept15-17,2014, Addis Ababa. ASLM Convening Power: Meetings are targeted and cross-cutting POC Meeting, Addis Ababa, Ethiopia, May 2012 ASLM2012 Conference, Cape Town, South Africa, December 2012 Viral Load Meeting, Cape Town, South Africa, April 2013 HIV Drug Resistance Meetings, Cape Town and Addis Ababa, June and July 2013 HIV and Microbial drug resistance Meeting, October 2013, Cote d Ivoire Improving Access and Increasing Quality of HIV Testing in Africa Dar es Salaam, June 2014

Diagnostics Access Initiative UNAIDS in partnership with ASLM, WHO, PEPFAR, UNICEF, CDC and CHAI launched the Diagnostic Access Initiative in July 2014 at the international IAS meeting in Melbourne, Australia.

Partnership Consolidate fragmented efforts Scale up by pooling limited resources Promote result oriented collaborative efforts Engage partners outside the lab health sector

Thank you.