Global Health Security in Africa

Finding Solutions and Emphasising the Critical Role of Laboratories:

The recent Ebola outbreak in West Africa and global COVID-19 pandemic has highlighted the importance of early disease detection and response in preventing the rise of new global health threats. ASLM is committed to supporting laboratory systems and networks that are efficient in combating global health security risks.

Updates on the Freetown, Sierra Leone, Regional Global Health Security Consultation:
  • New ‘Freetown Declaration’ advocates for increased prioritisation of functional tiered laboratory networks to close gaps in global health security agenda
  • View the press release  from the Regional Freetown Consultation.
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Early detection requires that rapid disease testing capacity reaches across countries and into rural communities where people live. Health experts in Africa are taking steps to strengthen laboratory networks in order to improve the early detection of outbreaks on the continent.

Significant progress has been made in strengthening laboratory networks since the adoption of the 2008 Maputo Declaration for Strengthening Laboratory Systems and Resolution AFR/RC58/R2 at the 58th session of the World Health Organization Regional Committee for Africa (WHO AFRO), both resulting in the scale-up of diagnostic services for HIV, tuberculosis, and malaria. Emerging threats now require even more responsive and harmonised laboratory networks, which are significantly integrated and aligned with public health institutes for effective surveillance responses.

Together with ASLM and WHO AFRO, high-level Ministry of Health officials from more than 20 countries in Africa have issued a “Freetown Declaration” calling for international and local stakeholders to bolster capacity to establish resilient tiered laboratory networks, regularly measure progress with a standardised score card, and effectively integrate these networks into disease surveillance and public health institutes.

SLIPTA

In 2009, World Health Organization’s Regional Office for Africa (WHO AFRO) established a framework for improving the quality of public health laboratories in developing countries to achieve ISO 15189 standards. This framework, renamed in 2011 and implemented by ASLM in Africa, is the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) programme.

Through standardised processes, SLIPTA measures and evaluates the progress of laboratories towards international accreditation and awards a certificate of recognition with 0-5 star ratings. SLIPTA enables laboratories to develop their quality management systems in order to produce timely, reliable and accurate laboratory results.

What is the difference between SLIPTA and SLMTA?
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Proportion of internationally accredited medical/clinical laboratories in Africa from 2014 and 2019

Since the launch of the SLIPTA programme and the Maputo Declaration, the number of accredited laboratories in Africa has increased from 422 in 2014 (Figure 1) to 633 in 2019 (Figure 2). As indicated in the figures, there the proportion of laboratories achieving accreditation outside South Africa is increasing, illustrating the overall advancement of quality management systems across the continent. Twenty percent of non-South African laboratories achieving ISO accreditation in 2019 have been engaged in the SLIPTA programme.

SLIPTA *Data collected from these accreditation bodies
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See the latest SLIPTA Audited Laboratories Distribution Map here.

See the WHO Guide for the Stepwise Laboratory Improvement Process Towards Accreditation in the African Region (with checklist) here.

View All SLIPTA Resources

Affiliations

ISO TC 212 is the global ISO committee that addresses the field of Laboratory Medicine. As a liaison organization of ISO TC212, ASLM contributes to the work of the technical committee and subcommittees.

AFRAC is a cooperation of accreditation bodies, sub-regional accreditation collaborations and stakeholders whose objective is to facilitate trade and contribute to the protection of health, safety and the environment in Africa. ASLM is a stakeholder of AFRAC and contributes by facilitating capacity building in accreditation across Africa with the goal of sustaining an internationally acceptable, mutual recognition arrangement.

The Pan-African Consortium (PAC)

The PAC is a unique partnership of Africa-based organisations with technical expertise, outreach to the Laboratory community and networks and political mandate to advance laboratory Medicine.

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MAAP

The Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) is a multi-organisation and multi-national collaboration led by ASLM that seeks to establish a system for the collection, storage, and analysis of antimicrobial resistance and antimicrobial use data across Africa.

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LabCoP

The Laboratory Systems Strengthening Community of Practice (LabCoP) is a new learning network, designed to link multidisciplinary teams from member countries to exchange laboratory experiences and best practices.

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LabMaP

ASLM’s role in the laboratory mapping program is to propose solutions for the standardised collection, storage and analysis of geo-located data on laboratory capacity, and to support the establishment of public and country portals in accordance with national requirements for data sharing.

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Integrated Diagnostics Consortium

The global market for diagnostics in low-resource settings does not meet the needs of the millions of people living with HIV, TB, HPV, Hepatitis and other diseases, so the Integrated Diagnostics Consortium was formed to enable the scale-up of better coordinated procurement and deployment of platform-based diagnostic technologies.

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Outbreak Coverage

Here you will find the latest news, guidelines and tools to fight endemic and pandemic outbreaks.

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Point-of-Care Testing

Point-of-care (POC) technologies bring tests closer to patients in a convenient and timely manner to allow rapid care and treatment. The introduction of molecular testing has been a game changer, particularly for major diseases such as tuberculosis and pediatric HIV. Tests for these diseases traditionally entailed transporting samples from local clinics to testing centres, and patients and clinicians often waiting hours, weeks or months, to receive results needed to inform care and treatment. Today, HIV test results are usually returned to caregivers on the same day and HIV-infected infants can begin antiretroviral therapy (ART) immediately, reducing the risk of loss to follow up. However, in many settings, obstacles remain to POC testing even when POC testing is available, and must be overcome if, the full potential of POC early infant diagnosis (EID) is to be maximised.

POC Testing is critical because:

  • It brings essential diagnostic testing closer to patients, therefore quicker access to results
  • It helps more children receive more access to life-saving care 
  • It facilitates more rapid clinical decision making
  • Point-of-care viral load (VL) testing can address systemic challenges and support PMTCT efforts
  • It can help avert vertical transmission from pregnant or breastfeeding mothers to their children
  • It facilitates more appropriate treatments and interventions

ASLM has partnered with The Clinton Health Access Initiative (CHAI) and UNICEF to accelerate adoption and uptake of new diagnostic technologies under the Unitaid-funded POC HIV Diagnostic Project, which brings essential diagnostic testing closer to patients. Together with the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), ASLM, CHAI, UNICEF and Unitaid, we have successfully supported the introduction of POC EID and VL technologies, pilot and scale up activities in 15 sub-Saharan African countries. 

In order to accelerate POC implementation ASLM disseminates related resources, evidence and lessons learned, leading the development of technical best practices of supportive systems, and establishing a community of practice for laboratory leaders, implementers, and partners to promote knowledge sharing and south-to-south learning.


The number of types of technologies formally registered per country can been used as a proxy indicator for uptake of this relatively new market of POC NAT diagnostics. This map indicates the distribution by type and numbers of POC Nucleic Acid Testing (NAT) for HIV, EID and VL technologies being used by some countries in Africa.  

       

ASLM and our partners have amassed a collection of tools, guidelines, publications, reports, presentations and other resources related to point-of-care, viral load testing, waste management and other relevant topics, to help build your knowledge base and enhance your organisation.

 

View All Point-of-Care Resources

Centres of Excellence

Centres of excellence strengthening laboratory medicine and improving health outcomes in Africa

ASLM’s Network of Centres of Excellence comprise a nucleus of the leading national public health laboratories on the African continent. These Centres of Excellence play a key role in strengthening laboratory medicine and improving health outcomes in Africa by becoming leaders in several important initiatives.

This ASLM laboratory network currently consist of six centres of excellence with a national and international reputation in laboratory medicine, research, policy guidance, technology assessment and implementation, and training, amongst other areas. Three of the centres are accredited to international ISO standards.

Significant opportunities exist for the ASLM network of Centres of Excellence to strengthen laboratory medicine in Africa, including:

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  • Improving regulatory harmonisation for diagnostics within economic zones. Opportunities exist for theC entres of Excellence to partner in efforts with other agencies to establish regional diagnostics regulatory harmonisation. Several groups, including WHO, ASLM, the London School of Hygiene and Tropical Medicine (LSHTM), and others are working on initiatives to build the appropriate political support, create assessment standards etc. The Centres of Excellence can play a key role by conducting evaluations of new technology to produce high quality data for regional regulatory review.
  • Establishing a south-south fellowship programme to provide opportunities for promising young laboratory scientists to train, study, and research at centres of excellence for several months at a time. This would promote skills transfer and collaboration between the network of laboratories on the continent and help develop the next generation of laboratory medicine leaders.
  • Establishment of an international network of proficiency testing (PT) providers to support SLIPTA and other quality improvement and accreditation programmes. Each Centre of Excellence would be responsible for a different range of PT services as part of a self-sustaining initiative, coordinated by a committee of the Centres of Excellence with a rotating lead.
  • Fostering the establishment of the Association/Network of National Public Health Reference Laboratories (NPHL) in Africa. NPHLs play a key role in training, assuring quality and developing laboratory capacity throughout the health care system in their respective countries. Linking these laboratories in a regional network is critical to increase research capacity, quality management systems, disease detection, and sustainability of health programs throughout Africa. Moreover, the regional laboratory network will facilitate South-South cooperation and collaboration.
ASLM’s Network of Centres of Excellence:
Ethiopian Public Health Institute (EPHI)
Kenya Medical Research Institute (KEMRI)
Institute of Human Virology, Nigeria (IHVN) 
West African Network of Excellence for Tuberculosis, AIDS and Malaria (WANETAM
National Health Laboratory Service (NHLS) 
National Health Laboratory Quality Assurance and Training Centre (NHLQATC)
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What is the difference between SLIPTA and SLMTA?

What is SLMTA?

Strengthening Laboratory Management Toward Accreditation

A task-based training and mentoring tool kit provided to the laboratory personnel in a multi-workshop implementation model. The foundation of this programme is a framework that defines the tasks a laboratory manager must perform in order to deliver quality laboratory services which support optimal patient care. Training activities are designed to enable laboratory managers to accomplish those tasks, using tools and job aides to enhance their management routines. It empowers laboratory managers to initiate immediate laboratory improvement measures, even without additional resources. For more information about SLMTA, please visit www.SLMTA.org

What is SLIPTA?

Stepwise Laboratory Quality Improvement Process Towards Accreditation

A framework of auditing developed in line with the ISO 15189:2007 Standards and to a certain extent with the 12 Quality System Essentials of the CLSI Laboratory Quality Management System Guidelines. It is used to measure and evaluate the progress of laboratory quality system and award a certificate of recognition (five star levels). It can be used at baseline, during supervision, and for monitoring and evaluation of laboratory progress towards accreditation.

For additional information about SLIPTA, please Email us.
For more information about SLMTA, please visit www.SLMTA.org
For more information about SLMTA, please Email Dr. Katy Yao.

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  • College of American Pathologists (CAP)
  • Comite Francais d’Accreditation (COFRAC)
  • Egyptian Accreditation Council (EGAC)
  • Ethiopian National Accreditation Office (ENAO)
  • Institute for Quality Management in the Healthcare (IQMH)
  • Instituto Português de Acreditaçăo (IPAC)
  • Joint Commission International (JCI)
  • Kenya Accreditation Service (KENAS)
  • Mauritius Accreditation Service (MARITAS)
  • Nigeria National Accreditation Service (NINAS)
  • South African National Accreditation System (SANAS)
  • Southern African Development Community Accreditation Service (SADCAS)
  • Système Ouest Africain d’Accréditation (SOAC)

To contribute to, or provide feedback on the compilation of the above laboratory accreditation data, or to learn more about ASLM SLIPTA implementation, please send us an email.

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The Ethiopian Public Health Institute (EPHI), the former Ethiopian Health & Nutrition Research Institute (EHNRI), is a national centre of excellence in providing evidence-based information through research findings; in handling public health emergency management; in conducting health-related surveys and surveillances; and in supporting the national laboratory system. Vaccines and diagnostic production are also important duties. EPHI also provides referral diagnostic and analytical laboratory services; trainings; and promotion of laboratory standards. Its polio and HIV molecular drug resistance and malaria RDTs lot testing laboratories are accredited by the World Health Organization (WHO) and provides laboratory support for the national polio and HIV surveillance programme.
https://www.ephi.gov.et/

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The Kenya Medical Research Institute (KEMRI) is a state corporation established through the Science and Technology (Amendment) Act of 1979 to serve as the national health research body of Kenya. It is affiliated with the United States Centers for Disease Control and Prevention. The KEMRI has two state-of-the-art laboratory facilities accredited by the South African National Accreditation Scheme (SANAS) and ISO-15189, as well as the only research laboratory capable of performing genotypic HIV drug-resistance sequencing. http://www.kemri.org/

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The Institute of Human Virology, Nigeria, (IHVN) addresses the development of infrastructure for treatment, prevention and support for people living with and those affected by HIV/AIDS, cancer, tuberculosis, malaria and other diseases in Nigeria. Established in 2004, it also implements the scale-up of the United States President’s Emergency Plan for AIDS Relief (PEPFAR) programme and conducts research and training to promote quality evidence-based health systems strengthening. IHVN has established five (5) regional training laboratories to support indigenous quality assurance; advanced laboratory training; and other specialised activities, such as HIV viral sequencing for drug-resistance. http://ihvnigeria.org/

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The West African Network of Excellence for Tuberculosis, AIDS and Malaria (WANETAM) is a sub-regional conglomeration of Networks of Excellence. It brings together 14 high-profile research institutions from seven West African countries: Burkina Faso, The Gambia, Ghana, Guinea Bissau, Mali, Nigeria and Senegal. The objectives of WANETAM include capacity building, technology transfer and creation of a regional network for scientific collaborations. https://wanetam.org/

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The National Health Laboratory Service (NHLS) is the largest diagnostic pathology service in South Africa with the responsibility of supporting the national and provincial health departments in the delivery of healthcare in all nine (9) provinces. The NHLS provides laboratory and related public health services to over 80% of the population through a national network of laboratories. Its activities comprise diagnostic laboratory services; research; teaching and training; and production of sera for anti-snake venom, reagents and media. Divisions of the NHLS include the National Institute for Communicable Diseases, National Institute for Occupational Health, National Cancer Registry and the South African Vaccine Producers, which houses the Anti-venom Unit. http://www.nhls.ac.za/

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The National Health Laboratory Quality Assurance and Training Centre (NHLQATC) supports laboratory public health, quality assurance and training activities in Tanzania. It was established in 2008. Its primary roles are to oversee implementation of laboratory quality management systems; provide technical assistance; train laboratory scientists; and promote and perform standardisation and evaluation of laboratory techniques, methods and equipment in Tanzania. http://nhlqatc.go.tz/index.php/en/