The need for strong public health institutes, disease surveillance systems and increased funds for epidemics preparedness were key takeaways from the 4th Biennial International Conference of the African Society for Laboratory Medicine (ASLM). ASLM 2018 convened laboratory scientists, clinicians, healthcare workers, health economists and health technology company representatives from across Africa and the globe in Nigeria from December 10-13, 2018.
Themed “Preventing and Controlling the Next Pandemic: The Role of the Laboratory”, the conference served as a platform for the international laboratory medicine community to share best practices, network, build capacities and discuss innovative approaches for combatting global health threats.
The African Society for Laboratory Medicine (ASLM) is an independent, pan-African professional body that mobilises and coordinates relevant stakeholders – local, national and international – with the aim of improving local access to quality diagnostic services for communities in Africa.
No single discipline has the sole responsibility in epidemic preparedness and response as it involves a multi-sectoral, multi-disciplinary collaboration to be effective. However, identification of epidemic-prone diseases before they escalate is very important in disease surveillance and response and this duty rests primarily on the shoulders of laboratory practitioners.
With the emergence and re-emergence of infectious diseases that have caused outbreaks and pandemics, the role of the laboratory has gained more prominence and relevance. The ASLM2018 provided a veritable platform to reaffirm these roles while setting out strategies to strengthen them.
The 4-day conference offered roundtables focused on three key tracks; Pandemic Threats, Laboratory Response, and Synergizing Partnerships.
Dr. John Nkengasong, Director of the Africa Centre for Disease Control emphasised in his keynote speech the importance of strong systems in preparing and responding to disease outbreaks. He said Africa needs strong national public health institutes, because without them it would be difficult to have effective responses to epidemics. Population, conflict, climate change, migration were the factors he said would drive future pandemics. To control and prevent these future pandemics, it is essential to strengthen networks and workforce capacity, collate and share data and encourage partnerships.
Professor Oyewole Tomori, ASLM board member, reiterated the need for context-based health systems in lieu of imported solutions. He said it is “important for each nation to design its own primary health care system because it knows the needs of its people.” He made it clear that health equity is the outcome of good governance, political will and commitment to do good to all citizens.
He also articulated that for a nation’s health care system to be successful it needs robust financing, a well-trained and adequate work force, accountability, and well-maintained facilities. These are impossible without good governance. Professor Tomori concluded by charging participants to work hard because “We have all it takes to free us from epidemics.”
Dr. Chikwe Ihekweazu, Director General of the Nigeria Centre for Disease Control (NCDC) said in his talk on “The Next Pandemic: What, When, Where?” that the world is more connected than ever, and shared the numerous benefits and returns on investment that can come from strengthening the disease surveillance system in Nigeria and Africa. He said improved disease surveillance across the country ensures that healthcare professionals are now able to detect viruses that over 30 years ago had gone undetected. Also, increasing the country’s capacity to diagnose Lassa fever improved the NCDC’s ability to track the number of confirmed cases this year as opposed to previous years.
He drew attention to the importance of preparedness against readiness when it comes to the next pandemic. “I really do not know what virus will cause the next epidemic or pandemic, and to be honest, in a way, we don’t need to know… I think even if we did, it will distract us from the critical function that we have of shaping the entire system”.
It is important to look at disease outbreaks from an economic perspective. Dr. Olumide Okunola, a Senior Health Specialist at the International Finance Corporation of the World Bank Group, in his plenary presentation on “Costing the Response: Health Systems and Laboratories”, drew attention to how the policies championed by the African Union to improve trade and free movement between countries can open more doorways to infectious diseases if enough funds are not invested in surveillance and strengthening laboratory systems for quick detection.
He noted that health is intricately linked to economic growth even though economic losses are not always considered or counted when there are disease outbreaks. “When a pandemic hits, people talk about the number of people who get ill or who die. This is heartbreaking but 60% to 70% of the losses actually are as a result of economic impact”, he said.
He made the case for more spending on health in Africa with Nigeria spending the least across the continent at 0.8%. Beyond investing enough funds for health, Dr. Okunola emphasised the need to be more proactive with spending. “We only deploy resources when we have people getting sick and dying from disease outbreaks. We spend 400 million when we should have spent 200 million,” he said.
The conference also brought attention to Non-Communicable Diseases (NCDs) which account for over 60% of global deaths. Participants deliberated on quality management systems in laboratories and the role of public health institutes in pandemic response using the National Public Health Institute of Liberia as a case study.
Creating a network of quality laboratories to strengthen surveillance and detection of infectious diseases was a major consensus at the end of the conference.
ASLM2018 ended on a high note with the United States Ambassador to Nigeria, Ambassador W. Stuart Symington, iterating the need for ownership of solutions by Nigeria and other African countries. “The only good that will truly last here will be done by people from here,” he said.
A major highlight of the closing ceremony was the presentation of certificates of recognition to accredited government laboratories that have passed through quality management and assurance checks. South Africa came tops with 27 laboratories accredited while Nigeria had six. A lifetime achievement award to recognise impact on public health through exceptional contribution to laboratory science was presented to Professor Souleymane Mboup, Board Chair, Global Research and Advocacy Group.
His acceptance speech should be enough to spur participants and other scientists working towards a strong and sustained global health security system. He gave this advice to the next generation of laboratory scientists; “Nothing is magic. Work. Be passionate. Recognize failures and let them teach you. Take initiative. Lead, and seek collaborations over the long term.”