Scientists call for measures to enhance disease surveillance in West Africa


Health researchers and scientists are urging West African governments to strengthen laboratory systems at all levels across the sub-region to better detect and manage infectious diseases. “There is an urgent need to enhance disease surveillance, epidemic prevention and laboratory system capacity in readiness for emerging and re-emerging infections,” concluded scientists at the recent CelebrateLAB West Africa 2021 Conference in Accra, Ghana.

Health Laboratory systems in West Africa face a number of challenges: including inadequate infrastructure, limited capacity to detect drug resistance diseases coupled with lack of robust gene sequencing facilities, while lack of standards across laboratories in the sub-region remains a significant issue.

Diagnosis is the backbone of modern medicine, the scientific experts affirmed, stating that substandard laboratory capacity poses challenges to Global Health Security and greatly undermines capabilities to curb pandemics. “Good national laboratory systems ensure improved surveillance systems that help to quickly detect outbreaks, monitor and implement interventions,” Conference delegates stated in a Communique issued in Accra, Ghana.  The Conference called for a comprehensive and effective monitoring system for surveillance of infectious diseases to ensure early detection and timely intervention.

Governments in West Africa must commit resources to development of the sector, stated the delegates. The conference proposed regional and national investment of about 5% of GDP in surveillance systems and for pandemic preparedness.

The conference, under the theme ‘Combatting emerging and reemerging infectious diseases through standardisation of laboratory practice across West Africa’, brought together more than 250 onsite and virtual participants from West Africa countries, as well as Uganda, Zimbabwe and United States of America, to deliberate on ways of strengthening laboratory systems in West Africa to improve health outcomes. Convened by Africabio Enterprises Inc., the Accra conference was organised in partnership with the Ghana Association of Medical Laboratory Scientists and co-hosted by the Ghana Health Service and Akai House Clinic.

COVID-19 has compounded Africa’s disease burden, with the continent already dealing with Malaria, HIV, TB and Lassa Fever.  The research and medical laboratory scientists called for the establishment of an integrated surveillance of COVID-19, Ebola, Lassa Fever, Typhoid and other infections. They encouraged the development of one discriminating or multiplex testing – similar to the Multiplex Test Kit developed by Liberian Biomedical Research Scientist, Dr. Chris Nyan Dougbeh – that can differentiate between TB, Malaria and COVID-19. The Nyan Diagnostic Test is capable of detecting and distinguishing between 3 to 7 infections in an hour.

The Conference further noted that access to vaccines and treatment is crucial to Global Health Security. “The recent COVID-19 crisis revealed countries’ lack of adequate preparedness for pandemics, non-compliance with international best practices and ill-suited medical research. It also highlighted the need to prioritise accreditation of clinical, research and public health laboratories as a matter of urgency.”

A number of laboratories in the sub-region are ready for accreditation but face constraints, including: lack of support from their institutional/facility managers; unavailability of accreditation bodies in the West Africa region; the unwillingness to commit resources in the training of persons to assist with the accreditation; and the lack of councils or regulatory bodies which are solely responsible for Medical Laboratories in the sub-region. The Conference urged governments in the sub-region to prioritise accreditation of clinical, research and public health laboratories as a matter of urgency.

The Conference concluded that the continuous occurrence of infection outbreaks indicates the importance of reducing collective and individual vulnerability to infectious diseases threats.

Conference delegates bemoaned the lack of research capacity in Africa, especially in the area of sequencing and interventions that suit the African context during pandemics. They called on governments in the sub-region to commit resources into research, especially in the medical field. “We believe that African governments must take decisions based on local research, and not just copy the western countries.”

The Conference called for establishment of regional regulatory bodies to regulate clinical, research and public health laboratories.

On management of hazardous laboratory waste to control re-emergence of infectious diseases, the Conference called for the development of a waste management programme that includes segregation of laboratory waste for implementation at all laboratory levels, and training of laboratory personnel and cleaners in waste management to prevent the spread of infectious diseases.

The Conference noted the recent pandemic has further highlighted the urgent need to work toward sub-regional self-sufficiency in health laboratory medicine. The Conference further noted that local innovators and businesses in the sector face a number of obstacles: including competition from government and government agencies; unstable currency; taxes and import duties; and regulatory demands and cumbersome processes – which seem to be stricter for local businesses and startups than foreign ones.

The Conference called on governments in the sub-region to re-prioritise and increase budgetary allocations for healthcare, science and technology. “Governments must support local innovations and manufacturing of laboratory equipment, materials, test kits and reagents. Countries need to support the growth stage of startups through tax waivers and other assistance that makes the environment conducive for business to thrive.”

The Conference also encouraged regulatory bodies to work with startups to expedite regulatory requirements to encourage local production. During the peak of the COVID-19 pandemic, local innovators faced a number of challenges with the regulatory approval processes. Incas Diagnostics, the Ghanaian startup developer and manufacturer of low-cost easy-to-use medical diagnostics kits, was one of them. The company was unable to secure approval for its COVID-19 rapid diagnostics test kit that could have helped Ghana expand testing.

The Conference proposed that regional bodies such as the Economic Community of West Africa States (ECOWAS), West Africa Health Organisation (WAHO), Africa Union (AU) and Africa CDC should be brought on board to help develop a harmonised system that enables local innovation and production.

Biomedical Laboratory Scientists (BMS) play key roles in infectious diseases detection and prevention of drug resistance infections. The Conference called on governments in the sub-region to increase investment in the training of laboratory scientists and researchers, and to involve the professionals in formulation of national and regional policies on the sector – as these are vital to strengthening laboratory systems in the region.

Ghana was chosen again to host the 2022 conference. Conference Ambassadors, who shape the structure and content of CelebrateLAB® West Africa, cited the enormous support received from the hosting partners, especially the Ghana Health Service, and ease of travel to and from Ghana during the COVID-19 pandemic period as some of the main reasons that contributed to voting for Ghana.

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