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Lack of tools, biggest challenge to health security in Africa — Prof. Alash’le Abimiku

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The outbreak of the Ebola Virus Disease, EVD, in West Africa five years ago, no doubt, had a massive impact on already fragile healthcare systems. Interestingly, laboratory medicine played a major role in the control of pandemic in Africa through accurate diagnosis. It is therefore no surprise that the African Society for Laboratory Medicine, ASLM, has themed its 2018 conference holding in Abuja: ‘Preventing and Controlling the Next Pandemic: The Role of the Laboratory’, with Prof. Alash’le Abimiku as co-chair.

An accomplished virologist and pioneer   early HIV researcher in Nigeria,   Abimiku is a Professor of Medicine at the Division of Epidemiology and Prevention of the Institute of Human Virology, University of Maryland, Baltimore, US. She is passionate about the development of lab medicine in Nigeria and across Africa, hence the establishment of the Institute of Human Virology Nigeria (IHVN) where she serves as Executive Director, Laboratory Diagnostics and Research.

She spoke with  CHIOMA OBINNA  on a number of laboratory issues and the impact of the upcoming conference will have on disease control in Nigeria and Africa at large.



Prof. Abimiku

Nigeria and other parts of Africa is currently faced with various outbreak of diseases, are there plans to establish more public health laboratories that will take care of diseases such as HIV, Ebola and among other deadly diseases affecting?

Definitely, a pillar of ASLM is increasing skilled laboratory workers to meet increased routine laboratory services as well as the urgent and immediate needs that arise during outbreaks.   ASLM, in collaboration with the World Health organisation, Regional Office for Africa (WHO AFRO), has been instrumental in moving laboratories toward accreditation through the Strengthening Laboratory Management Toward Accreditation and the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) programme which will ensure quality testing and accurate surveillance data that can be shared with partners.   We are working closely with Africa Centre for Disease Control, CDC, to strengthen overall laboratory networks and increase the number of public health institutions that can respond to deadly diseases.

What level of progress has ASLM recorded in managing and finding a cure to the deadly diseases?

Diagnostics is pivotal to accurately identifying, treating and preventing diseases in patients. And a robust network of laboratories equipped with quality diagnostics and skilled laboratory workers can quickly identify and pin-point diseases within communities, thus allowing for an immediate response. The ability to create reliable and up-to-date databases that are accessible to every discipline and community is important for this process to be successful and meaningful. In addition, laboratory medicine also goes hand-in-hand with research that can drive new technologies, vaccines and innovations.

What are the challenges you have faced in terms of providing health security in Africa?

There are two major challenges in providing health security in Africa. The biggest challenge is the continually changing landscape with emerging and re-emerging diseases and lack of tools including reliable data, intelligence and resources to combat these diseases. The other has to do with the non-communicable diseases like cancer, diabetes and heart disease.   Our upcoming conference will highlight two very important areas needed to help achieve health security in Africa – International Health Regulations (IHR) and Universal health Care (UHC). IHR requires countries to report across borders on certain diseases and outbreaks that have global implications. And UHC promises equitable and accessible health services for individuals, regardless of financial status. We need to stay focused on the essential health services and health systems strengthening in order to provide health security in Africa.

You are among those who pioneered early HIV research, how do you intend to expand the provision of HIV Viral load Monitoring Tools where there are no access?

ASLM works with key partners, such as the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), to scale up HIV viral load monitoring across Africa. In addition to the work ASLM does to advocate for the needs of countries, it recently launched a new project called the Laboratory Systems Strengthening Community of Practice (LabCoP). This new learning network is designed to link multidisciplinary teams from member countries to exchange laboratory experiences and best practices aimed at helping laboratories scale up VL via South-to-South learning amongst laboratorians, clinicians, policy-makers, patients and communities.

Do you think the Freetown Declaration in 2015 has helped to reduce the outbreak and control of diseases in Africa?

The Freetown Declaration brought together our organisation, World Health organisation, WHO-AFRO, and ministry of health officials from more than 20 countries in Africa to promote the development of laboratory networks for the Global Health Security Agenda in Africa. The Ebola outbreak demonstrated the critical need to reduce vulnerabilities in health care facilities and the laboratory system interface. The Freetown Declaration has been instrumental to the leveraging of resources for the integration of tiered laboratory networks into disease surveillance and public health institutes and has helped reduce the outbreak and control of diseases in Africa.

What are the objectives of the African Society for Laboratory Medicine, ASLM?

ASLM is a body of laboratory professionals working to advance laboratory medicine on the continent.   We have also set some goals to be achieved by 2020.   We are working towards strengthening laboratory workforce by training and certifying laboratory professionals and clinicians through standardised frameworks, transform laboratory testing quality by enrolling laboratories in quality improvement programmes, developing strong, harmonised regulatory systems for diagnostic products, and building a network of national public health reference laboratories to improve early disease detection and collaborative research.

What is your advice to young people who intend to pursue laboratory medicine as a profession?

One of my passions has been building capacity on the continent through laboratory training programmes and transitioning leadership roles to young people. Africa is a young and dynamic continent with endless possibilities. With so much new technology, we are seeing the field of laboratory medicine expanding to biomedical engineering, information technology, and even social media. I would say if you are curious and care about the health of your community, you should explore the many possibilities within laboratory medicine. It is a very rewarding profession.

Why the choice of Abuja for the 2018 ASLM Conference coming up in December?

The 2014 West Africa Ebola outbreak was the most widespread outbreak in history. All of West Africa felt the disruption, and is still feeling it. So since ASLM is a pan-African professional body working to advocate for the critical role and needs of laboratory medicine and networks throughout Africa, Abuja, the capital city of Nigeria, the largest country in West Africa, was a good choice. This year’s conference theme is: “Preventing and Controlling the Next Pandemic: The Role of the Laboratory” and ASLM2018 will provide a platform for laboratory professionals to come together and discuss current issues across Africa, including Ebola, and the role of the laboratory.

What are your expectations from the conference?

Every conference provides the opportunity to renew friendships and network with old and new friends and colleagues. The laboratory and clinical community is expanding and yet we are growing closer together with each conference.   There is tremendous enthusiasm and pride, as we share many of the same issues and concerns and tackle them together. The conference has become a platform to come together as medical professionals and discuss our successes and challenges. One of the highlights for me is to see and mingle with young African professionals who have grown into, or are on their way to becoming, leaders and experts in different fields on the continent.

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