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1 |
SRL München-G.
Institute of Microbiology & Laboratory Medicine
IML red
(Dpt of research, education and development)
Kuratorium against Tuberculosis in the World
Summary of activities
WHO / Global Laboratory Initiative – TB Supranational Reference Laboratory Network
2 |
SRL Country Support
Collaboration agreements established with
– Republic of Uzbekistan (MoH & NRL)
– Republic of Tajikistan (MoH & NRL)
– Republic of Kyrgyzstan (MoH & NRL)
– Nepal
• GENETUP (German Nepalese Tuberculosis Project)
• NATA (Nepalese anti-TB association)
• NTC (National TB Center Thimi, Bhaktapur)
– Bolivia, Santa Cruz de la Sierra
• Regional TB Center (Centro Bronchopulmonar I & II)
• International Committee of the Red Cross
WHO / Global Laboratory Initiative – TB Supranational Reference Laboratory Network
3 |
SRL in-country activities
Laboratory planning, supervision of construction, commissioning
– e.g. BSL-3 Laboratories:
• NRL of Uzbekistan (2007)
• NRL of Tajikistan (2011)
• NRL of Kyrgyzstan (2013)
• RRL of Samarkand, Uzbekistan (2013)
• GENETUP, Katmandu, Nepal (incl. refurbishment 2011)
• Bronchopulmonary Center II, (incl. reconstruction 2013-2014)
Final inspection and snagging report
Commissioning of premises
WHO / Global Laboratory Initiative – TB Supranational Reference Laboratory Network
4 |
SRL in-country activities
On-site staff training – Typical programs for NRLs in Uzbekistan, Tajikistan, Kyrgyzstan:
– Approximately 28 weeks on-site training for new NRLs (e.g. Trainings-plan TJK)
WHO / Global Laboratory Initiative – TB Supranational Reference Laboratory Network
5 |
SRL in-country activities
Quality Management System
– Accreditation of SRL:
• SRL Muenchen-G. DAkkS accredeted a/t ISO 15189:2007-08 in 2009
• Re-Akkreditation 2012
– QMS implementation trainings
• How to structure a QMS: Components, hierachy etc.
• How to write SOPs, forms and other QMS documents
• How to manage & control documents
– Provision of SOPs for equipment / lab methods / tests to NRL partners
• online on sky drive
• in Russian language
• with constant updates
WHO / Global Laboratory Initiative – TB Supranational Reference Laboratory Network
Drafts 107 UZB 32 TJK 48 KGZ 6
6 |
SRL in-country activities
Operational Research
– Drug resistance surveys :
• 2006 – Tashkent, Uzbekistan
• 2007 – Dushanbe, Tajikistan
• 2011 – National DRS Uzbekistan (WHO-HQ, WHO-CO, UZB: DOTS-Center, NRL, NTBI)
• 2011 – National DRS Tajikistan (CDC, ProjectHOPE, NRL, NTP)
• 2011 – National DRS Kyrgyzstan (CDC, ProjectHOPE, NRL, NTP)
Laboratory assessments & National TB Program reviews
– 2009 Tajikistan
– 2010 Uzbekistan
– 2012 Kyrgyzstan
– 2013 Tajikistan (re-assessment)
WHO / Global Laboratory Initiative – TB Supranational Reference Laboratory Network
7 |
SRL in-country activities
Project financing & management in Nepal / Bolivia
– Salaries / topping-ups
– Materials, reagents, consumables
– Maintenance
Programmatic support
– 2011 Nepal: Strengthening interfaces of laboratory / clinical services
– 2012 Tajikistan: Development of a national TB diagnostic algorithm (together with TJK NTP, NRL & ExpandTB, UNDP, KNCV, ProjectHOPE)
WHO / Global Laboratory Initiative – TB Supranational Reference Laboratory Network
8 |
Activities conducted at the SRL
Workshops in Germany
– 2011: Heads of NRLs in Central Asia (KGZ, TJK, UZB)
• Topics: molecular diagnostics of TB
Principles and Comparisons
– Genotype MTBDRplus (HAIN Lifescience, Germany)
– Xpert MTB / RIF (Cepheid, USA)
– probeTEC MTBC (BD, USA)
– Taqman MTB (Roche, Switzerland)
– 2012: Vice-directors & Chief Technicians of NRLs & RRLs in Central Asia
• Topics:
– Decontamination, Culturing, DST with proportional method & MGIT
– Prevention of cross-contamination
WHO / Global Laboratory Initiative – TB Supranational Reference Laboratory Network
9 |
Minister of Health & NTP managers of Republic of Kyrgyzstan (2009)
N. F. Salimov, Minister of Health of the Republic of Tajikistan (2012) – Topics:
• Transition from conventional TB sanatoriums to integrated pulmonary hospitals
• Integrated laboratory diagnostics
• Structure and management of laboratory networks
• Lab network logistics
Activities conducted at the SRL
WHO / Global Laboratory Initiative – TB Supranational Reference Laboratory Network
10 |
Engagement with in-country partners
Which partners?
– UZB: National TB Institute, National DOTS Center, ProjectHOPE, FIND, WHO
– TJK: NTP, FIND, UNDP, ProjectHOPE, WHO
– KGZ: NTP, FIND, UNDP, ICRC, KNCV, ProjectHOPE, WHO
– NEP: NATA, NTC, IUATLD
– BOL: ICRC, IUATLD
What works well?
– Programmatic work with FIND / Expand TB
– KGZ: Coordination / collaboration with UNDP, ICRC, FIND & other partners
WHO / Global Laboratory Initiative – TB Supranational Reference Laboratory Network
11 |
Funding
WHO sources? YES, since 2010
Other sources?
– Kuratorium against TB in the world
• Private donations
• Heritages
• BMZ: 75% support for refurbishments in Nepal / Bolivia
– IML red
• BMBF, international office
• KfW Development Bank
• GFATM, KNCV
WHO / Global Laboratory Initiative – TB Supranational Reference Laboratory Network
12 |
Funding
Funding gaps?
– Kuratorium
• Since financial crisis gaps of 30 to 40 TEUR / year
– IML red
• Depending on the extent of activities planned
WHO / Global Laboratory Initiative – TB Supranational Reference Laboratory Network
13 |
Challenges in meeting SRL TORs
Challenges
1. Coordinate ... GLI and its technical partners ... to facilitate implementation of WHO policy guidance...
Possible solutions
– Increase awareness of technical partners about roles of SRL in countries
– Strengthening communication & coordination of activities
WHO / Global Laboratory Initiative – TB Supranational Reference Laboratory Network