The Lab and Global Health

The medical laboratory contributes significantly to improving overall knowledge and treatment for infectious and chronic disease around the globe. This is especially evident in Sub-Saharan Africa where, for the past decade, the President’s Emergency Plan for AIDS Relief (PEPFAR) program has been providing continuing education to laboratory professionals in resource limited countries, where the fight against HIV/AIDS has reached epidemic levels.

Laboratory Participation
In 2005, the American Society for Clinical Pathology (ASCP) joined this effort, partnering with the Centers for Disease Control and Prevention (CDC) to treat and prevent AIDS and tuberculosis in Sub-Saharan Africa and alleviate suffering from other infectious and chronic diseases. The partnership was crucial since the laboratory plays a vital role in improving healthcare delivery through providing important information for diagnosis and treatment of diseases such as HIV. As an example, treatment for HIV can only be prescribed after a diagnosis is made and CD4 levels are determined.

ASCP’s initial involvement came as an emergency response to the health crisis in Sub-Saharan Africa. In resource limited countries, building laboratory capacity is essential for reliable diagnostic testing, effective treatment, and reducing mortality. ASCP is committed to improving global health through innovative methods and partnerships that improve laboratory practices. Working with the CDC, which had established relationships with administrators of the government public health labs, ASCP’s consultants began conducting assessments of the countries’ existing laboratory structure and helping to design basic and continuing education to bridge the gaps in knowledge and skills.

Laboratory professionals and pathologists serving as volunteer ASCP consultants traveled to PEPFAR countries to provide training through the Strengthening Laboratory Management Toward Accreditation (SLMTA) program that improves the skills of laboratory professionals in PEPFAR countries, guiding them through improvement projects. SLMTA training evolved from a concept outlined in a white paper that ASCP submitted to the CDC and the World Health Organization (WHO)-African Region. A companion program, Stepwise Laboratory Improvement Process Toward Accreditation (SLIPTA), provides a checklist that laboratories use as they work toward the goal of gaining accreditation.

Ongoing Assessment
With the success of these in-country trainings, ASCP consultants began to work with universities that have medical laboratory training programs, assessing their curricula and training their faculty in the operation of current equipment and expanding their knowledge to prepare their students to work in medical laboratories. Last winter, for example, laboratory professionals traveled as consultants to Nigeria to teach educators from 10 universities to use digital microscopes that can project images to a screen that accommodates larger class sizes. This workforce initiative presents a solution to traditional multi-observation teaching microscopes that can only accommodate a few individuals at a time.

As ASCP expanded its PEPFAR activities to many more countries, efforts have transitioned from an emergency response to building sustainability within the PEPFAR countries. The focus is on providing management training and mentoring.

Another example is the creation of the African Society for Laboratory Medicine (ASLM). A pan-African organization of laboratory professionals, ASLM has been working collaboratively with government and healthcare organizations to build a sustainable medical laboratory infrastructure that will improve access to quality patient care.

Last December, the ASLM conference in Cape Town, South Africa, convened laboratory professionals, policy and health delivery experts, government and non-governmental organizations, public and private sector groups, and the diagnostics industry to intersect, learn, and strengthen networks. One of ASLM’s goals is to have 30,000 trained and certified laboratory professionals by 2020.

Due to the substantial accomplishments throughout these countries in Africa, ASCP’s PEPFAR Initiative has expanded to Southeast Asia and Eastern Europe to address similar disparities in those underserved regions of the world. Rex Famitangco, MS, MLS(ASCP)CM, served as a consultant on one of ASCP’s new PEPFAR activities to provide support for bio-safety workshops in 15 laboratories in Ukraine. Famitangco, along with ASCP consultant Linda Andiric, joined staff from ASCP’s Center for Global Health to present the bio-safety workshops.

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