Laboratory is one of the core capacities that Africa must develop to achieve resilient health systems. Laboratory services play a major role in all the key processes of detection, assessment, response, notification, and monitoring of public health events.
Yet, for a long time, laboratory services were not considered a priority for most resource-limited healthcare systems in Africa, resulting in poor infrastructure, low human resource capacity and inappropriate technologies.
In the past decade, efforts to combat HIV, tuberculosis and malaria in sub-Saharan Africa have underscored the inadequacy of laboratory systems in most African countries, as they were not equipped to perform vital testing for HIV care and prevention programmes.
However, although billions of US dollars have been invested in these programmes over the years, only small fractions go into the laboratory stream.
In recent years, the COVID-19 pandemic further highlighted the central role of reliable and timely laboratory identification and characterization of infectious agents in strengthening pandemic preparedness and response. Africa must therefore rise to the challenge of building capacity in its laboratory systems, as many critical gaps still exist.
The accurate determination of chemical and biological properties of samples can save lives—and change society for the better
Analytical and diagnostic laboratories in Africa
Diagnostic laboratories play a critical role in the detection, monitoring, control, and management of diseases, including several communicable and non-communicable diseases endemic to the African region.
Thus, addressing the factors responsible for weak laboratory systems in Africa is critical to the successful reduction of the global burden of disease on the continent, and the reduction of erroneous diagnosis, ineffective treatment, and avoidable deaths.
On the other hand, analytical laboratories assist biotech, food, environmental, and pharmaceutical companies, amongst others, to ensure the safety assurance and quality control of products provided to customers. The accurate determination of chemical and biological properties of samples can save lives—and change society for the better.
Unfortunately, the reliance on locally obtained certificates of analysis has resulted in several African manufacturers and exporters suffering losses of invested funds and reputation because of rejected exported products. Thus, there is a critical need to raise the bar in the analytical space in Africa to provide globally acceptable, reliable, and quality results that protect lives and inspire confidence to encourage trade across the continent.
Strategies for capacity building of analytical and diagnostic laboratories in Africa – Bloom Public Health model
The challenges confronting Africa’s laboratory systems are multifaceted, with factors ranging from limited human, financial and technical resources to poor laboratory monitoring and accreditation systems. Thus, various strategies must be adopted for the capacity building of laboratories across Africa, including leveraging on the expertise of the private sector through public-private partnerships (PPPs).
PPPs can complement public sector efforts and fill critical gaps. A good example is Bloom Public Health, an indigenous public health think tank in Africa, that forms strategic partnerships with national ministries of health, government agencies, and internationally reputable organisations to address the issues within the analytical and diagnostics space on the continent.
In view of these, the following are key strategies for the capacity building of laboratories in Africa:
1. Strengthening laboratory accreditation and monitoring: Accreditation essentially establishes a system of standard procedures with the goal of improving quality and patient safety. Laboratory accreditation facilitates accurate and rapid analytics and diagnostics, and the reduction of errors in the laboratory process. Although a highly technical process requiring massive investment, laboratory accreditation can be achieved through strategic partnerships within the laboratory space. Through this kind of partnership, Bloom Public Health has supported some labs to attain ISO 17025 accreditation.
2. Strengthening laboratory human resources capacity through training is essential to guarantee effective management of analytical and diagnostics tools and is also vital to enshrining quality management systems, which guarantees the quality of results generated from labs.
Training can be achieved using several approaches, including self-training using e-resources, on-site training, centralised in-country training, and out-of-country training. For example, Bloom Public Health in March 2023 commenced a series of capacity-building training for the Standards Organisation of Nigeria (SON) laboratory analysts. Bloom Public Health has also supported the capacity-building efforts of the Nigeria Natural Medicine Development Agency (NNMDA) and LANACOME of Cameroon, amongst others.
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3. Increased investment in laboratory systems: Laboratory capacity building requires massive funding, which is typically unavailable to most labs except government or donor-funded laboratories. African governments, therefore, need a paradigm shift to ensure a significant fraction of the investment made in the health space in Africa is channelled to laboratories. Increased investment in laboratories can also be achieved through strategic partnerships in health financing within the laboratory space.
The Bloom Public Health, Katchey Laboratories and ND Western partnership that gave rise to Delta Plus Diagnostics, a world-class molecular diagnostic laboratory, still stands out. This role model partnership is one that should be emulated by other stakeholders and deployed across the entire laboratory space in Africa.
In Conclusion,
Despite the enormous challenges in Africa’s laboratory systems, through strategic partnerships and the concerted efforts of committed stakeholders, laboratories in Africa can be upgraded to world-class status. The impact of this will be a tremendous increase in patient safety through accurate test results and prompt treatment, and the rise of a critical mass of highly skilled laboratory scientists on the continent.
