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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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