Abstract
BackgroundThe recent emergence of a novel strain of influenza virus with pandemic potential underscores the need for quality surveillance and laboratory services to contribute to the timely detection and confirmation of public health threats. To provide a framework for strengthening disease surveillance and response capacities in African countries, the World Health Organization Regional Headquarters for Africa (AFRO) developed Integrated Disease Surveillance and Response (IDSR) aimed at improving national surveillance and laboratory systems. IDSR emphasizes the linkage of information provided by public health laboratories to the selection of relevant, appropriate and effective public health responses to disease outbreaks.MethodsWe reviewed the development of Rwanda's National Reference Laboratory (NRL) to understand essential structures involved in creating a national public health laboratory network. We reviewed documents describing the NRL's organization and record of test results, conducted site visits, and interviewed health staff in the Ministry of Health and in partner agencies. Findings were developed by organizing thematic categories and grouping examples within them. We purposefully sought to identify success factors as well as challenges inherent in developing a national public health laboratory system.ResultsAmong the identified success factors were: a structured governing framework for public health surveillance; political commitment to promote leadership for stronger laboratory capacities in Rwanda; defined roles and responsibilities for each level; coordinated approaches between technical and funding partners; collaboration with external laboratories; and use of performance results in advocacy with national stakeholders. Major challenges involved general infrastructure, human resources, and budgetary constraints.ConclusionsRwanda's experience with collaborative partnerships contributed to creation of a functional public health laboratory network.
Highlights
The recent emergence of a novel strain of influenza virus with pandemic potential underscores the need for quality surveillance and laboratory services to contribute to the timely detection and confirmation of public health threats
Experiences with external support to laboratory services were gathered through interviews with locally-based partners who worked closely with the Ministry of Health and the National Reference Laboratory (NRL) including World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), Columbia University and the United States Agency for International Development (USAID)
The WHO/AFRO Integrated Disease Surveillance and Response (IDSR) technical guidelines were adapted to ensure that Rwandan disease priorities would be emphasized in the streamlined system
Summary
The recent emergence of a novel strain of influenza virus with pandemic potential underscores the need for quality surveillance and laboratory services to contribute to the timely detection and confirmation of public health threats. To provide a framework for strengthening disease surveillance and response capacities in African countries, the World Health Organization Regional Headquarters for Africa (AFRO) developed Integrated Disease Surveillance and Response (IDSR) aimed at improving national surveillance and laboratory systems. Even though well-known, efficacious responses are available for the control and prevention of these diseases, the capacity for timely detection, confirmation and response actions needs reliable public health systems. The IHR (2005) are especially clear in calling for strengthening core capacities for detecting and confirming public health threats, especially those with potential to extend beyond national borders [6]. Progress in countries with limited resources depends on identifying opportunities for creating and streamlining resources to achieve functional national laboratory networks that meet national priorities and support global disease program objectives [7]
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