1. Biosafety and Biosecurity Challenges in the Caribbean Region Valerie Wilson Caribbean Med Labs Foundation Anticipating Global Biosecurity Challenges Istanbul, Turkey July, 2011

2. Caribbean Med Labs Foundation Outline Caribbean Region – the realities Biosafety Assessment Results Major Issues Some Solutions

3. Caribbean Med Labs Foundation

4. Caribbean Region Key strategic location linking North and South America Most tourism dependant region in the world: North America Europe China India Highly vulnerable to biosafety and biosecurity risks – anthrax, H1N1, SARS, etc. Major potential impact on economy and local and regional populations

5. Caribbean Med Labs Foundation Background Caribbean Med Labs Foundation – Caribbean Region  23 countries: English, French, Spanish, Dutch  Major economic differences – GDPs: Haiti - $600 US per capita Cayman Islands - $44,000 US  Major population differences – Haiti – 8 million; Montserrat – 4,000

6. Caribbean Med Labs Foundation Objectives:  Developing the supportive environment for high quality regional laboratory services  Advocating at the highest levels for laws, regulations and accreditation of laboratories  Mobilising resources for lab strengthening  Mapping of a regional sustainability strategy

7. Caribbean Med Labs Foundation The Caribbean Laboratory Network Bermuda Guyana Suriname

8. Caribbean Biosafety Assessment Results

9. Caribbean Med Labs Foundation Target Institutions Medical Labs Public Health Labs Veterinary Labs Agriculture Labs Labs conducting Zoonotic disease testing Food and Water Labs

10. Caribbean Med Labs Foundation Assessment Tool Total of 204 Questions in 20 Categories addressing:  General Infrastructure at National Level  International Health Regulations  Laboratory Safety Standards Initial focus on medical and public health laboratories (major national labs) in 13 countries

11. Assessment Results General

12. Caribbean Med Labs Foundation Formal Network for Co-ordination of Laboratory Operations in country

13. Caribbean Med Labs Foundation Network and labs involved in Animal testing

14. Caribbean Med Labs Foundation Formal collaboration between MOH and Min of Agriculture on Zoonotic diseases

15. Assessment Results International Health Regulations

16. Caribbean Med Labs Foundation Adoption of WHO policies for laboratory biosafety nationally

17. Caribbean Med Labs Foundation National regulations or policies for laboratory biosafety

18. Caribbean Med Labs Foundation Regulatory framework for enforcement

19. Caribbean Med Labs Foundation Accessibility of biosafety guidelines

20. Caribbean Med Labs Foundation Responsibility for laboratory biosafety and biosecurity nationally

21. Caribbean Med Labs Foundation Biosafetly guidelines, manuals and SOP dissemination

22. Caribbean Med Labs Foundation Staff training in biosafety

23. Caribbean Med Labs Foundation National System for biosafety levels

24. Caribbean Med Labs Foundation Biosafety Inspection Responsibility

25. Caribbean Med Labs Foundation Implementation and Monitoring

26. Caribbean Med Labs Foundation Biorisk Assessments

27. Caribbean Med Labs Foundation Biocontainment Engineering Expertise

28. Assessment Results Laboratory Safety Standards

29. Caribbean Med Labs Foundation Laboratory Biosafety Levels 13 countries responded Only 2 of these countries have a Biosafety Level 3 laboratory (or Level 2.5 with 3 practices) – mainly developed for TB testing There are 3 other Biosafety Level 3 labs already existing or under development within the region

30. Caribbean Med Labs Foundation Safety Management QuestionYesNoDK/N R Safety Officer94 Safety/Biosafety Officer742 Documented evidence of staff training292 Medical Surveillance and Occupational Health Programme 463 Records of staff immunisation841 Annual safety audit2101 Formal system for risk assessment193 Safety Committee661 Safety Manual available to staff67

31. Caribbean Med Labs Foundation PPE and other protective equipment QuestionYesNoDK/N R PPE – coats and gowns - available13 Other PPE – goggles and glasses available as necessary 112 Gloves available13 Respiratory protection (masks, respirators) available as necessary 112 Respirators used in accordance with training 433 (3 NA) BSCs provided for BSL II (as necessary) and BSL III 1021 BSCs installed and certified annually751 NA

32. Major Issues and Solutions

33. Caribbean Med Labs Foundation Major Issues Major gaps in biosafety implementation within the Caribbean region evident including:  Lack of national policies and regulatory mechanisms for biosafety  Lack of systems for biorisk assessment – nationally and at laboratory level  Challenge with assignment of time for safety functions  Limited adoption and monitoring of safety standards  Limited access to biosafety Level 3 facilities

34. Caribbean Med Labs Foundation Some Solutions Regional reference laboratory for communicable diseases – CAREC/PAHO/WHO in 1975 – transitioning to Caribbean Public Health Agency (CARPHA) Development of national reference laboratories has progressed significantly over the past 5-10 years e.g. Haiti, Dom Rep, Guyana, Suriname, Jamaica (support from CDC, EU, etc.) Small size of countries supports development of regional networks Regional network laboratories require systems for ensuring efficient transport, facilitation of Customs, management of data, legislation, quality of results, financing Capacity building for implementation of safety systems urgently needed

35. Special thanks to the members of the Caribbean Laboratory network for their support in conduct of the assessments, to IFBA for providing the initial guidance and funding http://cmedlabsfoundation.net