1. Making Lab network sustainable after Polio Presenter: Varavikova Elena, MD, PhD, MPH

2. The Global Polio eradication lab network is the best example of a global public health laboratories that we have. There is a potential for other health endeavours after polio is eradicated S.L. Cochi

4. Prepare for the Threats Avian Influenza pandemic H5N1 Biopreparedness Climate related diseases (vector) HIV/AIDS Pandemic Hep., Measles, Rubella, Yellow Fever Containment activities

5. Tenth informal consultation on the global polio laboratory network, 6-8 Sept. 2004 While maintaining polio eradication as there highest priority, WHO regional offices, in collaboration with headquarters, should begin the process of encouraging Member States and partners to progressively accept ownership of all polio network laboratories …over the next 5-10 years.

6. Changing situation Globalization (no geo barriers, weakening of Governments) Demography (Population rising, aging, urbanization, inequality) Reforms in Health sector, decentralization, medicalization, Public Health services – privatization New Threats Low capacity of National Lab services

7. Changing Donors behaviour Current situation with low interest to public health could change with biopreparedness in G7 countries Globalization G7/8, EU, WB, International standards Developing interest for HRH (salary, motivation) Existence of active forces private and NGO Interest to the research Polio success create new possibilities for Lab. services

8. 8 WHO-AFRO LAB NETWORK: Recommendations As we approach polio eradication direction for the network: –First assure completion of polio eradication –Review activities to identify strengths and failures –Working with partners, define future activities and funds Call on national governments to provide support for THEIR laboratories Continuing partner support for network activities Network to begin preparation for future roles in disease control

9. 9 WHO-AFRO Laboratory Network: Draft Budget 2003 BUDGET ITEMS US$ (x (10 3 ) Equipment/reagents/supplies 900.00 Laboratory support –TSAs for 16 laboratories including support for Sequencing capacity at RRL 200.00 Training Laboratory techniques 120.00 Data management 60.00 Consultants’ for lab. Containment 60.00 Laboratory containment issues 100.00 Meetings 200.00 Staff –Fixed term staff-(mo & admin support) 140.00 –Duty travels 80.00 –APWs for RRLs/NLs 350.00 Regional office Operational cost (communications, etc ) 50.00 Total 2,260.00

10. Problems facing laboratory services in developing world (1) Weakening PH systems and governmental responsibilities Failure to recognize the value and importance of surveillance and lab services for population health Lack of strategic planning and financing Inadequate training without analysis of competencies and skill mix required

11. Problems facing laboratory services in developing world (2) Inadequate investment in revenue Salaries and motivation are low Universal quality assurance and razing standards may close some labs Lack of environment for continuing education and career development Scientific educational background often deficient Work ethic

12. "Matreshka" Develop a consensus on the strategy (for instance- at international level – achieve an accreditation of the network labs for a list of viral infections, at regional – to upgrade polio labs into regional multy functional labs (PAHO) Developing set of the Core activities, standards, Info and reporting system, HR re-education, etc Gradually introduce the new set of activities Development financial plans Evaluation by input, process, outcomes

13. Conclusion Polio Lab network – best practice in modern PH There is a need for different strategy in Advocacy Decision must be made on maintaining international responsibility for the network Developing new strategy based on accurate evaluation on the current situation Building renewed collaboration of Donors (biopreparedness, survey of hardware etc.; HRH; research)