The project aims at strengthening capacities of the ISTC central Asian member countries to detect and manage outbreaks of high risk pathogens, in line with the International Health Regulations 2005 (IHR), the One Health approach, at the same time improving biosafety and biosecurity, and with a focus on Tajikistan and Kyrgyzstan.
In March 2014, the largest Ebola outbreak under record erupted in West Africa. This outbreak truly demonstrated that in the modern world of travel, trade and migration, infectious diseases do not respect geopolitical boundaries.
The outbreak also triggered preparedness activities across Europe and central Asia, to ensure that potential imported cases are promptly detected, handled in safe and appropriate manner, including contacts, and diagnosed and treated as required. However, handling of suspect cases has also revealed existing weaknesses in the area of management of high risk pathogens in Europe and central Asia.
This proposal outlines a set of activities aimed at strengthening laboratory preparedness for outbreaks of high risk pathogens, improving collaboration and integration of surveillance and response at the animal/human interface, and IHR implementation, during the following years, starting with activities suggested in this proposal. Among key impediments to the successful implementation of the IHR, the 2nd IHR Review Committee has underlined that many countries are not yet ready to use and apply IHR on a daily basis in an operational manner, despite capacities being available in many cases. Contributing to the issue is insufficient authority/capacity of National IHR Focal Points (NFPs) combined with high staff turnover, and the focus on IHR deadline extensions rather than on an expansion of capacities. The Review Committee also underlined that the Member States’ self-assessment of the country IHR implementation is limited by the varying quality and reliability of information provided.
The activities outlined in this proposal will ensure that the participating countries are better prepared to deal with outbreaks of high risk pathogens through
1. Strengthening the laboratory component of surveillance and response for control of high risk pathogens. This surveillance and response includes: active surveillance, case finding, contact tracing, response, and capacity for epidemiologic and laboratory analysis and program evaluation.
2. Strengthening International Health Regulations (IHR) core capacities, global health emergency workforce and member country capabilities for surveillance, preparedness and response to high risk pathogens.
Implementation of this project meets the ISTC Goals by increasing member country capacity to monitor and respond to outbreaks of high risk pathogens, thereby preventing accidental or malevolent release of pathogens and protecting the workers and the environment.
Activities will focus on strengthening the laboratory component of surveillance and response for control of high risk pathogens, and strengthening the IHR core capacities for surveillance, preparedness and response to high risk pathogens which pose a public health concern.
High risk pathogens covered by this project include: zoonoses, vector-borne pathogens, emerging pathogens (e.g. respiratory, blood-borne etc), intentional release of pathogens (eg. anthrax).
Activities will be led by the two institutions and those conducted in Kyrgyzstan and Tajikistan will occur under the auspices of the respective intersectoral National Laboratory Working Groups (NLWG), that include public health laboratories dealing both with human and animal health. Activities will include the development of a national laboratory response plan, with a focus on biorisk management, (as a component of an overall national emergency preparedness plan), defining the laboratory preparedness network in each country and the development of national guidelines for laboratory testing of high risk pathogens as part of outbreak investigation and response.. Laboratory experts will be trained as part of national rapid response teams for outbreak and biorisk management, this will include establishing communication throughout the laboratory network. Laboratory Information Management Systems will be established in x/relevant/selected national reference laboratories to ensure correct data collection, data management and analysis. Sample referral and transport systems will be established. External quality assurance programmes for high risk pathogens will be established.
Within the wider central Asian region, including Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan, national reference laboratories will be invited to participate in a network for the exchange of information on high risk pathogens. This network will be supported by a expert working group comprising of experts from the countries as well as from collaborating institutions and other international partners.
The above activities will take the form of expert meetings and missions, led by national experts from the NLWG, and international experts linked to foreign collaborators (i.e. WHO Regional Office for Europe and other partners). Training will be done on-site for the relevant sections of the public health system and the rapid response team. The participating institutes will undertake scoping exercises to determine the state of the art prior to development of information management and external quality assurance systems.
