Quality improvement of Laboratory Services for Viral Hepatitis in the Western Pacific Region
The World Health Organization (WHO) Western Pacific Regional Office (WPRO) is working with Collaborating Centres, including NRL, to establish a network of regional reference laboratories for hepatitis testing in the Western Pacific Region. Worldwide, there are 1.34M deaths from hepatitis per year, 96% due to HBV and HCV. About 60% of those living with HBV and 34% living with HCV are found in the Western Pacific region. Liver cancer and cirrhosis are in the top 10 causes of death for all age groups over 30 years of age in the region. So the burden of disease on the healthcare budget and the economy in general is significant.
Many regional countries are undertaking health intervention strategies to address the high level of hepatitis. With the advent of new and effective anti-viral medication, improved vaccination programmes and test and treat initiatives, some countries are seeking to reduce, and possibly eliminate, hepatitis. However, critical to the success of these interventions is laboratory testing. Without well selected, quality assured assay, trained testers, appropriate quality management systems, the interventions will be less successful. Laboratory testing underpins the cascade of care for patients, including the initiation and monitoring of treatment and the reporting of prevalence and incidence to appropriate bodies.
The WHO WPRO organised an informal consultation to discuss improvements to laboratory quality in the region. The meeting held between the 26-27 June included key collaborating centres: CDC Atlanta, the Victorian Infectious Diseases Reference Laboratory, the Korean Red Cross, the National Centre for Clinical Laboratories, China and the Pacific Community; and the Pacific Paramedical Training Centre. Given each meeting participant was a collaborating centre of WHO, it was proposed to utilise this network to improve laboratories and strengthen partnerships.
The objectives of the meeting included the review of:
the viral hepatitis laboratory capacity in the region;
methods to sustain quality laboratory management ;
accessibility to appropriate diagnostics for viral hepatitis.
Much of the discussion was held around the use of Pre-qualified (PQ) IVDs through the Geneva Prequalification Group activities with the use of PQ IVDs highly recommended. The importance of long term funding was also highlighted with the proposal that funding from member states be identified to enable continuous capacity building with sustainable outcomes. Member states were recommended to implement procurement systems that allow for the best quality of IVDs that are affordable, for future health initiatives.
This group, and others, will continue to collaborate to provide support to member state countries in the development of reference laboratories, the training in quality management systems, introduction and expansion of EQAS and further develop the reporting of epidemiological data to ministries of health. NRL is pleased to be part of this important collaboration.