After starting up slowly, the PPHSN Public Health Laboratory Network has been boosted by the first LabNet Technical Working Body (TWB) meeting, in Noumea on 23 July 2002, the day before the 8th Coordinating Body (CB) meeting.
The participants were representatives from the Institut Pasteur de Nouvelle-Calédonie (IPNC), WHO and SPC. The structure and progress of this meeting followed the plan of action drafted at the inaugural LabNet meeting in April 2000 .
The agenda included: official identification of LabNet labs by level; training needs; LabNet projects: the evaluation of rapid diagnostic kits for dengue and leptospirosis, organisation of a regional LabNet meeting; stockpiles of equipment and laboratory supplies; sustainability, especially financial arrangements in the short and longer terms; communication: use and distribution of PacNet-Lab, setting up the LabNet encrypted web site; and coordination.
Participants also considered recommendations related to LabNet from the three EpiNet workshops held between December 2001 and March 2002.
A brief of the discussions was subsequently presented to the CB members in the course of the 8th CB meeting. Issues that were especially discussed are detailed below.
Definition of a L1 lab
TWB members suggested, and CB members further agreed, that any existing laboratory in the Pacific Islands that provides public services will be considered a LabNet L1 lab. For official network communication and coordination, each laboratory’s designated member of the EpiNet National Team will be the L1 National Focal Point. All LabNet official communications (such as placing requests for L2 further testing, ordering rapid diagnostic kits and/or other lab supplies) should be channelled through these L1 National Focal Points.
Stockpiling of diagnostic kits and laboratory supplies
CB members agreed that, in order to avoid stock management problems, especially those related to expiry date, diagnostic kits should NOT be stocked in different locations in the region. It was suggested by TWB and further agreed by CB members that diagnostic kits should remain with the suppliers, who maintain ‘fresh’ stocks and have good distribution networks in the PPHSN core member countries. PPHSN-CB should, through the TWB, establish a proper agreement with the suppliers, allowing for last-minute orders and urgent delivery to L1 National Focal Points and/or laboratories if appropriate.
Laboratory supplies – such as vials, sampling tubes, transport media and materials, etc. – will be stocked in WHO offices throughout the region and at the Guam Public Health Laboratory. These are the most strategic locations for easy and rapid dispatching, and this arrangement will simplify stock management.
A letter will be dispatched to commercial airlines asking for clarification regarding their understanding of the air shipment of biological samples in the case of the PPHSN operations.
The CB members agreed in principle that a revolving fund should be established to assist regions in providing rapid response to outbreaks. This revolving fund will be comprised of contributions from the PPHSN core member countries and from other PPHSN partners.
The process could start with an initial capitalisation for one year. The use of the funds will be revised at least annually. A CB subcommittee, in consultation with all CB members, will work on further details such as the potential options for funds capitalisation and replenishment, and overall funds access, usage and management. A draft proposal will be submitted to the EpiNet National Team members at an EpiNet regional meeting, for their scrutiny and endorsement. Should a regional meeting not be held in time (by February 2003), the revolving funds proposal will be circulated to all EpiNet National Focal Points for their consideration, endorsement and advocacy at the highest level within their ministries. Ultimately, a final version of the proposal is intended to be presented to the next WHO/SPC Meeting of Ministers and Directors of Health for the PICTs, to be held in Tonga in March 2003.
Two LabNet-related projects
The Pasteur Institute (IPNC) has started a practical and small-scale evaluation of existing rapid diagnostic kits for leptospirosis and dengue. The project was discussed within the framework of the LabNet TWB, and it was agreed that IPNC will contact the Guam Public Health Laboratory with a view to including the FDA approved tests used in US territories in this evaluation process, for the sake of further comparison and better understanding of all kinds of tests that may be used by PPHSN members. This project is equally co-funded by IPNC, WHO and SPC.
A general LabNet meeting is to be organised in February 2003 to gather L1 National Focal Points – the laboratory members of the EpiNet National Teams – together with the representatives of the L2 and L3 laboratories. CB members agreed that this meeting should focus on technical and operational matters – that is, avoid discussing administrative and policy matters.
Communication and coordination
Discussions regarding the setting up of the LabNet encrypted website have been deferred to the meeting above mentioned, in accordance with the newly agreed collaboration with the PRISM project (Pacific Regional Information SysteM) carried out by SPC Statistics Programme, on the development of a regional database.
The CB members agreed that IPNC should take the technical leadership of the TWB. They also agreed that a TWB meeting should precede every CB meeting.
Last but not least, the CB members agreed that the development of LabNet should be a PPHSN-CB priority for the next two to three years.