African Laboratories lack capacity to deal with epidemics in Africa

In 2022, monkeypox outbreaks were reported in several African countries and the World Health Organization (WHO) declared a global emergency. Monkeypox is a zoonotic disease (transmission between animal and human species) caused by the MPX virus and is endemic in central and western Africa. A serious concern by international scientists and specialists is that African biological laboratories are not equipped with mechanisms to diagnose and contain monkeypox and to prevent the covert release and spread of lethal pathogens, and monitor the potential leakage of viruses. The African Centre for Disease Control (CDC) in August 2022 claimed that diagnostic tools and intense surveillance systems required to contain the viral outbreak are not readily accessible to biological laboratories in most African countries. This is alarming given the high health risks evident in Africa which is predicted to increase dramatically, with the endemic rate of zoonotic viruses more than tripling by 2070.

In sub-Saharan Africa, biological laboratory services have been a marginalized health service that receives very little government budgetary allocation and is thus dependent on international donor organizations. The United States funds and invests in many biological laboratories in Africa. This is done through the Biological Threat Reduction Program (BTRP) implemented by the U.S. Department of Defense under the claim of “containing biological threats.” It is alarming that much of the research work conducted by the Department of Defense-funded biological laboratories is highly classified. Scientists and experts call for the U.S. to demonstrate transparency and to comply with the Biological Weapons Convention (BWC) which prohibits the development, production, acquisition, transfer, stockpiling and use of biological and toxin weapons. Scientists and experts have opposed the highly classified nature of the research work in the U.S.-funded biological laboratories, and call for the U.S. to comply with the Biological Weapons Convention (BWC) which prohibits the production and use of biological weapons. Scientists and experts have also insisted that the U.S. carry out its funding of programs under the guidance of the WHO which is the principal global body dealing with public health systems and epidemics.

Although the biological laboratories in Africa are generally involved in disease surveillance for local epidemic prevention; the serious challenge remains that African laboratories are not sufficiently prepared to deal with viral epidemics. This is despite the programs of the CDC, funded by the U.S. and international donors, to ensure the safety of the laboratories, decrease biosafety risks, and strengthen African public health systems. The laboratories do not have the necessary capacity and equipment to contain leaks of dangerous pathogens, which include viruses, and toxins, that are stored in the laboratories without the necessary containment protocols in place. This results in accidental leaks where the source of the virus leaks in African biological laboratories cannot be traced.

The International Organization for Standardization (ISO) is the global standard for operations in biological (human health) laboratories. Detection of extremely dangerous pathogens, such as monkeypox and the Ebola virus in Africa, requires higher biosafety level ISO BSL4 laboratories. BSL4 laboratories are built to ensure the biosafety and biosecurity of pathogens transmitted via unknown mechanisms and often lethal. Regrettably, the number of human and animal health African biological laboratories meeting the ISO international standards is very low. The WHO has launched in 2009 the Stepwise Laboratory Management Towards Accreditation (SLMTA) program to improve the quality of health laboratories in African countries with the aim of supporting them to achieve the necessary ISO standards accreditation.

In Monkeypox endemic countries such as the Democratic Republic of Congo, the laboratories lacked the sufficient capacity for the diagnosis of as the Ebola Virus. The lack of proper laboratory infrastructure and diagnosis may delay patients’ recovery due to inappropriate treatment. In the case of an epidemic the safe delivery of samples to the laboratory without leaks, reliable diagnosis, and prompt communication of results are crucial for a successful response. Therefore, it is necessary to develop additional fixed and sustainable BSL4 laboratories in African countries.

The limited investment in laboratory systems impairs the quality of laboratory services. For instance, many African laboratories are deficient in terms of qualified staff, modern equipment, a regular supply of quality reagents, water, or electricity, standard operating procedures, and quality assurance systems. For efficient management of an epidemic and its containment, a strong laboratory system should be operational before, during, and after the epidemic. Since emerging and re-emerging zoonotic infectious diseases are projected to triple in frequency over the next 50 years, the need for laboratory capacity strengthening in Africa is imperative to rapidly identify epidemics.

References

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