The second International Conference of the African Society of Laboratory Medicine, ASLM, took place from November 30th to December 4th in Cape Town, South Africa, whose purpose is to advocate on the critical role of clinical laboratories in Africa which are increasingly essential to health systems, for a correct diagnosis, early treatment and monitoring, epidemiological surveillance, research and control of epidemics.
Unfortunately, for a long time the role of laboratories in Africa has been underestimated but now finally, after the commitment of the WHO and the Maputo Declaration of 2008 to the strengthening of laboratories in Africa, there is a growing awareness of the strategic importance of diagnostics laboratory.
From its beginning in 2002, DREAM adopted a diagnosis of excellence for a good monitoring of therapy, as well as the examination of Viral Load as an essential parameter of a good program for diagnosis and treatment of HIV and that is why it has accepted the challenge, establishing immediately in Africa molecular biology laboratories alongside care centers. After many years of pioneering work, finally in 2013 the WHO has recognized the need of Viral Load and international attention has grown around the quality of the laboratory work. Analytical reliable data and good quality are finally deemed necessary and it is possible to be obtained even in countries with limited resources.
At the conference, DREAM has participated with two contributions accepted as “oral poster”.
The first is evaluation study on the use of the Dry Blood Spot for collection and transport of samples for viral load. This is a method that allows to collect blood to be tested on a special map, so it can be transported easily, does not need to be refrigerated and allows it to offer a diagnosis of election also to very rural populations.
The second work, prized as the best “oral poster”, presented the good results obtained by DREAM in the Democratic Republic of Congo in the application of Option B plus and the opportunity to expand access to vertical prevention for women from rural areas, living far from quality services, through the use of a mobile unit and collaboration between public, international and non-governmental organizations and DREAM, using the molecular biology laboratory of Kinshasa as a reference.
Of course, much work remains to be done in Africa in order for laboratories to meet the expectations and demands of the large request for analysis on the one hand and certify the quality of their work on the other. Many efforts are being made to expand access to diagnostics through the simplification of systems and the development of POC (Point Of Care), tools that are easy to use and that do not require major infrastructure to operate or maintenance, designed to be implemented in health centers, even those located far away.
The challenges are therefore many, but over the years DREAM has shown how important results can be achieved primarily by building a network of diagnostic services of excellence in the area. In countries where DREAM works, the molecular biology laboratories have become a reference at national level, supporting the national health systems. In addition, the diagnostic capacity of DREAM was also important for many other organizations working in Africa in the care of HIV and who have used the examinations provided by the DREAM laboratories. Additionally, over the years a generation of biologists has been formed who work serving their countries, so it is possible for everyone to monitor the therapy through the laboratories.
In recent years at international level there is much talk of “Global Health”, meaning by this expression the improvement of the health of the people and at the same time the reduction of the disparities in access to care. In this sense, the work done by DREAM in these 12 years, the experience and all the components of the Program are fairly indicative of a new model that can be replicated, with the strong support of international donors and in partnership with ministries of health of the various countries, to achieve the goal of improving the health of many Africans.