The project starts off its third phase in 2019 as part of a partnership between the Mérieux Foundation and the Agence française de Développement, in order to continue to reinforce laboratory systems. The Foundation commits to pursue its efforts initiated during the first two phases, adding Publich Health major topics.

This third phase aims to continue the development of medical biology in Burkina Faso, Guinea, Mali, Niger, Senegal and Togo while improving regional cooperation for a coordinated and harmonized intervention approach between these French-speaking West African countries.

In close partnership with the respective Ministries of Health, two major topics will be the subject of targeted actions within the framework of the project:

• the continuation of institutional strengthening and support for the implementation of national medical biology policies,
• technical capacity building in biological diagnostics in the seven countries

Component 1: Contribute to the institutionalization and implementation of national policies for the development and regional harmonization of medical biology

In order to effectively strengthen biological diagnostics, this work needs to be embedded in a health system in which laboratory governance is clear and structured. Despite the work accomplished by the different actors of the RESAOLAB program and the development of medical biology policies in each country, the governance systems put in place in the countries are at different levels of progress and require continued efforts, through technical and financial support while strengthening the regional dynamics of the sector.

This component will be broken down into three main activities:

• Development/revision of normative and regulatory documents and action plans for the medical biology sector
• Strengthen the operational capacities of laboratory management and support the reflection on their financing and sustainability mechanisms.
• Support a dynamic of inter-country exchanges for the regional harmonization of the practice of medical biology.

Component 2: Strengthen the laboratories capacity in the countries to meet the needs of the population according to international standards by contributing to global surveillance tools

Since the start of the RESAOLAB program in 2009, public health challenges and issues involving the laboratory sector have developed and become more specific in Africa and in particular the Sahelian zone. The first efforts focused on the diagnosis of the 3 major pandemics of HIV, Malaria and Tuberculosis currently need to be evaluated and repositioned in a transversal approach around the strengthening of the national laboratory system. On the other hand, countries, alerted by WHO, are becoming aware of the threat AMR represents, the need to rely on laboratory results and to be better equipped to participate in this epidemiological surveillance. 

This component will be broken down into three main objectives:

• Training and equipping laboratory directorates to participate in AMR surveillance
• Improving access to and quality of biological monitoring for HIV and Tuberculosis in each of the 7 countries
• Strengthening the capacity of laboratory staff through the training of medical biologists

Methodology

Local actors are at the center of the implementation of the activities, supported by experts from member countries and the assistance of international experts to meet the specific needs of skills transfer. The implementation of phase 3 benefits from the tools developed and validated in a participatory way during the previous phases (modules, LabBook, management guide, etc.)

Expected results

All departments in charge of the Laboratory system have framework documents for the governance of the biology sector:

• The Directorate in charge of the laboratory system are able to carry out the control and regulation of laboratory systems;
• Laboratory systems are functional and regionally harmonized;
• Laboratory-based surveillance is functional in the countries of the network;
• The national HIV and TB reference laboratories have been audited and recommendations for their development have been made;
• The critical mass of medical biologists is increasing.

Additional activities to fight COVID-19

As of detection of the first positive coronavirus cases on the continent, the Mérieux Foundation was able to provide support for diagnosis by sending SARS-CoV-2 screening kits to Burkina Faso and Senegal.

To step up this response and to take further action to enable the network to arm itself against the epidemic, the AFD granted an additional subsidy of 1.5 million Euros to RESAOLAB through the Initiative “COVID-19 – Health in Common”. This funding is used to develop COVID-19 laboratory response strategies by mobilizing the expertise of the network to back national responses.

In order to be able to increase the number of screening tests in each of the 7 countries, the network laboratories will receive the necessary equipment for developing COVID-19 diagnosis (equipment, reagents and consumables), along with protective equipment for their staff, on the front line against the epidemic. The Mérieux Foundation brings its technical expertise, its knowledge of international recommendations for COVID-19 diagnosis and the experience of the other countries in which it intervenes, to support the laboratories’ strategies in the implementation of their national intervention plan.

The importance of networking and the synergy which results from sharing information and experiences between the countries are all the more critical in the context of a health emergency. In order to facilitate exchanges between the members of the network, a platform will be set up in order to provide documentation (response plans, training, WHO directives) in French, along with a forum led by experts from the Mérieux Foundation.

Finally, a study will be conducted later on, in order to measure and to highlight the laboratory’s key role, that of laboratory management and of the laboratory networks during a health crisis.