RESPONSE

Context

Many low- and middle-income countries (LMICs) are not able to safely diagnose and adequately respond to pathogens with epidemic or pandemic potential, such as Ebola or severe acute respiratory syndrome (SARS) virus.

Especially in relation to viral haemorrhagic fevers and neglected tropical diseases, Bernhard Nocht Institute for Tropical Medicine (BNITM) can contribute with its expertise in controlling outbreaks and building local structures.

The aim of this project is to secure missions within the framework of the German Epidemic Preparedness Team (SEEG) of the German Federal Ministry for Economic Cooperation and Development (BMZ), the European Medical Corps (EMC) of the European Civil Protection and Humanitarian Aid Operations (ECHO) of the European Commission and the Global Outbreak Alert and Response Network (GOARN) of the WHO. The missions serve to build capacity for outbreak management, conduct courses and training, or deploy mobile laboratory units to ensure diagnostics in outbreak situations.

Objective

Ensuring international deployment in health crises by establishing a highly skilled and stable pool of personnel available for rapid outbreak response and capacity strengthening activities.

Activities

Within the framework of the missions, target countries are supported as follows:

• Expanding infrastructure: This includes structures that ensure safe handling and storage of biological agents (such as viruses or parasites), but also structures that enable training and education programmes in addition to routine diagnostic activities. A reliable and cost-effective energy supply is also necessary to develop the laboratory sector.
• Equipment with necessary devices for modern and sustainable diagnostics and technology transfer: The focus here is on equipping the laboratories with devices for diagnostics, including molecular and serological testing. Attention is generally paid to low maintenance, on-site maintenance options, and robustness of the equipment to ensure sustainable use. If possible, existing and proven tests are transferred. Initially, the differential diagnostic test spectrum is defined on the basis of existing epidemiological information. Later, the spectrum can be expanded based on new data and knowledge on the spread of pathogens in the country.
• Establishing a pipeline for continuous supply of reagents and consumables to laboratories: In many countries, there is no possibility to obtain the necessary laboratory equipment of reagents and consumables needed for modern diagnostics. Logistical support can be part of the measures.
• Training of laboratory and surveillance staff, as well as the integration of academic education and training programmes: Primarily, staff is trained on site. Where possible, training is offered in combination with an academic programme. This means that routine diagnostics are linked to academic issues in order to retain MSc and PhD students in the laboratories and to mobilise the structures created for academic training. The training focuses on questions related to the pathogen spectrum in the country and the characterisation of diagnosed pathogens. Technical support is provided on for example diagnostics, next generation sequencing (NGS), bioinformatics, and the implementation of genomic surveillance of epidemic-prone pathogens. The supported laboratories and institutions are usually embedded in the national (Ministries of Health) and international (WHO) structures for outbreak control.