The international community has for years recognized the importance of clinical laboratories in Africa in carrying out a reliable diagnosis and an efficient monitoring of the main diseases present in the region.
Since its launch, DREAM has been one of the few programs which promoted the use of laboratories, mainly those specialized in molecular biology. Laboratories which could provide advanced diagnostics were in fact immediately established in all African countries where DREAM is present, alongside health centers.
The laboratories are managed by local personnel, trained and consistently supervised and updated through continuous training programs.
The World Health Organization African Region (WHO Afro) and its partners, including the African Society for Laboratory Medicine (ASLM), have promoted over the last few years the SLIPTA program (Stepwise Laboratory Improvement Process Towards Accreditation) to improve the quality of the laboratory services. It is a gradual process aimed at improving the quality of laboratory performance in the region, in view of the accreditation and compliance with international standards which are, for clinical laboratories, regulated by the ISO 15189 norm.
The laboratories need to develop and document their ability to find, identify, readily answer and report on the diseases which may have an impact on public health.
Therefore all non-profit public and private laboratories coordinating their work with national health systems, offering their support in diagnosing the main diseases in Africa, are subject to regular audits and are evaluated through a system which combines all relevant aspects (handling documentation, procurement, biosecurity, device maintenance and handling, and much more). The system then assigns a score between 1 and 5 stars based on the overall performance of the laboratory as well as a checklist which reflects the ISO 15189-2012 norm.
This program has been active in Malawi since 2013. The DREAM laboratories in Balaka and Blantyre which participate in monitoring the viral load (VL) and in the precocious diagnosis of the infection in exposed infants (EID) were also included in the process.
In their current state and following a process to improve quality, the laboratories were audited and reached respectively a score of 85% and 89%, thus both achieving a 4-star score, the best in the country. Such a success could only have been possible thanks to the commitment and dedication of the staff and the support of all the colleagues of DREAM Malawi!