Concept Paper for the “Establishment of a Regional Network Initiative for the Control and Prevention of Japanese Encephalitis in Viet Nam, Cambodia, and the Lao PDR”
Stephane P. Rousseau
Good news!
After the Report of the “First GMS Forum on Japanese Encephalitis/
Viral Encephalitis Prevention and Control” (Hué City, Vietnam, 29-30
October, 2009.) sent to us all by A/Prof. Phan Thi Nga from NIHE, I am
also pleased to inform you that a Concept Paper for the “Establishment
of a Regional Network Initiative for the Control and Prevention of
Japanese Encephalitis in Viet Nam, Cambodia, and the Lao PDR” prepared
by Dr. Florian Marks et al, of the International Vaccine Institute
(IVI) can be downloaded from the GMS JE Network website at
http://groups.google.com/group/GMS-JE-Net/files?hl=en. As you may
recall, this establishment of a GMS CDC JE Network was indeed one of
the key recommendations of the forum in Hue. Dr Marks, in concert with
the RCU, has taken the initiative of writing this concept paper and we
congratulate and thank him for that valuable contribution. Thanks to
him we are keeping up with that momentum created at the forum.
We kindly call for your critical review and comments of this concept
paper before 25 January 2010 to the latest. We recommend that you send
your comments on this forum (email: GMS-J...@googlegroups.com) so as
to keep the whole partnership aware of the discussion.
It is paramount that all partners involved in JE in the GMS subregion
agree on the final document, so that we can move forward in all what
is needed and were recommended at the forum.
Finally, as a reminder, please do not hesitate to visit the GMS JE
Forum website (http://groups.google.com/group/GMS-JE-Net) -- this is
yours! -- and add more materials of interest to it whenever you wish.
We look very much forward to hearing from you,
Kind regards,
Stéphane
Johnson, Barbara W. (CDC/CCID/NCZVED)
The U.S. CDC, Division of Vector-Borne Infectious Diseases, Arboviral Diseases Diagnostic and Reference Laboratory (DRL) is a WHO Collaborating Center (WHOCC) for Arthropod-Borne Viruses Reference and Research. Through this agreement CDC provides technical support, reagents and other services to the WHO and to participating countries through the WHO. CDC is a Global-Specialized Laboratory through the WHOCC and is developing the JE serological reference panel through an additional technical service agreement with WHO. In addition, CDC works in country with Ministries of Health at their formal request.
If I understand Dr. Marks' concept paper correctly, he is proposing to set up another laboratory network parallel to the WHO JE Labnet, with redundant activities, such as training, designating reference laboratories, and making recommendations on diagnostic tests, coordinated by IVI.
As I presented at the GMS JE meeting, a fully functioning JE Labnet with coordinated activities between the GMS countries already exists. The development of the Lab Network commenced in 2004, and over the last five years has strengthened and grown through the support of many organizations including WHO, CDC, the Armed Forces Research Institute of Medical Sciences in Bangkok, the University of Liverpool, PATH, the National Institute of Infectious Diseases in Japan, and others. These organizations have provided technical assistance and input over many years to help develop a well-functioning network that addresses multiple functions to support laboratories in better diagnosis of JE. The WHO JE Labnet was built on the existing polio/measles WHO Labnet structure, which has helped to make it better organized and coordinated in a relatively short timeframe than it otherwise might have been. In the first JE laboratory training workshop in the Western Pacific region in June 2009, reference laboratories for each country were identified, including those for Vietnam, Cambodia and Laos. At the second meeting on Laboratory Surveillance for Vaccine Preventable Diseases to be held next month in the Philippines, technical support to the JE Labnet will be strengthened by coordinating some of the training activities with the measles Labnet. The workshops provide a forum for laboratory staff from these three countries to interact with each other. In addition, they provide an opportunity to interact with other laboratories in the Western Pacific region to build stronger relationships in the region. The WHO Western Pacific Region LabNet is also linked with the WHO SEARO labNET, ensuring good communication and co-ordination and sharing of information across all JE-endemic countries.
In my mind, setting up another laboratory network through the IVI would be a backward step in enhancing laboratory capacity in these countries and use up valuable funds that are needed elsewhere. I propose that we build on existing structures and organizations to achieve the goals in the concept paper, rather than creating another organization or project. I understand that these suggestions will result in a less centralized ADB project structure, but I think that a project more focused on the countries themselves will increase their ownership of the project and enhance sustainability once the project is completed.
I propose that funding for JE laboratories is coordinated through the WHO JE Labnet and that they be used to support the following already established activities:
1. Provide funds to GMS laboratory personnel to travel and participate at the WHO Labnet training workshops
2. Provide funding to GMS MOHs for purchasing JE diagnostic kits (Cambodia and Laos)
3. Provide funding to GMS laboratories to assist them in improving and scaling up production of in-house assays (Vietnam)
4. Provide assistance to already existing quality control/quality assurance, proficiency testing
5. Provide travel funds directly to MOH laboratory directors so that they can attend meetings
6. Provide support to the already established JE laboratory proficiency program and reference serological pan
CDC remains committed to supporting WHO leadership, host governments, and international partnerships such as ADB in developing policy guidance, training materials, and technical tools to help countries and partner organizations implement effective and integrated laboratory systems that avoid duplication and promote shared systems. Because CDC has already committed to providing technical support to the WHO JE Labnet, I do not see a mechanism or justification for transferring that commitment to IVI. I do not know if the Institute Pasteur also works this way, but I expect this might be possible.
>Barbara W. Johnson, PhD
>Diagnostic & Reference Laboratory
>Arbovirus Diseases Branch
>Division of Vector-Borne Infectious Diseases (DVBID)
>Centers for Disease Control and Prevention (CDC)
>3150 Rampart Road, Bldg 401, room 3-322
>Fort Collins, CO 80521
>(970) 266-3543 (office)
>(970) 221-6441 (lab)
>FAX (970) 494-6631
>e-mail: bf...@cdc.gov
Stephane P. Rousseau (RCU)
Thank you very much for your valuable, informative and straightforward feedback on Dr Florian Marks’ concept paper. Let me assure you immediately that we fully agree with you; all should be done indeed to not create any duplication. The overall purpose of this Network – which the RCU is simply trying to facilitate -- is precisely to enhance good coordination (including developing synergies, exchange of data and information, etc) so as to ensure that the scare resources allotted to JE-related work are best used, and for actions that have been agreed upon by all concerned countries/partners.
For having discussed that with him, I know that this is also Dr Marks’ intentions, and I shall therefore let him respond on all these valuable points you raised in your message. All what is needed is a bit of fine-tuning to reach a clear understanding among all partners of who-does-what in JE in GMS.
On RCU’s side, we are pleased to provide this platform for these constructive exchanges, and I therefore thank you again for your contribution to this forum, and welcome all other stakeholders to do likewise.
Kind regards
Stéphane
_______________________
Stéphane P. Rousseau (Mr)
Regional Coordinator
Regional Coordination Unit (RCU)
Asian Development Bank
Greater Mekong Subregion
Communicable Diseases Control Project
Room 2104, 21st Floor,
Thanh Cong Tower,
57 Lang Ha Street,
Ba Dinh District, Hanoi – VIET NAM
Tel: +844 3514 79 33
Fax: +844 3514 80 12
Email: gms.c...@gmail.com
Website: www.gms-cdc.org/
Skype: rcu_gms_cdc
SILVIA OSTBERG
Sorry for the silence I was on leave first and enormously busy when I got back. So I'll start by saying may this year bring happiness and success to all of you. I know it is already February but I believe it is never inappropriate to send good wishes to friends.
Following the good wishes... Thank you indeed to Barbara for her valuable comments that are important not only for Dr. Mark's paper but in general for any initiative to be taken.
So, regarding the future: it is now confirmed that SISEA will not receive new funds to continue after the end of this year. At least not directly. During this year SISEA will support surveillance on AE through those partners that have asked for funding for that (in Vietnam and China only).
Besides that, I am thinking that if there is interest in having any regional activity on the subject it is now time to present such an interest. It would obviously have to be some specific initiative that can offer added value to what has been done so far. Any ideas? Let us know. We'll have to finalize our budget for 2010 no later than 28th of Feb in order to get the STeering Comittee's approval. Så any proposals would have to be discussed before that.
Cheers,
Silvia
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Silvia Östberg, Regional Project Manager
SISEA – Surveillance and investigation of Epidemics in Southeast Asia
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