National Reference Lab must keep improving - Dr. Ramsammy

National Reference Lab must keep improving – Dr. Ramsammy

Dec 22, 2010 News

The National Reference Laboratory has to be one that maintains accreditation and quality, as it is the lead laboratory in Guyana, says Minister of Health, Dr Leslie Ramsammy.

Health Minister, Dr Leslie Ramsammy

But according to him, with achievement comes an additional burden which should see the facility striving not only to be the best in Guyana but the Region, and even the world.
These remarks were forthcoming even as the Guyana National Bureau of Standards (GNBS) certified the entity’s operation.
“It would not be in the limits of my ambition to be the best in Guyana alone. I say that because sometimes we put limits on our ambition that we cannot be good enough to be talking about being the best in the world…”
The Minister asserted that it is not Guyana alone that faces some struggles in its health sector, adding that laboratories around the United States also have challenges to provide quality services.
“So although we face struggles we can be among the best. We have demonstrated that we do have the capacity…This laboratory (National Reference Lab) began working in September 2008 and it is now just two years on that we have been able to gain accreditation through the Bureau of Standards.”
According to Minister Ramsammy, the GNBS has not established a merely Guyanese GYS170 standard, but it has been based on the ISO15189 standard which is also being utilised by the CARICOM Regional Organisation for Standards and Quality (CROSQ). He related that there is an urgent need for organisations to work together to maintain a high standard of laboratory service, even as efforts are engaged to be among the best in the world.
Guyana, he asserted, should not be timid in embracing the current status of the National Reference Laboratory, but rather choose to believe that it can move to more impressive grounds. He related that one of the problems in developing countries is that of poor performing laboratories, as they have not worked hard enough to establish the standards.
“We are happy that we are part of the PEPFAR initiative that is seeking to establish laboratory standards throughout the world, particularly in the PEPFAR countries.”
It was just last year that the laboratory had introduced tests the likes of Deoxyribonucleic Acid-Polymerase (DNA) and other virology tests that were previously unheard of.
According to Director of the Facility, Dr. Colin Roach, the tests were even then being done with ease, as plans were being streamlined to push the capabilities of the facility to a higher level of proficiency.
After years of meticulous construction and a process of installation, the Reference Lab was completed and was handed over to the Ministry of Health on July 3, 2008. At a cost of more than US$4M, the facility was completed with funding from the United States Government through the PEPFAR initiative with support from the Centers for Disease Control and Prevention (CDC).
It was anticipated that the facility would be one that was sophisticated in its complexity, advanced in technology and equipment and have the capacity to store specimens for long periods.
And indeed the facility is living up to all of its expectations, according to Dr Roach. He emphasised the fact that the support from both the US and local government was exceptional, adding that the facility is an example of how the political will of governments can prove to be very effective.
“From our first anniversary celebration the response that we got from the US government was that they were proud about what is happening. We have not received any negative comments and CDC and the US Embassy have been extremely supportive of us.”
“We have been able to deliver most of our mandate in terms of the PEPFAR programme. We have lived up to the expectations, that is, to ensure that CD4 tests are accessible; to ensure we have viral load capacity for patients; to ensure we do early infant diagnosis; to ensure that the lab was furnished and equipped; to ensure that it was staffed. And I think that it is a record that we have done all this in one year.”
According to Dr. Roach, the capabilities of the Reference Lab stands out as it is able to process thousands of samples on a monthly basis with an average of 600 samples from the TB suites, 700 from the CD4 Suites, and about 1,000 from Serology Suites.
He explained that the idea behind the introduction of such a facility is that it not only engages in doing routine tests but also specialised tasks.
These, he said, include DNA-PCR and Ribonucleic acid (RNA) PCR which were completely new to Guyana. He explained that the DNA-PCR is the test used to diagnosis babies who are born from HIV-positive mothers.
And this is a breakthrough for the public health system, since according to Dr Roach, in the past such diagnosis could have only been confirmed until 18 months had elapsed.
And with the RNA-PCR, the viral load measurement, that is the measure of the severity of an infection, lab personnel are able to monitor HIV patients that are on Anti-Retrovirals (ARVs).
The lab has since also been able to introduce tests for the HINI virus, commonly referred to as Swine Flu.
According to Minister Ramsammy, the National Reference Laboratory adds to the menu of things that can be done in Guyana, thereby reducing the dependence on overseas laboratories.
However, he cautioned that it does not eliminate the need to send specimens to CAREC and beyond. He noted that there are certain things such as reliance on external agencies – a move that will have to continue deliberately to some extent.
“It doesn’t make sense for us to do certain things. The investment in equipment and personnel may not justify us doing certain things…because we would probably only need them once in years. So for those we will keep relying on external agencies.”
In addition, the Minister noted that the Ministry of Health will be relying on external agencies for more regular services such as proficiency testing, “This is so because if this lab is going to be the one utilised for proficiency testing in Guyana and if we are going to use this lab for other labs to test themselves against, we need to pass rigid proficiency external testing…”
For this reason, he said that there is a need for the Reference Lab to develop capacity continually so that it will eventually rely less and less externally.