25th NRL Workshop on Serology 2008
25th NRL Workshop on Serology
Silver Jubilee!
2- 5 July 2008
Hilton on the Park, Melbourne
Presentations from the 25th NRL Workshop, other than from NRL staff, remain the intellectual property of the individual presenter
26th NRL Workshop on Serology
Congratulations "Young Scientist" Winners
At the 25th NRL Workshop on serology there were 5 early Career Scientists who had been given "Young Scientist Awards". Their names were Irene Indalao, Vijesh Lal, Rebecca Wilde and Nicole Gardiner. The awards were sponsored by Inverness Medical Professional Diagnostics-Australia. We are grateful for this valuable incentive to encourage scientists in their early careers. We hope that this award will continue into the 26th Workshop which is to be held in Christchurch, New Zealand between 25th and 28th August , 2009. To achieve these awards the early career scientists were asked to have their supervisors write 50 words or less on how the nominated early career scientist has demonstrated quality in science. The NRL is strongly committed to supporting scientists and technical assistants early in their careers to reach for better understanding of their chosen work requirements and enriching their approach to quality. The NRL thanks Inverness for their support and again congratulates the 2008 winners!
25th Workshop on Serology - Its International Bent
The NRL's 25th Workshop on Serology was held in Melbourne between 3 and 5 of July. There were 200 delegates and they included international participants from Kenya, South Africa, Thailand and Korea. The NRL workshop has developed a truly international bent! Our opening speakers this year were from the African Continent: Dr Jean Emmanuel from Zimbabwe and Professor Wendy Stevens from the University of Witwatersrand, National Health Laboratory in Johannesburg, South Africa.
Dr Emmanuel gave a presentation entitled "Blood Safety in Developing Countries". He opened his presentationby reminding us that WHO's World Health Assembly in 1975 gave consideration to blood safety setting several benchmarks including that safety and adequacy of blood products is the responsibility of national governments and that blood donation should be based on voluntary, non-remunerated donation. Yet these resolutions have not been met across the world. He pointed out that the advent of HIV and its recognition as a transfusion transmissible infection raised the importance and urgency in attaining blood safety. Further, four of the Millennium Development Goals are pertinent to blood safety including reducing child mortality, improving maternal health, combating HIV, TB and Malaria and other infectious diseases and developing global partnerships for development. However, in many low to medium human development index (HDI) countries blood safety has not achieved the status that it should have. WHO is a prime advocate for promoting blood safety measures in these countries.
Although there were other important aspects to Dr Emmanuel's presentation, the second half was devoted to a proposal that external quality assessment schemes (EQAS) could be the basis of building capacity in blood safety. He advanced the argument that regional EQAS could promote the need for national schemes and the requirement for quality management and quality control. Collaborations to promote quality management systems could eventually lead to accreditation. [This line of argument is consistant with the NRL's international strategy (which can be found under 'International Activities' on the NRL website www.nrl.gov.au) for promoting laboratory development, which depends on a similar philosophy.]
Dr Emmanuel finished his talk by pointing out that sustainable national blood services do exist in numbers of medium and low HDI countries, so that it is possible to promote and achieve the safety of blood everywhere.
Prof Stevens tackled the huge topic of "the Response to the HIV Epidemic in Sub-Saharan Africa". Although most would think this an impossible task, she covered an enormous scope in the short time apportioned to her. Her introduction was sobering, reminding us that there are 22.5 million people infected with HIV in Sub-Saharan Africa. Seventy-six percent of all deaths are now due to HIV and AIDS. She also pointed out that there was no one epidemic but that the burden varied greatly between countries, populations, gender, etc. HIV is at least a "twin" epidemic with TB – 50-80% of those with TB are also infected with HIV.
Similarly, laboratories in the various countries show variedability to diagnose and deal with HIV. There are many challenges in African countries to maintaining useful laboratory services including lack of resources, utilities and training. Surprisingly, there are numbers of challenges in South Africa which many had not considered, and of which we were made aware. The first is the sheer volume of laboratory work imposed by the epidemics. Rapid testing is being used to offer access to the vast numbers of people needing to be tested. Some of the solutions to meeting the testing required were highly inventive and efficient. The need for and implementation of quality assurance methods is clearly a priority of Professor Stevens and her colleagues.
With such large numbers of infected people it is possible to perform highly efficacious trials of tests and testing with new tests becoming available such as real time PCR assays or the alternative assays for estimation of viral load. Because transporting specimens is often difficult a study using dried blood spots for monitoring viral loads has been trialed with highly stable results, offering a solution to the transport difficulties. Another fascinating investigation related to the prevalence of anti-retroviral (ARV) resistance in patients from an ARV clinic in Johannesburg which was found to be 68%. The mutations were similar to those reported for subtype B (remembering that in South Africa the overwhelming infecting HIV is subtype C).
We are grateful to Dr Emmanuel and Professor Stevens for offering such eye-opening perspectives and for most comprehensive presentations. They provided a stunning opening to the 25th Workshop on Serology.
Elizabeth M. Dax, Director
