ASM Convenes on Strengthening U.S.-Africa Partnerships
Global public health leaders discussed workforce development, infectious disease surveillance and data collection strategies at ASM’s satellite event to the U.S. Africa Leaders Summit 2022. Experts in biodefense, science policy and foreign affairs examined how microbiology can help tackle global public health threats, like climate change and antimicrobial resistance (AMR), with the understanding that microbiology is foundational to supporting resilient and independent African health systems.
“At ASM, we like to say that microbes touch everything,” said ASM CEO Stefano Bertuzzi. “The role of microbiology in global health security today resonates with many people. We've seen throughout the pandemic how pivotal microbiology is for responding to COVID-19 and resuming our livelihood. The innovative vaccines, the therapeutics and the diagnostics developed in record time are all underpinned by research in microbiology.”
Amidst the looming threat of another pandemic, which scientists predict will likely be of similar magnitude to COVID-19, robust investments in biomedical research and an understanding of how geopolitical and economic factors globally impact health systems are more critical than ever. Furthermore, collaboration between countries and, specifically, the integration of microbiology with other health systems, is imperative for strengthening U.S.-Africa ties and bolstering resilient, African health systems.
“With an increasing global population and the consistent threat of future pandemics, it’s not a stretch to make the case for why microbiology today plays a bigger role than ever before—not just in health, but on so many other fronts,” Bertuzzi said.
Building Holistic and Integrated Health Systems
ASM President Colleen Kraft emphasized the need for digital connectivity and sustainable health cooperation, especially when considering the potential for rapid diagnostics. “Infrastructure is vital to operational sustainability,” Kraft said. “We need a better way to be able to use our data, find our data and support our patients all over the world with their diagnostic results.”
Representative Ami Bera echoed similar sentiments. Bera serves on the U.S. House Subcommittee on Africa, Global Health and Global Human Rights and is a senior member of the House Committee on Science, Space and Technology. “The world is interconnected today—infectious diseases don't respect one border or another border, and the [COVID-19] pandemic showed us that,” Bera said. “The hope is that we can take some of the lessons learned through this pandemic and take those resources and apply them globally to build a coalition that can address malaria, tuberculosis, emerging infectious diseases and AMR. We can do this; we know how to do it. We just need to do it together—not just as the United States, but as a global community.”
Fostering Equity Through Lab Capacity Building
John Nkengasong, Ambassador-at-Large and Coordinator of U.S. Government Activities to Combat HIV/AIDS Globally, spoke about inequities in access to global health commodities, the impact of disease-specific programs and integrating services and systems to best prepare for global public health security threats. Nkengasong currently oversees the President’s Emergency Plan for AIDS Relief (PEPFAR), which aims to prevent millions of HIV infections worldwide—the largest commitment from any country. He previously served as the first director of the Africa Centers for Disease Control and Prevention in 2017.
At the ASM event, “Bridging Health Disparities: How Microbiology Underpins a Resilient, Self-Sufficient Africa Health System,” Nkengasong highlighted 3 key points:
Inequity in access to global commodities is a serious threat to overall health security that impacts all countries. “Such inequities, [whether they’re] in Africa or elsewhere, are a direct threat to the United States,” he said.
Disease-specific programs are a backbone for building platforms that can fight global public health threats. The best way to prepare for the unknown (i.e., global health security) is to invest adequately in what is known (e.g., programs focused on AMR, tuberculosis). “If we do that, we will very intentionally be preparing for the unknowns,” Nkengasong explained.
Integrating services and systems is the best way to prepare for global health security threats. It’s not a question of if there will be another global health threat, but when, Nkengasong added.
Nkengasong explained that a major component of strengthening laboratory capacity is gaining accreditation to meet international standards. Accreditation, he said, is “one of the best gamechangers in strengthening laboratory medicine in Africa and many areas of the world.” Since 2009, laboratory quality improvement training, supported by ASM in collaboration with the U.S. Centers for Disease Control and Prevention (CDC) and other laboratory partners, has helped more than 1,300 labs in low- and middle-income countries achieve Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA).
Nkengasong emphasized that health systems do not function by themselves, it is through partnerships with institutions that enable quality health services. “If you look at what we do collectively in lab medicine, we need a workforce that is retained, we need equipment management, we need supply chain management, information systems, referral systems and, of course, institutions,” Nkengasong said. “And if we do that, then [health services] can be delivered. That is the interface between services and systems, and that will give us strengthened and sustained programs that can be used in combatting multiple diseases.”
The Importance of Workforce Development for Global Health
Building lab capacity and capability is only possible with a steadfast commitment to training. Through a structured laboratory mentoring program, ASM provides laboratories with standardized support, assessment checklists and a mentorship toolkit. AMR training workshops focus on identifying priority pathogens, quality control strategies and antibiotic susceptibility testing, with an emphasis on data collection. “We need to improve our capability of data collection, data management and dissemination because this is what is needed to drive policy change,” said Martin Evans, Ph.D., a subject matter expert consultant for ASM’s Global Public Health Program since 2017.
Evans emphasized that laboratory capacity building and training should not be frequently provided by consultants, rather, training should ensure laboratory staff continue to pass on lessons learned. “Rather than continually send subject matter experts in microbiology to the country, we train key people in a national lab to replace us,” Evans said. “[This] helps us provide sustainability and self-sufficiency for that country.”
The Growing Threat of Antimicrobial Resistance
AMR is a leading cause of death worldwide, with an estimated 5 million deaths that could be attributed to AMR in 2019. Additionally, the region most impacted by AMR is the African continent. Addressing AMR requires examining not only human health, but environmental and animal health as well (i.e., employing a “One Health” approach).
Consistent data collection is critical when tackling issues related to AMR and surveilling outbreaks. “It's really complicated to explain the problem; it’s also complicated to diagnose the problem. It’s not doing tuberculosis only, or HIV only, it’s testing for a breadth of organisms against a breadth of sample types to get the data that we need,”said Diane Flayhart, Global Program Lead—AMR for Becton, Dickinson, & Co. She explained that data informs our potential impact from deploying tools that currently exist and by facilitating collaboration.
Equitable distribution of vaccines can also help combat AMR. For example, Streptococcus pneumoniae is one of the leading causes of death on the African continent, though it is a vaccine preventable disease. “Not only do we have an intervention, but we have an effective intervention,” Michael Craig, Senior Advisor for U.S. CDC, said. “The more you vaccinate, the fewer antibiotics you use. It doesn’t matter what type of vaccine we’re talking about—whether a bacterial vaccine or a viral vaccine—because if folks are vaccinated, they’re not getting sick, they’re not going to the doctor and they’re not going to get an antibiotic, whether it’s appropriate or inappropriate.”
ASM's Global Public Health Programs (GPHP) equip countries to surveil and respond to infectious diseases.