Lilongwe, Malawi – August 14, 2024 – Director for NPHL Mr. Joseph Bitilinyu Bangoh, alongside the National Microbiology Reference Laboratory (NMRL) and the National Genomic Sequencing Laboratory management teams.
The Fleming Fund Country Grant recently convened a strategic meeting with the Deputy Director of PHIM Laboratories Mr. Joseph Bitilinyu Bangoh, alongside the National Microbiology Reference Laboratory (NMRL) and the National Genomic Sequencing Laboratorymanagement teams. The primary focus of the meeting was to reinforce the collaboration between PHIM Laboratories and the Fleming Fund Country Grant while clarifying the critical roles these laboratories play in the successful implementation of the project.
Recognising the pivotal role that Public Health Reference Laboratories play in generating high-quality data for national surveillance, the Fleming Fund is committed to enhancing the capacity of both the National Microbiology Reference Laboratory and the National Genomic Sequencing Laboratory. Strengthening these laboratories is essential to producing reliable data that informs evidence-based policy decisions.
The Africa Centre of Disease and Control (Africa CDC) Pathogen Genomics Initiative ( PGI) is implementing the Cholera Genomics (CholGEN) project. CholGen project is a single consortium with a steering committee composed of John Hopkins University (JHU), Africa CDC, and the Bill & Melinda Gates Foundation (BMGF).
This collaboration between JHU and the Africa CDC aims to leverage existing laboratories and epidemiologists in seven African countries (Nigeria, Democratic Republic of the Congo, Mozambique, Cameroon, Malawi, Zambia and Uganda) to utilize Cholera genomic data for public health decision-making and improve the understanding of the molecular epidemiology of cholera in Africa.
CholGen project mainly has three objectives; to understand the molecular epidemiology of cholera in Malawi to inform decision-making, determine key drivers of cholera and other waterborne diseases transmission in Malawi and strengthen cross-border cholera surveillance including data sharing.
NPHL, Lilongwe-Malawi – August 8 and 9th, 2024 – The Africa CDC and the Africa Public Health Foundation conducted a technical support visit to PHIM to identify the progress made and challenges faced by the CholGEN project.
The team meet the Director and two Deputy Directors of PHIM responsible for Laboratory and Research. The Deputy Director, on his remarks, appreciated the support Africa CDC is rendering to Malawi in terms of trainings, equipment and supplies through the CholGen project. He promised that NPHRL will ensure that genomics in Malawi is growing to the requirement of giving answers needed to the health problems. He lamented “the lack of space for a genomics laboratory as the major problem affecting the growth of genomics”, he emphasized that “It is his dream to see PHIM have a state-of-the-art genomics laboratory that meets international standards and, can accommodate high throughput equipment.”
Dr. Mirriam Nyenje: in blue, – perhaps appreciating genomics lab apparatus.
Dr. Mirriam Nyenje the head of the National Genomics Sequencing Laboratory (NGSRL) in Malawi also added to the lamentation for the need for space that resulted in other machines allocated to other departments outside the NGSRL. She further thanked the Africa CDC for the support and gave a promise that she would work hard to see the NGSRL become a centre of excellence despite the lack of space. She cited Tuberculosis genomics as a low-hanging fruit to be the centre of excellence then Malaria and other pathogens.
Mr. Francis Chikuse, leader of the delegation added that the PGI is also looking into Malaria genomics though it is not easy and cheap, but it is very good for surveillance. He pointed to talking with PHIM to discuss the possibility of having genomics for Malaria which is crucial for the African region.
He said “The spectrum of human pathogens and the infectious diseases they cause is continuously changing through evolution, selection and changes in the way human populations interact with their environment and each other, therefore there is a need to understand molecular epidemiology surveillance of cholera strains circulating in the country. These will include sequencing of vibrio strains to study the virulence genes, the factors that support its survival in the environment in hot spots and phylogenetic inferences.”
Cholera and other diseases know no borders as such pathogens can be transmitted across geographical borders through movements of humans, animals and goods during an outbreak. Malawi, Mozambique, Zambia and Tanzania have some level of cross-border agreements. This project aims to operationalize/ strengthen these agreements.
There is a need to strengthen border surveillance systems with its neighbours and develop a Memorandum of Understanding (MOU) on data and sample sharing. There is also a need to build the capacity of Port of Entry staff on specialized training on surveillance of public health pathogens knowledge sharing and regional coordination.
The team, Rumphi District Hospital staff, and the Deputy Director responsible for the NPHL, Mr Joseph Bitilinyu Bangoh.
The Ministry of Health, through the Public Health Institute of Malawi (PHIM), has an established National Public Health Laboratory (NPHL). One of the crucial functions of NPHL is to conduct surveillance of various pathogens that pose a significant risk to public health. This vital task involves submitting isolates collected from laboratories across Malawi to the National Microbiology Laboratory, a section of NPHL, for confirmation, which are then shared with the Genomics Laboratory for sequencing and bioinformatics to determine the phylogeny, violence factors and resistance genes to known antimicrobials and diagnostic tests. The findings, crucial for public health decision-making, are disseminated to a wide range of public health experts and stakeholders, underscoring the importance of this surveillance process.
The teams received a warm welcome from the teams at Atupere Community Hospital in Karonga.
In an integrative effort, NGSRL and other sections of NPHRL planned to mentor and supervise facilities on genomic sample collection and transportation for various pathogens of public health across Malawi. The team interacted with the laboratory and top hospital staff as a way of sensitisation on genomic surveillance, focusing on optimising sample collection and basic microbiology. The team also discussed the laboratory’s strengths and challenges, particularly in handling samples that require sequencing. The teams collected samples from laboratories that kept isolates that required confirmation and genomics intervention to NPHRL for further analysis.
The Deputy Director, Mr Joseph Bitilinyu Bangoh, was actively involved in the exercise and tirelessly visited teams across Malawi and, at one point, interacted with staff at Rumphi District Hospital to emphasise the importance of genomics pathogen surveillance. He stressed the need to lobby for more laboratory staff to be deployed to refurbished laboratories in health centres and rural hospitals, with the example of Luzi, Mhuju, which has no laboratory technicians, and Bolero, with only one laboratory technician despite the heavy workload. He gave a tip that this could be through Human Resource Officers to the local government, which District Commissioners have all the powers. He added that if this could happen in Malawi, a cry for laboratorians’ lack of jobs could be minimised and quality work in peripheral laboratories would improve.
