Your Excellencies,
Distinguished guests,
Ladies and gentlemen - Good Morning (Sabaidee Ton Sao),
It is a pleasure to help open this important meeting today. I must start by congratulating the Ministry of Health for producing two excellent and important documents:
- Lao PDR’s National Biosafety Regulation, which sets rules for all laboratories on biosafety and biosecurity; and
- A set of National Quality Standards. These standards apply to all aspects of laboratory operations and management – from the competencies of the staff through to the quality of equipment used.
Second – and just as important – I would like to acknowledge the US Defence Threats Reduction Agency for their support in helping the Ministry develop these important documents.
Ladies and gentlemen - As we know, laboratory biosafety and biosecurity is one of the core capacities under the International Health Regulations (IHR). Biosafety means countries should have appropriate rules to stop high threat pathogens, such as plague bacteria or Ebola virus, accidentally escaping from their laboratories. Biosecurity means they must have rules to prevent them being deliberately stolen by criminals or terrorists. For both types of rules there must also be appropriate enforcement systems in place.
Biosafety and biosecurity in laboratories is crucial. Without it laboratories can be a hazard to public health – instead of being an asset in protecting it. They can also be a hazard for the committed health professionals working in them.
We all know about the worldwide campaign to eradicate the terrible disease smallpox in the 1960s and 1970s. Public health officials rightly like to congratulate ourselves on that great success. But did you know the last person to die of smallpox was a health worker in a medical university that did research on the smallpox virus?
The escape of the deadly smallpox virus from the laboratory at Birmingham University Medical School in England in 1978 was perhaps the most dramatic biosafety breach ever seen. But there have been others. A number of health workers, and even family members of health workers, have lost their lives this way.
Making sure our laboratories operate safely is an obligation of every hospital and every public health department, both at provincial and national level. Hospitals and health departments should need to be clear about who in their organisations is responsible for biosafety, and then given them the resources they need to do their job. We owe that to our staff and to the communities around our facilities.
Let me say just a few words about biosecurity. The pathogens in our laboratories can become deadly weapons if they fall into the wrong hands. We saw that in the US with the 2001 anthrax attacks. Again, we must make sure all our laboratories are properly secure. We need rules and systems to prevent unauthorized access to labs, loss or misuse of biological materials, and other biosecurity threats.
So biosafety and biosecurity are matters of life and deaths. But so too is laboratory quality. Which is why I welcome the second document your are looking at today: the National Quality Standards for Laboratories.
If the quality of laboratory work is poor then patients risk being misdiagnosed. Patients with the wrong diagnosis may be denied the treatment they need. Or they may even be put on a treatment that makes their illness worse. So misdiagnosis due to poor quality lab work can kill patients.
But its dangers are wider than just individual cases. If early cases are wrongly diagnosed, the public health authorities will not know a disease outbreak has started. If they don’t know about the outbreak, they cannot act to control it. This lost time at the start of an outbreak translates into more people getting sick, and more deaths, in the affected community.
Poor quality laboratory work – which leads to misdiagnoses – can harm patients and harm whole communities. If a lab keeps getting its diagnoses wrong then it is useless to our patients and useless to the public health system. Managers across the health system – from district to national level – need to take laboratory quality seriously. They need to appoint an officer responsible for quality, and invest in continuous quality improvement.
I would like to conclude by saying that accidents and errors of all sorts are not just a matter of chance. They can be prevented by having the right rules and right systems in place. These rules and systems should help laboratory workers be:
- Aware
- Systematic; and
- Cautious
Over the next two days, you will discuss and plan together. Your challenge is to translating these two excellent documents into excellent practice on the ground in laboratories of all types across Lao PDR. Let us make sure our labs are always an asset to public health, and never a hazard to it or to the health workers who work in them.
I wish you a successful discussion.
Thank you. Khop Chai