National microbiology reference laboratories are central to global health and must be adequately funded, according to a viewpoint article published in The Lancet Digital Health by researchers at Oxford Population Health and the Invasive Respiratory Infection Surveillance (IRIS) Consortium.
Microbiology reference laboratories enable the effective management of infectious diseases by tracking endemic diseases, monitoring rates of antimicrobial resistance, and providing data to assess how well vaccination programmes are working. These laboratories also detect outbreaks and were among the first to identify cases of COVID-19, monitored case numbers in real time, deployed public health responses to the pandemic, advised on policies to protect the public, and informed COVID-19 vaccination programmes.
The article highlights how, despite their key contributions to microbiology and the control of infection diseases worldwide, many laboratories struggle to secure sufficient funding for disease surveillance programmes from government health and science budgets. The authors suggest that, at least in part, this may be because the dedicated work performed by these laboratories is not often flashy and exciting.
However, the authors point out that the work of national reference laboratories is critical to public health, particularly as these labs ensure consistency in data generation and analyses over a long period of time, and the staff working in these labs provide highly specialised knowledge. This is especially important because the long-term nature of effective surveillance allows for the recognition of trends, as well as any deviations from long-term trends that may have an impact on public health. Such deviations might be a change in vaccine coverage, or an increase in antimicrobial-resistance organisms, or indeed the emergence of an outbreak.
Professor Angela Brueggemann, Director of the Infectious Disease Epidemiology Unit at Oxford Population Health, said ‘Microbiology reference laboratories are fundamentally important to informing strategies that reduce the morbidity and mortality from infectious diseases. Continued support, and increased funding for these labs where necessary, will help ensure a healthy future for everyone.’
To highlight the important role of national reference laboratories, the researchers provided an example from the Netherlands where the work of the national reference laboratory identified the specific cause of an invasive meningococcal disease outbreak, which led to adjustments in the national vaccination programme. The authors also discussed recent publications by the European Centre for Disease Control and Prevention, and the Centre for Global Development. These papers demonstrated that the benefits of supporting national laboratories far exceeded both the monetary and non-monetary costs, and have potentially transformative impacts at the individual, population, and health-system levels.
The IRIS Consortium, a network of national microbiology reference laboratories, was established early in the COVID-19 pandemic to track changes in invasive bacterial disease caused by four organisms: Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, and Streptococcus agalactiae (group B streptococcus). The IRIS Consortium is comprised of more than 100 clinicians, scientists and laboratory personnel working in over 50 laboratories and institutions across 30 countries. The current Lancet Digital Health paper also highlights how the findings of the IRIS Consortium are informing national public health policies.