Public health infrastructure refers to essential public health services, including the people who work in the field of public health, information and communication systems used to collect and disseminate accurate data, and public health organizations at the state and local levels.
The Center and its partners will maintain an integrated national and international network of laboratories that are fully equipped to respond quickly to acts of chemical or biological terrorism, emerging infectious diseases, and other public health threats and emergencies.
The Center will form a network of local and Georgian public health, food testing, veterinary diagnostic, and environmental testing laboratories and services that provide the laboratory infrastructure and capacity to respond to biological and chemical terrorism, and other public health emergencies. There are few laboratories, which are affiliated with federal agencies, military installations, international partners, and state/local public health departments and police department.
The Center will encompass both bioterrorism and chemical terrorism preparedness and response. So it will be important to have the capacity to measure metabolites in clinical specimens as public health laboratories that have been designated as reference testing laboratories for biological agent detection.
The approaches to a response, however, are different. Center bioterrorism preparedness and response activities emphasize local laboratory response by helping to increase the number of trained laboratory workers in state and local public health facilities; distributing standardized test methods and reagents to local labs; promoting the acquisition of advanced technologies; and supporting facility improvements. The chemical side of the Center employs a more centralized structure. This means initial testing in a suspected chemical event will occur at Center, using mass spectrometry, to measure human exposure. Results of these tests would be reported to alert appropriate public health officials, and if needed, appropriate LAB may be asked to test additional samples. This approach is necessary because the analytical expertise and technology resources required to respond to a chemical event is substantially high as well for outbreak detection. Other LAB facility may be chosen in different location to increase LAB capacity. If needed, additional laboratories may be invited to participate by a center director. New LAB must demonstrate certain capabilities and capacities to be admitted to the Center, they must also continue to prove those same characteristics and is subjected to routine proficiency testing in order to prove testing accuracy.
Besides non-commercial goal of Center’s foundation some routine tests may be performed “commercially” for private clinics, individuals, and etc., to help maintain capability.
Many diseases, such as anthrax, plague, and tularemia, are zoonotic, meaning that they can be shared by both humans and animals. Disease outbreaks are often preceded by illness among animal populations. Veterinary diagnostic laboratory should be a part of Center, so agent-specific response plans can be implemented.
We will provide appropriate training for all our employees with through hands-on training at Center and computer-based training, using analytical methods. As soon as we will receive methods and instrumentation we must participate in a rigorous quality assurance program to ensure that network labs provide precise, accurate, high-quality data. We will provide “train-the-trainer” course that will give project coordinators the tools they need to train partners in their jurisdictions, such as hospital staff, about sample collection and shipping.
Purchasing instruments needed for measuring chemicals in blood and urine. Because of the complexity of the instrumentation, on-site operation training will be provided by the instrument vendor as part of the purchase package.
Public health laboratory infrastructure in the Abkhazia is on the decline. Few remaining local public health laboratories are not capable of simple routine testing, and of course they are not capable of rapid molecular testing for biological threat agents. The ones that could test for threat agents were using traditional culture testing methods that take more time to yield results in Russia. Because getting test results within hours, not days, is critical in the event of a outbreak threat, it is clear that the Center is needed to improve laboratory capacity in the public health system. We will provide project that will enable local public health laboratories to renovate their facilities to comply with strict safety and containment standards; allow the purchase of state-of-the-art testing equipment.
Additionally it will fund tenth of laboratory worker positions annually from Abkhazia. In nearest future after funding Center will be capable to perform rapid tests for high-priority biological agents that cause anthrax, smallpox, and plague, avian influenza.
Ramaz Mitaishvili, MD
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