Confirm. Clinical Laboratory News for Uganda CENTRAL PUBLIC HEALTH LABORATORIES. Foreword: INSIDE THIS ISSUE: Foreword from the 1 chairman National

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1 CENTRAL PUBLIC HEALTH LABORATORIES M I N I S T RY OF H E A L T H INSIDE THIS ISSUE: Foreword from the 1 chairman National Health Laboratory Technical Committee The Central Public Health Laboratories and Coordination of Laboratory Services in Uganda: Working Towards Better Diagnosis The National Health Laboratories Services Policy: Providing Direction for improved laboratory services Scientific article: External Quality Assessment in Uganda: Helping laboratories evaluate their levels of performance through proficiency testing Key Events: 4 Upcoming events 5 Confirm Clinical Laboratory News for Uganda Foreword: By Dr. Alex Opio (Assistant Commissioner National Disease Control, NDC) It is difficult to imagine modern clinical practice without support from diagnostic services. Like imaging techniques, laboratory results often provide clinicians with information that put diagnoses beyond doubt. Indeed, for the vast majority of conditions, it is laboratory data that clinicians rely on for pinpoint identification of the etiologic agent. In view of its importance in deciding the course of patient management, users of laboratory data ought to be sure of its authenticity. Unfortunately many clinicians in Uganda have such little confidence in laboratories that they often prefer to rely on their clinical acumen alone. This mistrust is the culmination of years of perceived or actual inadequacy of Uganda s laboratory services. Issues like availability of laboratories in lower level health facilities have been major causes of concern. Even at the higher health facilities where laboratories are always present, many of the essential tests have not been regularly performed due to a lack of essential supplies like reagents and specimen collection materials like swabs and blood culture bottles. Excessively long prolonged turnaround times have also been a key concern for laboratory users. Quality management systems such as external quality assessment schemes and accreditation of laboratories that would promote user confidence were virtually absent in the country for a long time. To compound it all, many clinicians have been trained in a setting with limited functional laboratory systems and have not had an adequate opportunity to interface closely with The Assistant Commissioner National Disease Control, MOH & Chairman National Laboratory Technical Committee; Dr. Alex Opio laboratories. Fortunately, the Ministry of Health is sparing no effort in its drive to ameliorate the situation. Working closely with various development partners and stakeholders, the ministry has invested significantly in revitalizing the national laboratory network. Some of the key developments to this end include: Development and launching of the National Health Laboratory Services Policy for J A N U A R Y which a 5 year strategic plan for implementation shall soon be finalized. Establishing a credit line for provision of essential laboratory supplies to all health facilities Construction / renovation and equipping of laboratories in various health facilities Establishment of external quality assessment schemes Putting in place a number of in-service training programs. Unfortunately, many laboratory personnel, clinicians and the wider public remain largely unaware of these efforts and as such have not played their part in contributing to the drive. It gives me great gratitude therefore that the Central Public Health laboratories (CPHL), the focal point for laboratory services in the Ministry of health is launching the Confirm bulletin to bridge this gap. It is in line with the Ministry s strategy of keeping all stakeholders abreast with events at the Ministry. I hope you get informed as you enjoy the reading. Dr. Alex Opio Assistant Commissioner National Disease Control, MOH

2 PAGE 2 The Central Public Health Laboratories: History, functions and future: The Central Public Health Laboratories Offices on Plot 7/11 Buganda road the laboratory was established in 1983 in borrowed premises at the Institute of Public Health (IPH) with Mr. Gaspard Guma and Mrs. Scholastica Okui as its first personnel. CPHL Laboratorians in practice By Kajumbula Henry Coordinated health laboratory services in Uganda date back to the times of the British colonial administration. At that time, all laboratory services and functions were under the Chief Pathologist based at Wandegeya in the current Government Chemist and the National T.B reference laboratory buildings. At independence in 1962, the position of chief pathologist was dropped and the roles taken over by the Consultant pathologist at Mulago Hospital, assisted by 2 chief technologists (one in charge of the Mulago Hospital laboratories and the other in charge of upcountry laboratories). During the early postindependence era, the functions of disease surveillance and outbreak investigation were conducted by Mulago Hospital, the Makerere Medical school laboratories and the East African Virus Research Institute (now UVRI). With time, however, these roles proved too demanding for these institutions, which were not directly under the Ministry of Health. As such, the idea of a Central Public Health Laboratory was conceived in Unfortunately, the nascent plans for a laboratory at the current Mbuya industrial area were nipped in the bud by the prevailing political instability. Upon realizing that a CPHL building could not be attained in the short term, the laboratory was established in 1983 in borrowed premises at the Institute of Public Health (IPH) with Mr. Gaspard Guma and Mrs. Scholastica Okui as its first personnel. At inception, the laboratory was administratively under the office of the Chief Medical Laboratory Technologist for Upcountry laboratories, then Mr. Vincent Oyullu who was based in Wandegeya where the current National tuberculosis and leprosy program offices are housed. Upon retirement in 1985, Mr. Oyullu was replaced by Mr. Gaspard Guma who was heading the CPHL. As a result, the 2 offices of head of CPHL and the chief laboratory technologist for upcountry labs were unified. CPHL therefore became more involved in the coordination of laboratory services in addition to its surveillance and outbreak investigation role. In 1987, a laboratory division was formed under the office of the commissioner for curative services, requiring Mr. Guma to move from Wandegeya to the MoH headquarters in Entebbe. Subsequent restructuring in 1999 placed all health laboratory institutions including CPHL under the Uganda National Health Research Organization (UNHRO) and dropped the laboratory division at the ministry. However, this plan was never implemented as the Department of National Disease Control (NDC) felt that a UNHRO based CPHL would not adequately support disease surveillance and outbreak investigations. As such, CPHL was placed under the NDC. Increasing Ministry of Health and partner interest in reliable laboratory services in the country, together with finalization of the National Health Laboratory services policy and the near completion of a 5 year plan for implementation of the policy are a prelude to a promising future for CPHL. The United States Government (USG) through CDC-Uganda has generously offered to construct the CPHL building at Butabika. The design has been finalized and USG is in the process of following up the construction. With ongoing restructuring at the MOH, a proposal to accord CPHL a semi-autonomous status has been approved by the Ministry s top management. If accorded, a semi-autonomous CPHL would have a highly favorable staff establishment that would attract highly qualified and productive professionals. The new CPHL shall require a vividly articulated mandate, a key activity in the National laboratory services strategic plan. As contemporary practice is increasingly adopting molecular techniques in laboratory identification of infectious agents, CPHL plans to gradually introduce these methods in its routine procedures not only to keep up with the times but also to harness their potential cost saving benefits. Finally, CPHL shall have to harness its boundless research potential not only to inform policy and practice in the country but also to attract funding to sustain its activities. Simple but critically important topics such as antimicrobials susceptibility profiles and distribution of various strains of infectious agents in the country are already being developed for research. CPHL has coursed an undulating history, operating in the face of scarcity and promises of plenty. Current trends point to an increasingly bright future for a highly dynamic institution. CLINICAL LABORATORY NEWS FOR UGANDA

3 PAGE 3 The keyplayers at the Central Public Health Laboratories Mr. Amato Menya Senior Advisor CPHL Dr. Winifred Wafula Deputy Laboratory Chief CDC Dr. Hakim Sendagire Program Officer Laboratory Services, MOH Mrs. Okui Scholastica Senior Technologist CPHL Dr. Christina Consultant Laboratory Services Mr. Gaspard Guma Senior Advisor CPHL Dr. Henry Kajumbula Technical Advisor Mr. Tom Tenywa National STD/I Lab Coordinator Mr. Charles Kiyaga National EID Coordinator Mrs. Bakunda Kamaranzi Program Officer Training Mr. Wilson Nyegenye Mr. William Ziras Lali Lab Quality Officer Mr. Sulaiman Ikoba Project Administrator Mr. Michael Dfendu Lab Scientist Agnes Nabasirye Program Assistant CDC Thomas Alinaitwe IT Systems Rita N. Eragu Project Secretary Michael Nandala Lab Technologist Diana Kamusime Program Assistant CPHL Bernard Baitwababo Data Analyst Rebecca Nakidde Program Assistant EID Atek Kagirita Lab Scientist Mary L. Nakitende Program Assistant HCT Daniel Kasule Data Officer Susan Nambozo Program Assistant Nelson Ogwang Lab Technologist Joseph Nkodyo Lab Technologist Penina Nalukenge Program Assistant, HBC Susan Nandutu Janitor Nicholas Isa Janitor Edward Rutatinisib wa Fred Khauka Driver Bossa Khasim Office Messenger Madinah Nakate Janitor Boniface Bagonza Askari Ibrahim Kasujja Driver Paul Bwebale Driver Aggrey Ngobi Driver CLINICAL LABORATORY NEWS FOR UGANDA

4 District Laboratory Focal Persons; The Foot soldiers of laboratory services in Uganda The concept of District Laboratory Focal Persons (DLFP) was adopted in Uganda in 2002 as part of the Integrated Disease Surveillance Response (IDSR). According to IDSR guidelines, each district should have a laboratory professional on their rapid response team. All districts designated laboratory personnel from their existing staff to fulfill the role of DLFP. As various laboratory strengthening programs were rolled out throughout the country, the role of DLFPs expanded beyond surveillance and rapid response to include; coordination of logistics, quality assurance and training. activities Currently, DLFPs coordinate such activities as ordering, receiving and storage of laboratory creditline items, they act as the first controllers in the AFB slide rechecking external quality assessment scheme, and are engaged in regular support supervision of laboratories in their districts. With these increasing tasks, DLFPs need to be appointed as full time coordinators of laboratory activities and relieved of their bench tasks as advocated for in the draft National Health Laboratory Strategic Plan for Below is a list of current DLFPs and their contacts, save for a few new districts who are yet to assign the responsibility: District Name Tel. Contact Abim Omodo Christopher Adjumani Peter Madra Amolatar Ongom Dizzozo Justine Amuria Akol Peter Amuru Okello Mark Apac Okello Francis Arua Lou Lou Louis Budaka Tazenya Bududa Nanfungo Bugiri Musobya Daniel Bukedea Okwalinga Robert Bukwo Kotti Julius Buliisa Mvazomaniku Bundibugyo Ejoku Emma Bushenyi Lubega Dan Busia Nafula Scovia, Butaleja Owere Lawrence Dokolo Ogwanga Lawrence Gulu Muloya Felix Hoima Tibamwenda Anthony Ibanda Kiiza Aloysius Iganga Kirunda Menya Kakaire Isingiro Ddumba John Rogers Jinja Bikumbi Patrick Kaabong Lonio Isaac Kabale Kariisa Samson Kabarole Bisogo Mughusu Ezekeil Kaberamaido Epwonu James Frank Kalangala Ssebulime Richard Kaliro Acile Godrey Kampala Mulindwa Francis Kamuli Kintu Ali Ahmed Kamwenge Byarugaba Didas Kanungu Rwakoojo Anthony Blair Kapchwora Kiisa Sylvia Kasese Yet to assign Katakwi Ekoluot Geoffrey Kayunga Hibira Henry Kibaale Ondonga Jimmy Kiboga Byakika Grace Kiruhura Budaki Morris Kisoro Bakunzi Deo Kitgum Opoka G.Samson Koboko Atiku Alex Kotido Opio Francis Kumi Oguma Geoffrey Kyenjojo Mukokoma Erisa Lira Amuge Bernard Luwero Kalyesubula Edward Lyantonde Ndawula Anthony Manafa Opio Charles Masaka Ahimbisibwe James Masindi Tigambirwa Peter Mayuge Byekwaso John Bosco Mbale Ekeu Isaac Mbarara Namono Norah Mityana Mugwanya Adolph K Moroto Catherine Lorot Moyo Asi Gaone Abraham Mpigi Sonko Paul District Name Tel. Contact Mubende Kalema John Mukono Mule William Nakapiripirit Aboka Moses Nakaseke Luzira Isaac Nakasongola Okwir Alex Namutumba Wandera Tom Nebbi Odokonyero Henry Ntungamo Mugenda David Nyaduri Louga Albino Oyam Alinga John Bosco Pader Ongom Patrick Sisto Pallisa Emuduk John Rakai Nambale John Bosco Rukungiri Agaba K. John Paul Sembabule Arinaitwe Francis Sironko Okoboi Bosco Soroti Obonyo Charles Tororo Akol Beatrice Wakiso Matovu Baker Yumbe Dima A. Terence Nwoya Okello Mark Amuru onen Alfred Otuke Modest Adaku Aleptong Alex Odyek Kole Aumaaa Jane Buyende Kisawuzi Christopher Agago Ayella George Oryem Kibuku Oryem John Bosco Buwuma Aisu Alfred Buikwe Nasuna Chritine Serere Kasim Kata Kiryandongo Opio Samuel Namayingo Partrick Otak Kyegegwa Lwanga Sam Zombo Mugasha Sam Luuka Samson Nkulega Butambala Muyingo James Mpigi Sonko Paul Gomba Kakooza Shema Abenaitwe Amon Mitooma Bakengama Sam Buhweju Bemera Amon Bushenyi Lubega Dan Kumi Ejoku Bernard Ngora Enguria Issac Lwengo Yet to assign Bukomansimbi Yet to assign Kalungu Yet to assign Amudat Daniell Kalepun Napak Yet to assign Kween Selangat Jacob Some of the DLFPs attending a workshop in HIV rapid testing at Jinja.

5 S C I E N T I F A R T I C L E : PAGE 5 Implementation of Integrated National Laboratory Quality Improvement in Uganda Authors: William LALI 1, Gaspard GUMA 1, Henry KAJUMBULA 1, Peter NSUBUGA 1, Zainab AKOL 1, Peter AWONGO 2, Prossy NAMPIJJA 3, Nakitende Mary Lious 1, ONOMA N Virgil 4 Affiliation: 1 Central Public Health Laboratory, Ministry of Health, Kampala, Uganda. 2 National Tuberculosis and Leprosy Program, Kampala, Uganda. 3Uganda Virus Research Institute, Entebbe, Uganda. 4 School of Public Health, Makerere University; Location of Project/Program: Uganda Key Words: Quality Improvement, Quality Assurance Introduction: External quality assessment of laboratories involves the monitoring of the performance of a laboratory by an entity outside that laboratory. It may entail supervisory visits, retesting of a portion of the specimens tested by the laboratory or administering panels of specimens to the laboratory to check on its ability to test them correctly. A number of external quality assessment schemes have recently been set up in Uganda. These include the T.B slide rechecking by the National T.B Reference laboratory, the CD4 NEQAS where CDC in A total of 214, collaboration with CPHL distributes panels for CD4 lymphocyte approximately counts, the EAREQAS, where AMREF distributes panels to 93 laboratories and the CPHL NEQAS where CPHL distributes panels for malaria parasites, HIV rapid testing and stool micros- laboratories in 14.3% of copy. the public network were During 2009, CPHL reached a total of 214 laboratories with its CPHL NEQAS. In addition, quality audits were performed on reached in the the same 214 laboratories. Here we report on the findings. assessment. Methodology: Sets of panels for HIV screening, T.B microscopy and malaria microscopy were prepared and validated at the Uganda Virus Research Institute, The National T.B Reference Laboratory and the Central Public Health Laboratory respectively. The panel testing results were then scored at CPHL and laboratories adjudged to have posted satisfactory or unsatisfactory results based on a cutoff of 75% for each of the tests. The quality audit visits were performed by a central team of laboratory personnel who used a standard checklist and the key issues that could have compromised performance identified form the checklist. Discussion: External quality assessment schemes in the country remain very limited in coverage with CPHL reaching only 214 about 14% of laboratories in the public network. In 2009 however, CPHL NEQAS had only been in its second year of implementation and lessons for scaling up were still being learnt. The mean performance of the EQA was above the satisfactory score of 75% for each of the 3 panels. However, 14% of the laboratories returned unsatisfactory results. The unsatisfactory laboratories performed worst in the malaria tests particularly in the aspect of quantification of the parasites. Supplies, poor records management and inadequate personnel skills were key issues in the poorly performing laboratories Recommendations; There is a need to scale up the coverage and fre quency of the EQA schemes Poorly performing laboratories need closer follow up to support their logistics management, data man agement. Their personnel need mentoring and training to augment their skills Distribution of participating laboratories by level Results: A total of 214, approximately 14.3% of laboratories in the public network were reached in the assessment. Their distribution by level is summarized in figure 1. A total of 214 laboratories participated in the EQA program and assessment. These included 8 regional referral hospital laboratories (3.7%), 46 general hospital laboratories (21.4%), 49health center IV laboratories (22.8%), and 111health center III laboratories (51.8%). Lab Performance in the proficiency panel testing Overall, 180 (84%) of the laboratories scored satisfactory results, with 34 (16%) posting an unsatisfactory result in one or more of the test panels. Figure 2 summarizes the mean scores for each panel. The mean scores were 91% for HIV screening, 85% for malaria microscopy and 85 percent for T.B microscopy. sd at the bottom of the figure are the standard deviations. The laboratory audit data of the poorly performing laboratories was analyzed for findings of factors affecting quality of testing. The key findings were reagent stock out/expiries (32.4% of the failing labs), poor records management (29.4% of the failing labs), inadequate technician skills (20.5% of failing labs), lack of standard operating procedures (11.7% of failing labs) and failure to follow standard procedures (5.8% of failing labs). Lab Performance in the proficiency panel testing

6 PAGE 6 EVENTS: Uganda Launches a National Health Laboratory Policy From left to right: Dr. Giorgio Roscigno, FIND CEO; Mr. James Kakooza, Hon. Minister of State for Health (primary health care); Dr. Joaquim Saweka, WHO Representative for Uganda; and Dr. Kevin Mills McNeill, Country Director of CDC/Uganda As a follow up to the policy, a 5 year strategic plan for its implementation is being developed By Kajumbula Henry The 24 th September 2009 ought to be highlighted as a major milestone to delivery of health laboratory services in Uganda. It was on this day at a colorful ceremony in the Imperial Royale Hotel that the Honorable James Kakooza, Minister of State for Primary Health launched the National Health Laboratory Services Policy. While not a panacea to the rigours of delivering quality laboratory services, the policy forms an all important framework. It elucidates the strategies and objectives relating to laboratory services in the National Health Policy and the Health Sector Strategic Plan II. The process to develop a Policy to guide laboratory services in Uganda dates back to the mid 1980s. At that time, the Ministry worked together with AMREF and developed policy guidelines for laboratory services. Unfortunately, the document was never launched or widely publicized. While they acted as reference material for many stakeholders, these guidelines were neither official nor binding. In 2005, the second Health Sector Strategic Plan (HSSP-2) of made development of a comprehensive National Health Laboratory Services Policy a key objective. The National Health Laboratories Technical and Advisory Committee rose to the challenge in Working with the Central Public Health Laboratories (CPHL) with support from the Centers for Disease Control (CDC), a draft policy was developed. In 2008, the Foundation for Innovation in New Diagnostics (FIND) established a program in Uganda. A key objective of FIND s Uganda Program was to support the Ministry in finalization of the Policy. This concerted effort from the Ministry in partnership with FIND and CDC led to its completion in early In general, the policy aims at providing a framework for ensuring that the health laboratory services in Uganda are strengthened so as to support effective and efficient delivery of the Uganda National Minimum Health Care Package (UNMHCP). It sets the strategic direction in 13 key areas that are fundamental to attaining available and sustainable quality laboratory services in the country. These key areas around which the objectives of the policy revolve are: Organization and management Delivery of the services Laboratory facilities and safety Laboratory equipment and supplies Human resources Quality management systems Information systems Research and development Community involvement Partnerships Regulatory and legal framework Monitoring and evaluation Financing and accountability The policy gives a couple of strategies through which each of the 13 policy objective, shall be achieved. From left to right: Dr. Giorgio Roscigno, FIND CEO; Mr. James Kakooza, Hon. Minister of State for Health (primary health care); Dr. Joaqui saweka, WHO Representative for Uganda; & Dr. Kevin Mills McNeill, Country Director of CDC/Uganda. As a follow up to the policy, a 5 year strategic plan is being developed. A draft of the plan was presented to stakeholders in September Once finalized the strategic plan shall guide all government and partner investment in health laboratory services for the period of End CLINICAL LABORATORY NEWS FOR

7 PAGE 7 EVENTS: Uganda hosts East African Regional meeting for laboratory accreditation By Hakim Sendagire On 27 th and 28 th of July, Uganda hosted a meeting to review the progress of East African Countries in implementing the World Health Organization (WHO) s accreditation process that was launched in Kigali, Rwanda in July The meeting that attracted over 40 public health and laboratory systems experts from the Ministries of health of Uganda, Kenya, Tanzania, Rwanda and Ethiopia was organized by the Ministry of Health of Uganda in conjunction with WHO, CDC-Uganda and AFENET and was held at the Serena Resort in Kigo. Hon. Stephen Malinga Opening the meeting, Uganda s Minister of Health, Dr. Stephen Malinga underscored the central role played by laboratories in clinical management of patients, as well as the early detection and management of disease outbreaks. Attending countries updated the meeting on their progress in implementation of the accreditation process. The countries shared their experiences in the implementation of the Strengthening of laboratory management training towards accreditation (SLMTA). SLMTA is essentially a training and mentoring tool developed by CDC-Atlanta to strengthen management of laboratories in order to attain immediate and measurable quality improvement. At the end of the meeting, all countries committed to implementation of the WHO accreditation process and SLMTA. They resolved to explore mechanisms of setting up an East African Regional Accreditation Body while at the same time strengthening National Institutions. End CPHL and CDC-Uganda co-host a laboratory strengthening implementing partners meeting Dr. Alex Opio, MOH (top), Mr. By Eragu N. Rita Lali Ziras William, CPHL (centr), Dr. Winifred Wafula, CDC, Ms Agnes Nabasirye, CDC (bottom) and some of the delegates (left), in a discussions during the WHO Laboratory Accreditation workshop, that was hosted in Uganda, 27 th 28 th July The Ministry of Health recognizes the critical role played by various partners in the delivery of laboratory services in the country. To this effect, the Ministry teamed up with CDC-Uganda to host a 2 day meeting for laboratory services implementing partners. The event, held on 30 th September and 1 st October 2010 at Protea Hotel, Kampala sought stakeholder input to the draft National Health Laboratory Services Strategic Plan for and the draft National Laboratory Quality Assurance Plan. The meeting was also used as an opportunity to collect Data on services offered by various implementing partners. End The Director General for Health Services, Dr Kenya Mugisha (standing) sounding the move from ministry of disease to ministry of health, MOH s commitment to implement the Laboratory Strategic Plan and the curb false diagnosis reports tagged to monetary values especially in the private sector. Next to him is the Assistant Commissioner Clinical Services Dr. Jackson Amone and the WHO representative. CLINICAL LABORATORY NEWS FOR

8 EVENTS: PAGE 8 East Africa launches a project to harmonize laboratory efforts towards disease surveillance By Guma Gaspard : Increasing migration of populations across East African borders either in search of economic opportunities or as a result of forced displacement is a potential fuel to outbreaks of communicable diseases like cholera, meningitis, drug resistant tuberculosis and newly emerging global epidemics like swine flu (H1N1 influenza). While laboratories form a central cog in efforts for early detection and control of such outbreaks, they remain the weakest link to such efforts. In recognition of this fact, the 4 East African Countries of Kenya, Rwanda, Tanzania and Uganda have secured World Bank Loans totaling to USD 66.7 million to strengthen the public health laboratory network in the region. The project entitled The EAST AFRICAN PUBLIC HEALTH LABORATORY NETWORKING PROJECT (EAPHLNP) aims at establishing a network of high quality accessible public health laboratories for the diagnosis and surveillance of TB and other communicable diseases. It has 3 components namely; Strengthening of the regional capacity to diagnose diseases of public health importance and to share information to mount an effective regional response. Joint training and capacity building to expand the pool of qualified laboratory technicians Joint Operational Research, knowledge sharing/regional Coordination and program management In total, 25 laboratories across the 4 countries shall be built or refurbished, equipped and supported to operate effectively. In addition, the disease surveillance capacity of the East African Community health desk and the East Central and Southern Africa Health Community (ECSA-HC) based in Arusha shall be supported to coordinate the regional efforts. In Uganda, a new National TB Reference Laboratory shall be constructed in Butabika at the proposed CPHL site. In addition 5 regional laboratories shall be constructed/refurbished, equipped and operationalized to enable them perform T.B cultures and molecular assays and bacteriological/mycological cultures. The 5 laboratories include Arua regional Hospital, Lacor Hospital, Mbale Regional Hospital, Mbarara Regional Hospital and Mulago National Referral Hospital. The first 4 hospitals were selected on the basis of their location near national borders and would therefore be able to serve neighboring countries. The project has gone through cabinet and parliamentary approvals and is expected to be effective by the end of January End..more on lab strengthening implementing partners meeting The Assistant Commissioner National Disease Control, Dr. Alex Opio (centre above) addressing stakeholders, in company of Dr. Mwangi Christina (L), Dr. Hakim Sendagire and Dr. Henry Kajumbula. Stakeholders included PEPFAR Team, Walter-Reed funded, USG funded partners, Academia (National lab institutions), Civil Society Organizations, Private Not for Profit, Medical Superintendents and District Health Officers. Some of the lab implementing partners representatives in the meeting. CPHL Senior Advisors Mr. Amato Ojwiya (centre) and Mr. Guma Gaspard (front), Atek Kagirita, (L), Peter Awongo (R), Pendun Martha, (far right), Dr. Robert Downing, CDC and Bernard Baitwababo, CPHL.

9 EVENTS: PAGE 9 Association of Pathologists of Uganda hosts the 20 th Association of Pathologist of East Central and Southern Africa Congress. By Susan Gathoni On the 15 th to 17 th of September 2010, the Association of Pathologists of Uganda (APU) hosted the 10 th biennial Conference of Association of Pathologists of East Central and Southern Africa (APECSA) at Hotel Africa in Kampala. APU brings together specialists in the various fields of pathology in Uganda while APECSA is the umbrella for all pathologists associations in the regions of East, Central and Southern Africa. These associations aim at promoting quality teaching and practice of all the fields of pathology including histology, cytology, microbiology, hematology, chemistry and immunology. The conference s theme was Repositioning Pathology Practice in sub-sahara Africa: opportunities and Challenges. It drew a record attendance of 130 delegates from 16 countries, and 41 papers were presented. The Ministry of Health was represented by Dr. Asumani Lukwago, the Permanent Secretary. Other prominent speakers included Dr. Stephen Kijjambu, Dean of the School of Medicine at the Makerere University College of Health Sciences and Professor Sebastian Lucas of King s College London. Many speakers emphasized the need of laboratory services and all disciplines of pathology to demonstrate their relevance and become more visible in order to attract adequate support. APU brings together specialists in the various fields of pathology in Uganda while APECSA is the umbrella for all pathologists associations in the regions of East, Central and Southern Africa. Above and below: A cross-section of delegates during a session. One of the key events of the conference was launching of the College of Pathologists of East Central and Southern Africa (COPECSA), whose aim is the promotion of excellence in the practice of pathology through training, examination and professional development. Dr. Ranjiv Erasmus of South Africa was elected as its president. Dr. Henry Kajumbula and Dr. Othieno Emmanuel from Uganda were elected onto its 25 member council. End Below: Some of the posters showing findings displayed. more laboratory implementing partners representatives who attended the meeting cohosted by CPHL-MOH and CDC Upcoming Events: Uganda AIDS Indicator Survey February 2011 Pilot ing PIM A ( Point of Care) CD4 M a- chine in Uganda January 2011 Uganda.. Strengthening Laboratories Towards Accreditation (SLMTA) TOT-March Johannesburg South Africa

10 Social Corner CPHL says bye 2010 in style: For the first time in its history, CPHL hosted an end of year party. The event was hosted on 22nd December 2010 at the CPHL gardens. Patrons were treated to mouth-watering muchomo, a special treat by Mrs. Ikoba. Chief guest Dr. Zainabu Akol, Manager AIDS Control Program, Ministry of Health, thanked everyone for their efforts during 2010, and appealed to them to remember thanking God for the lives in 2010, and to be more conscientious in their work during Left: The master of ceremony could not hide his excitement. Right: Delicious nyama choma Above: Dr. & Mrs. Sebulime, Sharon and Lydia arriving at the venue. Right: Mr. Guma sharing his new year resolutions; as usual members had to hold their tummies to control stomachache caused by his humorous characteristic. Right: The beautiful Mastula Ikoba; the hands behind the special nyama choma. She left her office in time to make CPHL s day. With her are their lovely children Ryan and Anah, plus husband Ikoba Sulaiman (CPHL Administrator) Above: A few of the honorable guests who blessed the function. Watch out for the next issue! Ministry of Health It was all about lab technologists... Nandala Michael and Joseph Nkondyo, two of CPHL s lab technologists were introduced to their in-laws in breath-taking functions. Central Public Health Laboratories, Uganda Plot 7/11 Buganda Road, Kampala Phone: cphlug@gmail.com Smartness was the word as the CPHL family posed for the introduction functions. Micheal Nandala (left) with collegues on the d-day. Joseph Nkodyo (left) with collegues on his day