Joint WHO – US CDC assessment of Royal Centre for Disease Control (RCDC,) Bhutan for National Influenza center ( NIC) recognition process
The Virology laboratory at the Royal Centre for Disease Control (RCDC) under the Ministry of Health of Bhutan serves as the National reference laboratory for Influenza surveillance. During 2018 RCDC expressed its interest to become a National Influenza Centre (NIC), designated by the Ministry of Health, Bhutan and further for recognition by WHO as a NIC under the Global Influenza Surveillance and Response System (GISRS).
The NIC recognition by GISRS involves an extensive laboratory assessment using the WHO laboratory assessment tool for NIC to ensure that the Terms of Reference are fulfilled and the capacity to detect influenza viruses is satisfactory.
In 2018, WHO-SEARO and United States Centers for Disease Control and Prevention (US-CDC) jointly organized a preliminary preparatory onsite laboratory assessment to identify any potential issues that could hinder RCDC to achieve its NIC status. The assessment was carried out with in-person discussions with the laboratory lead and other staff personnel and by making observations on routine laboratory practices.
Key issues identified during the assessment were as follws.
- Systematic equipment maintenance, inventory, and equipment insufficiency
- Standard operating procedures and documentation for laboratory activities
- Transportation of specimens within and outside the country
- Technical issues in laboratory quality management, methods, and structure
- Trainings and continued education to ensure competence of staff personnel
Since the assessment, WHO along with US-CDC has been working closely to address major issues identified during the assessment. RCDC demonstrated significant advancements during the COVID-19 pandemic, especially in enhancing the overall testing capacity at their virology laboratory. The implementation of integrated SARS CoV-2 and influenza surveillance during the pandemic evidenced their technical competence. With this, a follow-up remote assessment was conducted during 2021, mainly focusing on the gaps that were identified during the 2018 assessment.
The current assessment has revealed efforts made by RCDC to improve and maintain laboratory standards, especially in the aforementioned areas identified as key issues. Certain chronic challenges pertaining to developing countries such as equipment maintenance (due to unavailability of local technical support) persist, but measures are in place by RCDC to ensure high quality and safe testing of influenza viruses.
Considering the outcomes of the recent assessment during 2021, it was evident that RCDC has met the requirements to become a GISRS recognized NIC. The regional office is currently formalizing the assessment reports and will be working with the global influenza programme (GIP) to complete the process of recognizing the Virology laboratory at the RCDC as a NIC.
