Advancing Diagnostic Network Optimization, Stepwise Laboratory Accreditation, and Integrated One Health Specimen Transport in Liberia - In the past nine (9) years (from 2015 to present), Riders for Health Liberia specimen transport system has played a critical role in supporting the laboratory diagnostics systems in Liberia participating in the fight against pandemics and large-scale outbreaks such as COVID 19, EVD and small to medium scale outbreaks such as Lassa fever and Measles. In all cases Riders for health timely transported the specimens to laboratory, enhancing the speed of diagnosis for timely disease detection and response activities helping to break the chains of transmission. The specimen transport system by Riders operates in all 15 counties of Liberia consistently despite the challenging road conditions and inclement weather and fully collaborates and cooperates with county and district health facilities, county diagnostic officers, county and district surveillance officers, national and regional laboratories, the Ministry of Health, and other Government of Liberia (GOL) entities and partners. Riders’ specimen transport system has stood a test of time it presents a solid foundation upon which other modelling scenarios for One Health Specimen Referral and Lab Diagnostic Network Optimisation can be modelled. The system has been highly acclaimed nationally by the National Public Health Institute of Liberia (NPHIL), The County Health Teams, MoH and Local partners in Liberia including WHO as a robust, flexible specimen transport system, strengthening laboratory diagnostics for effective and efficient detection of priority diseases by successfully sustaining a network of health facilities-laboratory linkages. The system is timely in transporting specimens picking specimens from 497 pickup points across all the 15 counties of Liberia, covering the entire population of 4.7million people. The project utilizes 82 professional couriers trained in Infection Prevention Control (IPC), utilising 82 motorcycles and five support vehicles. Before Riders, only 25% of samples reached laboratories within 24 hours using a collection of expensive models including helicopters and a chain of uncoordinated vehicles. Now, an average of 90% of transported samples reach laboratories within 24hrs and the remaining reach their designated laboratories within 48hrs and within 72 hours of collection. The purpose of this project is to strengthen the capacity to detect and respond to disease outbreaks rapidly through existing reliable geographically focused specimen transport, transporting One Health specimens (namely human, animal, and environmental specimens) from point-of-sample collection to intended destination for definitive diagnosis, thereby decreasing transmission of diseases between Humans and Animals. The short-term outcomes that we would expect to see would be: 1) Time required to rule-out priority diseases of public health importance are reduced ; 2) Appropriate clinical management is consistently delivered; 3) Faster specimen transport times. Over the entire project period of five years, we would expect the medium to longer-term outcomes to be: 1) All laboratories with public health relevance participate in detection and response to public health threats ; 2) Decreased disease transmission between humans and animal. As the landscape for Liberia’s health system is rapidly changing, we will need to focus not only on our current performance, but in building sustainability in coordination with MoH/NPHIL/MoA and other partners supported by CDC for long-term Lab diagnostic network success under one health.
