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World Bank Approves US$63.66 Million to Create Critical Public Health Laboratory Network in East Africa

Press Release No:2010/432/AFR

WASHINGTON, May 25, 2010- The World Bank's Board of Executive Directors has approved US$63.66 million to create a unique regional network of 25 public health laboratories across Kenya, Tanzania, Uganda, and Rwanda. This network will operate across country borders, improving access to diagnostic services to vulnerable populations in cross border areas and making optimal use of internet and mobile communications to improve public health.

"At a time when the global economic crisis has undermined Africa's recent economic achievements, regional integration is an essential strategy for restoring medium-term growth, unlocking economies of scale, and sharpening competitiveness in Africa," said Obiageli Ezekwesili, World Bank Vice President for Africa. "The World Bank is committed to supporting regional solutions that target important missing links in regional infrastructure, greater trade integration, and cross-border health issues critical to accelerating the attainment of the Millennium Development Goals."

Laboratories are currently the weakest link in the region's public health defenses, seriously hindering each country's ability to confirm and respond in a coordinated manner to disease outbreaks. By bolstering diagnostic and surveillance capacities, the new multi-country laboratory network will help to identify potentially devastating disease outbreaks at an early stage, enabling countries to act quickly to prevent the rapid spread of diseases across borders.

Communicating outbreak-related information across national borders in real time is more important than ever before, as labor mobility is likely to increase shortly with the establishment of the East African Community common market and with growing global travel.

The network will also support the roll-out of new technology for drug resistance monitoring and more efficient tuberculosis diagnosis, most notably for people living with HIV/AIDS. Greater access to diagnostic services is expected to significantly contribute to improved health outcomes, and ultimately to attaining the Millennium Development Goals.

All four countries have a high burden of tuberculosis with an increasing threat of drug resistance. Kenya, Tanzania, and Uganda are on the WHO list of 22 "high-burden" countries that together account for 80 percent of the world's tuberculosis cases while Rwanda is on the WHO list of 15 "high- TB incidence" countries.

"The East Africa Public Health Laboratory Networking Project effectively addresses both a key weakness in health systems and a critical gap in the continental response to TB," said Richard Scobey, Acting Director, Regional Integration in the World Bank's Africa Region. "It represents our strong commitment to expanding access to services to vulnerable groups and highlights the innovative use of ICTs to improve public health in Africa."

Information and communication technologies are an essential aspect of the project to ensure advanced connectivity between multiple locations. Innovations that will be built into the project include web-based knowledge sharing, e-learning modules, and health alerts. The project also supports joint training and capacity building across countries; and joint operational research, regional coordination and program management.

Each participating country will become a center of excellence for a key aspect of the project. Rwanda will take the lead on ICTs and performance-based financing. Kenya will serve as a center for integrated disease surveillance and response, and for operational research. Uganda will take the lead on laboratory networking and accreditation, and Tanzania will develop high-quality training programs.

"We have seen the importance of collective action already in the eradication of small pox and in progress towards the elimination of onchocerciasis and polio," said Miriam Schneidman, project leader and Lead Health Specialist at the World Bank. "This project goes one step further by enabling each country to take the driver's seat for a chosen area, creating expertise that can be pooled efficiently and systematically for a greater regional impact."

The project will serve as a vehicle to implement strategic disease control priorities of regional institutions such as the East African Community (EAC) and the East, Central, and Southern Africa Health Community (ECSA-HC). ECSA-HC will play a critical convening, coordinating, and monitoring role at the regional level, financed by the four participating countries.

Several partners have contributed actively to the design and development of the project, including the United States Centers for Disease Control, the World Health Organization, the United States Agency for International Development, and the International Union against Tuberculosis and Lung Disease. Parallel financing for specialized TB diagnostics will be provided through the International Drug Purchase Facility (UNITAID) grant for the EXPAND-TB Project which is a collaborative effort of WHO/Global Laboratory Initiative, the Foundation for Innovative New Diagnostics (FIND) and the Global Drug Facility.

"Strong partnerships have been invaluable so far in helping us review the case for a laboratory networking project, documenting the TB diagnostic gaps in the region, and providing technical support," said Eva Jarawan, Sector Manager, Health, Nutrition and Population for Africa at the World Bank. "With this approach, which will continue throughout the project's implementation, much can be done to strengthen health systems in a sustainable and coordinated manner."

Through this project, Kenya has received a credit of US$23.5 million, Tanzania US$ 15.05 million, and Uganda US$10.01 million; while Rwanda has received a grant of US$15.01 million. These funds are from the International Development Association (IDA)-the World Bank's concessionary lending arm. The credits are approved on standard terms of a 40-year maturity with a 10-year grace period provided by IDA.

For more information about the World Bank in Africa, please visit www.worldbank.org/Afr

Contacts

In Kampala: Steven Shalita, +256-414-302 248, sshalita@worldbank.org

In Washington: Herbert Boh, +1-202-473-3548, hboh@worldbank.org