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Résumé :
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Laboratories provide a large range of testing – from the site of patient care to addressing environmental issues – all of which require accurate and reliable results for disease prevention and management. Until now, external financing to strengthen laboratory services in low- and middle-income countries, including those of the World Health Organization (WHO) European Region has mainly benefited vertical programmes aimed at specific diseases. Insufficient national coordination and oversight of such initiatives has led to fragmentation, duplication and uneven quality within laboratory services. In response, Better Labs for Better Health, an initiative of the WHO Regional Office for Europe, has taken an intersectoral approach by assisting countries with the creation of national laboratory working groups (NLWGs), which have developed national laboratory policies and strategic plans. This article reports an analysis of four national policies and identifies a few strengths of the current systems, such as laboratories of better quality because of the support from vertical programmes, political commitment and motivated staff. It also reveals well-known core cross-cutting challenges such as human resources, infrastructure development and quality management systems. Three new challenges are identified: accessibility of services, sustainable financing of laboratory activities and ethics. All challenges need an intersectoral approach to find solutions at the country level, such as in education, clinical waste management, health system strengthening and collaboration with the private sector. The NLWGs form intersectoral platforms through which common weaknesses and capacity building can be addressed throughout national laboratory systems.
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