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CARICOM Endorses Urgent Action on Medical Laboratory Crisis

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CARICOM Ministers meeting in St Lucia have endorsed recommendations for reversing the crisis in medical laboratories after hearing startling information about the quality of medical laboratory services in the region. The Caribbean Med Labs Foundation (CMLF) had requested PANCAP to include the regional issues affecting laboratory services on the agenda of the 16th meeting of the CARICOM Council for Human and Social Development (COHSOD)

The quality of laboratory testing is of critical importance to the public because it is estimated that 70% to 80% of critical medical decisions are influenced by laboratory results. In the Caribbean, snapshots of testing reliability indicate that a high frequency of unreliable results may be occurring.

Among other things, clinicians use laboratory results to decide if someone has diabetes; to determine if someone is at risk for heart attack or has had a heart attack; to determine if someone is HIV positive or has cancer;and to decide on hospital discharge.

Director of CMLF, Valerie Wilson, in a presentation to the COHSOD meeting held in April 2012, disclosed that among CARICOM countries, only Barbados, The Bahamas, Belize and Guyana have established regulations making it mandatory for medical laboratories to be licensed and their operations monitored. However, compliance with regulations may not always be optimal. In contrast, most CARICOM governments have already implemented regulations and monitoring systems for food establishments and vendors, pharmaceuticals and other health professionals. In the wider region,Bermuda has implemented mandatory legislation requiring laboratories to become accredited.

The Ministers endorsed key policy recommendations for laboratory services and agreed to support development of national and regional laboratory networks. They agreed to establish national regulations and ensure development and implementation of strategic plans for national laboratory services; to allocate the necessary resources to ensure continuous laboratory support; and to transition from resources provided by regional partners to national support.

In August 2011, delegates at a meeting supported by the Caribbean HIV/AIDS Regional Training Network (CHART),Caribbean Cytometry and Analytical Society (CCAS), the US Centers for Disease Control and Prevention (CDC)and the CMLF had issued a Declaration calling for establishment of a Caribbean Laboratory Network.

The CMLF Director emphasised that “Clinicians depend on laboratories to  manage patients and when they don’t trust laboratory results they often have to rely only on their clinical judgement in managing their patients. Worldwide,direct and indirect costs of laboratory error can run into millions of dollars.”

Ms Wilson, in her presentation to COHSOD, held out hope for the region to move forward on medical laboratory standards. She listed a number of strengths that would facilitate regional and national action, an important one being that countries themselves are backing the move for licensing and accreditation of laboratories. The Trinidad and Tobago-based CMLF has been working in partnership with Ministries of Health, PANCAP, PAHOWHO and CDC-PEPFAR to assess laboratories in the region with the aim of remedying the situation.