Until June 2023, the government of Malawi, through national Public Health Institute of Malawi (PHIM) had been losing a lot of funds, sending samples of drug resistant cases of HIV, and TB, among others, abroad for analysis.
PHIM, which has its headquarters in the capital, Lilongwe, is a directorate within the Ministry of Health and it deals with disease surveillance and diagnostics, and quality management through refresher courses and mentorship to ensure quality results in district hospitals.
Other than losing funds, the country had also been wasting time as PHIM awaited the results of the samples sent abroad before making decisions.
But PHIM, today, no longer relies on foreign institutions to analyze any samples as the Institute can now do the task on its own, thanks to Global Fund.
“The Global Fund has been a good partner in laboratory services in Malawi: Previously, we used to send these samples either to South Africa, Uganda or Kenya and it could take longer than expected,” explains PHIM Deputy Director for National Public Health Laboratory, Joseph Bitilinyu Bango.
“But now, with the support from the Global Fund, we are able to carry out the tests on our own since June 2023, and it only takes 2 weeks before the results are out,” he adds.
According to Bangoh, the Global Fund’s support in drug-resistant sample testing is a relief to both the institution and clients who could, previously, wait for half a year to know what was wrong in their bodies.
As a directorate dealing with specialized tests, PHIM has the following departments: TB Reference Laboratory; HIV Reference Laboratory; Parasitology and Vector Disease Reference Laboratory; Micro-biology National Genomic Sequencing Laboratory; as well as Genomic Biochemistry, Hematology and Nutrition.
All these departments benefit from Global Fund’s support either through equipment and supplies, or capacity building through training of staff.
In HIV Reference Laboratory, for instance, Global Fund has been supporting department with reagents and supplies, and the Fund has also been supporting rapid testing across Malawi, according to Chifundo Banda, Chief Laboratory Scientist and Head of the National HIV Reference Laboratory, where the Genomics Reference Laboratory is also housed.
The department oversees about 6,000 service providers (public and private hospitals) across Malawi, ensuring provision of quality services regarding HIV testing.
The department also conducts verification of test kits; and it also conducts confirmatory testing when the service providers are not able to determine results after a test.
The advanced equipment which Global Fund supported PHIM within June 2023 remains a long stride in the HIV Reference Laboratory department – especially in determining drug resistant samples.
“Keeping patients waiting for 6 months before they knew what was happening in their bodies was very retrogressive,” explains Banda. “Now we are able to test drug resistant HIV and get the results in two weeks: This is progress.”
Banda adds that with Global Fund’s support towards her department, Malawi is on the right path towards achieving the 95:95:95 targets so that the country does not have any new infections by 2030, among others.
Global Fund has also been instrumental in supporting malaria programs through the National Parasitology Reference Laboratory department, whose role is to detect all kinds of parasites, and oversee other peripheral labs across the country.
According to Chief Laboratory Scientist and Head of the department, Shenton Kacheche, Global Fund has supported capacity building by training staff in malaria diagnosis.
He acknowledges that with the Global Fund’s capacity building support, the department’s performance has improved tremendously.
“The refresher courses are very important, and they have improved the performance of our staff and that of our peripheral health facilities,” explains Kacheche.
He adds: “Previously, this lab’s performance was very low – below 50 percent. But after the trainings, past rounds of KUHES (Kamuzu University of Health Science) test, we scored 100 percent.”
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More gains made through Global Fund’s support at PHIM are shared by Dorothy Moyo Kalata, Chief Laboratory Scientist and Manager for TB Reference Laboratory.
The department oversees TB diagnostic network across Malawi, doing TB culture, and conducting confirmatory tests, among other tasks.
The Global Fund has supported the department with procurement of equipment for testing, and establishment of culture labs in the south and in the north, given the overwhelming work that the department has.
“So, with the Global Fund’s support, we have set up culture lab at Zomba Central Hospital in the south, and another one at Mzuzu Central Hospital in the north,” Kalata explains.
Over the years since Malawi introduced molecular testing of TB using GeneXpert machine, the Global Fund has assisted the department with the procurement of the equipment and according to, Kalata, there are 210 GeneXpert machines across the country.
The Global Fund has also helped the TB Reference Laboratory in capacity building and testing coverage for TB as the department boasts 418 testing sites across Malawi, with some of these sites located in very remote areas.
With the Global Fund’s support, the TB Reference Laboratory also assembles Mobile Diagnostic Units (MDU) for TB in the form of vans equipped with GeneXpert and x-ray machines each, and they are deployed to the country’s border posts to test incoming and outgoing travelers for TB.
