Indira Gandhi Memorial Hospital (IGMH) Maldives has received recognition by WHO as a National Influenza Centre and subsequently a member of the WHO Global Influenza Surveillance and Response System (GISRS). A National Influenza Centre recognized by WHO will maintain direct working relations with the WHO Global Influenza Programme and WHO Regional Offices as well as WHO Collaborating Centers for Reference and Research on Influenza and will comply with the Terms of Reference for National Influenza Centers.
Indira Gandhi Memorial Hospital (IGMH) is a publicly funded hospital in the capital of Malé, Maldives and is the largest healthcare facility in country. Its primary function is to provide high quality tertiary level healthcare services to around 150,000 people living in the capital city and specialist referral services. IGMH houses modern investigative and imaging technologies in diagnostics, providing efficient patient-centered healthcare.
In the year 2013, the Health Protection Agency (HPA), Ministry of Health Maldives acquired support from US-Centers for Disease Control and Prevention to develop an active influenza surveillance system which included laboratory capacity development to routinely test for influenza. Since then, IGMH has been supporting Health Protection Agency with the laboratory detection of Influenza viruses. During the COVID-19 pandemic, the influenza laboratory was further upgraded into a molecular testing facility for SARS CoV-2, with several automated equipment being installed and utilized. Currently, the influenza laboratory is adequately spaced and is compliant to the workflow required for PCR testing. Throughout the years, WHO has continued to support IGMH with many trainings and provide laboratory consumables and reagents required for Influenza and COVID-19 preparedness, enabling testing and quality diagnostics in the Maldives and supporting External Quality Assessment Panels for quality management and trainings for the laboratory staff. WHO has also been a collaborative partner when Maldives had Influenza outbreaks in the years 2017 and 2018, in addition to the ongoing support to Maldives for the COVID-19 pandemic.
As the national referral center, IGMH provides a first line of defense in rapid recognition and prevention of communicable disease through the surveillance system lead by Health Protection Agency and provides laboratory support for outbreak investigations and health emergencies. It also serves as a national center for infectious diseases by providing laboratory capacity for identification of Mycobacterium tuberculosis, enteric and invasive diseases, vector borne diseases, respiratory diseases of public health importance, and early detection and confirmation of measles, rubella and HIV.
Ministry of Health expressed interest to WHO to officially designate Indira Gandhi Memorial Hospital as a National Influenza Centre. This was deemed an excellent opportunity to review the existing Maldives surveillance program as part of the NIC laboratory assessment, which was completed in March 2023. The aim of this review was to follow up on the gaps identified during previous assessments and evaluate the status of the laboratory in achieving the requirements to meet the WHO NIC Terms of Reference and become a WHO recognized NIC and a full member of GISRS.
The assessment of laboratories requesting WHO-recognition occurs through a process involving self-assessments using a standardized tool known as NIC-Laboratory Assessment Tool (NIC-LAT) and on-site visits by experts. The LAT evaluates the laboratories’ influenza-related work as well as laboratory quality to ensure influenza laboratories are operating at similar high standards of performance. This tool has been widely used by public health laboratories globally and is considered an efficient tool for putting in place a quality system which will help the laboratory to meet quality standards.
IGMH underwent a detailed onsite Influenza Laboratory Capacity assessment by WHO Southeast Asia Regional Office using the WHO NIC LAT Tool. The recommendations of this assessment helped IGMH to build on their strengths in preparation for the NIC recognition. The assessment was performed by experts from NICs of Sri Lanka and Bhutan, WHO Collaborating Center in Melbourne, US-CDC-India and WHO SEARO. Within the course of three and a half days (from 5th to 8th of March 2023), the team of experts met with the HPA and IGMH teams and performed the assessment, which included a series of questions accompanied by visits to different sections of the Influenza Laboratory. Advice and recommendations were made following the initial observations and examinations of the different documents. Remarkably, the National influenza Laboratory scored 90% across the general indicators and exceeded the recommended score of 85% or over to become a WHO recognized NIC. As a result, the WHO Southeast Asia Regional Office recommended the nomination of the National Influenza Laboratory at Indira Gandhi Memorial Hospital (IGMH) to be recognized by WHO as the National Influenza Centre.
“One of the most important lessons from the COVID-19 pandemic is the need for enhanced laboratory capacities to detect diseases quickly and accurately. This is a building block of pandemic preparedness and response, and as WHO, we have prioritized this well.” said Dr Nazneen Anwar. WHO Representative, “I take this opportunity to congratulate National Influenza Laboratory Team at Indira Gandhi Memorial Hospital (IGMH), headed by Dr. Shimal Thasneem on the well-deserved recognition they have received. This achievement increases the Maldives capacity towards responding to multiple respiratory pathogens of pandemic potential. Multisectoral partnership and country ownership are vital for ensuring sustainability of National Influenza programmes, which serve as an investment for greater health system strengthening pandemic preparedness and building back better.”
WHO recommends continued support to the NIC by the Government of Maldives and encourage Maldives to continue to contribute to regional and global influenza surveillance and enhancing its involvement in GISRS to further sustaining this achievement. WHO remains committed towards providing continued technical advice, assistance, and training to the National Influenza Center.