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Conclusion
The workshop concluded with discussions of possible future collaborations and projects to enhance laboratory network capabilities and effectiveness in Pakistan. Workshop co-chairs Anwar Nasim and David Franz invited comments from workshop participants and speakers.
A participant began by noting the many means of receiving and sending data from laboratories and clinics to a repository at the district via a disease surveillance network, and to various government facilities under the district, provincial, or national level. He asked how to facilitate the front end part of the network, meaning how to get people or animals to the laboratories so that the information about human and animal illnesses and their health can be included in the system itself. Once it is in the system, then the process to move the information through the system can be developed. But the front end is important because if people do not seek medical care from a doctor, hospital, or other provider there is no way of understanding health needs. A similar situation applies for the animal population, either livestock or other types of animal populations such as those that might be in transit for festivals or with refugee populations.
Franz reviewed the highlights of the workshop and praised the efforts of the breakout groups. He said that there are common challenges shared by Pakistan and the United States. As one example, he said he was struck that only 58 percent of the reporting in the United States is done electronically. He further noted that health challenges are everywhere. Infectious diseases remain one of the top 10 global causes of death; in 2016 the World Health
Organization estimated that 3 million people died from lower respiratory infections alone.1 In the United States in 2013, more than 1 million hospital-acquired infections occurred and were among the leading causes of death.2
Franz noted the great human resources, both intellectually and socially, within Pakistan. There are great technical and communication capabilities already present in the country. Some of those capabilities are not distributed equally across the country, which presents a challenge. A goal of the workshop and other efforts is to try to help those areas. In regard to the issues at hand, information allows healthcare workers and the government to respond. Surveillance data, and especially process data, can help experts understand trends and thus improve the capability to respond.
The workshop has focused on solutions, and progress was made, said Franz. The tools of communication are advancing quickly. Those tools will continue to improve and become more widely adopted in the future. It comes back to the two key words that arose during this meeting: communication and trust. Franz thanked the hosts and participants for their hospitality, kindness, and intellectual input.
Nasim thanked the organizers of the conference, which he said could serve as a model for future events. He praised the agenda of speakers and interactive discussions. There are challenges and opportunities, but they represent just part of the national situation in Pakistan. Many other activities, such as those through the Pakistan Biological Safety Association, are also taking place. The way forward must be led by the younger people, he said. He urged those in attendance to take up the work after the workshop, rather than forget the main messages. Those who have a genuine commitment and are prepared to work will move forward. He acknowledged the difficulties in acquiring research funding but urged persistence and commitment.
Many participants echoed that the workshop was an enriching experience. One participant reflected on the need and wish to come together and to share information and experiences. Building a network begins with effort, followed by a commitment to maintain the network. One way to
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1 WHO. 2018. The top 10 causes of death. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death.
2 U.S. Department of Health and Human Services. 2013. National HAI Action Plan: National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination. https://health.gov/our-work/health-care-quality/health-care-associated-infections/national-hai-action-plan#actionplan_development.
accomplish that is to share information and facilitate meetings and connections. The network will have to decide what to do and accomplish. The participant expressed his hope to remain in touch and help with some of the network building. Linkages are important. He expressed appreciation for the invitation and the warm reception. Another participant noted that despite the amount of data labs produce from the many tests run daily, people are the most important ingredient, based on their experience and expertise. He suggested taking a look at networks, and their structure and activities, and then use that information. Starting small, then working outward could be useful, but in all cases the people are most important.
Zabta Shinwari closed the workshop with a word of gratitude to Arshad Ali, Executive Director, Higher Education Commission of Pakistan, for his concluding remarks, and for his support of the workshop. He urged more interaction and friendship between Pakistan and the United States, and he also thanked the teams from the Pakistan Academy of Sciences and the National Academies of Sciences, Engineering, and Medicine for organizing a successful event.
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