Global Health - Laos

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In Lao PDR, CDC builds capacity for avian, pandemic, and seasonal influenza preparedness by strengthening laboratories, surveillance, outbreak response, capacity building initiatives, infection control guidelines and best practices, clinical case management, and pandemic planning. CDC technical investments have led to recognition of seasonal influenza as a public health problem, reliable laboratory capacity to detect influenza viruses, data sharing of viral data with the WHO Global Influenza Surveillance and Response System to inform global vaccine strain selection, and improvements and expansion nationwide of the Influenza-Like Illness and Severe Acute Respiratory Illness Surveillance Networks. WHO recognized the National Center for Laboratory and Epidemiology by designating it a National Influenza Center in August 2010. In 2012, Lao PDR introduced seasonal influenza vaccine through an innovative private-public partnership where excess vaccines from the United States and Australia were donated to Lao PDR. The partnership marked the first time seasonal influenza vaccine was introduced in a low income country from the region. In 2014, 763,000 doses were given to priority high-risk groups (pregnant women, elderly, chronically ill and health care workers), and CDC assisted Lao PDR Ministry of Health conduct an evaluation of the effect of vaccination on birth outcomes. This novel approach now serves as a model for vaccine introduction in other low income countries.

CDC’s contribution to the Expanded Program for Immunization is channeled through WHO in Lao PDR. CDC provides operational and technical support for vaccine initiatives to reduce death and disability. CDC experts also assist in monitoring vaccination campaigns, including pre-campaign planning and post campaign review, as well as evaluating the introduction of new vaccines. Recently, CDC's efforts in Laos have focused on operational research to increase the number of newborns receiving the birth dose of hepatitis B vaccine, a crucial intervention to prevent transmission from mother to baby.

CDC capacity building investments include standing up and providing operational support for the Lao FET. A year-long training initiative intended to decentralize outbreak response and surveillance capabilities, Lao FET is organized into three modules, with each consisting of one month of practical classroom instruction and three months of field work. The Lao FET has resulted in a national network of 39 alumni and uniquely brings human and animal health FET candidates together to carry out invaluable investigative work that has led to the following:

• Recognition of morbidity and mortality associated with seasonal influenza outbreaks
• Expansion and improvements of influenza surveillance networks
• Determination of the susceptibility of women of child-bearing age to rubella
• Assessments of adverse events following immunization and vaccine acceptability for pandemic and seasonal influenza vaccination campaigns
• Recognition of the outbreak potential of Japanese encephalitis (JE) virus and implications for JE targeted vaccination
• Recognition and control of human anthrax outbreak
• Management by the Lao FET of 25 outbreak investigations in less than three years

The CDC Thailand Global HIV/AIDS Asia Regional Office has worked in Lao PDR since 2009, to strengthen the country’s HIV response, with a focus on both clinical quality services and building health systems capacity, including: HIV prevention in men having sex with men, counseling and testing, care and treatment, laboratory capacity, HIV surveillance, health information systems, and mother-to-child transmission. Activities include development of innovative intervention models, training curricula, guidelines, and standard operating procedures; field supervision; and data-driven program planning and decision-making for maximum disease and health impact. CDC leveraged many “lessons learned” from Thailand’s experience to establish a high quality, robust national HIV/AIDS program tailored to the Lao setting. The Regional Thailand Office team works with the Thai Ministry of Public Health, and other Thai government and academic partners, to provide joint technical assistance to Lao PDR, such as training and study visits in several areas, including pediatric comprehensive HIV care and treatment, ART management and monitoring systems, antiretroviral therapy for prevention of mother to child HIV transmission, and sexually transmitted disease care for high risk groups. HIV/AIDS work has also benefited through collaboration with WHO and partnering with the National Center of HIV/AIDS and Sexually Transmitted Infections.

CDC is working with Laos to improve their ability to prevent, detect and respond to infectious disease threats.  This work helps meet the U.S. commitment to assist at least 31 countries in reaching the targets outlined in the Global Health Security Agenda. CDC’s extensive global health presence and experience are critical to achieving these targets.