Indonesia is now the country with the highest number of human fatalities caused by the H5N1 influenza virus, often referred to as ‘avian flu’. In an effort to tackle the deadly disease, the prestigious Eijkman Institute in Jakarta has built a new biosafety level 3 (BSL3) laboratory – with the help of DNV.
“Indonesia must remain alert to the dangers posed by avian influenza and other emerging diseases,” says Professor Sangkot Marzuki, Director of the Eijkman Institute. “This is a major issue with international implications; of the 105 cases confirmed to date, 84 have been fatal.”
Recognising the importance of safety at its new laboratory in Jakarta, Professor Sangkot and his team asked DNV to certify the physical features of the laboratory, and are now working together to devise a safety management system.
Capability push
Professor Sangkot explains, “Funding for the new BSL 3 facility was approved by the government in 2005. We wanted to build it relatively quickly as we need the capability to do work on this and other diseases in months and not years. We recognised that we needed an independent group to oversee the project and decided on DNV. DNV’s experience and approach was invaluable in making sure we got an excellent facility, despite the challenges in managing such a project in a developing country. We recently completed the development of the facility and are now working with DNV to develop our safety management system.”
In recent years, the Institute has responded to the challenge of emerging diseases such as avian influenza by working closely with the Ministry of Health NIHRD (National Institute for Health Research and Development).
The role of the Eijkman Institute in the national response to avian flu includes:
providing scientific and technological support to the national diagnostic laboratory network, including capacity building
leading research, in particular genomic research
providing a major back-up diagnostic facility in emergency situations
Adopted measures
Avian influenza was detected in poultry as far back as 2003 in Indonesia, when it affected the poultry industry in central Java. However, the disease began to receive intensified national and international attention after it took a toll on human life in 2005. Subsequent to bird flu breaking out in poultry, the Indonesian government adopted measures that meet the World Health Organisation (WHO) and Food and Agricultural Organisation (FAO) standards to cope with the disease.
In addition to culling 30 million chickens and vaccinating 50 million fowl, the government has also ensured that 44 hospitals and 300 public clinics across the country are prepared to treat bird flu cases. The Ministry of Agriculture is also stepping up animal surveillance and rapid-response activities to control the virus in poultry.
“To supplement these efforts, we have fast-tracked the development of our facility to provide support to the national diagnostic laboratory network,” says Professor Sangkot, a research specialist in the area of infectious diseases and human genome diversity.
Best-practice management system
Commenting on DNV’s role, Dr Paul Huntly, global leader for biorisk services, says, “Initially, the main focus was to establish the physical safety features of the laboratory. Our scope of work was then extended to include the development of an effective, best-practice biorisk management system, incorporating safety management process and associated procedures. This work is ongoing and has been supported with funding from the Norwegian Ministry of Foreign Affairs. The longer term aim is to produce a template which will be of value to other facilities in Indonesia and elsewhere in the world.”
Dr Huntly points out that DNV has recently developed the required element based structure for a comprehensive biorisk management system, and this has been peer reviewed by a number of eminent groups and found highly appropriate in describing the scope of activities for biocontainment laboratories.
Not without risk
He explains, “Typically, these facilities conduct research, diagnostic and production activities on many organisms of serious potential threat to humans and animals, and are designed to ensure that the risk of worker exposure and release of materials to the community or environment is minimised. However, the work of such facilities is not without risk and there have been several cases of laboratory acquired infection (LAI), perhaps most notably in recent years were the three LAI’s with SARS virus in Singapore, China and Taiwan. A feature of these cases is that often there is a failure of the safety management system, as opposed to deficiencies in the facility and equipment employed.”
He continues, “It is also our experience that in this field a great deal of emphasis is placed on the design and construction of the facility itself, but rather less attention can sometimes be paid to how the facility will be run and the staff deemed competent with regard to biosafety and biosecurity. This can be partly due to the difficulty in finding experienced personnel available in this field, but also to a lack of the necessary structures and frameworks around which facilities can build adequate biorisk management systems. Such problems exist in Europe and North America, but can be particularly severe in developing countries.”
International benefits
As the Eijkman Institute is the leading national laboratory in Indonesia, Dr Huntly firmly believes that capacity building of biosafety and biosecurity (collectively known as biorisk) at this institute will have positive ripple effects, at a national level, with the potential for further international benefits from the project.
“The aim is to develop and pilot a system for Eijkman Institute, but also to ensure that a generic model and supporting tools are developed for implementation in other similar institutes in Indonesia and elsewhere,” says Dr Huntly.
Considering the urgent need for laboratory research and diagnostic capacity in Indonesia, Professor Sangkot firmly believes there is a “large and growing need for such support not only in Indonesia, but in other regions who are struggling to manage real issues of potential global impact.”
“We greatly appreciate the support provided by DNV and the Norwegian Ministry of Foreign Affairs. Indeed, we welcome any assistance from the world community,” he says and concludes, “At the end of the day, this is a global problem. If we reduce the risk here, this will bring positive benefits to the international community. ”