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Using open research to develop a high-quality network of laboratories to survey, control and eliminate neglected tropical diseases. Laura Dean and Imelda Bates, Liverpool School of Tropical Medicine, discuss their work on the first critical step to developing this important network and the benefit of open access for its accessibility and transparency.

Laboratories are recognised as one of the weakest elements of health systems due to chronic under-investment. This results in poor laboratory infrastructure; inadequate numbers and skills of technical staff; insufficient and uncoordinated technical assistance; and a lack of diagnostic tools appropriate for low-resource settings.

Current capacity

Yet laboratory services are integral to interventions for the surveillance, control and elimination of neglected tropical diseases (NTDs) as they provide clinical and monitoring data about disease prevalence and trends, making them essential for flagging up early signs of drug resistance.

Current NTD laboratory networks are informal and specialist laboratory expertise is not well publicised, making it difficult to share global expertise and provide training, supervision, and quality assurance for NTD diagnosis and research.

Our study based at the Centre for Capacity Research at the Liverpool School of Tropical Medicine aimed to identify laboratories within five World Health Organisation (WHO) regions that provide NTD services and could be regarded as reference laboratories.

Lagging behind

Globally, few laboratories specialise in NTDs and laboratory support for NTD programmes generally provided by parasitology laboratories within national health care systems or research institutions. We identified 32 laboratories distributed across four of the five WHO regions which have potential to be regional or national reference laboratories for NTDs. Between them, these laboratories reported having the technical skills to provide expertise in 17 different NTDs, with each laboratory focussing on NTDs prevalent within their region.

As no central register of specialist NTD laboratories exists, the global laboratory infrastructure for NTD control programmes lags behind many other global health programmes which have successfully established a globally connected network of laboratories and systems for externally validating disease-specific laboratory data as recommended by the World Health Assembly.

The first step to creating a functional network

To identify and harness existing capacity and to improve efficiency, laboratories that support national NTD programmes need to be mapped and organised into a functional international network. At the top tier, there should be internationally accredited and interlinked national reference laboratories, each of which should head a pyramidal referral structure comprising

laboratories at provincial level to support more peripheral district and primary care sites involved in front-line diagnosis and surveillance.

Creating an accessible database of laboratories that includes a description of what support they can provide for NTD programmes is an essential first step in the process of establishing an international and regional NTD laboratory network.

The benefit of accessibility

We believe that all research results should be accessible, and this is especially important when working in resource poor settings. Working with F1000 allowed us to quickly publish our research and the open peer review process enabled a level of transparency rarely seen in other publishers. In addition, it is important to us that our research is listed in large databases, such as pubmed, which publishing with F1000Research allowed us to achieve.