Assessing rapid response mobile laboratory (RRML) capacities in Europe and Africa to improve One Health disease surveillance activities and pandemic preparedness across two continents.

Abstract

Background: Europe and Africa are increasingly affected by (re-)emerging risk group 3 and 4, zoonotic viral disease epidemics, which not only require diagnostic BSL-3/4 laboratory capacity but also a One Health-based control strategy for efficient outbreak containment. In many European and African countries such laboratory capacity is often not readily available, and rapid response mobile laboratories (RRMLs) can play important, complementary roles in outbreak responses and pandemic preparedness activities on national, regional and international level.

Main body: The aim of the present review was to assess whether existing European and African RRML infrastructure is prepared for future One Health outbreak responses and to identify potential diagnostic gaps. Based on a literature review (2007-2021), we identified 291 mobile laboratories (Europe: 192, Africa: 99) and assessed them in respect to purpose (e.g. military, civilian), design (suitcase, modular, vehicle mounted), biosafety level, laboratory equipment, diagnostic portfolio, sample types analyzed (human, animal) and quality assurance measures. Following peaks in 2014 (Ebola/West Africa) and 2020 (COVID-19), mobile laboratory numbers have steadily increased. Whilst laboratories were originally designed to diagnose viral haemorrhagic fevers, there has been an increased focus on SARS-CoV-2 since 2020. Recently, there was a shift of African countries to develop an independent mobile laboratory capacity, rather than relying on external support for outbreak responses.

Conclusion: We identified key shortcomings of existing laboratories, as the majority only process samples of human origin (not compliant with One Health principles), only 5% have sufficient capacity to diagnose emerging risk group 3/4 (arbo)viruses, 1-10% have accredited quality assurance systems in place, and mobile laboratories are not interconnected to allow concerted national and international responses. Our results reveal the gaps that should be addressed to make future responses to zoonotic, high-consequence pathogens more effective.