Sustainable Laboratory Capacity Building in Sierra Leone: From Ebola to COVID-19.

The onset of the Ebola outbreak in 2014 originated in Guinea and proceeded to swiftly reach Sierra Leone and Liberia (1). Unfortunately, these nations were critically deficient in their capacity for pathogenic testing and diagnostics, the availability of healthcare workers, and their supply of epidemic prevention materials, thereby impeding their ability to address the outbreak efficiently (2). This grave scenario underscored the need for support from the worldwide community. At the time, Sierra Leone lacked the domestic capacity for laboratory testing, including that of biosafety level 3 (BSL-3). Recognizing this constraint, the Chinese government hastily dispatched a mobile BSL-3 laboratory and corresponding technicians to Sierra Leone to facilitate testing within the country. Furthermore, the Chinese government expedited the establishment of the Sierra Leone-China Friendship Biosafety Laboratory (BSL-3) within a span of three months, observed to be operational by March 2015. It is important to note that this laboratory also conducted investigations centered on the detoxification of body fluids in Ebola survivors, fueling advancements in the understanding and management of the Ebola virus (3). The laboratory has played a significant role in the prevention and control measures during the Ebola epidemic. The Ebola outbreak in West Africa underscored a lack of ability to identify and diagnose emerging and re-emerging infectious diseases. While the outbreak has since ended, it underscored the necessity of strengthening the health system to better respond to future public health crises. This was underscored to the government and health practitioners. Sierra Leone, in particular, experienced a high mortality rate due to diseases such as malaria, pneumonia, diarrhea, cholera, Lassa fever, and measles. The nation continues to bear the brunt of public health crises, experiencing significant morbidity and mortality. Consistent international efforts are crucial to building the resilience and capacity of the public health system. To this end, China CDC, in collaboration with the Ministry of Health and Sanitation, Sierra Leone, implemented a multi-year capacity building program that incorporated laboratory operational capacity development and personnel capacity building (4). This article evaluates the performance and outcomes of this program (Table 1).