Charting pathways: Expert consensus on priorities for strengthening communicable disease surveillance in Serbia

In a significant gathering held on January 25, 2024, at the Institute for Public Health of Serbia "Dr Milan Jovanović Batut", the expert groups on health policies and epidemiological surveillance convened for their second meeting. The expert groups were established in late August 2023 by the decision of the Serbian Minister of Health to develop the regulatory and normative framework of the communicable disease surveillance system equipped with the procedures, datasets and standards in line with EU/ECDC requirements. The expert groups have been set up to facilitate the implementation of EU Twinning project “Strengthening the capacity of the Serbia's health sector for communicable disease surveillance". The members of the expert groups are leading specialists from the Serbian Ministry of Health, the network of the institutes of public health, including the Institute of Public Health of Serbia, University Clinical Centre of Serbia and the network of the national microbiology reference laboratories.

The meeting initiated with a joint session of both expert groups where notable presentations were delivered, focusing on the organization of diagnostic microbiology's licensing and quality control system. Dr. Saara Salmenlinna detailed Finland's approach to external quality assurance (EQA) in microbiology laboratories, emphasizing the mandatory licensing and the strategic implementation of EQA to enhance laboratory reliability and patient safety. This presentation set a foundational context for further discussions on improving Serbia's clinical microbiology standards to align with EU directives.

Subsequent presentations shed light on Serbia's current practices in external quality assurance within its national reference laboratories (NRLs). Experts from various NRLs highlighted the achievements and challenges, particularly in financing, and shared insights into laboratory quality management and the necessity of external quality assessments.

The expert groups then proceeded to separate sessions. The lively discussions held by the expert groups underscored the following priorities towards a more robust system of communicable disease surveillance system and enhanced microbiology laboratory excellence in the country:

-        the legislative and regulatory framework as well as relevant technical documentation require amendments, e.g. the list of notifiable infections and implementation of the case definitions in compliance with the ECDC requirements.

-        the experts will continue consultations and discussions regarding possible solutions and approaches for the reorganization of the network of national microbiology reference laboratories. The experts have agreed that the execution of the reference function will require financial support from the state budget.

-        the question of systematic quality control of the clinical microbiology laboratories’ performance is critical from the perspective of the patient safety and reliability of laboratory results. The experts will explore and discuss possible mechanisms for quality assurance by laboratories and propose a model appropriate for the Serbian context.

-        the experts agreed to establish a task force to develop a guidance for biosafety and biosecurity in the diagnostic microbiology laboratories

-        the experts will finalize the Algorithm for Microbiology Diagnostics (collection, handling, and transportation of samples) and submit it to the Ministry of Health for approval.

-        Last but not least, the experts will prepare and conduct a survey among diagnostic and reference microbiology laboratories regarding their respective testing methodologies, practices and performance of mandated functions.   

 

The next meeting of the expert groups is scheduled for May 2024.