Royal Centre for Disease Control Recognised as a NIC in the WHO Global Influenza Surveillance and Response System

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Tshering Dorji

In a remarkable accomplishment, the Royal Centre for Disease Control (RCDC) has been officially recognized by the World Health Organization (WHO) as a National Influenza Centre (NIC) in the WHO Global Influenza Surveillance and Response System (GISRS). This recognition serves as a testament to Bhutan’s unwavering commitment to influenza surveillance and the substantial advancements made over the past decade.

Since the 2009 H1N1 influenza pandemic, Bhutan has been diligently working to enhance and sustain its virological surveillance of influenza. The pivotal moment arrived when Bhutan’s National Reference Laboratory, housed within the Virology and Molecular Laboratory at RCDC, received the distinguished honor of becoming a NIC in the WHO GISRS. This significant development signifies Bhutan’s exemplary efforts in fortifying its laboratory capacity for influenza detection.

To bolster its influenza surveillance capabilities, Bhutan established a sentinel influenza surveillance system, which underwent a transformative digitization process. This forward-thinking approach played a pivotal role during the COVID-19 pandemic as Bhutan swiftly expanded its existing influenza surveillance system and designated additional hospitals as universal surveillance sites for detecting the SARS-CoV-2 virus.

Recognizing the importance of continuous improvement, the RCDC worked closely with the WHO and partner agencies, including the US Centers for Disease Control and Prevention (CDC). In 2018, RCDC expressed its keen interest in becoming an NIC within the WHO GISRS. A rigorous laboratory assessment, facilitated by the WHO South-East Asia Regional Office (SEARO) and the WHO Collaborating Centre (CC) at the US CDC, was conducted. The assessment utilized the WHO laboratory assessment tool (LAT) for NICs, and various areas were identified for further strengthening. These included equipment maintenance, locally adapted standard operating procedures, specimen transportation, and quality management.

Determined to address these areas of improvement, the RCDC collaborated with the WHO and the US CDC’s WHO CC to implement necessary measures. The dedicated efforts of RCDC were clearly demonstrated during the response to the COVID-19 pandemic, with significant advancements made in enhancing the overall testing capacity at their virology and molecular laboratory. A follow-up remote assessment was conducted in 2021 to evaluate the progress made by RCDC.

The final assessment revealed the resounding success of RCDC’s efforts in improving and maintaining laboratory standards essential for achieving NIC recognition by the WHO. Despite encountering certain persistent challenges, such as equipment maintenance and human resource turnover, RCDC has implemented measures to ensure the high quality and safe testing of influenza viruses. Furthermore, RCDC actively shares influenza viruses with WHO CCs, actively participates in WHO’s global external quality assurance program conducted annually, and dutifully reports laboratory data to FluMART.

Following a recommendation from the WHO South-East Asia Regional Office, the WHO Global Influenza Programme made a significant announcement in April 2023. RCDC, Bhutan’s Royal Centre for Disease Control, has been officially recognized as the latest NIC within the WHO GISRS. This recognition solidifies Bhutan’s status as a vital contributor to global influenza surveillance efforts and affirms its pivotal role in monitoring and responding to influenza outbreaks effectively.

Lyonpo Dasho Dechen Wangmo, Ministry of Health said, “I think it is gearing toward Bhutan trying to establish a regional centre of excellence for infectious disease both in terms of research and development. When we become a reference laboratory we also have the opportunity for further research and development”.

The achievement of becoming a National Influenza Centre is a testament to Bhutan’s dedication to public health and their relentless pursuit of excellence in influenza surveillance. With this milestone, Bhutan stands as an exemplar for countries around the world in their quest to combat the threat of influenza and safeguard the health and well-being of their citizens.

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