One of the central efforts of EU Twinning Project “Strengthening the capacity of Serbia’s health sector for communicable disease surveillance” has been placed on reinforcing the system of the Serbian microbiology national reference laboratories (NRLs). The current system was established in 2008, and the NRL mandates have been widely dispersed across 25 NRLs. Such an extensive structure of NRLs may jeopardize effective coordination and efficiency of the reference system. Besides, there has been no systematic budget funding of the reference functions. No organization has the mandate for an overall coordination of the NRL system, and there is no information collected centrally on the volume or results of NRL activity in each of the nominated NRLs.
The proposal for the re-organisation of the Serbian network of microbiology NRLs was developed by Petri Ruutu and Saara Salmenlinna from the Finnish Institute for Health and Welfare. The experts visited a few NRLs in Serbia to interview the staff and collect data about the performance of reference diagnostics. Besides, Batut Institute conducted an in-depth survey of the NRL functions performance. The proposal uses Finland’s (and some other Nordic countries’) experiences and practices of organizing the NRL network where the population size is comparable to Serbia’s and distances may even be longer. Also, the microbiological methodology used in modern NRL testing work is changing rapidly. Genomic testing of microbes and samples by whole genome sequencing (WGS) is replacing older methods. The major advantage of the new NRL methodology is that the same laboratory processes and equipment can be used for a great diversity of microbial testing needs. Besides, the proposal argues that keeping the reference functions in fewer laboratories would expedite the logistics of transportation of microbial isolates and samples. And nominating one organisation as the coordinator of the NRL network would assure better effectiveness and transparency of the overall NRL system.
These and other questions were raised at the expanded meeting of Serbian public health actors, including Serbian Ministry of Health (MoH), which discussed the NRL reorganization proposal on 15 May in Belgrade. The discussion went quite dynamic and vibrant keeping in mind the proposal suggested reducing the number of NRLs to four. The meeting participants agreed that without earmarked funding from the budget the NRL system will never work, re-organised or not. Serbian colleagues did an exercise to estimate the costs the NRL system would require annually. Valuable comments and inputs were collected, the proposal will be updated and submitted to the Serbian MoH for further approval procedures.