Building back better a more resilient health system: WHO supports Maldives to successfully run COVID-19 Genomic Sequencing for the very first time

The Maldives successfully ran COVID-19 Genomic Sequencing on the MiSeq Machine for the first time ever, with technical support from WHO. This breakthrough was achieved during the ‘Sequencing and Bioinformatics training’ at National Health Laboratory (MFDA) conducted by WHO and Institute of Genomics and Integrative Biology (IGIB) which was aimed to expand capacity and establish Genomic Sequencing in the country.

The extensive hands-on training was conducted for participants from National Health Laboratory, Indira Gandhi Memorial Hospital Laboratory, Maldives Food and Drug Authority and Maldives National University.  Providing the workforce with these skills and tools beyond the Ministry of Health will lay the foundation and pave the path towards success for Indhira Gandhi Memorial Hospital and Maldives National University in potentially establishing their own sequencing capacities in the future.

During the COVID-19 pandemic, The Republic of Maldives faced many hardships particularly due to the lack of in-country capacity to sequence specimens. Establishing the capacity to sequence COVID-19 positive samples was a particularly important requirement to identify and prepare for the any variants that could be circulating in the country. A technology as such helps the country predict the waves of COVID-19 cases, including the rise and fall of cases based off which Public Health and social measures are implemented in the country.

At the peak of the pandemic, WHO was actively supporting the Government of Maldives with transporting specimens to laboratories in WHO Collaborating Centers based abroad. The process was time-consuming, logistically difficult, costly, and further added to the workload of overseas laboratories whose countries were experiencing high numbers of COVID-19 cases themselves.

In addition to this, Indhira Gandhi Memorial Hospital was supporting majority of the COVID-19 testing with samples which were inbound from all over the nation including peripheral islands and resorts. The Institute of Genomics and Integrative Biology (IGIB India) also accepted samples from WHO (50-100 samples per week) and supported in sequencing samples from Maldives which helped the country to predict the COVID-19 situation and adjust public health and social measures as per the variants emerging globally.

To overcome majority of hurdles, Ministry of Health long envisioned to establish Genomic Sequencing technology in the National Health Laboratory. The Ministry also planned to expand the National Health Laboratory to include components of Public Health, which is being supported by WHO. The National Health Laboratory is an independent laboratory and thereby is an added advantage, as they can support Ministry of Health to make public health interventions and evidence-based decisions for the public in a timely manner.

“The work begins with COVID-19 sequencing, but with this technology, we have the scope to expand further to include testing for Cancer, Thalassemia, and other pandemic prone diseases as well.” said Dr Nazneen Anwar, WHO Representative.

A state-of-the-art sequencing machine was procured for the Government of Maldives, selected in consultation with WHO experts. The technology is ideal for the country’s population and for running moderate number of samples per run. WHO also supported the initial batch of reagents and consumables required for running the sequencing cycles in Maldives. Furthermore, supporting equipment and mechanisms were provided by WHO to ensure installation, maintenance, and upkeep of the machine. USAID has been a key partner in providing WHO and Maldives Food and Drug Authority with aid and equipment to set up a quality-assured Genomic Sequencing laboratory for the first time in the Maldives. 

“This is surely a groundbreaking achievement and a steppingstone to further enhance diagnostics and laboratory capacity in the Maldives.” said Dr Nazneen Anwar, WHO Representative “Thanks to this partnership with IGIB, we are receiving software in Maldives which helps the bioinformatics, data entry and updating for global data platforms. With the plans to expand National Health Laboratory into a BSL 3 Lab in the next chapter, we are grateful to have partners like IGIB and their world-class experts to lead and guide Maldives and enhance country capacity.”

Throughout the pandemic, the joint efforts of WHO and Ministry of Health, proactive measures, and critical transfer of technology by WHO to strengthen laboratories have helped Maldives manage COVID-19 infections and reopen borders which boosted the country’s economy. Moving forward; medical teams, laboratories and public health experts will be better prepared and equipped to provide scientifically accurate, life-saving interventions.