Originally, the global HPV LabNet (LabNet) was successfully established by WHO in 2005, to support the introduction of HPV vaccines, and surveillance of disease and infection.
The mission of the global HPV LabNet continues having the same foundation, but has taken a step forward aiming to achieve and support all efforts to eliminate cervical cancer in recognition of WHO’s Global Strategy for cervical cancer elimination adopted in 2018. WHO calls for 90% of girls to be vaccinated by age 15, 70% of women screened using a high-performance test (like HPV primary screen) by the age of 35 and again at age 45, and 90% of women with cervical cancer and precancer by 2030. Therefore the LabNet’s mission also includes developing laboratory expertise and infrastructure for HPV testing used in cervical cancer screening.
The recent work performed by the global HPV LabNet includes a) distribution of proficiency panels developed for cervical screening assays, b) publication of an interactive and up to date HPV Laboratory manual, c) guidance for quality assurance in HPV testing for primary cervical screening, d) guidance for confirmatory testing (re-analysis of “HPV-negative” high grade lesions or worse and, e) establishment of an e-learning platform aiming to provide e-resources for HPV researchers and laboratory users.
LabNet is nowadays supported by the Bill and Melinda Gates Foundation, and is composed of 16 national reference laboratories (NRL) distributed in 5 WHO Regions worldwide, with the International HPV Reference Center (IHRC) coordinating the network.
- Argentina
- Australia
- Belgium
- Brazil
- France
- Gabon
- Germany
- Japan
- Mexico
- Norway
- Perú
- Rwanda
- Scotland, UK
- Slovenia
- Sweden
- USA
In response to increasing global needs, additional expert laboratories may be assigned as NRLs if their corresponding authorities (national government) appoint them as such.
What is a National HPV Reference Laboratory (NRL)?
An NRL is a laboratory active in HPV testing that is appointed by a responsible government authority in their country to serve as an HPV expert laboratory coordinating efforts in quality assurance, training and communication regarding HPV testing.
What is expected from a NRL:
An NRL is expected to be active in the following four areas:
- Scientific and technical advice
- Quality assurance
- Training
- Communication
How?
1.Scientific and technical advice
– Provide scientific advice to HPV laboratories in their country, e.g. in HPV screening and in virological surveillance of HPV.
– Collaborate with national public health and research institutions, as well as with WHO and other international agencies.
– Disseminate knowledge on, and the use of, HPV international standard reagents to improve accuracy of HPV testing, including genotyping and derived information (all levels).
2.Quality assurance
– Be proficient at annual proficiency studies.
– Ensure that all HPV assays perform at acceptable levels of sensitivity, specificity and reproducibility (all levels). Critical test reagents used in WHO studies should be validated by the relevant NRL prior to utilization.
– Participate in developing guidelines and SOPs for establishing laboratory-based quality control programmes.
– Serve as a resource for storage and distribution of standardized reagents, proficiency panels and cell lines to other laboratories in their country, as required.
– Perform confirmatory testing on samples from other laboratories in the project area, if necessary
3.Training
– Contribute to developing training materials for HPV laboratory research and surveillance within its respective region, as required.
– Coordinate and participate in laboratory training workshops for staff within the laboratory network.
– Assure that sufficiently trained and qualified personnel are available to fulfill the tasks related to HPV detection.
– Provide training on the appropriate collection of clinical samples for HPV testing and typing.
NRLs should have involvement in public health and should preferably be able to provide evidence of efforts in improving it. Reference laboratories would offer training courses (theoretical and practical) for staff members of other laboratories in their country. Laboratories should have experts in virology, become internationally recognized, and should produce publications in the relevant area. Diagnostic routine work must be a separate function, and can be allowed, provided other laboratory obligations are fulfilled. Testing performed as part of network activities should not be used for clinical diagnosis.
4.Communication
– Promote and participate in the exchange of information between national, regional and reference laboratories, and the HPV laboratory network.
– Within determined timelines, provide information to WHO on laboratory activities, and an annual compilation of virological surveillance.
5. Evaluation of novel HPV tests
– NRL are to evaluate and validate novel HPV assays developed within their countries.
What can the Global HPV laboratory Network do to help new national reference laboratories?
Laboratories wishing to approach the responsible authorities in their countries can request a letter of support from the International HPV Reference Center, detailing the support that the global HPV LabNet will provide in supporting the establishment and continuously improved operation of the new NRL.
NRLs will always be able to obtain bulk HPV proficiency panels for use in their respective countries (regions) at no cost.
NRLs are entitled to participate in the networking activities and international collaborative studies performed by the HPV LabNet.
NRLs will always be able to obtain panels for evaluating novel HPV tests.
Do you want to contact an NRL? Click here to see where to find them, their competence and more.