^{10th Annual} Medical Microbiology Summit & Expo

Purpose: The presentation attempts to compare an advanced microbiology lab in California, with a lab in a rural India, one in a provincial hospital in Cambodia and one in a remote hospital in Tanzania.

Introduction and Observations: Microbiology is the pillar of infectious disease diagnosis and treatment. Contribution of clinical microbiology cannot be underestimated or overlooked. Strengthening of services is mandatory to achieve health goals laid out by organisations like WHO or Gates Foundation.

However, diagnostic microbiology services offered even for certain diseases like Malaria, HIV, TB or diarrhoeal diseases that are more prevalent in resource poor countries, differ remarkably between various labs. Many factors contribute to this disparity. For any lab, compared to routine tests offered in Haematology, Biochemistry, Serology, and Urinalysis, providing reliable basic microbiology services is challenging. In less developed regions it is a Herculean task. Based on personal experiences of working or visiting labs in different countries and settings, some observations stand out. To begin with, there is a lack of awareness amongst physicians and common folk about the

contribution of clinical microbiology towards patient care. There is little regulation on antimicrobial susceptibility testing and therapy starting from drug

manufacturing, testing and availability. QA/QC systems are not in place or not followed in the right manner. Infrastructure and maintenance costs can be formidable. Better technical skills are required for troubleshooting and reporting results. Communication between lab staff and clinicians is critical but minimal. Sterilization or safe disposal of microbiology waste adds another layer of difficulty. Return of investment is not attractive for the technician, the lab or hospital offering services. Unreliable supply of water or electricity hampers many aspects of workflow. For various such reasons, microbiology is given low priority in poorer regions. One is confronted with many burning questions. Is the disparity in different settings, fair? Whose responsibility is it to step up lab capacity building? Despite these obstacles and pitfalls, significant changes have taken place in some health care centers due to the efforts of a one odd passionate microbiologist, pursuance of astute physicians, remarkable work of organisations like LabCAP, DMDP, CDC, etc., by inventors to simplify diagnostic tools and make them affordable yet reliable and by global pressure to step up containment of diseases. Conclusion: More of us need to get involved, efforts need to be constant and probably faster to keep pace with the growing population and spread of diseases.