Dr. Ateba Etoundi Aristide Otto, Director of Pharmacy, Medicine and Laboratories, Ministry of Public Health, talks on regulating medical laboratory practice.

What does it take to open a medical laboratory in Cameroon?

Specific documents are required of people who want to open medical laboratories. These documents are specified in a decree signed by the Head of Government. The decree dates back to 1990 and needs to be reviewed. But there is a document that gives the conditions that should be fulfilled in order to be authorised to open a laboratory. First of all, you need to be a medical biologist.

We have to crosscheck the certificates to know the level of training, the premises in which the applicant intends to operate, the equipment to be used and the people to work with. The support staff also needs to have particular qualifications. The applicant has to indicate the analyses he intends to do. Depending on the type of analysis, we will ask for particular equipment to be acquired. 

A good number of laboratories have obsolete equipment and the staff are not up to date with new technologies. What impact does such a situation have on the test results produced by these laboratories?

The situation is a matter of great concern to the Ministry of Public Health. The regulations are obsolete – dating back to 1990. So, there are many things that need to be reviewed. Some laboratories that do not have the appropriate staff and equipment don’t even know the standard operational procedures to respect. In most cases, the results are not accurate and therefore not reliable. If you investigate, you will even find out that the authorisation they have is not correct.

The problem of laboratories is on the same level as that of fake drugs sold on roadsides and in markets. No matter how much you combat them, they will still come back. There are laboratories that shouldn’t operate, but since they generate revenue, they still continue. The fake test results they produce lead to wrong diagnoses and prescriptions; thus the treatment might even be worse. So, the issue is really a matter of great preoccupation to public health authorities.

In some cases, erroneous laboratory results have ended up in court. What is government doing to prevent the situation?

When such a case is discovered, the first thing is to close down the laboratory and sanction the person who carried out the wrong analysis. Legal action is not ruled out. In any hospital or health facility, the specialty that is carried out is by professionals who have the appropriate qualifications. You cannot say you offer gynaecology when there is no gynaecologist working there. You cannot say you are doing surgery when you don’t have any surgeon.

 It is the same with medical biology. You cannot say you will open a medical biology laboratory in a health facility when you don’t have the qualified staff. In some cases, somebody who happens to have worked in a laboratory elsewhere describes himself as a biologist and carries out analyses, giving out wrong results.      

Are there refresher courses for practising laboratory technicians and scientists?

This is why we say that the regulations are obsolete. Normally, practitioners should be periodically obliged to go for refresher courses. But the current decree does not oblige them to do so. You can have somebody who graduated in the 1980s and is still practising with methods that have been forgotten. He doesn’t know and does not have the appropriate equipment; so he gives out wrong results.

Every year, there are laboratory technicians of different levels who graduate and are sent to different hospitals. Some are trained in private institutions and thereafter open their laboratories. Others don’t undergo good training, but due to the financial interest, they claim to be already laboratory technicians and begin practising.