TB laboratories need to be safe. TB laboratories do not need to cost a fortune. alcamilabs aims to bring the services of a TB laboratory where they are needed most through low-cost, highly-portable converted shipping containers.
alcamilabs was born in the course of work on TB diagnostics in Peru, in which the ubiquitous problem of how to deliver adequate TB control in prisons presented a significant challenge. Though it was clear that enhanced laboratory capacity was needed for the prison service it was equally clear that construction, staffing and maintenance of an on-site TB laboratory in every prison was neither desirable, practical or necessary.
So the challenge was to deliver high-quality TB diagnostic capacity from time to time without the economic burden of an expensive lab sitting around unused between campaigns. In response to this challenge alcamilabs built the first Portalab – a converted shipping container – in Lima with the support of The Wellcome Trust (UK). Prior research work in developing the non-commercial MODS (microscopic-observation drug-susceptibility) method for rapid, inexpensive detection of TB and MDR-TB (multidrug-resistant tuberculosis) by liquid culture provided the perfect tool for delivery of high-quality diagnostic testing in a short timeframe and without the need for vast incubator space.
The plan was to move the lab around the country, undertaking sequential month-long campaigns of TB testing in all the major prisons. However, just before it began, a huge earthquake struck southern Peru, destroying the hospital and with it the regional TB reference laboratory in Ica, an area historically troubled by MDR-TB.
In that moment, the versatility of the portable TB laboratory was proven. alcamilabs transported the lab down to Ica where it became the regional reference laboratory until the hospital was rebuilt. It has subsequentely been donated to the Peruvian National Institute for Health and been moved farther south to provide laboratory support in a region previously devoid of lab capacity.
alcamilabs has since moved into one additional region. In a vivid demonstration of the inverse care law, Somalia is a high TB-burden country without a single TB culture lab. In the course of a TB REACH-supported project, laboratory services have started to be upgraded and this has included delivery (from Peru) of a Portalab to Hargeisa in Somaliland.
The security situation in Somalia and in conflict-affected fragile states around the globe discourages significant investment in infrastructure such as laboratories from which personnel may need to be evacuated at short notice and which may be damaged during periods of unrest. The ability to pick up and evacuate the entire Portalab and withdraw at short notice for deployment in a place of safety is indispensable, enabling otherwise unthinkable delivery of high-quality TB diagnosis.
alcamilabs was created in an attempt to facilitate wider use of the Portalab – the design is not a secret or patent-protected and we welcome and encourage the building of container labs by others, wherever containers can be found.
