Eliminate Yellow Fever Epidemics (EYE) Strategy & the Laboratory Technical Working Group (LTWG)

Jean-François (Jeff) Lemaire

Eliminate Yellow Fever epidemics (EYE) strategy 

Yellow Fever (YF) is a mosquito-borne viral disease endemic in sub-Saharan Africa and Central/South America. An effective human vaccine is available but due to the natural occurrence of YF in non-human primate populations, this viral disease cannot be eradicated and outbreaks in human populations will always be possible. Following major outbreaks in Angola, Democratic Republic of Congo, and Brazil in 2016, the EYE strategy was developed by a coalition of GAVI Alliance, United Nations Children’s Fund (UNICEF) and WHO. Launched in 2017, the EYE strategy is an unprecedented initiative. With more than 50 partners involved, the EYE partnership supports 40 countries in Africa and the Americas at risk of Yellow Fever to prevent, detect, and respond to YF-suspected cases and outbreaks. The EYE strategy aims to protect at-risk populations, preventing international spread, and containing Yellow Fever outbreaks rapidly. By 2026, it is expected that more than 1 billion people will be protected against the disease by meeting the demands for Yellow Fever vaccine.

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Eliminate Yellow Fever Epidemics Laboratory Technical Working Group (EYE-LTWG) 

The advisory Eliminate Yellow Fever Epidemics Laboratory Technical Working Group (EYE-LTWG), formed in 2017, is part of the EYE strategy. It consists of technical experts from various organizations around the globe involved in arthropod-borne virus (arbovirus) science and specifically in YF laboratory activities. Through guidance provided by the EYE-LTWG, the EYE strategy supports the improvement of laboratory capacity in the Global Yellow Fever Laboratory Network (GYFLaN) to better inform immunization programs. The EYE-LTWG functions alongside and in collaboration with three other EYE strategy working groups in support of the EYE strategy: the Demand & Supply, Vaccine Delivery, and Risk Analysis Working Groups.

A series of Podcasts “EYE on yellow fever” describes some of the activities within the EYE strategy since inception and is also available on Spotify, Apple, Deezer, Amazon, Google and Gaana.

Mission of the EYE-LTWG

The mission of the EYE-LTWG is to support the EYE strategy through contribution to its third objective: Containing outbreaks rapidly.

The EYE-LTWG priority work areas are:

  1. Strengthening Laboratory Network Capacity & Advising Countries on Laboratory Best Practices
  2. Support Regional Reference Laboratories in the GYFlaN 
  3. Monitor, identify and resolve performance challenges in the GYFLaN 
  4. Assess network laboratory capacity through molecular & serology external quality assurance (EQA)
  5. Lend support to laboratory surveillance efforts
  6. Research and development

During 2018, prior to developing a workplan for the EYE-LTWG, a comprehensive survey of the existing capacities of YF laboratories in Africa was undertaken, involving in-person laboratory assessments of facilities, staff, and procedures. This exercise provided key insight into the needs of the GYFLaN and helped to formulate the workplan for the EYE-LTWG. This work is described in this paper. 

Achievements of the EYE-LTWG to date

A number of significant steps in support of the EYE-LTWG mission have been achieved to date, each of which relates to 3 or more priority work areas. These steps include: Image1.jpg

  • Preparation of global laboratory testing guidance for yellow fever
  • Evaluation of an accessible commercial assay for molecular diagnosis, culminating in a report and publication of the evaluation. This test is now included in UNICEF Supply Catalog, is supported for procurement by Gavi, and is being implemented for routine use in the GYFLaN 
  • Evaluation of new commercial ELISA and lateral flow YF serological assays for future use within the network 
  • Market shaping and procurement of commercial YF assays through expression of interest calls and product listing through coordination with Gavi and UNICEF Supply Division 
  • Provision of guidance on the procurement and delivery of reagent/consumable bundles and critical laboratory equipment including biosafety cabinets, ELISA and RT-qPCR instrumentation in coordination with Gavi and UNICEF Supply Division 
  • Expert contributions to regional and national trainings on YF diagnostics with broad curricula covering all basic aspects of YF molecular and serological diagnosis. Intensive practical sessions have been facilitated in the African Region and in the Region of the Americas. Examples include the 2020 workshop in Mexico City 
  • Contribution of guidance to EYE Strategy’s international sample transport operations (EYE.Ops) established in 2019, which significantly improved the international shipping of YF specimens 
  • Execution of an external quality assessment (EQA) exercise for serological diagnosis of YF across the GYFLaN 
  • Harmonization of standard operating procedures (SOPs) 
  • Compilation of a comprehensive YF Laboratory Manual 
  • Sourcing of serological controls for EQA and test validation 
  • Provision of expert content material for this website (a.k.a EYE-LABS) and the GYFLaN 
  • Initiation of field trials to support molecular testing 

Yellow fever fact sheet

The WHO YF fact sheet contains key facts and details about yellow fever. The YF Q&A and News is a quick resource for additional information.