Imagine a Nigeria where every lab test is timely, accurate, and rock-solid reliable—no matter where you are. That’s the future ECEWS, an indigenous NGO, is building. Over the years, systemic challenges such as unreliable electricity, equipment downtime, fragmented services, and limited quality assurance have undermined laboratory performance nationwide.

ECEWS has emerged as a leader in turning these challenges into opportunities. Supported by PEPFAR (US CDC and US Department of State), the Global Fund, and other global health initiatives, ECEWS has implemented bold, forward-looking interventions that prioritize sustainability, innovation, and government ownership. These efforts are not only improving patient outcomes but also building the foundations of a stronger national diagnostic system.

Proven Achievements in Laboratory Systems Strengthening

1. Solar Powering Laboratories for Reliability:

For decades, power shortages have threatened the accuracy and consistency of diagnostic testing in Nigeria. ECEWS responded by installing solar power systems in PCR laboratories and health facilities, guaranteeing uninterrupted operations for PCR machines, biosafety cabinets, and cold-chain systems for reagents and client sample storage.

The results speak for themselves:

• A 50% reduction in test failures and sample rejections.
• Significant savings on diesel and reagent wastage.
• Faster turnaround times lead to improved patient care.

This model demonstrates how renewable energy can reinforce diagnostic resilience while advancing Nigeria’s global health security agenda.

2. Elevating Quality through Inter-Laboratory Comparisons/Continuous Quality Improvement:

Diagnostic credibility relies on consistent results across multiple facilities. ECEWS has driven inter-laboratory comparison exercises aligned with WHO-AFRO’s Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA). The impact includes strengthened laboratory performance through external quality assessment (EQA), institutionalized corrective actions, and enhanced trust in laboratory outputs both nationally and internationally.

3. Championing Laboratory Recognition and Accreditation

Accreditation under ISO 15189 is a gold standard for laboratory excellence. Through mentorship, document development, and embedding Quality Management Systems (QMS), ECEWS has supported laboratories to achieve accreditation readiness. UUTH Uyo and COOUTH Awka are now ISO 15189:2012 accredited, while several others have advanced their SLIPTA star ratings. The two molecular laboratories are currently being supported for transition to ISO 15189 2022 accreditation before December 2025. 

4. Local Solutions for Program Equipment Sustainability

Laboratory downtime, particularly from faulty centrifuges, once stalled viral load testing and delayed critical services. Rather than relying on costly external vendors, ECEWS empowered the host government’s biomedical engineers to repair and maintain essential laboratory equipment.

This approach has:

• Restored stalled services by rapidly repairing backup centrifuges.
• Reduced dependence on private contractors.
• Extended equipment lifespan, cutting costs, and reducing e-waste.
• Elevated the role of state biomedical engineers as champions of sustainability.

5. Improving Molecular Laboratory Waste Management

Molecular laboratories generate effluent containing guanidinium thiocyanate (GTC), a hazardous chemical that poses risks to the environment and public health if not properly managed. ECEWS collaborated with relevant stakeholders to introduce protocols and capacity building and put in place a centralized system to ensure safe handling, neutralization, and disposal of GTC-containing effluent.

Impact:

• Reduced environmental contamination risks.
• Improved laboratory biosafety and biosecurity standards.
• Strengthened compliance with international laboratory waste management requirements.

6. Establishing State Laboratory Technical Working Group (TWG)

Recognizing the importance of governance and coordination, ECEWS has supported the establishment of State Laboratory Technical Working Group in Cross River State. This platform brings together stakeholders from government, implementing partners, and professional bodies to coordinate, review performance, and align interventions.

Impact:

• Improved state-level ownership and accountability for laboratory services.
• Enhanced coordination of resources and interventions.
• Streamlined alignment with national laboratory policies and standards.

Ongoing Work to Strengthen Laboratory Systems

ECEWS continues to pursue system-wide improvements with two flagship interventions:

• Integrating HIV Services into Routine Laboratories: Breaking away from verticalized models, ECEWS is embedding HIV diagnostics into routine health facility operations. This ensures sustainability, reduces duplication, and enhances patient access to comprehensive care.

• Driving Digital Transformation: Through LAMIS–LIMS integration and Remote Sample Login implementation, viral load (VL) and early infant diagnosis (EID) workflows are being digitized. Test requisition and electronic transmission of results are now the order of the day. This innovation improves the timeliness of results, reduces turnaround times, prevents loss-to-follow-up, and strengthens data-driven decision-making.

Conclusion

ECEWS is not stopping here. We’re charting an ambitious agenda for the future to solidify Nigeria’s health security. Our efforts are not just about laboratories; they are about health security, sustainability, and building systems that last. By continuing to deepen integration, expand digital transformation, and cultivate leadership, ECEWS is positioning Nigeria as a regional hub of excellence for health systems and diagnostics resilience across Africa.