With support from the UK Health Security Agency (UKHSA) International Health Regulations Strengthening Project (IHR-SP) and the National Institute of Health (NIH), Sindh province hosted the inaugural review of its newly established provincial Integrated Disease Surveillance and Response (IDSR) laboratory network.

In February 2025, Sindh became the first province in Pakistan to formally establish an IDSR Laboratory Network, comprising 50 public sector laboratories,14 at the tertiary level and 36 at the secondary level. This advancement delivers on commitments in the National roadmap for IDSR, enhancing Pakistan’s capacity to detect and respond to disease threats.

With technical assistance from UKHSA, Sindh also pioneered digital laboratory data reporting via DHIS-2, integrating provincial lab surveillance with the national IDSR system. Weekly data reporting has achieved 92% compliance rate following training of 100 laboratory staff from across the network’s laboratories.

Fortnightly virtual meetings co-led by UKHSA’s IHR-SP, the Provincial Publich Health Reference Laboratory (PPHRL) and the Sindh Health Department are supporting continuous monitoring and quality improvement of the network, reinforcing a collaborative model for strengthening disease surveillance through laboratory systems.

Reviewing Sindh’s progress so far

The first review meeting of the IDSR Laboratory Network took place in Karachi on 19–20 March 2025, bringing together laboratory representatives to evaluate progress, identify gaps, and propose practical solutions based on the initial eight weeks of lab reporting.

UKHSA’s in-country microbiologist presented key trends, achievements, and reporting gaps. Each laboratory updated on their progress and challenges and participants engaged in group discussions to raise critical issues and co-develop realistic, lab-specific solutions.

Several actionable recommendations emerged from the discussions, including recruitment of dedicated staff for laboratory data entry, provision of essential IT equipment and reliable intertnet access at all laboratories of the network. The recommendations were formally submitted to provincial and federal authorities for endorsement and follow-up.

Pakistan IHR-SP’s Commitment to System Strengthening

At the close of the session, UKHSA, the Provincial Health Department, and NIH jointly reaffirmed their commitment to pursuing  system strengthing prioirites to improve the quality and timeliness of laboratory data. As part of this, UKHSA IHR-SP’s IT and laboratory teams will develop video tutorials to support laboratory staff in effective and standardised DHIS-2 data entry.  Additionally, UKHSA was requested to provide support for the implementation of an open-source electronic Laboratory Information Management System (eLIMS) across the network laboratories, to help enhance data quality and timeliness. Implementation will begin with two pilot laboratories.

Plans were also initiated to expand the Sindh Provincial IDSR Laboratory Network to include private sector laboratories  for the first time in Pakistan. This marks a significant step forward to improve the timeliness, completeness and coverage of laboratory data reporting even further, as private labs have historically not been part of any formal public health laboratory network. The expansion process will began with initial consultations with the Sindh Healthcare Commission, the regulatory body for private hospitals and laboratories in the province.