With an acute public health event reported every four days on the continent, it is more important than ever before for African countries to be able to respond to health emergencies. African health ministers today adopted a 10-year regional strategy that aims to strengthen integrated disease surveillance and response and mitigate the devastating impact of outbreaks, such as Ebola.
Africa has more outbreaks and other health emergencies than any other region of the world, and many of them could be prevented or controlled through proven public health interventions.
Worryingly, recent analysis by the World Health Organization (WHO) indicates that emerging and re-emerging infectious diseases and other public health emergencies are on the rise, predictably in certain areas and unpredictably in other places. This increase is largely attributed to the growth of cross-border movements and international travel, increasing human population density and informal settlements along with climate change impacts and changes in the way humans and wild animals interact. More than 80% of the public health emergencies in the WHO African Region between 2016 and 2018 were due to infectious diseases.
The new strategy aims to ensure that countries can cope with major outbreaks and other health emergencies. It is crucial for all countries to have an effective surveillance system, which can track common diseases and set off alarms for the timely containment of disease epidemics or for early detection and investigation of any abnormal clustering of cases or deaths of a new event.
The Regional Strategy for Integrated Disease Surveillance and Response 2020–2030 was adopted by health ministers during the 69th session of the WHO Regional Committee for Africa, which is taking place in Brazzaville, the Republic of Congo. The Regional Committee is the governing mechanism involving health ministers from all 47 Member States of the WHO African Region.
The new strategy builds on more than 20 years of working with a comprehensive, evidence-based integrated surveillance system that ensures countries stay a step ahead of many dangerous pathogens.
“The current Ebola outbreak in the Democratic Republic of the Congo is a poignant reminder of the importance of a strong surveillance system,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “Only when every case is promptly detected, quickly hospitalized and offered timely medical care – and all close contacts vaccinated and properly monitored – will the Ebola outbreak end. Equally important, devastating outbreaks can be ‘nipped in the bud’ if cases are quickly detected before they widely spread in communities.”
The regional strategy urges the 47 WHO Member States to establish and sustain robust public health surveillance and resilient health systems and to commit the necessary financial resources (domestic and external) for priority interventions, including: ensuring good leadership and vigorous accountability frameworks, promoting the availability of skilled health workers at all levels, providing feedback to communities and sharing information among Member States, strengthening high-quality community-based surveillance for the early detection and reporting of priority diseases and improving national laboratory systems.
A WHO progress report looking at the past five years of integrated disease surveillance and response finds that countries have made significant advances. Chief among the progress highlighted is the multidisciplinary regional workforce in place that has been instrumental in responding to major outbreaks. Additionally, a large number of countries in the WHO African Region have a public health emergency operation centre and have conducted risk profiling and mapping. By 2018, 38 Member States had conducted voluntary joint external evaluations of their emergency response capabilities.
Member States are signatories to the International Health Regulations (IHR) (2005) and thus are legally bound to work together to stop the international spread of disease. In 2017 and 2018, all 47 Member States submitted their IHR annual reports, compared with only 22 Member States in 2016. Great concern remains that no Member State meets all the required IHR capacities, and thus no country has the full capacity needed to prevent outbreaks from spreading beyond their borders.
Only six countries have mobilized adequate resources to implement IHR, and fewer than a third of the Member States have a functional laboratory system.
“With this new blueprint for strengthening Africa’s surveillance and response to disease in hand, we hope countries will make the investments needed to beef up their capacities,” said Dr Moeti. “Paying now for robust surveillance will create a huge dividend in better health for Africans, not only now but in the future.”
The new strategy calls on WHO and partners to provide technical and financial support for its implementation and to document progress.