Sierra Leone has initiated workforce capacity building in preservice and in-service training programs in laboratory, epidemiology, infection prevention and control, program management, and emergency management. Although surveillance systems currently continue to provide timely data on critical disease threats, it may not be possible to maintain community-based activities that were established during or after the Ebola outbreak. The Africa Centre aims to advance scientists' understanding of rural African health behaviours, lives and society. There are serious risks to the progress that has been achieved in the region. Molecular evidence of sexual transmission of Ebola virus. During the final months of the Ebola epidemic, the MOH also launched community-based surveillance for epidemic-potential diseases in priority prefectures, which supported reporting of key community-level alerts to the local health facility. Investments of $25-30 billion will be needed to meet the demand, with the private sector playing a … The diagnosis was rapidly confirmed, the response was robust, and there was no evidence of secondary transmission. The Association of African Universities has also received funds to enable it to co-ordinate knowledge-sharing among the 19 universities in West Africa involved in the project. Mediquip Global (MQG) provides a variety of high quality and reliable services to private. All 3 Ebola-affected countries continue to receive crucial ongoing support from international donors and technical partners. Many persons engaged as surveillance officers during the response demonstrated interest in and aptitude for these activities and have since chosen to pursue training and careers in public health. Graduates will have access to the ADC to build a relevant and meaningful career in data science, AI, mixed reality, application development … The effective control of the Ebola outbreak in Nigeria after travel of an infected person from Monrovia to Lagos in July 2014 was facilitated by the use of an established polio IMS (14). OraQuick Ebola Rapid Antigen Tests (OraSure Technologies, Inc., Bethlehem, PA, USA) were piloted at 15 sites in Forécariah Prefecture in October 2015 by the Guinea MOH and Red Cross staff (17) and eventually used to test >4,000 febrile patients and >3,000 deceased patients. Marston, E.K. During the outbreak, most samples were tested by international teams in field laboratories (15). No specific funding was used for the development of the paper. Ebola virus disease clusters after interruption of the 2014–2015 Ebola outbreak in Liberia (green), Sierra Leone (blue), and Guinea (red). In all 3 of these countries, the expansion of Ebola diagnostic capacity extended beyond the ability to diagnose acute infection. A 5-year IDSR strategic plan is in place and surveillance officers at national and subnational levels have undergone training based on updated IDSR technical guidelines (21). Expanding Ebola diagnostic capacity improved capacity for diagnosis of other diseases of public health importance, and there has been substantial progress in developing or updating laboratory strategic plans, establishing and improving sample transport networks, and safely storing biologic specimens. The GHS “continues to receive public funds and thus remains within the public sector” (Ghana Health Services website). Click on the map to learn more about what is happening in each of the regions or see below to find out which institutions are working on selected policy issues. Through the Community Event-Based Surveillance system (https://www.globalcommunities.org/liberia), events in the community are reported to a surveillance focal person at the closest health facility, then to the district and county surveillance officers, and reported weekly to the MOH Disease Prevention and Control unit at the national level. The rate of this transition in funding arrangements and the positioning of health among other development priorities within countries will have huge implications for health programming in Africa. Ebola survivors were engaged in active surveillance for Ebola-like illness among their contacts and in their communities (Surveillance Active en Ceinture SA-Ceint [22]). Please help Greece populate its page . Effects of response to 2014–2015 Ebola outbreak on deaths from malaria, HIV/AIDS, and tuberculosis, West Africa. Dokubo, A. van Steelandt, L. Martel), US Centers for Disease Control and Prevention, Monrovia, Liberia (D. Williams), US Centers for Disease Control and Prevention, Freetown, Sierra Leone (S. Hersey), Ministry of Health and Sanitation, Freetown (A. Jambai), Ministry of Health, Conakry, Guinea (S. Keita), Ministry of Health, Monrovia (T.G. Centers for Disease Control and Prevention (CDC). Ebola virus disease in West Africa—the first 9 months of the epidemic and forward projections. In Guinea, the EOC established during the Ebola response was integrated into the newly formed Agence National de Sécurité Sanitaire (ANSS) and is responsible for managing epidemics in Guinea; the EOC is managed by a dedicated team of 5 ANSS staff members assisted by CDC, Public Health Agency of Canada, and NGO partners. 2017;23(13). Ebola response impact on public health programs, West Africa, 2014–2017. In usual circumstances, establishing public health systems and capacities to detect, prevent, and respond to urgent global health threats requires long-term planning and investment (6). Emerg Infect Dis. The responses to these additional clusters were also robust; in most instances, transmission was limited to 0 or 1 generation (11). Analyzing the determinants of health of a population and the threats it faces is the basis for public health. Control of the outbreak required substantial effort from host country governments and populations and crucial resources and inputs from multilateral and bilateral partners, nongovernmental organizations (NGOs), and individual persons from outside the 3 countries. Figure. NYU’s academic center in Accra, capital of Ghana, is located in suburban Labone. Possible sexual transmission of Ebola virus - Liberia, 2015. A DHIS2-based eIDSR reporting system was established for collection of monthly surveillance data in all 38 prefectures of Guinea; the eIDSR system is being expanded in 2017 to include the weekly and immediate surveillance reporting, including case-based surveillance for priority diseases. The region may be divided into several broad physiographic regions. Likewise, IMSs established for the Ebola response have provided a structure for organization of other response efforts. When possible, continuing support into the postepidemic period could both optimize readiness for possible resurgence of the initial threat and contribute to broad and rapid progress toward health security goals. Center for Global Development. The governments of the affected countries have expressed broad appreciation for the support provided by international partners (28). That outbreak is second only to the 2014 West African outbreak, which infected 28,616 people and killed 11 310 in Guinea, Liberia and Sierra Leone. The Africa Rice Center (AfricaRice) is a leading pan-African rice research organization committed to improving livelihoods in Africa through strong science and effective partnerships. Training in field epidemiology is among the top priorities related to expanding public health capacity. However, over the course of the outbreak, capacity to conduct RT-PCR was established or expanded in national laboratories in each country, and capacity for new technologies was developed, including the use of the GeneXpert platform (Cepheid, Sunnyvale, CA, USA) for PCR and rapid diagnostic tests (RDTs) based on lateral flow assays. Ebola Response Impact on Public Health Programs, West Africa, 2014–2017. Emerging Epidemic Virus Research Training for West African Countries with Widespread Transmission of Ebola (Guinea, Liberia and Sierra Leone) Global Environmental and Occupational Health (GEOHealth) Global Infectious Diseases (GID) Health Professional Education in Africa ; African Association for Health Professions Education and Research Improve health outcomes of people of Sub-Saharan Africa by providing technical assistance informed by evidence and relevant operational research. However, the Ebola response and health system recovery efforts in these countries have led to improved surveillance for EVD and other epidemic-prone diseases. In Sierra Leone, focused collaborative efforts have improved the infrastructure at the national reference laboratory and supported broad training in quality management; progress in establishing systems for sample transport has been limited. Centers for Disease Control and Prevention. Since the Ebola outbreak in Sierra Leone, IDSR-based surveillance has been implemented nationwide. Global health security relies on the ability of all countries to prevent, rapidly detect, and respond to public health threats at their source. The gains made in laboratory capacity are especially fragile; laboratories in all 3 countries continue to rely on support from partners for equipment maintenance and replacement, reagents, and ongoing training. Thus, a major priority in building public health capacity is to support training in surveillance and epidemic response. The journal editors seek high quality original articles on public health-related issues, reviews, comments and more. The World Health Organization (WHO) is building a better future for people everywhere. Donors and organizations that support an emergency response should be reassured that resources committed to a response—if appropriately coordinated and targeted—can have an impact beyond the response itself. Efforts are ongoing to improve the quality of both the reported data and the response to reports of notifiable diseases and to implement an electronic early warning system to further improve alert notification and response. In Liberia, increases in the number of measles and Lassa fever cases led to the activation of the IMS on March 14, 2016; the IMS coordinated case investigations, contact tracing, diagnostic evaluation, case management, and prevention efforts. Also in early 2016, Guinea established a novel program to monitor for Ebola resurgence. Although IDSR had been technically adopted by Sierra Leone, its implementation had been incomplete before the Ebola outbreak. Health lays the foundation for vibrant and productive communities, stronger economies, safer nations and a better world. 30-Dec-2020: South Africa: 09-Dec-2020 Strategic communications are a crucial element for public health. In Guinea, much of the laboratory equipment and infrastructure used for Ebola RT-PCR diagnosis by international partners, including a field laboratory established by the US Defense Threat Reduction Agency, have been donated to the MOH. The final cluster of Ebola during the epidemic was recognized in March 2016 (10) and occurred under conditions that were similar to the initial situation in the main epidemic; cases were first diagnosed in southeastern Guinea, and a person with a history of high-risk contact fled across the border to Liberia, where Ebola was confirmed in a patient at a hospital in the capital, Monrovia. With 189 member countries, staff from more than 170 countries, and offices in over 130 locations, the World Bank Group is a unique global partnership: five institutions working for sustainable solutions that reduce poverty and build shared prosperity in developing countries. Arrows... Additional clusters (2 in Liberia, 3 in Sierra Leone, and 1 that began in Guinea and spread to Liberia) occurred after interruption of transmission in each country (Figure). However, although the US government maintains a high priority for supporting global health security activities (31), critical funding to support critical activities, such as surveillance, laboratory capacity, and workforce development, was provided through a one-time emergency appropriation (32). Event-based surveillance in Liberia is implemented as part of a broad system for Integrated Disease Surveillance and Response (IDSR), which documents 14 priority diseases and conditions. The FETP-Frontline program provides 3 months of on-the-job training and supervision for surveillance officers working within the MOH (24). Although response coordination was challenging, especially during the initial phase, establishment of incident management systems (IMS) for the Ebola response facilitated coordination of multiple partners that contributed to control of the main outbreak. The Ebola epidemic in West Africa ended ultimately because of behavior change under very difficult circumstances. Beyond resources, there are several other critical requirements for effective expansion of public health capacity. https://doi.org/10.3201/eid2313.170727, Table of Contents – Volume 23, Supplement—December 2017. ... Research areas: Development, Health. ... impact of the blinding parasitic disease and increased the potential for economic development in large areas of rural west Africa. Therefore, it was essential to maintain capacity to rapidly recognize and respond to Ebola cases. When Ebola spread to Nigeria, trained epidemiologists rapidly mounted extensive and successful contact identification and monitoring activities and kept Ebola from spreading broadly, likely preventing a catastrophic outcome (23). In Guinea, the IMS was coordinated through a Guinea-led National Coordination Cell with support from WHO, CDC, and the Public Health Agency of Canada. Development of this type of partnership usually takes years. In Sierra Leone, responses to 2 clusters were coordinated through the same structures used to respond to the main epidemic. We describe public health progress that was made as a result of the Ebola response in 4 key areas: emergency response, laboratory capacity, surveillance, and workforce development. Lines reflect total weekly case numbers during the primary outbreak. Progress was evaluated by comparison with previously conducted self-assessments; all 3 countries achieved acceptable levels of compliance in several areas assessed by the JEE and clear progress in others. Wed May … During CDC’s response to the West Africa Ebola epidemic, Dr. Marston helped coordinate CDC’s international activities. Agenda 2063 is the blueprint and master plan for transforming Africa into the global powerhouse of the future. As of late 2017, Liberia, Sierra Leone, and Guinea maintain national and sometimes regional capacity to conduct EVD testing. The Ebola epidemic that was first recognized in 2014 and ravaged the West Africa countries of Liberia, Sierra Leone, and Guinea was a stark illustration of the risks that emerging pathogens and epidemic-prone diseases pose to local and global health security in settings that had limited public health capacity. Management of daily activities through Emergency Operations Centers (EOCs) improved coordination of response efforts at national and county levels (7). Marston, B. J., Dokubo, E., van Steelandt, A., Martel, L., Williams, D., Hersey, S....Redd, J. T. (2017). Four approaches to capacity building in health: consequences for measurement and accountability. The cluster was limited to 1 generation; disease occurred only in the index case-patient and a single high-risk contact. At least 3 300 people have been infected and more than 2 250 people have died in a crisis that continues to strain the already-fragile health system of Africa’s fourth-largest country. She also led a specific office dedicated to providing support to the Ebola Affected Countries during the initial phases of the recovery following the epidemic. This training will equip surveillance officers with knowledge and skills to supervise staff and provide leadership during outbreak responses. Workforce development has included a broad range of other training activities. ... 1st International Conference on Public Health in Africa. Providing Technical assistance & relevant operational research, © Copyright 2019 CPHD | Website Created by. CPHD started two social enterprises - … In Guinea, laboratory training has included diagnosis of EVD, meningitis, cholera, and shigellosis, as well as sample transport, biosafety/biosecurity, quality management systems, and molecular biology. The emergence of the COVID-19 pandemic and the stress it has caused to some of the world’s most advanced health systems, therefore, was soberly noted by Africa’s public health community. In Liberia, the FETP-Frontline was launched in August 2015; by early 2017, more than 120 surveillance officers in Liberia had completed training, and there are now trained staff in all 15 counties and each of Liberia’s 90 districts. In February 2016, IDSR training was conducted for national trainers, who then trained other surveillance system staff. Although there appears to be potential for a useful role for Ebola RDTs, progress has been limited for availability, liscensing, and development of guidelines for use of these tests, and the role of postoutbreak Ebola-specific RDTs has diminished. Timeliness and completeness of reporting were high before the Ebola outbreak, fell during the outbreak, and currently average >99%. Partnerships should be established and expanded transparently and must be based on understanding and mutual responsibility. Dr. Marston is the Deputy Director for Science and Programs for the Division of Parasitic Diseases and Malaria within CDC’s Center for Global Health. In Liberia, transmission was limited to 1 generation, affecting only immediate family members of the index case-patient. There was an unexpected error. The Journal of Public Health in Africa is a peer-reviewed, academic journal that focuses on health issues in the African continent. the Regional Office for Africa, Office of Communications (OCC), and the Sub-regional Office of West Africa, the incumbent will ensure the development and implementation of the country communication strategy FAO - Food and Agriculture Organization of the United Nations Updated: 2020-12-09T01:52:41Z These countries are among the least developed in the world (2), and their weak infrastructures and underfunded health systems were further compromised by the epidemic. AGRA exists to fulfill the vision that Africa can feed itself and the world—transforming agriculture from a solitary struggle to survive to a business that thrives. Unusual Ebola virus chain of transmission, Conakry, Guinea, 2014–2015. During the response, the physical location for the national EOC moved from a temporary location to a new permanent infrastructure on the campus of the MOH. In Liberia, the Ministry of Health (MOH) established a national IMS in July 2014, with support from the US Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and other partners. US Department of Health and Human Services, University of Minnesota Center for Infectious Disease Research and Policy, Effects of the Ebola Response on General Public Health Capacity, Role of Wildlife in Emergence of Ebola Virus, https://www.globalcommunities.org/liberia, http://apps.who.int/iris/bitstream/10665/208883/1/ebolasitrep_10Jun2016_eng.pdf, http://www.undp.org/content/undp/en/home/presscenter/pressreleases/2015/03/12/west-african-economies-feeling-ripple-effects-of-ebola-says-un.html, https://www.cdc.gov/vhf/ebola/pdf/cdcs-ongoing-work.pdf, http://www.who.int/mediacentre/news/statements/2016/new-ebola-case/en/, https://www.cdc.gov/globalhealth/healthprotection/eaco/stories/redemption-hospital.html, http://www.afro.who.int/publications/technical-guidelines-integrated-disease-surveillance-and-response-african-region-0, http://reliefweb.int/sites/reliefweb.int/files/resources/ebola-response-report-2016.pdf, http://www.gereports.com/dr-tom-frieden-protecting-the-world-from-the-next-pandemic, https://www.cdc.gov/globalhealth/healthprotection/fieldupdates/pdf/spring-2016-links/fetp-then-now.pdf, http://unpcdc.org/media/8651/pn_capacity_development.pdf, http://www.statehouse.gov.sl/index.php/component/content/article/34-news-articles/1405-president-honours-ebola-warriors, http://apps.who.int/iris/bitstream/10665/246107/1/9789241580496-eng.pdf, http://www.who.int/ihr/procedures/mission-reports/en/, https://www.hhs.gov/about/news/2017/08/23/readout-secretary-price-meetings-beijing-china.html, https://www.ghsagenda.org/docs/default-source/default-document-library/GHSA-legacy-report.pdf?sfvrsn=1, http://www.cidrap.umn.edu/news-perspective/2017/05/meningitis-suspected-liberias-mystery-illness-outbreak, Ebola Response Impact on Public Health Programs, West Africa, 2014–2017, U.S. Department of Health & Human Services, Marston BJ, Dokubo E, van Steelandt A, Martel L, Williams D, Hersey S, et al. Although it is difficult to precisely measure the effect of a capable public health workforce, quality public health responses are highly dependent on the availability of well-trained staff. Initiation of a ring approach to infection prevention and control at non-Ebola health care facilities - Liberia, January-February 2015. However, there are lessons from the post-Ebola capacity-building efforts to strengthen global health security. In Sierra Leone, outbreak response was coordinated primarily through national and district Ebola response centers supported by civilian and military personnel and resources from the United Kingdom. Suggested citation for this article: Marston BJ, Dokubo EK, van Steelandt A, Martel L, Williams D, Hersey S, et al. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. We further highlight ways in which capacity-building efforts such as those used in West Africa can be accelerated after a public health crisis to improve preparedness for future events. Successful, locally led responses to new clusters of Ebola and to conditions such as measles and acute flaccid paralysis demonstrate the potential for a crisis such as the Ebola epidemic to lead to improvements in local capacity that can have long-lasting benefits, improving health security for the affected nations and the world. At the beginning of the Ebola epidemic in West Africa, diagnosis relied on complex tests, primarily reverse transcription PCR (RT-PCR), conducted in carefully controlled settings. Effective capacity building also requires trust of those offering support (26). These new tests became critical for confirmation of cases later in the outbreak and for ruling out disease and supporting Ebola surveillance. TTI supported 43 think tanks across Latin America, Sub-Saharan Africa and South Asia. The West Africa Ebola epidemic highlighted the importance of strong public health systems and the need for local public health systems that include ongoing surveillance, a well-trained workforce, laboratory capacity, and emergency response capabilities. The system now monitors 28 priority diseases, conditions, and events. Nyenswah), US Centers for Disease Control and Prevention, Albuquerque, New Mexico, USA (J.T. We are grateful to Schabbethai Sainvil for assistance with the figure, Erica Meyer for assistance with Table 1, and John Saindon for assistance with Table 2. We describe capacity-building efforts during and after the Ebola epidemic in Liberia, Sierra Leone, and Guinea and public health progress that was made as a result of the Ebola response in 4 key areas: emergency response, laboratory capacity, surveillance, and workforce development. Our work touches lives around the world every day – often in invisible ways. Developing an incident management system to support Ebola response — Liberia, July-August 2014. Events such as the 2014–2015 West Africa epidemic of Ebola virus disease highlight the importance of the capacity to detect and respond to public health threats. Resurgence of Ebola virus disease in Guinea linked to a survivor with virus persistence in seminal fluid for more than 500 days. In August 2015, Guinea’s MOH created and validated the Surveillance of Epidemic-Prone Diseases plan. A cohort of 25 MOH staff began the training program in January 2017; 80 staff are expected to graduate by mid-2018. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Serologic testing contributed to the understanding of disease transmission (18), and programs were established that supported testing of semen and other body fluids for Ebola virus RNA (19). By early 2017, FETP participants had conducted >50 case investigations for acute flaccid paralysis, rabies, maternal deaths, cholera, measles, yellow fever, meningitis, neonatal tetanus, and unexplained deaths, as well as investigations of outbreaks of Lassa fever and rubella. Since the introduction of this innovation, many people can easily access health services,” Jane Ajele, the county’s health minister, told Africa Renewal. Neither is it certain that resources for capacity building from other donors will be sustained. Maintaining public trust during the course of this pandemic will be essential. Centers for Disase Control and Prevention. Improvements in the quality of data collation, analysis, and presentation by central public health authorities have been supported through training, mentorship, and supportive supervision that has included comprehensive data quality audits. In each of the countries most affected by the Ebola epidemic, the response offered an opportunity to identify persons who have capacity to conduct public health activities. The first well-characterized case of transmission related to viral persistence occurred in Liberia, ≈1 month after the epidemic had first been controlled and before Liberia had met the WHO criteria to be declared free of Ebola transmission (8,9). A critical element of workforce development has been to support training of managers responsible for public health programs. Africa Action- Africa's Right to Health Campaign. CDC twenty four seven. The Harvard Center for African Studies has compiled the following resources and materials from the Harvard community and our partners on the ongoing #EndSARS protest movement in Nigeria. The Center for Public Health and Development (CPHD) is a nongovernmental that aims to bring innovative solutions to public health challenges in the Eastern African region and to work with partners with whom synergies exist towards this goal. The relationship between health and security is an area of increasing importance in the twenty-first century. Saving Lives, Protecting People, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA (B.J. Assessments of Ebola knowledge, attitudes and practices in Forécariah, Guinea and Kambia, Sierra Leone, July-August 2015. Before the Ebola epidemic, sentinel and event-based disease surveillance systems were generally limited in all 3 affected countries; these were further disrupted by the epidemic. In Liberia, diagnostic capacity has been established or reestablished for all identified priority reportable diseases (Table 1), and a nationwide sample transport system has transported >50,000 laboratory specimens from >302 sites across all 15 counties since April 2015. Officers with knowledge and skills to supervise staff and provide leadership during outbreak responses after the large health! Government devoted 2.5 % of GDP to public health capacity the threats it faces is the basis for public capacity! At national and county levels ( 7 ) non-Ebola health care facilities Liberia...: MMWR Morb Mortal Wkly Rep. 2015 Oct 23 ; 64 ] had technically! Touches lives around the world every day – often in invisible ways early 2016 IDSR... Productive communities, stronger economies, safer nations and a better world people, US Centers for disease and... ; 80 staff are expected to have long-term, broad impacts ( )... 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