ECSA Health Community 1 The East African Integrated Disease Surveillance Network (EAIDSNet) Collaboration of EAIDSNet and EAPHLNP Dr Willy Were

ECSA Health Community Presentation outline 2 Genesis and evolution of EAIDSNet and EAPHLN project Regional Legal Instruments Major achievements in the joint project/EAIDSNet implementation

East African Community 1999 Area: 1.82 million Km 2 Population: Million EAC, 2015

ECSA Health Community Examples of Recent Epidemics in EAC CountryDisease BurundiMeasles (2000), cholera (2012,2013,2015) KenyaMeasles (2002), Rift valley fever ( ), cholera (2009, 2010, 2014, 2015), Dengue (2011, 2013, 2014), meningitis (2006) RwandaMeningitis (2000), cholera (2012) TanzaniaCholera (2012, 2013, 2015), hepatitis (2013), rabies (2009), plague (2011), Anthrax (2012, 2014), measles (2011) UgandaMeasles (2001), yellow fever (2010), meningitis (2012)Marburg (2012), Ebola (2007, 2012), Crimean Congo fever (2013), Typhoid (2015).

Enabling Legal Instruments EAC Treaty 1999 Article 108 Plant and animal disease control Article 118 Human Health Protocol on Cooperation on Health Framework on Cross-Border Surveillance in EAC IHR (2005) Articles 44 (Collaboration and assistance ) 5

IDSR 1998 IHR 2005 EAIDSNet 2000 Epidemiologist and Infectious diseases Experts Public Universities Research Organizations MoH Voluntary Rockefeller funding Coordinating disease control activities 2004: Moved to EAC for easier and sustainable operation 6 Disease Surveillance Strategies

EAIDSNet: Objectives i.Enhance cross-country and cross-institutional collaboration on disease prevention & control, ii.Promote exchange and dissemination of information on Integrated Disease Surveillance iii.Harmonize disease surveillance systems in the region, iv.Strengthen regional capacity for disease surveillance and response v.Ensure continuous exchange of expertise and best practices for disease surveillance and control. 7

Progress of EAIDSNet Stakeholders recognized that labs were the weakest point in disease surveillance Aimed to establish efficient, high quality labs accessible in esp remote peri-border areas 8

EAPHLNP 5 Yr World Bank funded (since 2010), extended for 4 yrs-The East Africa Public Health Laboratories Networking Project Closely works with EADSNet 9

ECSA Health Community Project Sites 10

ECSA Health Community Implemented SLMTA to accelerate laboratory improvement Coordinated and supported peer laboratory audit in preparation for accreditation - 90% scored =>2 stars, while 72% scored =>3 stars in March 2016 Trained mentors and laboratory auditors to support implementation of Improved Projects Enrolled laboratories to regional EQA scheme Supported buy-in proess for increased utilization of TB Supranational Reference laboratory in Uganda (18 countries MoU) 11 Achievements: Laboratory Diagnostics - Lab Networking & Accreditation

Disease Surveillance Established a framework for joint response to outbreaks Developed the Regional Mobile phone web based system for surveillance and laboratory data Supported cross border meetings & establishment of cross border surveillance committees- Supported Joint IDSR and community based disease surveillance Supported VHF field simulation exercise in preparedness for VHF outbreaks Supported investigation/control of Ebola, Marburg, Cholera outbreaks (material and RRT) and Needs Assessment for Burundian Refugees Developed a Regional One-Health Contingency Plan for Health Events in EAC 12

Cross-Border Surveillance Committee Activities Work plans – Joint Disease Control Activities Routine, Quarterly Emergency, as needed Epidemic, as needed – Trainings – Information and data sharing on disease outbreaks-Formal and informal – Simulation exercises 13

Provided training to over 10,290 across all countries. Courses for laboratory/health workers include: Mentorship, Lab auditing, Research methodology, ICT Web Refresher, M&E, Quality Management Systems and Biorisk management Developed e-learning platform with the following modules: Laboratory Management, Lab based surveillance, ICT and Biorisk Management 14 Joint Training and Capacity Building

Harmonized curricula for training of laboratory professionals (degree diploma and certificate curricula were reviewed) Worked with MUHAS and other stakeholders and upgraded the laboratory management course to professional course offered at university Pilot training was held at MUHAS from 29 th March to 29 th April, JOINT TRAINING AND CAPACITY BUILDING

Operational Research Three multi-country, multi-site studies in Tanzania, Kenya, Rwanda, Burundi and Uganda: Malaria TB Enteric pathogens Emerging antimicrobial drug resistance Offshoot studies Publications of the study findings Identified capacity needs in the use of new diagnostic technologies Capacity building in conducting operational research for technical staff

Knowledge and experience sharing 17

Conclusion EAPHLNP is supporting EAIDSNet to achieve the grand objectives set at the beginning Disease control in EAC is still “work in progress”. A lot more is still needed. Involvement of all stakeholders at all stages is important to deal with the ever changing target 18

Thank you 19