Ebola Response Impact on Public Health Programs, West Africa, 2014–2017. Health lays the foundation for vibrant and productive communities, stronger economies, safer nations and a better world. ... 1st International Conference on Public Health in Africa. Local determination of viral sequences also provided key information to inform control efforts; for example, a laboratory established in Sierra Leone in April 2015, staffed by locally trained scientists, conducted rapid sequencing of full Ebola RNA genome sequences and informed the investigation of subsequent Ebola clusters (13,20). Laboratory Response to Ebola - West Africa and United States. By the time control was achieved, there had been widespread, devastating impacts on those infected and their families, as well as on the nations’ healthcare systems and economies (4) and population health (5). Jobs in Africa at CRS - Catholic Relief Services, ECOWAS Commission, Ford Foundation, Jhpiego - John Hopkins University and NDI - National Democratic Institute from IntJobs - … The responses to these additional clusters were also robust; in most instances, transmission was limited to 0 or 1 generation (11). In Liberia, transmission was limited to 1 generation, affecting only immediate family members of the index case-patient. 30-Dec-2020: Morocco: 09-Dec-2020: 1-the Leasing Of The Outbuildings Of The Weekly Souks (ct Bzou) Including For The Year 2021.-cattle Souk.-fees Collected At The Souk.-fondouk.-communal Weighing Machine.-parking Fees.-the Stalls Of. Governments should communicate rather than simply compel. The World Health Organization (WHO) is building a better future for people everywhere. In a 2008 practice note (26), the United Nations Development Programme highlighted the essential nature of the “demand side” of the capacity-building equation: the requirement that host countries value and support the need to invest in the identified capabilities. 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. 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. Human Resources for Health Development. The Association of African Universities (AAU), the Regional Facilitation Unit (RFU), of the Africa Centres of Excellence (ACE) Project, is pleased to announce the conditional selection of 44 centres of excellence in 12 participating countries in West and Central Africa (Benin, Burkina Faso, Cameroon, Cote d’Ivoire, Djibouti, Gambia, Ghana, Guinea, Niger, Nigeria, Senegal, and Togo) under the ACE for Development … 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. In settings with limited public health capacity or in which the magnitude of a health threat overwhelms local capacity and requires international support, response efforts provide a unique opportunity for strengthening public health systems and can serve as a further catalyst to accelerate progress toward global health security goals. Ebola virus disease cluster—northern Sierra Leone, January 2016. 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. Likewise, IMSs established for the Ebola response have provided a structure for organization of other response efforts. 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. As of late 2017, Liberia, Sierra Leone, and Guinea maintain national and sometimes regional capacity to conduct EVD testing. 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. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. 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. Possible sexual transmission of Ebola virus - Liberia, 2015. Therefore, it was essential to maintain capacity to rapidly recognize and respond to Ebola cases. Construction Of A Main Rescue And Provincial Command Center In Fahs - Anjra. While not every university offers a public health major, concentrating in health science, community health, or nutrition provides a strong foundation for a public health career. All 3 Ebola-affected countries continue to receive crucial ongoing support from international donors and technical partners. 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 aim of the journal is to move public health discourse from the background to the forefront. A cohort of 25 MOH staff began the training program in January 2017; 80 staff are expected to graduate by mid-2018. 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. 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. https://doi.org/10.3201/eid2313.170727, Table of Contents – Volume 23, Supplement—December 2017. Graduates will have access to the ADC to build a relevant and meaningful career in data science, AI, mixed reality, application development … Thus, a major priority in building public health capacity is to support training in surveillance and epidemic response. 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. 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). Effects of response to 2014–2015 Ebola outbreak on deaths from malaria, HIV/AIDS, and tuberculosis, West Africa. During CDC’s response to the West Africa Ebola epidemic, Dr. Marston helped coordinate CDC’s international activities. According to a recent IFC report, The Business of Health in Africa: Partnering with the Private Sector to Improve People's Lives, spending on health in Sub-Saharan Africa is expected to double over the next 10 years. CDC twenty four seven. 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. Analyzing the determinants of health of a population and the threats it faces is the basis for public health. Frontline Field Epidemiology Training Programs (FETPs) have been established in all 3 of the countries most affected by the Ebola epidemic. Center for Global Development. At that point, the response structure and resources remained in place. 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. Message not sent. During the response, new infrastructure was created to increase coordination capacity, emergency response coordination plans were developed, and designated staff were trained. 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. Development of this type of partnership usually takes years. 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. 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. In Sierra Leone, the IMS was activated for an outbreak of measles, which was successfully controlled after a vaccination campaign, and for investigation of cases of acute flaccid paralysis. 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. 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. Our work touches lives around the world every day – often in invisible ways. 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. The region may be divided into several broad physiographic regions. 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. Liberia and Sierra Leone were among the 25 countries that completed initial JEEs by the end of 2016 (29); a JEE was completed in Guinea in April 2017. Public health has been defined as "the science and art of preventing disease”, prolonging life and improving quality of life through organized efforts and informed choices of society, organizations (public and private), communities and individuals. Our Work. 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. The Ebola epidemic in West Africa ended ultimately because of behavior change under very difficult circumstances. 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. 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. Unusual Ebola virus chain of transmission, Conakry, Guinea, 2014–2015. Please help Greece populate its page . Marston BJ, Dokubo E, van Steelandt A, et al. During the initial months of the Ebola epidemic, limited capacity to rapidly identify suspected cases, confirm diagnoses, and implement preventive measures contributed to widespread transmission (3). Comment submitted successfully, thank you for your feedback. The Journal of Public Health in Africa is a peer-reviewed, academic journal that focuses on health issues in the African continent. Maintaining effective relationships built during the crisis has likely accelerated progress during postepidemic recovery. 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. There was an unexpected error. In August 2015, Guinea’s MOH created and validated the Surveillance of Epidemic-Prone Diseases plan. 30-Dec-2020: South Africa: 09-Dec-2020 The Africa Centre aims to advance scientists' understanding of rural African health behaviours, lives and society. IMSs have proven beneficial for response efforts beyond those for which they were originally established. 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. In all 3 of these countries, the expansion of Ebola diagnostic capacity extended beyond the ability to diagnose acute infection. In Guinea, the FETP was launched in December 2016 by the training of 8 MOH staff who will mentor their peers. Maintaining public trust during the course of this pandemic will be essential. Also in early 2016, Guinea established a novel program to monitor for Ebola resurgence. 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. Please use the form below to submit correspondence to the authors or contact them at the following address: Barbara Marston, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop A06, Atlanta, GA 30329-4027, USA. Management of daily activities through Emergency Operations Centers (EOCs) improved coordination of response efforts at national and county levels (7). 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. NYU’s academic center in Accra, capital of Ghana, is located in suburban Labone. Lines reflect total weekly case numbers during the primary outbreak. Centers for Disase Control and Prevention. Ebola response impact on public health programs, West Africa, 2014–2017. Figure. Agenda 2063 is the blueprint and master plan for transforming Africa into the global powerhouse of the future. Multiple partners are assisting the MOH to expand diagnostic capacity on these platforms to other diseases of epidemic potential. In February 2016, IDSR training was conducted for national trainers, who then trained other surveillance system staff. In Sierra Leone, responses to 2 clusters were coordinated through the same structures used to respond to the main epidemic. ... eliminating polio as a threat to public health in the Western Hemisphere in 1991. 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. 2017 Suppl [date cited]. Minister for Health through its governing Council - the Ghana Health Service Council. 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. No specific funding was used for the development of the paper. 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. TTI supported 43 think tanks across Latin America, Sub-Saharan Africa and South Asia. The responsibility for emergency response coordination was transferred to the Ministry of Health and Sanitation on January 1, 2016. In Liberia, Sierra Leone, and Guinea, focused training and mentoring on infection prevention and control (IPC) principles and practices was provided at health facilities in the area of an Ebola cluster by using an approach termed ring-IPC (25), and thousands of healthcare workers have been trained in IPC principles. https://dx.doi.org/10.3201/eid2313.170727. More than 28,000 Ebola cases were reported from the 3 countries during the epidemic, and >11,000 persons died (1). Emerg Infect Dis. Although IDSR had been technically adopted by Sierra Leone, its implementation had been incomplete before the Ebola outbreak. Redd). Box 34005-00100, Nairobi Kenya Building public health capacity within the staff of governments is expected to have long-term, broad impacts (6). However, the swift and massive response to this epidemic established methods and resources that are transferable to responses to other health threats, affording an unparalleled opportunity for more rapid expansion of emergency response capacities than would usually be possible in such settings. Ebola Response Impact on Public Health Programs, West Africa, 2014–2017. Improve health outcomes of people of Sub-Saharan Africa by providing technical assistance informed by evidence and relevant operational research. After more than 50 years of working in global health, the U.S. Agency for International Development (USAID) is proud of the progress made with many partners across the globe—improving health and saving lives in record numbers. 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. 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. The relationship between health and security is an area of increasing importance in the twenty-first century. Strategic communications are a crucial element for public health. The resources committed to the Ebola response and post-Ebola recovery have facilitated improvements in the public health systems in West Africa. The EOC has been activated to coordinate investigations and responses to yellow fever and measles outbreaks and provides strong support to the surveillance unit of the ANSS by coordinating meetings and information sharing, producing situational reports, and providing logistic support. Although the cluster in Guinea was not identified until there had already been 3 generations of viral transmission, and initial contact identification efforts were delayed by community resistance, the response was effective, containing spread to 2 additional generations. West Africa Health Organisation - WAHO Web ... Heath Research Web is a public platform for information on research for health and development, it depends on contributions and participation from all who are interested in promoting health, health equity and development. The governments of the affected countries have expressed broad appreciation for the support provided by international partners (28). This organization is the service provision arm of the health care system in the Emerg Infect Dis. Implementation of a national semen testing and counseling program for male Ebola survivors—Liberia, 2015–2016. The JEE is not meant to be used to compare countries; however, the performance measures in the Ebola-affected countries were consistent with those achieved by several countries that had higher development indexes. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Africa Action- Africa's Right to Health Campaign. However, the Ebola epidemic juxtaposed external responders with those from the host country under conditions that demanded close and effective working relationships that could not function without mutual trust and respect. Marston, B. J., Dokubo, E., van Steelandt, A., Martel, L., Williams, D., Hersey, S....Redd, J. T. (2017). 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