Cameroon’s Public Health Emergency Operations Center serves as the focal point for COVID-19 response

Cameroon’s Public Health Emergency Operations Center (PHEOC) has been activated for COVID-19, cholera, and increased maternal, perinatal, and neonatal deaths. As the focal point of Cameroon’s COVID-19 response, the PHEOC supported the development of a National Plan for COVID-19 Operational Research, created a COVID-19 emergency response plan, strengthened surveillance, and developed data collection tools and training data clerks at district and regional levels. The PHEOC also engaged with the MoH and U.S. Government technical experts to improve and standardize surveillance and response tools to decrease avoidable maternal, perinatal, and neonatal deaths.

Cameroon’s Public Health Emergency Operations Center serves as the focal point for COVID-19 response

Graduates and current fellows of Cameroon’s robust Field Epidemiology Training Program (FETP) played a crucial role in responding to COVID-19 as well as yellow fever, cholera, malaria, and other diseases. The FETP graduates and current fellows supported outbreak investigations throughout various regions and health districts, strengthened surveillance efforts, laboratories, and regional-level health departments, and collaborated with different partners, including other countries in the West/Central Africa region, on outbreak and response work.

 

 

Africa Cup of Nations safely hosted in Cameroon despite COVID-19

Cameroon hosted the Africa Cup of Nations (AFCON), Africa’s biggest soccer tournament, from January 9 – February 6, 2022. The MoH, in collaboration with the U.S. CDC, developed COVID-19 mitigation and safety measures including requiring proof of full vaccination status to attend the games and access stadiums, other public viewing places, and hotels. Leading up to AFCON, the MoH opened more vaccination sites. The MoH and CDC also collaborated with Google and Apple to utilize a COVID-19 exposure notification system to verify game attendees’ vaccination status.

 

 

Adapting Trainings in Response to COVID-19

Institute Pasteur of Cote d’Ivoire received support to stand up multimedia spaces to conduct virtual trainings since in-person meetings were halted due to the COVID-19 pandemic. Virtual meetings were organized for experts from across the West African sub-region to exchange information and guidelines for COVID-19 response, for training personnel on lab procedures, and for health systems strengthening trainings.

 

Public Health Emergency Operations Centers Enable Rapid Response to Public Health Threats

In 2019, a presidential decree ordered the creation of Public Health Emergency Operations Centers (PHEOCs) in six priority health regions in Cote d’Ivoire (Tonkpi, Cavally, San Pedro, Kabadougou, Gbeke and South Comoe). In 2021, national public health institute collaborated with international partners and the defense and security sectors to conduct exercises in priority health regions in using a One Health (human, animal, and environmental health) approach for responding to a hypothetical Ebola outbreak in Cote d’Ivoire.

DRC expands laboratory capacity in response to Ebola, COVID-19, and HIV

DRC is working in collaboration with U.S. Centers for Disease Control and Prevention (U.S. CDC) and other partners to expand its capacity to detect and respond to various diseases across multiple laboratories. In 2020, Lualaba province’s first molecular lab capable of performing Early Infant Diagnosis and HIV viral load tests, as well as COVID-19 testing, became operational.

Equipment, supplies, training, and technical support were provided to labs in Ingende and Kinshasa to improve critical diagnostic testing and sequencing activities for Ebola, malaria, and other pathogens. Reliable data communication was ensured with the installation of solar power and internet.

 

DRC works towards establishing National Public Health Institute (NPHI)

In July 2021, the Democratic Republic of Congo’s Ministry of Health (MoH) and General Directorate for Disease Control convened a technical working group (TWG) to establish a National Public Health Institute (NPHI). The NPHI’s purpose is to lead and coordinate public health functions, in particular, the detection of and response to public health threats in-country. Based on DRC’s existing public health system gaps and capabilities, the TWG adapted the Africa CDC-defined core public health functions of an NPHI to DRC’s context and added an additional function to document emergency response efforts to better learn from past outbreak response efforts and better prepare for future ones, especially for Ebola.

 

 

Nuclear Threat Initiative (NTI)  – Hosted the 5th Global Biosecurity Dialogue

NTI | bio, with support from the Government of Canada, convened approximately 50 high-level biosecurity experts and policymakers from across the public, private, and civilian sectors, including global and regional organizations, for the 5th Global Biosecurity Dialogue (GBD) in Cape Town, South Africa. The in-person meeting—the first since 2019—was held November 7-9 and focused on accelerating global actions to reduce risks of deliberate biological events.

Participants resolved to take the following actions to advance biosecurity in 2023 and beyond:

• Launch a biosecurity advocacy agenda
• Optimize impactful biosecurity collaboration at the regional level
• Create transparent biosecurity systems with clear performance indicators
• Incentivize actions that reduce emerging biological risks associated with advances in technology
• Foster the next generation of biosecurity leaders These actions support the biosecurity targets under GHSA 2024 and advance country capacities as measured by the Joint External Evaluation and Global Health Security Index

Nuclear Threat Initiative (NTI)  – Launched the International Biosecurity and Biosafety Initiative for Science

NTI | bio is working with global partners to launch the International Biosecurity and Biosafety Intiative for Science (IBBIS), a new organization that will seek to strengthen biosecurity norms and develop innovative tools to uphold them. IBBIS will be the first international organization with the primary mission of reducing emerging biological risks associated with advances in technology.

Advances in bioscience and biotechnology offer tremendous benefits for fighting disease, protecting the environment, and promoting economic development. At the same time, innovations in this area can pose heightened risks of accidental or deliberate misuse, with potentially catastrophic consequences. IBBIS has been designed to address these problems and engage in the following types of activities:

• Oversee and manage an international Common Mechanism for DNA synthesis screening to help DNA providers ensure that the building blocks dangerous pathogens don’t fall into the hands of malicious actors.
• Support the development of biosecurity standards for use by life-science funders.
• Guide universities and industry in developing effective approaches to strengthen oversight of dual-use bioscience research conducted within their laboratories.
• Work with publishers to update their guidelines regarding publication of manuscripts containing information that might be misused.
• Develop proposals for governments to incentivize or require stronger biosecurity practices.

These and other actions will support the biosecurity targets under GHSA 2024 and advance country capacities as measured by the Joint External Evaluation and Global Health Security Index

Nuclear Threat Initiative (NTI)  – Launched the Second Edition of the Global Health Security Index

In December 2021, NTI, in partnership with the Johns Hopkins Center for Health Security and Economist Impact, launched the second edition of the Global Health Security (GHS) Index. The main finding was that all countries remain dangerously unprepared for future epidemic and pandemic threats, including threats potentially more devastating than COVID-19. More information: ghsindex.org. The Global Health Security (GHS) Index is the first comprehensive assessment and benchmarking of health security and related capabilities across the 195 countries that make up the States Parties to the International Health Regulations (IHR [2005]). The GHS Index aims to spur measurable changes in national health security and improve international capability to address one of the world’s most omnipresent risks: infectious disease outbreaks that can lead to international epidemics and pandemics.

EcoHealth Alliance – Strengthening One Health Biosurveillance and Biodefense in the South Caucasus

The South Caucasus region lies at a geographic crossroads between the Middle East, Europe, Russia, and Asia, making it a critical region for global health security. In line with the strategic objectives of the Zoonotic Disease Action Package (ZDAP) and Workforce Development Action Package (WDAP), EcoHealth Alliance (EHA) partnered with a diverse array of One Health stakeholders from human and animal health, agriculture, wildlife, environment, national security, and other sectors to improve national and regional collaboration to prevent, detect and rapidly respond to emerging pathogens. EHA led virtual and in-person workshops with stakeholders from Armenia, Georgia, and Azerbaijan to assess national and regional methods to enhance biosurveillance and biodefense and identify efficiencies and commonalities across sectors and countries. EHA organized a regional workshop in Tbilisi, Georgia (6-8 December 2022), that brought together 42 participants from 20 different affiliations across the three countries: including Ministries of Health, Environment, and Agriculture, national security, academia, tourism, revenue service, and NGOs., and Azerbaijan) outlining opportunities to strengthen multisector collaboration in the South Caucasian region are currently being developed and will be published in 2023. The workshop aimed to foster cross-sector and cross-country collaboration and strengthen understanding of One Health concepts and operations. Over the 3-day workshop attendees participated in a zoonotic-disease tabletop simulation exercise, activities to identify emerging infectious disease risk factors and entry points for multisector collaboration, and training in core One Health principles. These activities were developed and implemented in alignment with the ZDAP and WDAP objectives of improving technical capacities of a multisectoral One Health workforce to support zoonotic diseases prevention, detection, and response activities and strengthen information sharing among GHSA member countries. The project was funded by a grant from Uniformed Services University to EHA under the Global Health Engagement Research Initiative (GHERI). 

EcoHealth Alliance – Strengthening One Health and Veterinary Programs in Africa

The persistent burden of endemic diseases like malaria, tuberculosis, and rabies – alongside emerging diseases like Ebola virus and COVID-19 – continue to pose challenges to health systems in Africa. Combating these challenges and preventing cross-border spread requires multisector One Health solutions. In an effort to strengthen regional and global health security, EHA partnered with experts from 11 African nations to assess coverage of programs to identify capacity and operational needs to tackle current and evolving health threats at regional, national, and continental levels. Funding for the project was provided via the Global Health Engagement Research Initiative (GHERI) from Uniformed Services University. Through extensive consultation with country experts, EHA conducted in-depth strengths, weaknesses, opportunities, and threats (SWOT) assessments of operational, political, logistical capabilities of One Health and veterinary systems.

Conservation International – Biodiversity – Health Convergence

GHSAC Member, Conservation.org provided this summary of work being done and a paper that was developed to address these challenges, In 2022, 196 government parties to the Convention on Biological Diversity (CBD) agreed to update and redesign their national biodiversity strategies and action plans (NBSAPs) by the end of 2024. This process offers an opportunity to influence the implementation of the Kunming-Montréal Global Biodiversity Framework and to shape how countries frame and address biodiversity–health interlinkages for the next decade. Historically, NBSAPs have not drawn on available health expertise in their implementation. This is the time to prioritize fundamental gaps in the knowledge-to-policy interface and to improve policy coordination to advance systems-level, holistic health approaches to implementation. This paper proposes recommendations for aligning NBSAPs to optimise outcomes for biodiversity and health. The paper can be found here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01431-9/fulltext. 

FHI360 – Cambodia establishes a Healthcare-Associated Infections (HAIs) Surveillance System

Globally, seven out of 100 hospitalized patients will be infected by HAI. The risk of HAI in low- and middle-income countries is double the risk in high income countries, often due to inadequate infection prevention and control measures, surveillance, and reporting system. Data on HAIs and IPC-related practices in Cambodia are scarce. Only one hospital is implementing HAIs surveillance.  The Cambodia Ministry of Health, in collaboration with EGHS and WHO, initiated a HAI surveillance pilot in six government hospitals. All six pilot hospitals developed HAI implementation plans, starting HAI surveillance in ICUs. HAI surveillance began in November 2023 using bi-weekly point-prevalence surveys. Establishment of HAIs surveillance system in pilot government hospitals is the initial step to strengthen IPC practices and improve safety among ICU patients, ultimately contributing to combatting AMR.

FHI360 – Guinea Pilots an Integrated Specimen Transport Mechanism to Strengthen Specimen Referral System

Since 2021, Guinea has piloted and scaled an integrated specimen transportation mechanism to address long turnaround times, high specimen rejection rates, delay in notification of results, and lack of appropriate biosafety and biosecurity precautions and cold chain. Guinea piloted an integrated specimen transportation mechanism utilizing public transportation and transportation unions to ensure frequent and consistent transportation of specimens. Training and defined processes for specimen packaging and storing for transportation, and an electronic specimen monitoring tool that includes temperature monitoring, allows Guinea to transport specimens from peripheral areas to referral laboratories in 24 hours, with ensured quality and reduced cost. Guinea’s integrated transport mechanism pilot has decreased specimen reception time from 7 to 10 days to 24 hours or less, decreased rejection rate of specimens from more than 10% to less than 1%, and improved turnaround time for laboratory results notification. The pilot success led to scale up to additional regions and expansion of integrated mechanism into 33 health districts. The success of this mechanism in transporting human specimens has also generated interest from partners at Ministry of Agriculture and Food and Agriculture Organization (FAO) to use this system to transport animal specimens under One Health surveillance. Collaboration across health sectors and among different stakeholders under a One Health approach is instrumental in expanding and strengthening strong specimen referral and transport systems globally.

FHI360 – Kenya Strengthens Multisectoral Emergency Preparedness and Response Capability

Training + preparedness plan and outbreak response guidance + EOCs improved emergency and outbreak response capability shown through cholera outbreak, polio outbreak and flooding response. 

• MOH-Disease Surveillance and Response to optimize data use through virtual training of 11 surveillance officers on data analysis and visualization using Power-BI to improve the division’s capacity to manage and use data
• Training of Kenya Red Cross Society emergency operation center (EOC) personnel on data management. 28 participants from
  five counties (Kilifi, Mombasa, Garissa, Kwale and Tana River) were trained on data literacy, data collection, data management, data analysis and data visualization. 
• The EOCs are expected to use the skills gained to generate quality data and optimize data use to inform preparedness and response to public health emergencies.
• Review and update the preparedness and response guidelines and plans to address emerging needs brought by the changing dynamics in occurrence and spread of cholera and Marburg virus disease. 

TA included examining global and national strategies and guidelines and experiences and lessons learnt from previous and ongoing
outbreaks and provided recommendations to improve existing plans.

• Improved ability to respond to ongoing cholera outbreak, worsened by current El Nino flooding across country. 
• Activation of national EOCs, daily sitreps and reporting, data compilation, analysis and visualization. 

Updated guidance and multisectoral coordination efforts allowing more effective response.

FHI360 – Rapid Detection of Tuberculosis Cases at the Peripheral Level in Bangladesh using Truenat

The Infectious Disease Detection and Surveillance (IDDS) project, with NTP, BRAC, and the Damien Foundation completed the first phase of the Truenat (a portable, battery operated TB diagnostic tool that can be used in remote sites with limited electricity) introduction in Bangladesh in 38 sites. Each site received refurbishments to ensure they were well-equipped to accommodate the new tool, new reporting templates, job aids, and other tools, and training and supervision/mentorship for end-users on the technical and programmatic components. A monitoring and supervision plan with a tailored checklist for supportive supervision of Truenat testing at the facilities was created to ensure sustainability of adequate support at the sites.

The data showed a steady increase in rapid testing (from 65 to 95%) and in bacteriological coverage (from 19 to 77%). The overall positivity rate for Truenat has been 7.5 percent, compared to 3.2 percent for microscopy in the rollout sites. The increased coverage of rapid diagnosis resulted in early detection of a large number of TB cases that would have remained undiagnosed with microscopy. 

The success of the Truenat rollout demonstrates its potential to improve TB detection, including DR-TB cases, particularly at rural and outlying health care facilities. Based upon the IDDS initial successful piloting, the NTP procured an additional 112 Truenat systems to improve access to the molecular diagnostics at peripheral level in Bangladesh.

FHI360 – Indonesia Supports the Detection and Surveillance of Priority Infectious Diseases

IDDS Indonesia supported the improvement and expansion of the SIZE is an integrated health surveillance information system that links public health, animal health, and wildlife health information systems to enable a One Health approach to disease surveillance in Indonesia. IDDS Indonesia supported SIZE gap analysis and the national SIZE Roadmap which guided the improvements to increase SIZE to support multiple diseases (Rabies, Anthrax, Avian Influenza and Leptospirosis) from one disease previously (rabies only), and made it accessible to healthcare workers via mobile apps or the web in four districts. Training materials have been finalized and a national launch and nationwide trainings are prepared for FY24. Animal health, human health, and wildlife all report disease information that feeds into SIZE, which then displays information from all three information systems so that health officers in all sectors can access and analyze OH data. SIZE is supporting GOI to optimize resources for surveillance and testing systems and improving timely and more accurate data collection and analysis for more effective disease monitoring and response. In the long term, this activity will contribute to improving the quality of its detection and response to emerging and priority diseases with epidemic and pandemic potential and mount a measured, timely, and less resource-intensive response

FHI360 – Ethiopia Strengthens AMR Detection and Surveillance through Intense Mentorship at Animal and Human Health Laboratories Makerere University Walter Reed Project (MUWRP)

Based on results from the Infectious Disease Detection and Surveillance (IDDS) project baseline assessment of AMR surveillance at Bahir Dar Animal Health Investigation and Diagnostic Laboratory (BAHIDL), IDDS, Ethiopia Animal Health Institute (AHI) and BAHIDL staff, initiated an AMR surveillance program to identify priority AMR pathogens and operationalized BAHIDL’s laboratory diagnostics. The mentorship focused-approach trained staff in areas to prepare the laboratory for International Organization for Standardization 17025 accreditation, which covers the competency of laboratories. Though some laboratories in Ethiopia are ISO 15189 accredited, none of the public health laboratories are accredited for bacteriology tests. The intense mentorship program was used at five human health AMR laboratories.

Makerere University Walter Reed Project (MUWRP) – Ongoing Efforts to Strengthen Global Health Security 

MUWRP implements a US DoD Global Emerging Infections Surveillance (GEIS) Network grant. This funding supports the Governments of Uganda and Somalia to strengthen surveillance for: influenza and other human viral respiratory pathogens, antimicrobial resistance (AMR), causes of acute febrile illnesses including viral hemorrhagic fevers, zoonotic pathogens in poultry, bats, swine, migratory birds, and cattle, pathogenic causes of acute enteritis and their antimicrobial resistance patterns, and pathogens harbored by vectors (ticks, mosquitoes, fleas, lice) in high risk areas for hemorrhagic fever outbreaks.

• These efforts contribute to Uganda and Somalia’s epidemic intelligence reports that are critical for early response in case of outbreaks.
• Our efforts have led to the development of guidelines and protocols for influenza and other respiratory pathogens surveillance by the Ministry of health. 
• Our data contributes to the national integrated surveillance system.

MUWRP sits on Uganda’s national task force on Integrated Epidemiology Surveillance and Public Health Emergencies. We provide technical advice to the Ministry of health during the weekly meetings on prevention, preparedness, early detection and response to global health security threats.

• We are contributing to the development of Uganda’s national action plan on health security.
• We are supporting the finalization of the Uganda biosecurity guidelines.

MUWRP’s JMEDICC Program utilized previous funding from US DoD JPEO through ACESO, to develop human resource capabilities and infrastructure relevant to conducting research on medical countermeasuresin especially dangerous pathogen infection outbreaks.  Current projects investigate causes of acute febrile infections in Rwenzori region in Uganda that is highly prone to outbreaks of high consequence pathogens.

• Seat at district, regional referral and national level emergency operation centers to provide technical support in terms of emerging infectious diseases.
• Maintain capability to respond to filoviral outbreaks
• Have developed protocols for use of investigational drugs during outbreak settings
• Maintain a facility and critical abilities for treatment of people with hemorrhagic fevers
• Ability to train and have mentored health workers in IPC, high level care of patients with especially dangerous pathogens.

Through our Sepsis study, we are contributing to the understanding of sepsis causes/outcomes and antimicrobial resistance patterns that will guide development of hospital and national guidelines.

Merrick & Company – Science Safety Hub 

GHSA Consortium Member, Merrick & Company developed the Science Safety Hub, a free online reference library for all things biosafety and biosecurity. The Science Safety Hub also contains standard operating procedure (SOP) templates, recorded video instruction for developing biosafety and biosecurity SOPs, recorded webinars on general biosafety and biosecurity best practices, as well as downloadable reference source links to additional webpages related to biosafety and biosecurity best practices.

The open-source reference library can be accessed from any computer or mobile device using the following link: https://www.sciencesafetyhub.com/. The Science Safety Hub helps to promote safe science practices around the world and serves as a tool for emerging scientists to use to enhance their knowledge and awareness of biosafety and biosecurity.

Merrick & Company – Facilitate Trainings in North Africa, Sub-Saharan Africa, and Southeast Asia

Merrick & Company facilitated a series of trainings in North Africa, Sub-Saharan Africa, and Southeast Asia for law enforcement, counterterrorism, counter weapons of mass destruction (WMD), and other relevant experts to review the principles of chemical, biological, radiological, and nuclear (CBRN) investigations and strengthen partner governments’ law enforcement investigative capabilities to prevent the criminal and terrorist acquisition of WMD materials. Participants in this training series gained a better understanding of employing foundational aspects of CBRN investigations to establish mitigation strategies to prevent, detect, and disrupt criminal and terrorist acquisition of WMD materials. Understanding how to influence operational and national-level implementation procedures and strategies is critical for countering CBRN terrorism.

The Gambia’s COVID-19 Response

The Government of The Gambia has committed $10 million USD to the COVID-19 response and formed a multisectoral committee to facilitate coordination. The development of the COVID-19 Plan and having the Incident Management Structure within the Public Health Emergency Operations Center (EOC) were some of the strengths that helped The Gambia in their COVID-19 response. The Joint External Evaluation and the development of the National Action Plan for Health Security helped The Gambia better understand the importance of multisectoral collaboration as they work to establish the One-Health Platform. Gambia’s request for technical assistance for COVID response led to a memorandum of understanding with Senegal’s EOC for epidemiological information sharing and development of Gambia’s Public Health EOC handbook.

The Gambia – Strengthening One-Health Coordination through the Multisectoral Coordination Mechanism Operational Tool 

Strengthen the One-Health Coordination Mechanism in The Gambia using the Multisectoral Coordination Mechanism Operational Tool (MCM OT) in May 2022. The main objective of the workshop is to promote, developed, and strengthen the collaboration, communication, and coordination mechanism between the One – Health partners including the Private Sector through Public-Private Partnership and shared health concerns at the human-animal-environment interface.

Indonesia’s Presidential Instruction No. 4 Strengthens Nationwide COVID-19 Response

Aligning with JEE recommendations, Indonesia published their National Action Planning for Health Security (NAPHS) in 2019 and instated the Presidential Instruction No. 4 of 2019, which provided the necessary legal foundation for nationwide efforts to respond to the COVID-19 pandemic. Notably, within the program of Zoonotic disease control, the One Health approach was taken to implement joint epidemiologic investigation and to develop the real-time reporting System of Information on Zoonotic Disease and EID (SIZE). In all, the issuance and implementation of the Presidential Instruction No.4 of 2019 has made significant impacts on the efforts to improve cross-sectoral coordination and collaboration in Indonesia.

 

 

Italy Chairs G20 Global Health Summit in Support of Health Systems and Response Preparedness

In 2021, Italy and the European Commission chaired the G20 Global Health Summit, comprised of initiatives geared towards strengthening preparedness and response to health threats. Leaders of G20 have laid out principles and guiding commitments, which will serve as voluntary orientation for current and future action for global health to support the financing, building and sustaining of effective health systems and Universal Health Coverage.

 

Italy Implements PanFlu to Fortify Influenza Preparedness Response

In 2021, Italy approved PanFlu, a new national plan for preparedness and response to pandemic influenza. In addition to strengthening preparedness and pandemic response at both national and local levels, the plan aims to reduce influenza case numbers and its impact on health, social and essential services, while protecting the health of first line respondents and preserving economic activities.

 

 

Malawi – One Health Approach

The Public Health Institute in the Ministry of Health in November 2018 activated its One-Health committee to respond to an outbreak of anthrax among the hippos in Machinga district. A total of 48 hippos succumbed to the disease. Good collaboration and response among the responding agencies resulted in the condition getting restricted within the animal kingdom. Neither humans nor livestock were affected. In addition no other wild animals were affected other than the hippos.

Malawi – Public Health Emergency Operations Center Activation

The Malawi Ministry of Health (MOH), activated the Public Health Emergency Operations Center (PHEOC) in both national and district level to coordinate the multisectoral COVID-19 pandemic, Wild Polio Virus outbreak and cholera response. This included multisectoral coordination group in Malawi and cross-border preparedness was established with meetings held by health officials from MOH, WHO and Partners in Mozambique and Zambia through inter-district committees for Cholera response.

Malawi – National Vaccination Campaigns

The Government of Malawi with support from partners has carried out all the planned four rounds of national vaccination campaigns, Supplementary Immunisation Activity(SIA) against wild poliovirus Type-1. Cooperation with UNICEF, WHO and Global Polio Eradication Initiative (GPEI) to strengthen immunization supply chain. Improving the LQAS in every round from 17%, 31%, 65.5%  and 72% in the first, second,  third and fourth rounds of SIA respectively. Ten functional environmental safety surveillance sites operational, 80% registering >50% positive isolation.

Malawi – National COVID-19 Preparedness and Response Plan

Development of the Malawi National COVID-19 Preparedness and Response Plan. Inter-Cluster Coordination, Health, Education, Public Communication, Local Governance, Protection and Social Support, Employment and Labour Force Protection, Transport and Logistics and Security and Enforcement, as opposed to the previous 15 (fifteen) clusters. Engage partners, including the United Nations agencies, and the private sector to technically and financially support the implementation of the interventions identified. It defines goals; underlying principles; strategic objectives; and key strategic interventions, with a view to building resilient capacity to manage the present outbreak and to prevent, prepare for and control future surges of the same.

Malawi – Emerging Health Issues Hotline Implementation

The Malawi Minister of Health hosted health officials from South Africa for a three-day visit to learn more about the Chipatala Cha Pa Foni (CCPF) idea that Malawi has been implementing since 2010. CCPF has been handy in dealing with emerging health issues including Covid-19, polio and the current cholera outbreak by providing a hotline, enabling people to call and talk to qualified health workers and listen to prerecorded messages on different health topics.

Mekong Basin Disease Surveillance – Progress in Combatting Antimicrobial Resistance for Member States

Documentation of: (1) Monitoring Regional Progress on Addressing Antimicrobial Resistance in the WHO South-East Asia Region (2) Antimicrobial Resistance (AMR) Progress in Addressing AMR “Cambodia, Lao P.D.R and Myanmar” (3) Antimicrobial Resistance (AMR) Mapping and Gap Analysis “Cambodia, Lao P.D.R and Myanmar” and (4) Antimicrobial Resistance (AMR) Tricycle Program “Cambodia, Lao P.D.R and Myanmar” during 2020-2022. Identify progress and gap related with AMR activity and supporting reviewing of Member States AMR NAP and implementation.

Pakistan – Integrated Disease Surveillance and Response

Integrated Disease Surveillance and Response (IDSR) is a strategy devised by the World Health Organization (WHO) to strengthen the surveillance system. An effective communicable disease surveillance and response system is a critical need for every country as it can ensure early detection of threats, save lives, prevent disease, and contribute to rationalizing resources and fulfilling global responsibilities. Pakistan, the fifth most populous country with inadequate public health services, is no exception. Since 2016, Pakistan has developed a comprehensive IDSR training program for health facility in-charges aligned with the health department’s objectives. It strengthens priority disease response and local capacity to address endemic and emerging communicable diseases. The program focused on building local capacities to detect priority infectious diseases, report cases to District Health Information Software (DHIS)-2, and respond to disease alerts, clusters, and outbreaks. Pakistan has a frequent history of seasonal episodes of disease outbreaks.

From January 2023 till August 2023, more than 90 districts of Pakistan with approximately 5400 trained personnel have been trained on IDSR. Currently, IDSR is implemented in 136 districts of Pakistan (80% coverage in the country), reporting 33 notifiable diseases with 100% coverage in Sindh and AJK. Monitoring 33 notifiable diseases through DHIS-2 under IDSR holds significant public health importance.

Pakistan – Successfully Completed 2nd International Health Regulations (IHR) Joint External Evaluation (JEE)

Pakistan was the first country to volunteer for the JEE in the EMRO region in 2016; a baseline of Pakistan’s IHR core capacities and Global Health Security Agenda (GHSA) to develop a five-year National Action Plan for Health Security (NAPHS) was established. Subsequently, a 5-year roadmap was developed, prioritizing real-time surveillance and Integrated Disease Surveillance and Response (IDSR). The United Kingdom Health Security Agency (UKHSA), National Institutes of Health (NIH), and Federal Ministry of Health developed an IDSR three-pillar strategic approach to implement IDSR across Pakistan, strengthening coordination, core surveillance functions, response, preparedness, human resources, and laboratory capacity. This initiative is aligned with Pakistan’s health department objectives and strengthens priority disease response and local capacity to address endemic and emerging communicable diseases. The program focuses on building local capacities to detect priority infectious diseases, report cases to DHIS-2, and respond to disease alerts, clusters, and outbreaks. 

Post-JEE, in addition to NAPHS planning and its implementation, the second round of JEE is critical to continue building momentum toward preventing, detecting, and responding to infectious disease risks. Pakistan completed JEE for the second time in 2023 post-COIVD 19 to identify gaps and track progress. Pakistan will use the results to prioritize actions to improve preparedness and response capacities, strengthening health systems and preparedness capacity. Further, based on the findings of the second JEE and Mission Report Recommendations, the national health security action plan will be updated. This evaluate-plan-implement cycle will allow Pakistan to systematically determine how to improve national health security most effectively and further strengthen global health security. To increase Pakistan’s IHR core capacities and to strengthen IDSR, three key priority areas:

• Supporting effective structures and coordination, establishing transparent processes for coordination and reporting of health data.
• Strengthening core surveillance through detection, reporting, analysis, and preparedness.
• Supporting practical support functions through workforce development, lab networks, workforce development/HR, and SOPs/guidelines.

Government partners are closely involved in the planning, delivering, and evaluating country activities. Over the next few years, IDSR capacity will be enhanced by strengthening coordination structures, core surveillance, and critical support functions, exploring new areas for collaboration with the national government on Emergency Preparedness, Resilience and Response (EPRR), chemical and environmental hazards, and multisector coordination.

Pakistan – National Health Security and Public Health Emergency Operations Centre (PHEOC)

Pakistan’s PHEOC supported the development of a National Plan for COVID-19 Operational Research, created an emergency response plan, and strengthened surveillance. In addition to COVID-19, PHEOC effectively responded to  Cholera and Monkey Pox. Further, the Incident Management Structure (IMS) within the PHEOC, Joint External Evaluation (JEE), and the National Action Plan for Health Security (NAPHS) development are crucial for enhancing multisectoral collaboration and establishing the One-Health Platform.

Public Health Emergency Operations Centre (PH-EOC) and Incident Management System (IMS) provided a platform for inter-sectoral coordination, and collaboration to enhance the efficiency of response activities and help in the effective control of disease outbreaks. Pakistan faced a heavy outbreak of Dengue fever (DF) from August to December 2019. National Institute of Health (NIH), Islamabad activated its Public Health Emergency Operations Centre (PH-EOC) with the objective of implementing principles and practices of IMS for control of the outbreak. PH-EOC was activated on 16th September 2019 and remained operational for the next 81 days till 05th December 2019. Incident management structure, incident action plan (IAP), and risk communication plan were developed and executed during this phase. A task force and technical committee, as an advisory, for multi-sectoral and multi-disciplinary collaboration were formed. Under the committee, daily morning and evening meetings were held during all operational days. Federal and provincial health departments, district health offices (DHO), and government/private hospitals were coordinated for the collection of the data pertaining to Dengue-confirmed cases and deaths. As of 05th December 2019, a total of 52,877 confirmed Dengue cases were reported from all across Pakistan. Four sections of SOPs were developed including operation, logistics, finance, and planning. Provincial Disease Surveillance and Response Units (PDSRUs) were linked with- committees and Task Forces. The available national data collected from 2015 to 2023 by FE&DSD, NIH, Provincial Health Departments, Provincial Disease Surveillance and Response Units (PDSRUs), Expanded Program on Immunization (EPI), Directorate of Malaria Control and laboratory-based data from NIH has been analyzed to assess the exhibited patterns of high priority communicable infectors diseases.

These National IPC Guidelines were prepared with the help of experts from the WHO and a national technical working group comprising medical microbiologists, infectious diseases physicians and consultants in public health from all over the country. The entire process was facilitated by the National Institute of Health (NIH) in Islamabad. In addition, it was very influential in antimicrobial consumption and strengthened the Antibiotic Stewardship programme, to reduce the burden of antimicrobial resistance (AMR) which is a global priority.

In December 2017, Pakistan recognized the significance imparted to diagnostic laboratories under the IHR (2005) and One Health agenda.  Realizing the importance, The National Laboratory Policy was developed in a series of interactive, facilitated workshops involving primary stakeholders and some external facilitators from WHO and the Royal Tropical Institute (KIT) in Amsterdam. the National Laboratory Policy was integrated with already existing health policies and strategies and at the same time incorporated with international best practices in laboratory systems strengthening. In order to ensure wider national ownership as well as the commitment of all relevant parties, a post-workshop policy dialogue phase and consultations with all stakeholders was performed.

Philippines – Establishment of the COVID-19 Genomic Biosurveillance Program

The COVID-19 Genomic Biosurveillance Program was established in 2021 to provide additional evidence for quick COVID-19 response through the detection of and monitoring of circulating SARS-CoV-2 variants. Provide strong evidence to support the need for stronger border control and enabled the country to stop the transmission of 1 VOC (Gamma VOC). Reinforced community-led activities (i.e. Minimum Public Health Standards) to motivate individual and social responsibility to slow down transmission,
alleviate stretched health systems and protect the most vulnerable through the creation and implementation of Pandemic Surge Preparedness and Response Plan in preparation for entry of the Delta VOC in June 2021 and subsequent increase in cases, including stockpiling of oxygen supplies.

Philippines – Implemented the COVID-19 Alert Level Classification System

The Philippines implemented COVID-19 Alert Level Classification System through the Presidential Executive Order No. 151 series of 2021. Provided an objective matrix to assess the risk at the national, subnational, and local levels. Each risk level had specific public health and social measures for implementation resulting in consistent and risk-appropriate response across all levels. Allowed businesses and establishments in low risk areas to gradually reopen.

Philippines – Reconstituted Key Committees to Provide Evidence-Based Surveillance

Reconstitution of the following key committees to provide evidence-based surveillance strategies and actions to effectively guide public health policies and response:

• National Adverse Events following Immunization Committee
• National Polio Expert Review Committee
• National Verification Committee for Measles

These key committees allowed the health sector to engage the private medical professionals and medical societies to share their expertise to and ensured:

• Timely conduct of causality assessment for serious AEFI cases detected/identified;
• Closure of polio outbreak in 2021; and,
• Update the subnational measles risk assessment

PSRT – PSRT Signs Memorandum of Understanding with Uganda’s Ministry of Health

The PSRT signed a Memorandum of Understanding with Uganda’s Ministry of Health in 2021 committing to work together to improve national health security. This strategic partnership is engaging PSRT member companies to help Uganda address urgent challenges in responding to health emergencies. The PSRT, the Ministry of Health, and the Public Health Emergency Operations Center in Uganda identified needs concerning human capital development and health workforce strength, gaps in awareness about the importance of investments in health security, and opportunities to enhance monitoring and evaluation systems.

PSRT – J&J’s Partnership with Rwanda’s Ministry of Health

Johnson & Johnson (J&J), a member of the PSRT, partnered with Rwanda’s Ministry of Health to train personnel in vaccinating over 200,000 individuals with its two-dose Ebola vaccine regimen. Led to over 94% adherence, as well as while a mobile training platform will reinforce key public health messages for the community health worker population.

PSRT – UPS Training Program to Handle Complex Ultra-Cold Chain Vaccines

UPS, a member of the PSRT, provides tools and training to build healthcare workers’ capacity in how to handle complex ultra-cold chain vaccines, enabling them to treat the most vulnerable populations and expand healthcare coverage. Through its efforts, UPS delivered more than 50 million COVID-19 vaccine doses during the pandemic and provided over 100 ultra-cold freezer across the African continent.

PSRT – Becton, Dickinson and Company Collaborated on Public-Private Partnership – Labs for Life

Becton, Dickinson and Company (BD), a member of the PSRT, collaborated with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the U.S. Centers for Disease Control and Prevention (CDC) and ministries of health in a public-private partnership called “Labs for Life,” to strengthen laboratory systems in countries across Africa and Asia. Labs for Life has provided frontline training for laboratory staff in seven countries with high rates of HIV. BD contributed personnel time through trainers, mentors and subject matter experts, and deployed more than 300 Global Health Fellows to short-term, in-country assignments.

PSRT – Qlik’s Developed an Interactive Data Analytics Platform on the WHO’s Strategic Partnership and Health Security Portal

Qlik, a member of the PSRT, developed an interactive data analytics platform that will be available on the WHO’s Strategic Partnership for Health Security portal to help countries gauge health system capacity and the state of health system preparedness. Collecting data on early-stage respiratory, diarrheal, neurologic, hemorrhagic and acute febrile syndromes, this dynamic tool proactively informs decisions and action plans to improve health system capacity and respond to epidemics and other health emergencies.

Nigeria – Establishment of the Nigerian CDC Office of the Director General

Establishment of the subnational dept. The NCDC formed a new department with the primary task of providing coordination support to Nigerian states. This is consistent with the NCDC’s aim to build subnational capacity to effectively plan for, detect, and respond to infectious illnesses and public health emergencies. The Subnational Support Department is divided into three divisions: subnational public health emergency operation center, advocacy and health promotion, and liaison. Subnational support officers collaborate with the State Ministry of Health and other MDAS to ensure a synergy between the national and state levels for infectious disease preparedness and response. The formation of the Subnational Support Department demonstrates the
NCDC’s commitment to bolstering subnational capacities for infectious disease preparedness and response. The department
intends to increase coordination, advocacy, and communication between the national and state levels by establishing dedicated
divisions and engaging with state ministries and other agencies. This can result in more effective infectious disease planning, detection, and response, thereby improving Nigeria’s overall health security.

Nigeria – Expansion of Laboratory Diagnostic

The expansion of Nigeria’s lab network, where a molecular lab is established in each state to strengthen diagnostic capacity in Nigeria has made the country to become west Africa’s regional lab for the Africa CDC and serves as the National Aids focal person and a key contributor to sharing sequencing data. This development has filled up previous gaps in our lab capacity by increasing the
number of labs which shows how investment in health security is beneficial to the nation and members of the GHSA in achieving our goals.

Nigeria – SARS-COV-2 Testing at National Reference Laboratory

Covid-19 testing was made a priority by the presidential steering committee in COVID-19 and the federal ministry of health as one of the key interventions enlisted the national reference laboratory (NRL) of the NCDC to generate reliable results for the timely management of COVID-19 infected patients and provide information for public health decisions.This led to the creation of a
framework that effectively coordinated and managed COVID-19 and improved the capacity of the NRL.

Nigeria – Review and Validation of National Public Health Workforce Strategy

With the use of this approach, the nation will be able to define the tasks and responsibilities of public health professionals and give
pertinent information about the workforce’s current makeup and geographic distribution. Human resources for health desk officers
participated in a one-day stakeholders meeting in 2021 to discuss how to carry out this process successfully. Additionally, all states
receiving world bank funding under redisse had public health workforce maps completed. The stakeholder meeting achieved its goal of finalizing and validating the consultant’s draft NPHWFS. This is intended to address parts of the plan that call for input from pertinent parties. The program addressed the IHR JEE’s gap and identified the need to improve the coordination of health personnel for capacity building.

Nigeria – Strengthening Sub-National Disease Surveillance

High-level convening on incorporating new frontiers in developing an effective surveillance system. Participants includes state
epidemiologists, disease surveillance/notification officers, laboratory focal persons, health promotion officers (HPO), national
stakeholders, and representatives of partner organizations. Participants adopted a one health strategy which includes crucial participants from important departments, agencies, and government ministries (Health, Agriculture, and Environment). REDISSE, UMB, AFENET, RTSL, UKHSA, and US CDC were partners who provided support for this event. The meeting intends to enhance the early detection and response to potential disease outbreaks, thereby preventing them from becoming epidemics, and it also promotes the importance of biosafety and biosecurity measures. By including the One Health approach, it demonstrates the relationship between human, animal, and environmental health, as well as the importance of international, multilateral, and multisectoral collaborations in achieving global health security.

 

Senegal’s infection prevention and control activities contributed to COVID-19 mitigation

Senegal employed infection prevention and control (IPC) strategies to improve its response to COVID-19. The Senegalese Ministry of Health (MoH) worked with the Alliance for International Medical Action (ALIMA) to ensure 125 healthcare professionals from 23 health structures were appropriately trained in IPC. Additional medical equipment and treatment facilities allowed for rapid detection of severe COVID-19 cases and improved quality of treatment. Early efforts to isolate all positive cases in facilities including hotels also made a clear impact on the first wave of COVID-19 cases.

 

 

Southeast Asia One Health University Network (SEAOHUN) – Developed One Health Education Curriculum with Partnership from Chevron

SEAOHUN has been funded by Chevron, a member of the GHSA Private Sector Roundtable, since January 2021 to strengthen One Health education and raise One Health awareness in school-aged children and their teachers; university students and their professors; and practicing health professionals working to solve complex health issues in their communities throughout Southeast Asia.

A collaboration between the Southeast Asian Ministers of Education Organization (SEAMEO) Tropical Medicine and Public Health (TROPMED) Network, SEAMEO STEM Education and SEAOHUN to improve One Health literacy among Thai school children resulted in the development of four One Health modules for Kinder 1 to Grade 9 that can be mainstreamed into school curricular. The SEAMEO TROPMED Network is now convening high officials of SEAMEO member countries and SEAMEO centers along with FAO, UNESCO and WOAH to identify how One Health curricular could be integrated into schools throughout Southeast Asia.

As a result of the collaboration between SEAOHUN, SEAMEO TROPMED and SEAMEO STEM-ED to promote One Health education in Southeast Asia, SEAOHUN has been granted SEAMEO affiliate membership status. 

SEAOHUN has fostered One Health young leaders through student engagement programs among more than 100 SEAOHUN member universities. More than 100 health professionals from around the world learnt how to apply the One Health approach to solve their community health challenges through an online course delivered in collaboration with the Tropical Disease Research Center (TDRC) of Khon Kaen University, Thailand. Twenty-three One Health professionals from eight Asian countries who completed the course were selected to visit the demonstration field site in Thailand so they could apply the lessons learned in their countries.

Thailand Implements GHSA on Provincial Levels, Encouraging Collaborative Disease Response

Thailand has applied the Global Health Security Agenda (GHSA) to provincial levels, encouraging collaborative approaches to effective disease response. Prior to COVID-19, disease prevention and control activities were led mainly by the health sector as a standard method of practice, posing obstacles of cooperation along border areas. As a result of GHSA implementation on local levels, Thai stakeholders of various geographical representation and representing a wide variety of disciplines, including medicine, immigration and security, have convened in open discussion on coordination practices for improved detection and response to emerging infectious diseases.

 

Thailand Establishes Regional Public Health Laboratory Network to Expedite Information Sharing

In October 2019, Thailand established the Regional Public Health Laboratory (RPHL) Network to expedite the implementation of a Strategic Roadmap on Laboratory System Strengthening, aligning with the GHSA. The RPHL strengthened communication between country members through the nomination of POCs within ASEAN Member states, Nepal, and key development partners of GHSA Permanent Advisors: FAO, OIE and WHO. As a result, RPHL encouraged effective resource mobilization and information sharing platforms, which were valuable in organizing technical sessions based on requests of GHSA members during the COVID-19 pandemic or sharing updated guidelines on the RPHL Network Website.

 

Thailand’s Regional Public Health Laboratory Network: Regional approach to advancing global health security 

The Regional Public Health Laboratory Network (RPHLN), represented by national public health laboratories of 12 countries members [ASEAN Member States, Nepal and Timor-Leste] aims for efficient and reliable health laboratory systems in Asia Pacific.

In addressing the two strategic objectives of the RPHL Network:

• Facilitate capacity building
• Build knowledge management platform among members and others, a Situational Assessment for capacity building development was conducted in December 2022 with two objectives:

1. 1. Inform more targeted and tailored interventions
   2. Identify and leverage country capacity strengths and opportunities for interventions

This assessment was a joint collaboration of the RPHL Network with key development partners including CHAI, FIND, US CDC, WHO, and the Global Fund. A country-driven workplan on Capacity Building Development [2023-2027] promoting peer-to-peer and south-south cooperation

Find out more about the network, please visit the website RPHL Network (therphl.net).

Thailand – Sub-National Global Health Security Program  

Drawing upon the Vision, Mission, and Core Principles of the GHSA 2024 Framework, Thailand implemented a sub-national global health security program that embodied a multi-sectoral approach (including agencies representing public health, animal health, interior, labor, academia, village health volunteers, NGOs, natural resources and environment, defense, and foreign affairs) and galvanized local leadership in order to develop core capacities in 16 border provinces. 

Through this program, Thailand developed provincial-level, multisectoral action plans in 16 border provinces that can implemented during health emergency situations. Each province assumes ownership of their action plans, which aim to address gaps based on the GHS Index and JEE.

Examples of follow up activities include emergency preparedness for diseases and health hazards through table top exercises, joint-cross border Field Epidemiology Training Program training for workforce development, and training programs for Communicable Disease Control Units (CDCUs) for multi-sector outbreak response.

Thailand – Workforce Development and Multisectoral Collaboration: Migrant Health Volunteers for pandemic prevention, control, and response 

Migrant Health Volunteers (MHVs) have played a crucial role during the COVID-19 pandemic in Thailand, especially in responding to a large outbreak among migrant communities in Samut Sakhon province. To overcome communication and cultural barriers between public health, healthcare, and migrant communities, Thailand applied the concept of the village health volunteer workforce (consisting more than 1 million volunteers) to reach migrant populations. Migrant Health Volunteers have become a critical aspect of the health workforce for disease prevention, control, and response due to their unique ability to access all corners of the population.

Thailand coordinated across sectors to build a network of 1,700 migrant health volunteers across the country. In collaboration with local administrative agencies and international organizations, Thailand conducted training for capacity building (Disease prevention and control) on topics such as outbreak investigation, contract tracing, risk communication, event-based surveillance, basic case management for MHVs. Tasks for MHVs were integrated with local public health administrative units for COVID-19 prevention and response. Best practices on MHVs were shared with neighboring countries.

Impact from these programs included:

• Improved communication between local public health agencies and the vulnerable migrant communities.
• Enhanced community trust and engagement between migrants and migrant health volunteers
• Developed capacity for MHVs to support surveillance, detection, and rapid response to prevent the spread of outbreaks in migrant communities
• Improved access to essential healthcare services for migrant in Thailand

Togo Prioritizes Antimicrobial Resistance Surveillance through Professional Workshops and Laboratory Support

With AMR posing a significant public health threat, AMR surveillance activity has been a new strategy targeted for Year 3 and 4 programs in Togo. In 2019, Togo led antimicrobial resistance (AMR) workshops for health personnel and students in various regions, providing successful sensitization on how to address AMR threats. In addition, 14 laboratories performing AMR surveillance were visited by national AMR experts and were provided with effective monitoring supervision.

 

 

Ukraine Implements Intra-Action Review to Strengthen COVID-19 Response

In January 2021, an Intra-Action Review was conducted in Ukraine to assess their national and subnational COVID-19 response. The review provided an opportunity to share experiences and collectively analyze the ongoing in-country response to COVID-19 by identifying challenges and best practices. Through consensus building among and the compiling of lessons learned by various stakeholders during the response, the review aided in improving the current response by sustaining best practices that have had demonstrated success and by preventing recurrent errors. Following the review, Ukraine was able to utilize the lessons learned to strengthen health systems, while also providing a basis to validate and update the Country COVID-19 strategic preparedness and response plan and other strategic plans accordingly.

Ukraine Completes JEE to Address Gaps in Preparedness and Response Capacities

Since March, 2021, a WHO Joint External Evaluation (JEE) has been conducted in Ukraine to engage all stakeholders to identify critical gaps within human and animal health systems. Though currently in a stage of self-assessment, Ukraine can use the results to prioritize actions to improve preparedness and response capacities, strengthening health systems and preparedness capacity.

Ukraine Establishes Emergency Operational Center to Prevent Health Emergencies and Educate Public

Within their Public Health Center, Ukraine has established an Emergency Operational Center (EOC), which ensures preparedness capacity and the implementation of measures to prevent and respond to emergencies and hazardous events. Additionally, the EOC is responsible for monitoring and prediction of the occurrence of emergencies and their development in the health care field, identifying the risks of emergencies and providing timely information to interested executive bodies and the general population.

Ukraine Develops Legal Framework and Emergency Response Plan to Support Biosafety and Biosecurity

With the goal of strengthening response capabilities and threat identification, Ukraine has developed a Law on Biosafety and Biosecurity, assembling a working group and sending a first draft to the MOH by the OSCE for approval. In addition, Ukraine has developed the National Public Health Emergency Response Plan of Ukraine, which describes and identifies the main roles and responsibilities of all relevant stakeholders in case of public health emergencies. Aligned with the One Health Approach, Project Law “On the System of Public Health” has also been recently developed in Ukraine to support full-fledged systems of epidemiological surveillance.

Ukraine – Public Health Center of the Ministry of Health of Ukraine Organized a Series of Events at the Regional and National Level with the Aim of Epidemiological Surveillance Improvement 

In 2023, the Ministry of Health responded to the outbreak of poliomyelitis in the country, trainings were held for epidemiologists of the Center for Epidemiological Diseases, medical workers of health care institutions of Zhytomyr, Cherkasy, and Chernihiv regions on polio surveillance.

The Law of Ukraine “On the Public Health System” introduced a comprehensive “One Health” approach, which should promote better communication between the health care service, veterinary service and authorities in the field of food safety. This law also contains a clear provision that information on cases of infectious diseases common to animals and humans should be established and exchanged between the bodies and institutions of veterinary medicine and health care institutions. In this regard, a seminar on prioritization of zoonotic diseases based on the principle of “One Health” was held, at which zoonotic diseases of greatest concern were identified by specialists of the department using a multisectoral “One Health” approach based on equals contributions from representatives of the human health, animal health (livestock and wildlife) and environmental health sectors and other relevant partners.

Conducting online training on the topic: “Deepening knowledge about zoonotic influenza”. Training for influenza surveillance workers.

Round table “Strengthening cooperation with the mechanisms of cooperation with the Ministry of Agriculture and the State Service of Ukraine for Food Safety and Consumer Protection on the exchange of knowledge on zoonotic animal influenza virus and sample results and increasing the ability to identify new influenza viruses in animals and humans and the ability to identify pandemic threats”, Training on contact tracing and response to outbreaks at the regional and sub-regional level in Chernivtsi and Uzhgorod.

Work has begun on implementing a pilot project, jointly with Concentric by Ginkgo, on monitoring the environment and detecting cholera, COVID-19, and participation in training.

Trainings for epidemiologists of the Center for Syndromic Epidemiological Surveillance have been started.

UK Provides JEE Support for IHR Compliance and Health Systems Strengthening

Through Public Health England and the Tackling Deadly Diseases in Africa (TDDA) Program, the UK has provided direct technical input into 46 WHO Joint External Evaluations (JEEs) across all WHO regions, spearheading assessment and evaluation of preparedness capacities. Furthermore, through its Official Development Assistance (ODA) programming, the UK has provided support in twelve ODA-eligible partner countries to strengthen IHR compliance post-JEE, using JEE insights to improve health systems within low and middle-income countries.

UK Takes Collaborative Approach to Antibiotic Stewardship in Livestock

Recently, the UK has taken a voluntary collaborative approach to antibiotic stewardship in livestock production, cutting antibiotic sales for food-producing animals to half of that in 2014, making the UK one of the lowest users of antibiotics in agriculture across Europe, and the lowest of those countries with a significant livestock farming industry. Additionally, the UK is committed to sharing knowledge regarding exploring options for implementing antimicrobial stewardship in their own livestock farming sectors, and have produced a forthcoming report highlighting this approach.

UK Tackles Antimicrobial Resistance through Surveillance and Laboratory Support

Since 2016, the UK has committed over £265 million to tackle the escalating threat of antimicrobial resistance (AMR) through building One Health AMR surveillance and laboratory capacity in 21 low and middle income countries across Africa and Asia. As a result, 10 out of 20 countries enrolled by December 2020 reported that their AMR surveillance capacity had increased by 20% or more, with more than half of the countries sharing data with the Global AMR Surveillance System (GLASS), which can be used to support governments to take informed action against AMR and help improve patient care.

The UK government has committed to tackling the escalating threat of AMR through building One Health AMR surveillance and laboratory capacity in low- and middle-income countries across Africa and Asia, including through the Fleming Fund.

The achievements from the first phase of the Fleming Fund programme are showcased in a Phase I Report, titled ‘The Fleming Fund Phase I: A Summary’. Impacts include quantification of the  burden of AMR worldwide through the Global Research on AMR project; country level estimates of AMR burden were recently launched as part of a data visualisation hub.

UK Support Countries and Regional Organizations to Strengthen Health Security 

The UK has invested over £150m Official Development Assistance (ODA) funding since 2016 to support low- and middle- income partner countries and regional organisations to prepare, prevent, detect and respond to disease outbreaks and health threats and strengthen health security.

For example, the International Health Regulations Strengthening Project has partnered with the Ethiopian Public Health Institute to strengthen public health capabilities in Ethiopia, including, at their request, their capacity to detect MPox cases in-country. Working with local partners, the project team trained 36 staff from 12 regional labs to build capability to detect MPox across Ethiopia, as well as other Pox viruses. As a result, the Ethiopian Public Health Institute delivered the first MPox test in Ethiopia and has now delivered over 1200 tests. 

The Tackling Deadly Diseases in Africa Programme (TDDAP) has helped to integrate participation of civil society organisations (CSO) into health security structures within our 5 partner countries. CSOs are now part of the National One Health Platforms and are being brought from the fringes of Global Health Security structures into the main fold, recognising their key roles as the actors with eyes and ears on the ground. 98% of the 111 CSOs TDDAP has worked with represent vulnerable groups and/or geographically vulnerable areas. Through CSO-led vaccination sensitisation and awareness campaigns, TDDAP reached over 1.7m people across Uganda, Chad, Mali, Cote D’Ivoire and Cameroon.

UK Supports GHSA Action Package Working Groups

The UK has chaired the GHSA Zoonotic Diseases Action Package (ZDAP) for two years, from 2022-2023. The UK Chair and Secretariat has been a successful cross-government collaboration between the UK Health Security Agency and the Department of Environment, Food and Rural Affairs.

As of mid-2022, we have held 15 meetings of the Action Package with 14 presentations, including a meeting co-hosted with the AMR Action Package and a GHSA lessons observed webinar seminar. Working in partnership with the Dutch chairs of the AMR Action Package, we also held a side meeting on One Health at the GHSA Ministerial Meeting in 2022.

The UK ZDAP Chairs have produced four reports and submitted two articles on ZDAP for the GHSA newsletter to highlight key activities.

UK  Evaluates and Supports Pilot Program to Develop New Antimicrobials 

The UK has piloted a new way of evaluating and paying for antimicrobials, introducing a pilot subscription model in England that de-links payments for two antibiotics from the volumes used. This project is the first implementation of a fully delinked pull incentive globally. It aims to incentivise the development of new antimicrobials by ensuring that the level of remuneration over the lifetime of the product is sufficient to make it commercially viable for companies to develop new products and bring them to market – a “pull incentive.”

This project contributes to the strategic objectives of the GHSA AMR action package, which the UK has previously chaired. In particular:

• supporting the Global Action Plan on AMR, which highlights the need to incentivise development into new antimicrobials
• keeping AMR on the agenda at the highest political levels at multiple fora.

Officials in the UK continue to engage with their counterparts in other countries to share lessons learnt from this project.