ABIDJAN — A year and a half ago, the Africa Centers for Disease Control and Prevention was created as a continent-wide public health agency, aimed at helping African Union countries respond to health emergencies. It joined the ranks of other international institutions working to protect the health of the continent — its hope is that with increased understanding of local contexts, African experts could provide a more timely, coordinated response.
Since its official launch in January 2017, Africa CDC has intervened in 10 crises, from the Lassa fever outbreak in Nigeria; to landslides in Sierra Leone; to, most recently, the Ebola outbreaks in the Democratic Republic of the Congo.
“What we are bringing now is the Africa response that was missing for so long,” Benjamin Djoudalbaye, Africa CDC’s head of policy and health diplomacy, told Devex.
Its strategic priorities for the next five years include strengthening surveillance systems and establishing disease “intelligence hubs” to improve public health action. The group also seeks to improve workforce competency through inspections of clinics and labs.
Devex spoke with Djoudalbaye on the role of Africa CDC in building the continent’s health systems.
The conversation has been edited for length and clarity.
Africa CDC’s mandate tasks it with establishing early warning and response surveillance systems to address health emergencies quickly and effectively. What kind of systems are being used?
We have an emergency operations center in Addis Ababa, so whenever there is an outbreak or alert, we activate the center. It operates as an electronic-based tool. We scan the continent to detect an emergency signal in wildlife, the environment, or an outbreak. If we don’t receive an alert from the country, we let them know what is going on and ask if they are on top of it.
If the country is aware and has already sent a team, then they share the results of their investigation with us and detail if, and where, they require support — this is the event surveillance aspect that we are advocating because it is very critical.
Another initiative being widely implemented on the continent is “integrated disease surveillance and response.” This is an indicator-based method, which means a suspected disease has to be detected in a health facility, reported to the district head, sent to the regional director and capital city — so there is a delay.
We are crafting a response system using event surveillance coupled with the integrated disease surveillance so that we have a robust system in place where we cannot miss any event that could have life-impacting consequences.
What are some of the longer-term, strategic objectives of the Africa CDC?
Africa CDC has a five-year strategic plan, 2017-2021, with five strategic pillars: Disease intelligence and surveillance; preparedness and response; information systems; laboratory networks and systems; national public health institutes and public health research.
Pillar number five is very critical because we have many public health institutes on the continent, but they don’t perform the same functions. We now have a framework to determine the core functions for a national public health institute. If there is an outbreak, it should be the institute’s responsibility to address the response.
“Many systems are being utilized on the continent but we are trying to create a harmonized platform.”— Benjamin Djoudalbaye, head of policy and health diplomacy, Africa Centers for Disease Control and Prevention
We have put up a call for funds that can help us to develop electronic-based surveillance. We appreciate that some countries, such as Tanzania, have implemented Afia Health. Using very simple mobile phone technology, health care workers can enter the symptoms, the number of cases, and even the geo-localization of suspected cases to determine the cluster size. If it passes a threshold, they can declare an outbreak.
Many systems are being utilized on the continent but we are trying to create a harmonized platform. We are also strengthening laboratory capacities for diagnosis and workforce development because there is a huge gap in human resource capacity in African health centers.
Is there any criteria for Africa CDC support?
Our intervention is based on the request of member states. Now that countries know there is an Africa CDC, they call us for support in the field whenever there is an outbreak. We support in conducting needs assessments, send full teams to support outbreaks or coordination — there are many deployment types but they depend on the request from the country.
Let’s talk about how Africa CDC is currently responding to the Ebola outbreak in North Kivu, an ongoing conflict zone. As head of mission, can you discuss in what ways your team has supported the Congolese Ministry of Health?
Currently, what we are doing is based on our comparative advantage. In 2015, during the Ebola outbreak, the African Union Commission pledged to establish the Volunteer Health Corps and this standby workforce can be mobilized to respond as needed anywhere on the continent.
We established a roster of experts — Ebola responders in West Africa in 2014-2016 — and are expanding our training to get other experts onto the roster. [The African Union, of which Africa CDC is now an agency] deployed 87 volunteers from DRC to Guinea to respond to the Ebola outbreak, and these are really subject matter experts in terms of Ebola.
We are able to mobilize them within 24 to 48 hours, based on the needs of the country and our roster. They work in different pillars associated with our strategic framework such as patient surveillance and the improvement of lab systems.
How have Africa CDC interventions on the ground evolved since the emergency operational center was launched in May 2017 to monitor an Ebola outbreak in DRC?
When there is an outbreak, there are many responders and Africa CDC is one of them. What we are bringing now is the Africa response that was missing for so long. If anything happens, we rely on external partners. But now if there is anything on the continent, countries call on Africa CDC to come on board and respond.
For instance, when there was the plague outbreak in Madagascar, Africa CDC strengthened the capacity of the ministry of health in establishing the incident management system. What made the difference was that this system brought in a multisectoral approach.
Since the official launch of Africa CDC, we have responded to more than 10 outbreaks. This is in the context of African solidarity. Africa cares about Africa. We don’t go to take over, we go to embed ourselves within the existing structures to do the job we’re called to do.