a strong global health security force

Populations around the world require protection from emerging public threats. The World Health Organization (WHO) defines global public health security as the activities required to minimize the danger and impact of acute public health events that endanger people’s health across geographical regions and international boundaries. The COVID pandemic—which killed more than 7 million people—highlighted for everyone the importance of this work, as well as the difficulties. The Task Force has many programs working to shore up protections and minimize the risk of such events.

One example is the effort to eradicate polio. The Task Force plays a key part in this global initiative by reinforcing countries’ capacity for polio outbreak preparedness and response.  Launched in 1988 at the World Health Assembly, the Global Polio Eradication Initiative has reduced polio by 99 percent (from 1988 to 2023), from an estimated 350,000 cases in more than 125 endemic countries to just 12 reported cases of wild poliovirus in two endemic countries (Afghanistan and Pakistan). The Task Force’s Polio Eradication Surge Capacity Support team, funded by the CDC, responds when a new case has been detected—with team members deployed within 72 hours to help countries provide vaccinations, analyze surveillance data and assess the risk of virus spread. During the past four years, The Task Force has contributed to efforts to vaccinate more than 200 million children in 16 African countries.

The Task Force Strengthening Outbreak Notification and Response (SONAR) initiative combines the capacities of several Task Force programs to help 14 countries in Africa and Asia build early-warning disease surveillance systems to respond to outbreaks and better respond to future pandemics. Supported by the Global Fund, this work taps our expertise in field epidemiology, public health informatics and building immunization systems, as we collaborate with ministries of health and other partners to ensure alignment at every step in the surveillance and response chain. We bring together experts in human health, animal health and environmental health, the private sector, pharmacies, educators, health clinic staff and patients and many others—and coordinate with WHO and the Africa CDC to achieve the goals of the participating countries.

A Task Force program known as the Brighton Collaboration works with a range of partners to continuously improve methods to monitor vaccine safety. This work, with a network of 1,300 members in 110 countries, is helping to shorten the time it takes developers to produce safe, effective vaccines against emerging pandemic pathogens. 

Ebola Response Inspires Dr. Squire’s Career in Early Disease Warning Surveillance

“There are still houses that are locked up because the Ebola outbreak of 2014 wiped out an entire family,” said Dr. James Squire who worked as a district medical officer at the epicenter of the 2014 Ebola outbreak in Kailahun district of the Eastern Province of Sierra Leone. The lasting signs of the outbreak and the devastating impact of the disease in the community ignited Dr. Squire’s dedication to work tirelessly to set up early warning disease surveillance systems for Sierra Leone. 


Early warning disease surveillance systems allow countries and their healthcare workers to detect threats to a community, notify relevant health authorities, and then rapidly respond to  threats so they can be contained.


When the Ebola outbreak wreaked havoc in the Kailahun district, Dr. Squire remembers how there was no infrastructure in place to respond to emergencies.


At that time, we could not detect the [Ebola] outbreak on time. By the time we detected it, a lot of lives were lost. I lost over 55 healthcare workers. From that time to now, almost 10 years, I have been passionate about being part of work involving early warning disease surveillance systems so that what happened in 2014 and 2015 in Sierra Leone would not be repeated.”


A medical doctor and epidemiologist, Dr. Squire has more than 15 years of public health experience and currently works for The Task Force for Global Health. He serves as the national lead for Sierra Leone on the Strengthening Outbreak Notification And Response (SONAR) project. SONAR helps countries in Africa and Asia build early-warning disease surveillance systems to respond to outbreaks. The Task Force, in collaboration with Africa Centres for Disease Control and Prevention, and World Health Organization (WHO) – is working as the implementing partner for The Global Fund’s SONAR program. Squire works with Sierra Leone’s Ministry of Health and the National Public Health Agency to ensure that early warning surveillance systems are sustainably implemented in the country. 


Creating a Sustainable Early Warning Disease Surveillance for Sierra Leone


Dr. Squire explains how he has been working with his colleagues to improve surveillance systems in Sierra Leone since 2016.


“We have an electronic integrated disease surveillance system that operates at all of our important health facilities. Once a healthcare worker detects a notifiable disease condition based on the case definition, the healthcare worker immediately notifies us and the district. Then, the national level can easily see that notification and be able to put up a response system. We are leveraging that for the SONAR project.”


Dr. Squire also adds that involving other sectors will ensure commitment on the importance of surveillance for global health security of a country.


“With SONAR, we are using the one health approach. We are involving other sectors like the Ministry of Agriculture and the Ministry of Environment. And we have seen ownership from all these sectors in regards to implementation of the SONAR project. With that collaboration and coordination among the sectors, we will be able to sustain the SONAR project.”


Dr. Squire shares that before the Ebola response, Sierra Leone’s Civil War disrupted the economy, healthcare, and all sectors of society. The echoes of this devastation can be felt even today, but there were people like maternal child health aides who stepped in during many emergencies since the Civil War and continue to support Sierra Leone build strong surveillance systems.


“After 10 years of civil war [Sierra Leone Civil War], the health systems were devastated. We had shortages of healthcare workers across different cadres and there was a dire need for health services to be delivered, especially in hard-to-reach areas. As a stop-gap measure, we had these maternal child health aides, now called maternal child health assistants who helped. Over the years, their roles evolved and they supported surveillance activities in the health facilities. If we want early warning systems to succeed, we need to involve the maternal child health assistants to strengthen and give them capacity and the necessary resources for them to implement surveillance activities.”

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