By Andi Kezh, Intern
Early detection of outbreaks is a critical part of pandemic readiness. However, the COVID-19 pandemic highlighted the limits of early detection systems across the world, resulting in loss of life and a global economic downturn. To address this issue The Task Force for Global Health this month began partnering with The Global Fund to strengthen early warning surveillance systems in a number of high-priority countries in Africa and Asia.
“Pandemic preparedness including early warning surveillance and response is something new for The Global Fund,” said Button Zhao, Senior Specialist for Impact and Evaluation at The Global Fund.
“We were originally mandated to end HIV, TB, and Malaria by 2023. But we clearly felt the impact of COVID-19, as well as the future of similar pandemics, and we needed to shift our agency’s direction.”
The Global Fund is an international financing and partnership agency that raises and invests money to defeat infectious diseases and strengthen health systems in more than 100 countries.
“The main objective of this project is early warning to help countries shorten the time from when an outbreak starts to occur and when people know about it and are able to respond,” said Dr. Tony Mounts, Director of The Task Force’s COVID-19 Vaccine Implementation Program (CoVIP).
The surveillance project is modeled after CoVIP’s work to help low- and middle-income countries introduce, deploy and evaluate COVID-19 vaccines in more than 38 countries, working with more than 40 local implementing partners.
“This project is really an expansion of our work from vaccine program implementation to surveillance implementation, because we see surveillance strengthening as the foundation for the data needed to introduce vaccines,” said Dr. Joe Bresee, Director of The Task Force’s Respiratory Virus Prevention programs, including CoVIP.
The initiative supports countries with long-term technical support, provided by country-based consultants, to meet needs identified by ministries of health. The objectives are to increase country capacity to implement early warning surveillance and epidemic intelligence systems, and increase interconnectivity between laboratory and epidemiologic data systems to improve accessibility and use of data for response.
The Task Force will work alongside the Africa Centres for Disease Control and Prevention and the World Health Organization in Nigeria, Ghana, Sierra Leone, Central African Republic, Madagascar and the Philippines, and additional countries may be added. The Global Fund has invested nearly $9 million in the first year of the project.
“The overall investment of the Global Fund, including this new surveillance program, is one of the largest health investments Nigeria has ever had,” said Dr. Aminu Muhammad, Country Lead for the Global Pandemic Response Project in Nigeria. “Nigeria is the largest country in Africa with a population of more than 200 million, which is 70 to 80% of the U.S. population. Comparing the GDP of Nigeria to other nations, you can see how this funding is so necessary to provide a proportionate level of resources for our health systems.”
“We selected The Task Force firstly because of their expertise in the area of surveillance and response through their many programs,” said Zhao, of the Global Fund. “Secondly, The Task Force has good networking connections with the CDC and WHO, as well as other agencies. They also have established relationships with in-country stakeholders, which is an essential asset,”.
The Task Force works across programs to bring a wide variety of skill sets to the work of improving early warning surveillance in low- and- middle-income countries. Task Force teams on the project include Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET), the Partnership for Influenza Vaccine Introduction (PIVI), Public Health Informatics Institute (PHII), and the COVID-19 Vaccine Implementation Program (CoVIP). These programs have decades of experience in building capacity for end-to-end surveillance from community level outbreak detection through data visualization and use.
Through hands-on, in-country mentoring using field epidemiologists and data management experts, The Task Force will consult with each country’s Ministry of Health to establish regional technical working groups and guidance for early warning surveillance and data management, develop training materials for use regionally and in-country, and hold discussions with leadership and key stakeholders to determine surveillance gaps and weaknesses and craft country-specific work plans.
“The ultimate legacy of this project is to ensure every country can detect threats as soon as they appear in a sustainable way,” said Yannick Kamga, Africa Regional Director for the surveillance project.
“It is extremely important to not only focus on a specific disease, but try to strengthen the entire health system itself to save lives. Without a foundational health system, no disease can be fully targeted.”
The program will continue through the end of 2025, a commitment that Bresee considers important for two reasons.
“It both recognizes that building surveillance systems takes a long time, and signals that Global Fund is interested in incorporating surveillance strengthening over the long term,” he said.