Strategic plan : 2006 - 2015

I , J ,:r#ill .,$.$Lj{ I, : WORLD HEALTH OIIGANIZATION REGIONAL OFFICE F'OR AFRICA Diyision of Prevention and Control of Conrmunicirble Diseases NIULTI DISEASE SURVEILLANCE CENTRE OF OUAGADOUGOU STRATEGIC PLAN 2006 - 20rs November 2004 TABLE OF CONTENTS I. Executive sllmmary II. Project sllmmary IIl. Background IV. Mrssrorr V. Goal VI. Objectrves VIL Expected Results VIII. Ix. x Page Strategic Orientation 7 - Tracl<ing major priority cotnntunicztble and uorl comnlunicable diseases 7 - Pronrotion ol conrnrunication 7 - Builcling capacity 7 - Devclopment of database 7 - Brrilding parlnership 7 Areas of Intervention - Epidemicsurveillance - Entomologicalsun,eillance - Laboratory support - Documentatior-rccutre - Trainrng - Research Strategy for Implententation - Management - lnputs - Implcntentatiouschedule XI. Monitoring and Evaluation l0 XII. Budget 11 J 4 5 6 6 6 6 8 8 8 8 8 8 9 9 9 9 10 2 I. EXECUTIVE SUN{MARY The Multi Disease Sun'eillance Centre of Ouagaclougou (MDSC) r,r'as created in2002 at tlie end of the Onchoccrciasis Control Progranr (OCP), in order to preserve the gains achieved in onchocerciasis control, while expanding acquired experience to the control of other priority diseases such as meningitis, nralaria, and HIV/AIDS using the existing infrastructure. The MDSC is created to serve as a centre of excellence 1br disease surveillance in the WHO Africa Region. Established in the premises of the Onchocerciasis Control Programme (OCP), the MDSC inherited the facilities of OCP, including thc buildings, the laboratories, the library, and teleconrtrurticat i t-rn ccpripnrcnt. The MDSC rvill supporl the WIIO Aliican Region countries in the sun,eillance of Onchocerciasis and other communicable cliseases such as Meningitis, I-lIV/AIDS/TB and Malaria. As the Centre is strengthened, the range of targcted diseases ri'ill be expar-rded and fi"rrther include Non Communicable Diseases. Tlie core activities of tlre MDSC includes compilation and in depth analysis of surl'eillance data, r.rsirTg the information generated to establish disease trends and to predict epiden-rics. Parlicr-rlar emphasis is laid on integration of laboratory into disease surveillance. The Centre will off'er to WHO Member States of the region, facilities and mechanisms fbr tlaining of eprdenrrologists, entomologists, data managers and laboratorians, laboratory quality assLrrAnce ancl quality control, and exchange of key epidemtological infbrmation. The MDSC starlcd wtth a projecl paper. The phase 1 fi'om 2001-2003 tvas the creation and establishment of the MDSC as a unit of the World Health Organization, Regional Office for Ah'ica (WHO/AFRO). During Phase 2 (2004-2005), the activities of the MDSC covered surueillance of onchocerciasis and epidenric meningitis, and the development of a strategic plan. Tlris strategic plan for strengthening the MDSC covcrs a span of ten years f}om 2006 to 2015. \t will be sub-divided in biennium rvorkplans to fit WHO biennial planning. By 2010, the MDSC will be ftrlly operational, thus exerting the role o1'a centre ol'excellence in the area of disease surveillance anc'l extencling its activities to other conulunicable and non-comniunicable diseases. The MDSC is establishing linkages with the countries of the region, and with institutions and partners involved in disease surveillance. In order to allow paftners and courrtlies parlicipation in the management/govemance of the MDSC, a Steerrng Committee and a Scientific Advisory Committee are created. The World llealth organization contributes significantly to the resources of the MDSC in terms of tacilities, staffing, and operational costs and rvould welcome the supporl of paftners. Tlie WHO contnbutions rvill need to be complentented with extra-budgetary funds. The pr-rrpose of tliis strategic plan is to prcscnl the strategic orientations and interventions of the MDSC and to advocate 1br rcsourcc's nceded for the establishment of tl-re MDSC as a centre of excellence in disease surveillance fbr the Ati'ican region. J II. PROJECT SUMNTARY \\,ORLD H EALTH ORGANIZATION REGIONAL OFFICE FOR AFRTCA Title of the Project: Multi Disease Surveillance Centre of OuagarlougoLr ll'HO Progrumnte Budget - Areo of lVork: ComnrLu'ricable Disease SLrrveiIlance and Response Geographtcul foarc: WHO Africa Region Summary of Objectives: To establish a centre of excellence lor nrLrlli drsease surveillance in WHO Africa Region S ttrttm ory of Pl u n n e d .4 ct it,it i e s : Epiderniological and entonrological surveillance: Laboratory strenglhening; Capacity building; Information sharing; Operational researcl.r Project Implementiliort 2006 - 2015: 1" bienniurr : l " January 2006 - 31 Decemb er 2OO7 2nd biennium : I't January 2008 - 31 December 2009 3''d biennium : 1" January 2O1O - 31 Decer-nber 201 I 4'r' bienniurn : I 't Januar y 2C)12 - 31 Decernber 201 3 5tr'biennium : 1't Januat'y 2014 - 3l December 2015 Totol Budget Category of expenditure tnd budget Costs Total funds required US$ Personnel Field investigation Laboratory Research Trairring Meetings, Worl<shops and Conferences Teleconrmunications Documentation Office equipnrent and supplies Total arnount being requestcd US$ Vehicles & ntaintenance Operating costs Subtotal W'HO contribution Gap Programnre support costs (13 %) Anrount requested Approval/Signature Responsible Officer Date: Division Director: Dale Dir. Programme Management Date Approved by Rc'gional Director Date 4 2III. BACKGROUND The Onchocerciasis Control Programnre (OCP) closed in December 2002 after achieving successfully its goals. Indeed, Onchocerciasis is no longer a public health problenr or a hindrance to socio-econonric developnrent in West Alrica. At tlie Accra meeting in Decemt'rer 1998 the 19rl'Joint Prograurnre Comntittee of OCP/APOC agreed on the use oIOCP prenriscs ancl infi'astrurcture by WHO/AFRO to establish a MLrlti Disease Sun,eillancc Centre (MDSC). Such a centre is crucial in a context wlien communicable diseases are the predominant callse of morbidity aurd mortality in the Af ican region. Unfortunately, there is paucity of quality infonrration for the early detection and control of these diseases due to weal<ness in disease surveillance systenrs. A good integrated disease surveillance systetl has the potential to provide early detection of epidentics, their control and coustitule the basis fbr planning. resource allocation, and resource ntobilization Taking ilito account that the sr"rrveillance systern in the African Region is not contributing efficiently to cor.nr.nunicable diseases control, the Regional Comrnittee for Africa in Septernber 1998 decided to inrplement the Integrated Disease Surveillance(IDS) strategy in the regiorr, (Resolution AFRO/RC58/R2). To further strengthen surveillance, the Multi Disease Surveillance Centre (MDSC) was created and installed in the OCP preniises in OLragadougou. Tlre Centre will sen,c as a centre of excellence and a reference poitrt lor suneillance w'ith the capacity to lorecast epidemics, monitor the occttrrence and spreacl of resistaurt strains of disease through its well-equipped laboratory and perlorrtr research actil,itres as rvell. J 4. 6 5 MDSC rvill build on the effective epidenriologrcal and entomological surveillance developed by OCP. It rvill provide continuing surveillance support to countries where onchocerciasis has been controlled in order to detect early recrudescence of the disease. Currently, MDSC is equipped and stafled 1o provide high-level epider-niological, entomological and clata ntanagenrent support to countries. The centre has two functronal laboratorie's. The Molecular Biology Laboratory, which is well known for its work iu identifying vectors and parasites of Onchocerciasis, has been upgraded to cover tlie other diseases and a Microbiology laboratory has been established. The Certtre has onc of the best publications Iibraries in the region. It is ideal for researcli and lilerature reviervs. Thc library provides services via the Internet to clients and for thosc' visiting the library publications on priority diseases can be viewed on CD ROM. The Radio Commttnication System that served the OCP so well has been upgraded with new radios and modems that allorv the electronic transntission of data as well as voice messages. The WAVEMAIL system allows connection to the Intemet. There is a well-equipped conf'erence hall, with aucliovisual equipment for simttltancous translation and projection, u,hich can seat 100 clelegates contfortably. 7 8 9 5 I The car uraintenzrnce garage is probably the best iri Ouagadougou and it is used by intemattional orgarnisation 1or tlre repairs and servicing of their vehicles. IY. MISSION 10. The missiorr of the Multi Disease Surveillance Centre is to provide high level tecl-u-rical sLrpport to Mcnrber States in sun,cillance of onchocerciasis and priority corttmunicablc ancl non-conr.nLnricable cliscases in the Alrican Region. V. GOAI, l1 The MDSC strives to serve as a relerence centre for disease surveillance in the African Region through quality sLrpport to the countries in the surveillance of onchocerciasis and priority diseases. The activities of tlte MDSC are geared torvards contributing to overall WHO objectives and rclcl'ant Millcnniunt Developments Goals. VI. GENERAI, OBJECTIVE To prol'ide critical infomration to African coLrntries for the elfcctive management of priority communicable and non-comnlunicable diseases prevention and control programnles. o VII. SPECIFICOBJECTIVES a To provide continuous entotrological and epidemiological onchocerciasis strveillance support to countries to nraintain the achievcnrents of OCP; To off-er facilities ior high level quality assLrrance to the laboratories and diagnostic services of Ah'ican countries; To predict the anti-rnicrobial susceptibility of aetiological agents of priority diseases; To predict the occuttence of epidenrics of priority diseases in the Alrican region; To facilitate the exchange of informartion and best practices between countries that is critical lor elfective preveutron and control of priority diseases; To contribute to in-service training for priority diseases to Nationals in-charge of surveillance; To initiate/participate in research activities leacling to the better understanding of tlie rnajor comrlunicable ancl norl contmunicable diseases of the region; To train countries in field epidemiology and research niethodology; To strengthen couritries capacity in data analysis and mapping; To facilitate infomtation sharing through [T network. a a a o a a a a a 6 VIII. STRATECIC ORIENTATIONS Tracking major cornmunicable and non-communicable diseases The activities of the Centre are underpinr-red by the [rtegruted Diseuse Survcillunce Strotegr adopted by WHO Regional Comrr.rittee in 1998. This strategy aims at establishing national integratcd disease sun'eillance systerns that will ensure a continuous and tinrely provision and Lrtilization o1-inlonnation to all national prevention and control plogranrnres and hcalth services at all ler,'els.l In orderto be useful, such systetns tnust be sinrple. flexible. and oriented to actior-r. The sun'eillance activities that are comnlon to all disease control progranlntes r-r-rr.rst be coordinated for efficiency. Laboratory capacities will be strengthened. A systenr of high level analysis of surveillance data will be set up to provide accurate infornration to countries for tinrely decision making and contribute to the global alert systent. In addition a specific entomological and epidemiological surveillance system will be put in place to support countrics to prevent the recrudescence of Orrchocerciasis. t4 t2 13 15 Reaction tinte altd fi'equency of epidenrics will be reduced to contribute to the reductiou of nrorbidity and nrortality. Surveillance and conrmunicable disease preventiotr and coutrol interventions will be irriproved throurgh widely used research. A system of surveillance and tracking non-commluricable diseases will be established and control strategies developed. Promotion of conrnrunication i6 The Centre will set up atrd becorre a hub lor the sharing of sr.rrveillance and scientific inforuation between countries and rvith partners through lT network. This will be used as a proactive tool: for response to epidemics, research, communicable and non- communicable diseases in the African region. Building capacitl, 17 Countries lvill bc supported to build arncl intprove National capacities related to surveillartce attd lalrorartory inr,'estigations lol cor-nt-nlrnicable disease control. For this pLlrpose the Centre rvill oflcr relevant training and guidelines. Exchange of technical staff with similar centres and institutions will be promoted to enhance cross- fertilization of ideas and inrprove skills. Development of databases 18 The Centre will sct up databascs lor onchocerciasis, major epidernic and endemic diseasc's. geographical arrcl enr,'ironnrc-ntal inlorntation. Thcse databases rvill be accessible to countl'ies artcl partners and uill conrplenrent the global dalabase of AFRO. 7 WHO-AI'-RO. Integtatcd Dtseasc SLttvr-rllar'rcc ul Lhe Alircan Regron A Rcgronal Stlatcgy fbrConurunrcablc [)rseases 1999-2003 22 t9 Building partnership The mentber slates u,'ill rc'gularly provide surveillance data and information related to Onchocerciasis and priority diseases to thc MDSC through WHO country offices. The WHO inter-courrtry teanrs in sub regions of Africa rvill be urajor collaborators since they will be in tlie lront line of epidemics. In retum, the Certtre will perlorm in-depth data analysis, including sLrb-regional trends and predictions and provide feedback to the countries. 20 The Centre rvill eslablish partnership u'ith other institutions and organisartious sen'ing similar purposes. Thc partncrship will be conrplementary and r.r,'ill include research institr"rtions. disease surveillance institutions, training institutions, libraries, reference laboratories. and Sub legional organisations. 2t Tlre MDSC rvill also promote and build partnership rvith Bilateral and MLrltilateral organizations interested in the reduction of morbidity and nrortality due to the nrajor communicable and non conrmunicable discases. Ix. AREAS OF INTERVENTION Epidemiological su rveillance The MDSC is a source of technical advice and support for the implementation of Integrated Disease SLrrveillance and Response (IDSR). To this effect, it assists countries in the preparatior-r of surveillance guidelines and tools, formulation/revision of strategic disease surveillance plans and evaluation of sun,cillatnce activities. The MDSC conrpilcs ancl analyse dala on epidernic-prone discascs fionr Member States in order to establish cpidenriological trends and predict luture c'pidemics. Lrlomration sharing rvill be a priority. 23 In the ficld of epidenriology, tl-re MDSC u'orks as a nrultidisciplinary team to address issues raised by member states such as : - ln-depth analysis of surveillance data to create models that can predict epidemics; - Support in the investigation of epidenrics; - Research into new intervention stratcgics; - Assessurent of country sun'cillance systems and training in epidemiology and epidenr ic ittr c'sti gat ion : - Mapping diseasc distribLrtion by cour.rtry; - Tracking origin and spread of epidemics. 24 MDSC has the capacities in the developn-rent of data management tools, training in data management and mapping, as well as updating administrative/health boundaries of countries. The Centre is establishing country based health facilities maps for surrveillance and planni ng purposes. Entomological su n'eillance Entotlology as an epidenriological surveillance tool is poorly developed in Africa. MDSC has a challenge to develop tlie science. The Centre continues to be the surveillance point for Onchocerciasis. MDSC provides entonrological and 8 25 26. 27 28 29 30 31 32 JJ parasitological analysis and infonration to thc ex-OCP countries atid the Afi'ican Prograurme for Otrchocerciasis Control to monitor the inrpact of thcir intcrventions. The MDSC ri'ill extcncl the onchocerciasis e-ntonrological surr,'eillance technology to other vector borne diseascs such as nralaria, yellow fever, trypanosomiasis, lymphatic filariasis.... Laboratory'support A key compouent of priority comrnunicable disease surveillance is the existence of a functional network of pLrblic health laboratories able to provide rapid confinnation of aetiological agents. Laboratory confirmation of the etiological agents involved in epidenrics is usr"rally the u,eal<est aspect in surveillance in Africa. The laboratories rr'ill extend their technology to cover identification of etiological agents of priority diseases. MDSC laboratories will sLrpporl countries to confirm etiological agents and monitor resistance to drugs. Furthernrore, the labs ll'ill conduct sequence typing and built a strain banl<. ln collaboration w'ith WHO/CSR/Lyon ancl WHO collaborating centres, an extental quality assLrrance and cprality control (QA/QC) unit will be cleveloped at the MDSC to support National Reference Laboratories in the region Documentation Centre The docuntentatiorr centrc w'as started by OCP to keep records of the pioneering lvork. To keep the staff abreast rvith developrnents in their field, the documentation centre subscribes to over 50 dilferent scientific journirls and publication, and books on medicine, parasitology, entomology and other allied topics. The Library will dcvelop sectiotls in documentation, archiving, public relations and prornotion/visibility of MDSC by exhibitions and dissemination through Information Technology. Training The Centre has the capacity to host and lacilitate training sessions on surveillance, epidemic inr.'estigation, etrtonrology, laboralory techniqLres, clata management and other allied topics of interest to Menrber S1a1es or organisatior.rs operating in Africa. The trairting will enrphasize the relationship between surveillance and laboratory support in the control of epidentics. There is a need to have a computer-based training room. The Centre is progranlme o11 Africa. Sintilar institutions. the venue lor the WHO/CSRlLyon and WHO/AFRO training "Strengthcning capacity o1- National Reference Laboratories" lor training progranrme can be established in collaboration with other 9 34 35 Tlie Centre will open its doors to postgraduate Researcl-r Fellows working on studies of interest and importance to health in the Regior-r. The outpLrt of such Research Fellows rvill immediately be applied appropriately. Research 36 The Ccntre will unclcrtalie research activities on nrajor communicable and non- comtnutticable discascs irr order to improvc thcir prevention and control. The Centre will establisli scientific collaboration with other research ir-rstitutions for sonre research activities. The Centre w'ilI issue publications as appropriate on the outcorne of the researclres. 37 To be able to keep abreast *'ith the fhst changing pace of science, the Centre u,ill undertake research prograur.lnrcs to discolcr ue\\,materiarls, neu,ntethods and develop new slrategics for sLtn'cillance and inten'cntions. Tlie new lechniques and equiprnent being developed nced to be introduced inlo the courrtry surveillance system and therefore regular in-serr,'ice training have to be organised to upgrade the skills of surveillance and laboratory staff in the Region. Radio Communication 38. Radio conrmunicatiott rvas crucial for the OCP work since cornnrunication in Africa is poor. Att cxtensir,'c network was established connecting all corners of the programnle area. MDSC will cotttit.tuc upgrading the intcrcountry radio conununication network to support disease sun,eillance and tirnely data transmission. 39 The MDSC radio rretwork allolvs real-tinre transmission of infonnation ancl feedback advice aud gr.ridance or1 actior-rs necessary to be conrmunicated to field staff. A Wave- mail sysLem allows linkage tlrrough to thc wHo/HQ server in Geneva. As part olIDSR slt'cn-ethelting ol'national suncilliince, the r,r,ell-trained MDSC Radio Technicians are availablc to adr,'ice and undertake installation of national radio comnrunication syslerus to connect districts. X. STRATEGY FOR IN{PLEN{ENTATION Management 41. The MDSC is a WHO/AFRO progranlrre under the supervision of tlie Director of Preventiott and Control o{'Conrnrunicable Diseases (DDC division). It lvorks closely with the CSR urrit and thc inter country eprdentiologic blocs. The Centre's organisational structurc is as shorvn in appendix 1. There are six main units: o Management, adntinistration and snpport, o Infonlation Technology and Data rnanagement, o Epidemiology, o Entomology, o Laboratory. o Docurnerrtatiorr NB: Research and training lvill be arr activity ri,itlrin cach unit. 40 l0 44. 45 46. 47 42. To ensure that the activities of the MDSC address the priorities of member states, a forum ri'ill be creal.ed at which the country technical representatives will input into the plan of work of tlie Centre. 43 For its govenrance, and in the spirit and tradition of WHO partncrship policy, a broad- based Stcering Corrnrittcc lor thc N4DSC riill facilitate joint participation olpartners and coutttrics in the nruning of the Ccntre including resoLrrce mobilization. A Scientitlc Advisory Conrnrittee r,r'ill advise the MDSC in its u,orl<. This comnrittee will review' the u,'orkplans and research proposals lor relevance and priorities of the Region. Implementation Schedu le The MDSC started r,'r'ith a project paper rvhich outlined establishment phases. Tlie first phase (2001-2003) rvas the crealion and establishment of tl-re MDSC as a unit of the WHO/AFRO. During this phase the centre focussed ort rlaintaining surveillance ot-t ot-tcltocerciasis as part of the devolution process of OCP, and meningitis surveillance in the belt. The MDSC is cumently in phase 2 (2004-2005), and is focussing on establishing a framervork for sun,eillance ol1 onchocerciasis and epider-nic meningitis and the developtnent of a long tenl stratcgic plan (2006-2015). The centre is building functional relationship with countries to ntaintairrirrg entouroloqical and epidenriological surl'eillance activities on Onchocerciasis. The laboratory f,unction will be adaptcd to the orientation of the Centre and its scope of activities expanded The comntunication systern will be adapted and strengthened to facilitate comntunication with Member States. This current strategic plan lor strengthening the MDSC covers a span of ten years frorn 2006 to 2015. It will be sub-divided in biennium workplans to fit WHO biennial plar-rning. The plan outlirtecl rvould enslrre that by 2010, MDSC rvill be fully operational, thus exerting the rolc of a centre of excellence in the area of disease sttrveillance aud extending its activities to other conrnrunicable and non- comntut-r icable di seascs, This strategic plarr aims at strengthening laboratory capacity and expanding tlie MDSC's scope of work to meet the expectations of Member States, the regional priorities and to create opportunities for partnership. It focuses on supporting countries to tnal<e lrore acclu'ate clecisious on comrrunicable and ltolt-corlllunicable diseases control. xI. N{ONITORING AND EYALUATION 48 The Scientific Advisory Cornmittee cornposed of renorvned experts in disease prevention and control will monitor the work of MDSC. The MDSC will submit regular reports to the Steering Comtnittee which will make them available for partner's consideration. 49 11 a50 MDSC ri'ill submit reports according to WHO monitoring plan which include: bier-rnial r,vorl<p1an, Senri-Annual Monitoring, Mid-Tem Revielv and independent evaluation. Monitoring aud Evaluation lndicators will be established for each biennial workplan PERSPECTIYES These perspcctir,,es preslnre that the activities outlined in this strategic plan period have becn exccuted. In other tenrs by 2015. thc MDSC ivill be fully staffed, infi'astructurc developed, funcling secured, and goals achieved. The MDSC lvhen fully functional will be a centre of excellence to rvhich menrber states can call at any time to support them in solving difflcult problems. Stafled with multi disciplirrzrry experts and uell-eqLrippecl larboratories, thc Ccntre will act as a technical Rapid Response Tennr, and u'ill have perlormance sinrilar to wHo collaborating Centres. The Centre rvill be uorking on priority issues detemrined by Member Stertes. MDSC envisages ultimately to become the Coordinating Centre for surveillance of priority contmunicable and non-conlnlunicable diseases in the African Region. In view of the wider scope of work of MDSC in surveillance of both communicable and nort-contntuuicable cliseases, it nray bc necessary to revierv tl-re administrative link of MDSC rvithin WHO/AFRO Organogranr. KII. BUDGET 56 This strategic plan is presented forpartner's consideration in view of the resource constraints faced by MDSC during phase I and 2. The budget is elaborated to ensure the operational activities of tlie centre lor the next ten years. 57. Attached are : o The suntr.narized butlget lable o The 2006 - 201 5 rl orl<plan. 51 XII 52 53 55 54 t2 IG ltf o o G .9 =(L G'= €f o) o o E o c IJJ Ec tr o o o TL o o c G iI 9oEtEc BE a? ,ES g o (g .9oc otrg,E o(Jg o =o (E L G oL o o @ .= f o ': G ,9, .E ELo o o .= o o E E o o) ol- o. 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