Meeting on the Multi Disease Surveillance Centre: Ouagadougou 6-7 October 2004

tWORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR AFRICA ORGANISATION MONDIALE DE LA SANI BUREAU REGIONAL POI.'R L'AFRIQUE N{eeting on the Multi Disease Surveillance Centre Ouagadougou 6 =7 October 2004 REPORT Division of Communicable Diseases Prevention and Control HECfl,F | 4 FEV. 2005 Arc I. INTRODUCTION The African region is still confronted with a high burden of communicable diseases while non-colrununicable diseases are also on the increase. In order to strengthen the surveillance system in the African Region, the Regional Committee for Africa in l99g adopted a regional strategy on Integrated Disease Surveillance (IDS) through Resolution AFRO/RC58/R2. Ilre Multi Disease Suryeillauce Centre (MDSC) was established in ZOO2 atthe closure of the onchocerciasis Control Programme (oCP), in order to preserve the gains achieved by OCP in onchocerciasis control and to achieve better coordination of disease surveillance activities in the region. hr the initial phase of MDSC activities, four major diseases namely Onchocerciasis, Meningitis, Malaria and HIV/AIDS, which are contributing to high disease burden and poverty, are targeted. With the expansion of jts capacity the MDSC will progressively extend its actrvities to cover other priority communicable and non-communicable diseases. From 6 to 7 October 2004, a meeting on the Multi Disease Surveillance Centre (MDSC) was held in Ouagadougou, Burkina Faso. The purpose of the meeting was to review the progress made by the MDSC and to establish a framework for partnership. The participants included representatives from three counkies, namely Burkina Faso, Democratic Republic of Congo, and Ghana; representatives of partner institutions such as the World Bank, Canadian International Development Agency, Meningitis I Vaccine Project; a representative from the African Union; and WHO secretariat led by Dr Ebrahinr Malick Samba, WHO Regiorial Director, with support from Dr Anarfi Asamoah-Baah, Assistant Director General, Dr Mohamed Mahmoud Ilacen, WHO representative in Burkina Faso, and Dr Antoine Kabor6, Dir"ctor of the Division of Disease Control (See list of participants in Annex 2). II. OBJECTIVES OF THE MEETING Thc objectives and expected results of the meeting were as follows (a) Objectives To review the role of MDSC in Disease Surveillance a a a a To advise on the management structure of the MDSC To agree on MDSC 2005-2006 PIan of action (b) Expected results Consensus on the MDSC Stnrcture MDSC plan of action 2005-2006 III. PROCEEDINGS Following the welcome remarks by Dr Sam Bugri, a bureau of the meeting was nominated with Dr Theodore Kangoye, country representative of Burkina Faso as chairperson, seconded by Dr Amofa George, country representative of Ghana as vice- a 2 chair. Dr P.S. Lusamba-Dikassa and Dr M.Ir. Djingarey wel.e nominated as rapporteurs. Dr Sanr Bugri introduced the participants and the provisional agenda, which was adopted. In his speech Dr Samba stressed the three main reasons for the creation of MDSC: Firstly, to etrsure that onchocerciasis is never forgotten, secondly, to maintain the unique public health infrastructure put in place by OCP, and thirdly, to coordinate integrated disease surveillance efforts including onchocerciasis in the Region. Dr Sanrba also stressed that the MDSC, which is still "a baby" in a context of high infant mortality, needed the support of all partners in order to survive, to grow and to achieve its objectives. Session 1: Review the role of the MDSC in disease surveillance a) Sutnnnry of discussiorts Presentation made on the surveillance of the priority diseases highlighted the strength' and weaknesses of existing national surveillance systems in the region and the rational of implementation of Integrated Disease surveillance and Response (IDSR) strategy adopted by Member states in September 1998. Participants recognized that countries have achieved significant progress in IDSR implementation despite the challenges. However there is a need for countries to pursue the implementation of the strategy to be able to timely detect any outbreak/epidemic occurrence, to analyze data and use information for decision taking, to respond adequately to outbreaks/epidemics, to produce timely report and to ensure effective feedback 3 As far as the role of MDSC is concerned, participants recogni ze that the mission of MDSC is to provide high-level technical support to Member Sates in surveillance for priority communicable diseases, including laboratory services unA i"r"urch. The fbllowing achievcments of the MDSC during the first two years of operation the MDSC were acknowlcdgcd: a Coordination of enhanced surveillance of meningitis in the African region, with the production and dissemination of a weekly feedback bulletin; Upgrading of the PCR unit in the biomolecular laboratory for the confirmation of meningitis outbreaks using PCR technique; in two years, more than 400 cerebrospinal fluids specimens have been processed; Entornologicai and epidemiological surveillance of onchocerciasis to detect any recmdescence of the disease in the countries; over 200 000 flies from previously covered by OCP and those currently covered by ApOC are screened each year for infection rates, parasite identification and evaluation of interventions; using the nricro satellite technique to confirm the migratory movements of Sinrulium populations; Establishing a new microbiology laboratory with bacteriology, parasitology and immuno/serolo gy services; Ongoing and research activities. a a a a a The participants agreed on the importance of the MDSC and its crucial role in disease surveillartce and laboratory strengthening in the African region. They recognize how 4 irtiportant is tlie surveillance and prevention of onchocerciasis and other diseases .As a regional stntcture, the MDSC in collaboration with existing structures should coordinate the multiple surveillance activities across Africa. There is also a need to build linkages between the centre, the response units and the countrier, u, if they are working as one body. It was singularized that main challenges MDSC faces are the establislrmcnt of an appropriate structure of governance and the mobilization of resources to meet planned activities. b) Decisiotts talcert MDSC to continue onchocerciasis surveillance as well as other diseases such as meningitis, HIV/AIDS, malaria, tuberculosis, etc, and include other priority diseases as needed and possible. Activities of the Centre to include trans-border surveillance Partners to support MDSC technically and financially The MDSC to link with other centres (wHo, country and collaborating centres) and fit within existing wHo/AFRo structure as a complementary, not a competitive unit. session 2: Advise on the managemenugovernance structure of the MDSC a) Sumnnry of discussions The participants agreed with the proposal of setting-up a Steering Committee tasked with reviewing progress reports, work plans and budget of the MDSC, and advising a a a 5 :l the Regional Director, WHO/AFRO on most appropriate strategies for the irnplementation of MDSC activities. The MDSC is a WHO centre where partners have a say in the nranagement. Indeed, true partnership is needed in order to ensure success. This partnership should involve Member States, relevant sub-regional and regional organizations, donors and WHO. The partnership should also warrant thrust alllollg partncrs. Thc possible evolution of the overall environment should also be taken into consideration, hence the need for an interim srructure that needs to be. evaluated after a period of two to three years.. They also agreed to establish a Scientific Advisory Committee composed of renowned experts in disease prevention and control to provide technical guidance to the MDSC. b) Decisiorts takerr with regard to the steering committee, the participants agreed on the following: l) The Director of the Division of prevention and control of communicable Diseases (DDC/AFRO) wilr chair the steering Committee 2) The Director of MDSC will ensure the secretariat 3) The chairperson of the scientific Advisory committee will be a Member of the Steering Committee 4) The Director of the MDSC will report to the steering committee a 6 a5) The steering comrnittee will meet once a yer and exceptionally twice a year to rcview the Work plan and progress of the MDSC. In relation to the Scientific Advisory Committee, the participants agreed on the following: 1) The Members of the Scientific Advisory Committee will elect their Chairperson and their Secretary 2) The Scientific Advisory committee will meet once a year to review the research agenda of the MDSC as well as other activities as recommended by the steering committee. Session 3: To agree on the MDSC 2005-2006 plan of Action a) Suntnnry orf discussions The MDSC workplan for the period from 2005 -2006 was discussed. The plan outlines the issues and challenges facing the countries of the African region in the area of epidemiological surveillance and epidemic preparedness antl response. The key products of work plan are: 7 A functional surveillance system for MDSC targeted diseases developed (Onchocerciasis, Meningitis, malaria, HIV/AIDS) operational rescarch projects for improving detection and control of targeted diseases developed Functional bacteriology, parasitology and molecular biology laboratory cstablished Functional Reference Library established Functional managerial team maintained b) Decisions takett The participants agreed on the need to develop a long term Strategic Plan covering a period of 5 to l0 years, from which annual and biennial plans will be exhacted. The plans should avoid duplicating activities undertaken by other units or partners and focus on delivering products that only MDSC can deliver. The vision of MDSC should be consistent with global health objectives. For example, currently FIIV/AIDS, Malaria and Tuberculosis should be addressed as a package. Support to countries in building capacity should not be reshicted to basic epidemiology and surveillance. The plan should also show linkages between the MDSC and other WHO units (APOC, Intercountry teams, and Regional programs) and institutions participating in disease surveillance. The work plan should include an evaluation scheme. a a a a 8 5 Itl order to facilitate resource mobilization the parlicipants have agreed to develop apd sharc anrong all partners four key documents A two years workplan for 2005-2006 A trvo-page concept paper to be presented to the next meeting of the Joint Action Forum (JAF) by December 2004. This document should focus on onchocerciasis and meningitis surveil lance activities. ll A strategic 5-10 years plan iv. A co,cept paper to be submitted to the Gg summit. This ', document should be prepared by wHo/AFRo in collaboration with WHO/He, WHO/EMRO, African Union, World Bank, CIDA, African De'velopment Bank, WAHO, UK prime Minister Group, etc. IV.SUMMARY OF PARTNER STATEMENTS In their statement, the representatives of partner institutions attending the meeting indicated their interest in the work of the MDSC. They adhered to the proposed nlanagement structure for the MDSC that includes a Steering Committee and a Scientific Advisory Committee. The World Bank committed to support the MDSC. 9 lll The CIDA confinncd its interest in participating in the development of the strategic plaus and tlic concept papers. V. THE WAY TORWARD Dr AnLoine Kabord lhanked thc participants for their valuable contributions. FIe indicated that WHO will finalize the report of the meeting, the proposal on a nranagcment structure for the MDSC, and MDSC workplan 2005-2006. WIIO/AFI{O will also scnd revised documents to all participants. The specific steps forward are as follow: ' Fi,alization of the documents discussed during the meeting . Dissemirrate the report of the rneeting to countries and partners . Sensitization of other partners ' Organize partners meetings to mobilize resources for the implementation of 2005-2006 and support the strategi"-l]u, o setting-up of Steering committee and scientific Advisory committee ' Organization of first annual meeting of Scientific Advisory Committee r Organization of first annual meeting of Steering Committee VI. CLOSING REMARKS In his closing remarks, Dr Samba thanked the authorities of Burkina Faso who have accepted to host the meeting and particularly the Prime Minister and the Minister of Flealth who have promised to support the MDSC. Indeed, Burkina Faso has hosted the OCP and contributed significantly to the control of onchocerciasis. Dr Samba also 10 thanked the interpreters, the support staff, and the participants for contributing to the stlccess of thc mecting, whicl: has been an important step forward. He reiterated his thanks to the World Bank and CIDA for their presence and continued support to disease control in Africa. Finally, he emphasized that the MDSC is an importunr structure for epidemiological surveillance not only for Africa, but also in the world. The participants expressed the wish that the MDSC be named "Multi Disease Surveillance Centre Dr Ebrahim Malick Samba" in recognition of the outstanding contribution of thc Regional Dircctor toward the elimination of onchocerciasis and improvement of I-iealth in Africa. 1l Annex 1..Agenda MEE]'ING ON MULTI DISEASE SURVEILLANCE CENTRE Ouagadougou, Burkina Faso: 6 - 7 October 2004 12:30 - 14:00 Lunch Breal< 14:00 - l7:00 Wcdncsrlay 6 October 2004: 9:00- 9:30 . Opening by the Regional Director . Introduction of participants ' objcctivcs and Expected Results (Dr A. Kaborc DDC/AFRO) . Adoption of the agenda . Administrativeissues 9:30 - l0:30 CoffEe Brcak 10:30 - 12:30 objective L: Review the rote of the MDsc in Disease surveiflance a Surveillance of Priority Diseaie in the wHo African Region (Dr p.Lusamba CSR/AFRO) concept and role of MDSC: progress and chailenges (Dr s. Bugri)a Objective 2: Advise on the structure of the MDSC Presentation of the proposed structure (Dr A. Kabore) a a Discussions 12 ursda tober 2 04 09:00 - l0:30 Objcctive 3: To agree on the MDSC 2005-2006 plan of Action o Prcscntation of thc MDSC 2005-2006 pran of Action (Dr s. Bugri) . Discussiou o Partner's statements o Wrap-up and way forward l0:30 - 12:00 . Coffee brcak o Prcparation of draft report (Rapporteurs) l2:00-13:00 . Adoption of meeting's report . 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