It has been a very productive first half of 2016 for the Global Health Security team. We have many new faces to welcome to our team, including Carla Villoria (Project Specialist), Kerry Gallo (Communications Officer), Zahra Lutfeali (Project Administrator), and Olivia Rao (Project Assistant) in Seattle, and Laura Lane (Team Associate) in Vietnam.

Moving from concept to implementation is where the rubber hits the road. Through this collaborative process, CDC and PATH have supported innovative work in Vietnam that strikes to the core of prevention—strengthening surveillance through an early warning and response system, supporting the functionality of a data warehouse, and building capacity in data visualization. In Senegal, there has been a focus on laboratory networks, as well as improvements in surveillance and antimicrobial resistance detection. In Tanzania, our work has focused on supporting supervision and training for disease surveillance.

Throughout all of this we have been learning by doing, through collaborations with colleagues working in water, sanitation, and hygiene, as well as new diagnostic and digital health approaches to improving the quality and access to data.

Last but not least, we would like to say thank you and adieu to our wonderful colleague, Emmanuel Cour, who has led our GHS work in Senegal over the past year. He has been an inspiration and a catalyst for us all!

Sixty-five countries report continuing mosquito-borne transmission of Zika. The first case of female-to-male sexual transmission was reported.  Guinea-Bissau is the latest country to report mosquito-borne Zika virus transmission, and Puerto Rico has reported a surge in confirmed cases. Sanofi SA teamed up with the US Army on a Zika vaccine, and genetically modified mosquitos are also being considered to fight the outbreak. The risk of spread of the virus from the Olympic Games this summer is "very low" according to  the World Health Organization (WHO), but expert scientific opinions differ. A recent study shows four countries face the highest risk of transmission from the games. (See more news on Zika below).

As of mid-July, there are reports of 3,625 cases with 357 deaths of yellow fever in Angola and 1,798 cases with 85 deaths of yellow fever in Democratic Republic of the Congo (DRC).  WHO is monitoring the risk of spread  since two counties have imported cases from Angola (Kenya and China), whereas seven countries report yellow fever outbreaks not linked to the Angola outbreak.  An emergency meeting was held in May to assess the gravity of the outbreak.  WHO launched a yellow fever vaccine campaign in both countries, aiming to immunize 15.5 million people by the end of August in an unprecedented push. (See more news on yellow fever below).

Wild poliovirus cases increased to 19 in 2016, with 13 cases in endemic Pakistan and 6 cases in endemic Afghanistan. Vaccine-derived poliovirus cases remain at three in nonendemic Laos.  For the first time, Pakistan did not report wild poliovirus. A type 2 vaccine-derived polio strain was found in sewage water in Hyderabad, India, prompting a vaccination drive of 300,000 children.

Health officials report a 179% increase in dengue cases for the first four months of this year compared to last year. Cases have reached 25,441, including ten deaths in Vietnam.

Guinea and Liberia declared the end of the most recent outbreak of Ebola virus. The risk of additional outbreaks originating from exposure to infected survivor body fluids remains and requires sustained mitigation through counselling on safe sex practices and testing of body fluids.

United Nations Security General Ban Ki-moon underlined progress toward strengthening responses to global health crises in a recent briefing report at an informal assembly meeting. At the Advancing Global Health Security: From Commitments to Actions meeting in Southeast Asia, WHO, governments, and health agencies committed to advancing global health security.

The Senate blocked a Zika bill due to lack of bipartisan support. The appropriation of funds to combat Ebola, Zika, and future pandemics remains unclear. PATH's David Fleming, vice president of Public Health, shares his opinion in a Seattle Times op-ed on the unreliable funding of public health agencies exposing communities unnecessarily to threats like the Zika virus.

In Tanzania, joint supportive supervision implementation meetings were held with the Ministry of Health, Community Development, Gender, Elderly and Children; CDC; and Regional and Districts' Integrated Disease Surveillance and Response (IDSR) teams. Regional and district officials were introduced and oriented to a revised electronic IDSR (eIDSR) supportive supervision checklist to conduct the pilot phase in Kilimanjaro and Arusha regions.

Additionally, PATH had a series of meetings with CDC and other stakeholders, including the Association of Public Health Laboratories, Information and Communication Technologies sector, and Health Quality Assurance sector to discuss improvements to the supportive supervision checklist, linking eIDSR with laboratory data, and solving issues related to the eIDSR reporting system.

Nancy Shamge joined our Tanzania team in May as a senior program assistant.

The Senegal team implemented a questionnaire for disease mapping, and it has already been completed by 25 laboratories, including 4 of which were not yet enrolled for notification of mandatory declaration diseases. Furthermore, the reporting of antimicrobial resistance has begun in a pilot program in four laboratories using DHIS2. IDSR evaluations were also conducted at the regional (7 regions), district (14 districts), community (14 village watch committees), and central levels.

PATH Senegal supported the Direction of Laboratories in conducting a three-day workshop with 48 participants for the validation of the strategic surveillance plan for the 2016-2020 period. Furthermore, meetings were held in June with the Community Health Unit of the Ministry of Health to verify and validate the work plan for year two, as well as develop an implementation plan for community-based surveillance.

Our Vietnam team has focused on refining and finalizing the event-based surveillance (EBS) system interim technical guidelines, finalizing the EBS rapid assessment, finalizing the Field Epidemiology Training Program guidelines, and familiarizing government counterparts with the new District Health Information Software (DHIS2).

A US congressional delegation visited the Emergency Operations Center (EOC) at the National Institute of Hygiene and Epidemiology on May 23, featuring a successful first connectivity dry run. Other key recent meetings in Vietnam included two meetings with the Vietnamese Government Department of Preventative Medicine, WHO, CDC, and other partners regarding surveillance of severe acute respiratory infection (SARI) and yellow fever. 

In the coming months, a series of consensus meetings will take place to finalize the EBS implementation guide with our governmental and global partners. A series of data visualization trainings of DHIS2 and Tableau are scheduled for July through September. 

Quang Tran Hong joined the team in May as a health information system strengthening program officer and Laura Lane joined the team in July as a team associate.