Senegal’s experience with the Ebola virus has shaped the country’s approach to prevention, detection, and response to deadly outbreaks. PATH leveraged this experience in Senegal to host a delegation from the newest GHSP country, the Democratic Republic of Congo (DRC), to prepare for the build-out of DRC’s emergency operations center. While the circumstances and contexts of Senegal and DRC may be vastly different, the experiences the two countries shared highlighted the ability of GHS partners to collaborate, grow, and learn by doing. Read the full article here.

Quick and timely disease reporting is critical to identifying and containing outbreaks. Tanzania is working to improve reporting speed and access to surveillance data by transitioning from a paper-based reporting system to an electronic one. It’s taken a combination of mobile network expansion, education, creativity, and lost sleep—with some health workers staying up late into the night to ensure they can connect to the network to get reports in on time. Read the full article here.

PATH in DRC is kicking off its first quarter as part of the GHSP. In November 2016, a delegation from the DRC, including PATH staff and the country director of the Directorate of Disease Control (DLM), visited Senegal to learn from their experience in establishing an EOC. Over four days, the teams met with the Senegalese Ministry of Health, staff of Le Centre des Opérations d'Urgence Sanitaire, the emergency medical assistance service, CDC, and the Institut Pasteur de Dakar. The DRC GHSP team plans to apply those learnings in DRC’s EOC build-out and usage. In addition, PATH and the DLM have determined the location of the EOC and are in active discussions to determine the equipment and design.

Additional accomplishments in the first quarter of the GHSP in DRC include supporting Dr. Gaston Tshiabenda to participate in the CDC Public Health Emergency Management Fellowship in Atlanta; and supporting the relocation of the DLM office.

Staffing updates: PATH has assembled a team in Kinshasa that will serve as an asset to the GHSP. Trad Hatton, chief of party for PATH in DRC, continues to oversee all GHSP activities in the country. Dr. Leon Kapenga, deputy chief of party, has joined as project director, and Guy Mvulanianga is serving as project administrator.

PATH’s GHSP work in Senegal now involves six major components: surveillance, laboratory network strengthening, antimicrobial resistance (AMR) monitoring, information systems strengthening, emergency management, and immunization. Activities are implemented in partnership with the appropriate direction or division of the Ministry of Health (MOH): the Direction of Prevention, Direction of Laboratories, PRONALIN (a national program that fights hospital acquired infections), the Department of Health and Social Information Systems, the emergency operations center, the Health Community Unit, and the Medical Assistance and Emergency Service. This past quarter, PATH held several meetings with partners from the MOH to define and ensure that the workplan for this year was aligned with MOH objectives.

For surveillance, the technical group continued to hold periodic meetings and organize training sessions on integrated disease surveillance and response (IDSR) for private facilities and district focal points for surveillance. Additionally, the communication tools, monitoring tables, and job aids for IDSR were developed, and PATH assisted the Direction of Prevention in printing community-based surveillance tools.

The main accomplishment for this first quarter under laboratories was developing the 5-year national strategic plan. Two workshops were held to develop the lab policy documents and the lab strategic plan. Additionally, several labs have been trained to use the District Health Information System 2 platform for AMR notification. In collaboration with PRONALIN, the infection prevention and control (IPC) technical group is having meetings with the National Service for Education and Information for Health as they develop communication materials for IPC practices and patient security in healthcare settings.

Under the immunization work stream, PATH participated in a workshop for the Direction of Prevention to develop the 2017 work plan. As part of the emergency management component, PATH had a high-level meeting with the head of staff at the MOH.The meeting served to discuss the evaluation of the emergency care and recovery units of the health facilities in the 14 regions of Senegal.

Staffing updates: The PATH team in Senegal has welcomed the new GHSP program coordinator, Dr. Papa Moussé Ndiaye, who is a valuable asset to the program. The program will benefit from Dr. Ndiaye’s nearly two decades of experience and leadership in the Senegalese Armed Forces Medical Services, as well as his expertise as a health services manager and organizational development consultant.

In October, PATH in Tanzania shared electronic integrated disease surveillance and response (eIDSR) reporting trends to analyze the impact of the project since the start of project implementation. The data show a substantial improvement in completeness and timeliness of weekly reports compared to the same period before implementation of the GHSP. There are still challenges in achieving the recommended target of >80 percent timely reports, with an average of 65.9 percent and 54.7 percent of reports coming on time for Arusha and Kilimanjaro, respectively. Extensive supportive supervision has been deployed in areas with poor reporting to support reaching the >80 percent target.

During the month of November, PATH distributed laptops and modems to both regional and district eIDSR focal points of Kilimanjaro and Arusha regions to expand capacity for visiting the eIDSR database system to review data quality and approve data being sent on weekly basis. Initially it was difficult for district focal points to access the system, which resulted in a large number of incorrect data and late reports. However, since the distribution of these laptops there has been substantial increase of timely reports as well as frequent identification and reporting of problems with the eIDSR data base system.

PATH participated in several activities organized by both the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), UNICEF, WHO and the University of Glasgow research group. UNICEF disseminated the results of its bulk chlorination project pilots in Dar es Salaam and Morogoro. A research group from University of Glasgow conducted a workshop in Arusha entitled Knowledge Exchange Workshop Enhancing Zoonotic Disease Surveillance in Ngorongoro Conservation Area (NCA) and Beyond, where PATH presented their GHSP experience in the Ngorongoro conservation area. Additionally, PATH staff participated in a workshop organized by the MoHCDGEC in Morogoro designed to develop zoonosis surveillance system guidelines to facilitate efficient capturing of animal diseases of public health importance.

The Tanzania team also participated in a workshop organized by MoHCDGEC to review eIDSR materials to fit end users (i.e., health facilities), to identify technical eIDSR questions to be incorporated in the general quarterly supervision checklist, and to harmonize eIDSR activities with other partners. Additionally, PATH continued participating in the MoHCDGEC surveillance sub-committee where surveillance partners meet to discuss updates, including the status of the ongoing cholera outbreak.

In December, PATH also participated in an International Health Regulations (IHR) meeting supported by WHO, with the aim to develop a strategic partnership for country planning post-JEE and to develop Tanzania’s 5-year national action plans. PATH also met with the MoHCDGEC Environmental Health and Sanitation group to discuss PATH’s upcoming WASH project in order to finalize details of geographic scope and target population.  WASH objectives and activities will be aligned with guidelines for WASH in healthcare facilities released by MoHCDGEC, National Institute for Medical Research, University of Dar es Salaam, and Muhimbili University of Health and Allied Sciences.

The Vietnam team continued to build upon activities in Year 1 while expanding the technical components of its workplan. Year 2 activities now includes IPC, HIV self-testing, and monitoring and evaluation for event-based surveillance.

The health information systems (HIS) team continued work with the General Department of Preventive Medicine (GDPM) at the Ministry of Health as GDPM closed out their current electronic communicable disease surveillance system as of December 31st. The team continues to work on the data warehouse and data visualization tools with GDPM.

In Year 2 the HIS team is also supporting AMR activities. The team conducted site visits to hospitals in preparation for a WHONET training--WHONET is a software developed by the WHO to improve infrastructure for the collection of AMR data. This training will increase capacity for staff of 16 hospitals to use WHONET more effectively, while also serving to identify issues for sharing AMR data within the Vietnam Administration for Medical Services structure. Prior to the training it was important to gather information directly from the hospitals to inform planning of interoperability between hospital laboratories and the integration of laboratory information systems for AMR and healthcare associated infections. These site visits also served as an opportunity to customize the training for the Vietnam context.

Additionally, team members participated in group meetings. The first of these groups supports alignment and coordination of AMR/IPC activities with other GHS-funded programs. Participants in these meetings included CDC, WHO, Health Advancement in Vietnam, and Oxford University Clinical Research Unit. The second group supports laboratory activities within AMR/IPC, but also includes entities that are not funded by GHS.

On December 26–27th, 2016 a workshop titled Emerging Infectious Diseases Situation Update, Preparedness, and Response for Zika was held in Ho Chi Min City, Vietnam. This was a unique opportunity for information sharing for public health leaders in the region and relationship-building to facilitate cross-country collaboration, especially when there is a public health event that demands international cooperation and data sharing. Dr. Ha Thu Nguyen, the Emergency Operations Center Coordinator at GDPM, served as Master of Ceremonies at the event.

Staffing updates: In December, Miquel Sitjar joined PATH as the technical advisor for health information systems; a program associate, Huyen Nguyen, and the infection prevention and control project manager, Ha Thi Thu Tran, joined the team in January. In February, the team welcomed Huyen Thanh Nguyen as the senior monitoring and evaluation officer.

The PATH Global Health Security Partnership team recently joined the Joint External Evaluation (JEE) Alliance, a group dedicated to supporting independent country assessments under WHO's International Health Regulations (IHR) Monitoring and Evaluation Framework. Though participating in the Alliance, PATH will help to facilitate engagement between countries, international organizations, donors and technical experts involved in the JEE assessment process. In this role, PATH will directly support WHO Member States and GHSA partner countries as they assess their progress toward full IHR implementation objectively and transparently. PATH now has experts on the JEE roster; additionally, the GHSP team has developed ways to better understand how PATH’s projects contribute specifically to capacity improvements based on country JEE scores, and we are reimagining how to align PATH’s work to global standards of health security capacity measurement. Upcoming evaluations will take place in Kenya, Burkina Faso and Guinea-Bissau in 2017.

On December 13th, a briefing on GHS was held for members of Congress on Capitol Hill in Washington DC, led by PATH’s Advocacy and Policy team. Following this briefing, a high-level event was held at the State Department on December 14 with Secretary of State John Kerry highlighting the importance of GHS. PATH CEO and President, Steve Davis, delivered a message emphasizing the critical importance of health systems, targeted impact-driven investments, multisector collaboration, and an integrated and holistic approach to sustaining the gains of the GHSA. “Regardless of our politics, our policies, or our profits,” Davis said, “Or whether we are coming from this as a policymaker or funder, NGO leader, activist, business leader, or a professor—our common interest lies in finding global solutions to global threats.”

PATH also represented the Global Health Security Agenda at the World Economic Forum in Davos, where Steve Davis further discussed the importance of strengthening public health systems to help the countries to better prevent, detect, and respond to epidemic threats. This includes PATH’s work to more quickly develop and test new vaccines for emerging and reemerging diseases so they can be deployed as early as possible. The Coalition for Epidemic Preparedness Innovations (CEPI) was announced at Davos, a $460 million public-private effort to speed up the development of new vaccines that may prevent future outbreaks. CEPI builds on lessons from past outbreaks where vaccines may have been critical tools, such as the Ebola epidemic in West Africa, which might have been averted had Ebola vaccines languishing in the research and development pipeline been available.