The African One Health E-Surveillance Initiative

Information and Communication Technology (ICT) has the potential to strengthen disease surveillance by providing critical real-time information. Potential impact is great in the African region, which has the specter of newly emerging threats, such as Ebola Hemorrhagic Fever, while also having growing ICT infrastructure and political will to improve surveillance systems.   Electronic surveillance, or e-Surveillance, is defined as “the use of electronic systems to facilitate public health surveillance functions of prevention, prediction, detection, and response.”1 E-Surveillance in Africa must support the mandate of the International Health Regulations (2005), the Integrated Disease Surveillance and Response (IDSR) framework, and the interdisciplinary concepts of One Health to address the rising threat of emerging and re-emerging zoonotic diseases. e-Surveillance falls under the umbrella of e-Health. While e-Health interventions have proliferated across the African continent in the wake of improving ICT infrastructure such as mobile Internet, few have successfully been brought to scale due to a crippling cycle of donor-funded short-term pilots led by external contractors, and phenomenon known as “pilotitus.”

The One Health e-Surveillance Initiative used a project framework conceived by PHP that built capacity for implementation and strategic planning for e-Surveillance systems. OHSI’s unique approach was to conduct an assessment with the deliberate intent of establishing key personnel, or champions, of e-Surveillance within the Ministries of Health and Agriculture/Wildlife.

From 2013-2015, PHP partnered with the African Field Epidemiology Network with support from the United States Defense Threat Reduction Agency to undertake OHSI in five pilot countries: Burkina Faso, Cameroon, Kenya, Nigeria, and Uganda. OHSI established and engaged national, interdisciplinary country-level work groups (CLWG) composed of representatives from the Ministries of Health and Ministries of Agricultural/Wildlife. Training programs on e-Surveillance were provided. PHP worked closely with the United States Centers for Disease Control and Prevention (CDC) under guidance from the World Health Organization Regional Office for Africa (WHO/AFRO) to develop an e-Surveillance assessment tool that inventoried the variance of capacity to implement ICT solutions for surveillance across various offices within the national surveillance network. The purpose of the tool was to inform both national and regional strategic planning. PHP then supported CLWG members in collecting, cleaning, and analyzing data and drafting national reports.

Project outcomes included:

  • Final reports that are owned by national ministries to inform strategic planning for e-Surveillance;
  • The sustained and ongoing engagement of the CLWG members in national strategic planning processes, guided by WHO/AFRO;
  • Ongoing advocacy by CLWG within their ministries for One Health e-Surveillance; and
  • Establishment of CLWG members as Points of Contact for the ongoing efforts of WHO/AFRO to implement regional standards for interoperability of surveillance systems through the African Surveillance Informatics Governance Board.

The OHSI project framework was successful in realizing true sustainability, as CLWG are deeply involved with ongoing efforts now guided by WHO/AFRO. Discussions are underway to replicate the project model in the Middle East North African region, and the project activities can be replicated in other regions to build sustainable e-Surveillance systems on the national scale.

Also see: OHSI Overview to AFENET Sept 5, 2013