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A New Day for African Public Health [Africa CDC]

Thursday, 2nd of March 2017 Print

The Lancet Infectious Diseases, Volume 17, No. 3, p237, March 2017


A new day for African public health

The Lancet Infectious Diseases

Published: March 2017


DOI: http://dx.doi.org/10.1016/S1473-3099(17)30061-0

Article Info

The Ebola virus disease outbreak in west Africa in 2014—2016 showed how a lack of regional capacity to respond quickly and effectively to public health emergencies can result in devastating outcomes, that affect not only health but also security and social and economic development in the long term. In 2016 alone, Africa experienced many disease outbreaks, including yellow fever in Angola and the Democratic Republic of Congo, and cholera in South Sudan. It is widely acknowledged that public health systems across the continent need to be strengthened to prevent, detect, and respond to future infectious disease outbreaks rapidly and effectively.

Thus, there is great hope for the new Africa Centers for Disease Control and Prevention (Africa CDC), which was officially launched in Addis Ababa, Ethiopia, on Jan 31. The Africa CDC is Africas first continent-wide public health agency, and it will be headed by John Nkengasong, who worked for more than 20 years for the US CDC. The aim of the Africa CDC will be to establish early warning and response surveillance systems, respond to emergencies, build capacity, and provide technical expertise to address health emergencies in a timely and effective manner.

The headquarters of Africa CDC is in Addis Ababa, which will also be the site of the Emergency Operations Center, where a team of ten epidemiologists will be responsible for disease surveillance, investigations, analysis, and reporting of disease threats across the continent. Taking into account the differences in health systems and resources among African countries, Africa CDC will operate on a decentralised model allowing each country to facilitate the implementation of surveillance and response frameworks according to its economic and human resources. Five Regional Collaborating Centers (in Egypt, Gabon, Kenya, Nigeria, and Zambia) set up with the capacity to rapidly detect known and unknown pathogens will be the reference centres for the organisation in the five African subregions (Central, East, North, Southern, and West).

Four strategic priority areas in need of strengthening have been identified: health-related surveillance and innovative information systems, with a focus on improved capacity for event-based surveillance, disease prediction, and improved public health decision making and action; functional and linked clinical and public health laboratory networks in the five African subregions; support for member states public health emergency preparedness and response plans; and strengthened public health science for improved decision making and practice. This multifaceted approach will support African countries in achieving existing international health targets, including the Sustainable Development Goals, the International Health Regulations, and universal health coverage. Furthermore, Africa CDC will advocate and promote the establishment or strengthening of national public health institutes in each member state, with the ultimate aim of forming an African public health network.

Clearly Africa CDC will not operate in a vacuum, so collaboration with international agencies such as US CDC, European CDC, and in particular WHO and its regional office will be essential for ensuring the success of the new agency. Future interventions made by Africa CDC will further strengthen existing public health programmes in the region. In early 2016, WHO launched a new global Health Emergencies Programme, aimed at reforming the way countries prepare for, respond to, and recover from public health crises. Then, in August, the WHO African Region office initiated the Regional Strategy for Health Security and Emergencies, based on the One Health approach, essential to control zoonoses.

Although at the moment there is optimism regarding Africa CDC, insufficient funding is the key element that could hamper implementation of any programme in the field. Despite receiving funding from both the African Union and China, there is uncertainty regarding the impact that a change in the commitment of the new US government to support the Global Health Security Agenda could have on Africa CDC. Moreover, issues with bureaucracy and limited capacity to recruit and retain experienced epidemiologists have already been identified for the new agency.

Nevertheless, the intrinsic value of the new Africa CDC remains: as an African-owned institution, the agency will be in the unique position to promote programmes that protect the health of Africans specifically. For that reason, we hope that a new day for African public health has finally come.


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