Surveillance and outbreak alert

Preparedness is key to fight Ebola

Health workers in Timor-Leste practice using Personal Protective Equipment (PPE) during a WHO training on infection prevention control for Ebola virus disease in Health Care Settings.
Health workers in Timor-Leste practice using Personal Protective Equipment (PPE) during a WHO training on infection prevention control for Ebola virus disease in Health Care Settings.

The 11 Member States of WHO’s South-East Asia Region have been stepping up preparedness to respond to Ebola Virus Disease (EVD). On August 8, 2014, WHO declared the EVD outbreak as a public health emergency of international concern. Since then, the focus globally has been on containing the outbreak and preventing its further spread from West Africa through an internationally coordinated response.

Ebola virus disease, formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans. The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission. The average EVD case fatality rate is around 50%. The first EVD outbreaks occurred in remote villages in Central Africa, near tropical rainforests, but the most recent outbreak in West Africa has involved major urban as well as rural areas. Community engagement is key to successfully controlling outbreaks. Good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilization.

The Ebola preparedness initiatives in the South-East Asia Region are led by the Regional Director, Dr Poonam Khetrapal Singh, who has been in regular contact with the Health Ministers of the 11 Member States advocating for strong health systems with effective surveillance, infection control and community mobilization. The focus is on building national capacities for early detection, prompt management and rapid containment.

A briefing session on Ebola preparedness was held at the Sixty-seventh session of the Regional Committee, the governing body of WHO’s South-East Asia Region in Dhaka, Bangladesh, in September 2014. The need for Ebola preparedness has been regularly highlighted at other high-level meetings such as the SAARC consultation on cross-border collaboration and the SAARC consultation for Influenza preparedness, both in Kathmandu, Nepal, in September 2014. The Regional Director briefed stakeholders, donors and Ambassadors on the Region’s preparedness in New Delhi on 3 December 2014.

WHO has been supporting Member States with periodic technical guidelines, technical sessions and briefings, and hands-on training and other capacity building initiatives. The technical guidelines relate to case definition, surveillance at point-of-entry, sample collection, shipment and laboratory investigation, infection prevention and control. A regional laboratory workshop on biosafety in August 2014 was followed by a number of regional and national workshops for laboratory preparedness for EVD.

Capacity building activities have been held for IATA awareness, training for shipping and packaging of infectious, biological substances, dangerous goods and cold chain maintenance to facilitate shipment of suspected EVD specimens to WHO designated laboratories.

Focusing on the challenges facing the health workforce during EVD outbreaks, a workshop was conducted on Healthcare Acquired Infection Prevention and Control in Chiang Mai, Thailand in February 2015.

The Regional Office has procured and supplied personal protection equipment (PPE) and laboratory related supplies for Ebola diagnosis worth US$ 400 000 to the Member States, as per their requirement.

To support Member States in communicating risks of Ebola effectively, and to get the desired community response, WHO has been conducting risk communication trainings in Member States for the ministries of health and representatives of other stakeholders. A regional media workshop focusing on Ebola among the emerging infectious diseases in Kathmandu, Nepal, in October 2014 triggered a series of national-level media workshops to bring clarity on EVD as well as strengthen partnerships with media to save lives in the event of an EVD outbreak or any other public health emergency.

Media workshop on Ebola in Bangkok, Thailand with WHO and Ministry of Public Health representatives responding to queries.
Media workshop on Ebola in Bangkok, Thailand with WHO and Ministry of Public Health representatives responding to queries.

Overseeing the preparedness at the regional level is an Ebola Task Force which meets periodically to assess the progress of preparedness and address issues and bottlenecks, if any. The preparedness initiatives are being measured and evaluated periodically. The Region has developed a checklist for Ebola preparedness to enable Member States assess their readiness. In addition, table-top simulations are being conducted at the regional and national level.

While working on Ebola preparedness, the South-East Asia Region has been extending support to the affected countries in West Africa. Thirty-six staff members from WHO-SEAR - emergency and humanitarian action coordinator and officer, surveillance medical officers, information and technology officer, crisis management logisticians, procurement assistance and communication officer – were / are deployed to support the Ebola response in Liberia, Sierra Lone, at the WHO Regional Office for Africa in Brazzaville, and in WHO headquarters in Geneva.

The International Health Regulations, IHR (2005), call upon Member States to be transparent in sharing information on diseases that may have the potential to move across countries to facilitate an international response. IHR regulations also specify, among others capacities, surveillance, response, laboratories, human-resource, risk communication and preparedness for early detection and prompt treatment.

The EVD preparedness activities are in line with IHR and are helping to strengthen the Region’s capacity to respond to disease outbreaks and save lives in emergencies.