Non-communicable diseases (NCDs) & injuries and mental health conditions constitute a serious impediment to achieving the vision of Agenda 2063 to build an integrated, prosperous, and peaceful
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Africa driven by its own citizens. Each year, these conditions cause millions of premature deaths and disabled lives across Africa. These conditions also lead to annual economic loss of multiple billion US-Dollars. Their burden both in terms of disease morbidity/mortality and socio-economic impact is increasing.
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Non-Communicable Diseases (NCDs), including mental disorders, currently pose one of the biggest threats to health and development globally, particularly in low and middle income countries2. It is pr
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edicted that unless proven interventions are rapidly implemented in countries, in the short to medium term, health care costs will increase exponentially and severe negative consequences will ensue not only to individuals and families but to whole societies and economies. NCDs are already a major burden in South Africa, but without added rigorous and timely action the health and development consequences may well become catastrophic. Immediate and additional, high quality, evidence based and focussed interventions are needed to promote health, prevent disease and provide more effective and equitable care and treatment for people living with NCDs at all levels of the health system. The problem is further compounded by the rising global prevalence of multi-morbidity (defined as the coexistence of two or more chronic diseases in one individual).
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The application of digital health technology is growing at a rapid rate in Africa, with the goals of improving the delivery of healthcare services and more effectively reaching out to remote
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and underserved communities. The lack of enabling guidelines and standards across the continent, on the other hand, makes it difficult to share data in a meaningful way across the continent.
Considering this, Africa Centres for Disease Control and Prevention (Africa CDC) established a task force of 24 members to provide expertise and guidance in the development of AU HIE guidelines and standards. Members of the task force were subject matter experts working in Africa and internationally on the collection, analysis, and exchange of health information. Some of these experts had been involved in previous consultations on defining Africa CDC’s health information systems strategy. A chairperson, co-chairperson, and secretary were elected to engage the task force members in different technical working groups.
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Ebola disease and Marburg disease outbreaks continue to occur in Africa, with increased frequenc
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y. In addition to resulting in high mortality and morbidity, the outbreaks generate fear and mistrust about the response activities within the communities affected.
Infection prevention and control (IPC) is a key pillar in the outbreak response; adherence to IPC practices can prevent and control transmission of infections to health and care workers, patients and their family members.
During the 2014-2016 West African Ebola disease outbreak, there was an urgent need for rapid IPC guidance to help support ministries of health, health-care providers and non-governmental organizations (NGOs). In response, WHO produced several documents related to the outbreak based on expert opinion, including IPC-specific documents and documents on clinical management that also referenced key IPC principles and practices. Since that time, many practices in the field have become institutionalized.
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In 2006, the Special Session of African Union Health Ministers adopted the Maputo Plan of Action for implementing the Continental Policy Framework on sexual and reproductive health
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and rights (SRHR), which expired at the end of 2015. The goal was for all stakeholders and partners to join forces and re-double efforts, so that together, the effective implementation of the Continental Policy framework including universal access to sexual and reproductive health by 2015 in all countries in Africa can be achieved. The Revised Maputo Plan of Action (MPoA) 2016 – 2030 was subsequently endorsed by the African Union Heads of State at the 27th AU Summit in July 2016 in Kigali, Rwanda. The plan reinforces the call for universal access to comprehensive sexual and reproductive health services in Africa and lays foundation to the Sustainable Development Goals, particularly Goal 3 and 5, as well as the African Union Agenda 2063.
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The African Centers for Disease Control and
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Prevention and the African Union together have called for a New Public Health Order which will safeguard the health and economic security of the continent as it strives to meet the aspirations of the Agenda 2063. A key pillar of this mandate seeks to expand the local manufacture of vaccines, diagnostics, and therapeutics. Presently, less than one percent of vaccines administered on the continent are manufactured locally. This places a great burden on the health systems of African countries and reduces their ability to respond to pandemics and other health crises.
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The Event-based Surveillance Framework is intended to be used by authorities and agencies responsible for
surveillance and response. This framewo
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rk serves as an outline to guide stakeholders interested in implementing
event-based surveillance (EBS) using a multisectoral, One Health approach. To that end, the document is arranged
in interlinked chapters and annexes that can be modified and adapted, as needed, by users.
This is a revised version of the original “Framework for Event-based Surveillance” that was published in 2018. This
framework does not replace any other available EBS materials, but rather builds on existing relevant or related
documents and serves as a practical guide for the implementation of EBS in Africa. This framework is aligned with
the third edition of the WHO Joint External Evaluation for the following indicators: strengthened early warning
surveillance systems that are able to detect events of significance for public health and health security (Indicator
D2.1); improved communication and collaboration across sectors and between National, intermediate and local
public health response levels of authority regarding surveillance of events of public health significance (Indicator
D2.2); and improved national and intermediate-level capacity to analyse data (Indicator D2.3). As countries begin
to implement and demonstrate EBS functionality they will ensure an increase in JEE scores and progress towards
meeting the requirements outlined in the IHR3F
Additionally, in African Union Member States that have adopted the Integrated Disease Surveillance and
Response (IDSR) strategy, this document is a complement to and can enhance the implementation of IDSR,
especially for the 3rd edition (2019) that includes components related to EBS.
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Visit the AIDSinfo website to access the most up-to-date guideline.
Register for e-mail notification of guideline updates at https://aidsinfo.nih.gov/e-news.
Healthcare-associated infections (HAI) are a significant burden globally, with millions of patients affected each year. These infections affect both high- and limited-resource healthcare settings, but in limited-resource settings, rates are approxim
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ately twice as high as high-resource settings (15 out of every 100 patients versus 7 out of every 100 patients). Furthermore, rates of infections within certain patient populations are significantly higher in limited-resource settings, including surgical patients, patients in intensive-care units (ICU) and neonatal units. It is well documented that environmental contamination plays a role in the transmission of HAIs in healthcare settings. Therefore, environmental cleaning is a fundamental intervention for infection prevention and control (IPC).It is a multifaceted intervention that involves cleaning and disinfection (when indicated) of the environment alongside other key program elements to support successful implementation (e.g., leadership support, training, monitoring, and feedback mechanisms). To be effective, environmental cleaning activities must be implemented within the framework of the facility IPC program, and not as a standalone intervention. It is also essential that IPC programs advocate for and work with facility administration and government officials to budget, operate and maintain adequate water, sanitation and hygiene (WASH) infrastructure to ensure that environmental cleaning can be performed according to best practices.
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The importance of robust mortality surveillance systems cannot be overstated in an era marked by increasing global health challenges where health threats loom large and population dynamics continue to evolve. Accurate
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and timely mortality data is essential for identifying trends and detecting emerging health threats, evaluating the impact of interventions, and guiding evidence-based policy decisions.
This framework outlines a holistic approach to strengthening routine mortality surveillance systems, considering the unique contextual factors and challenges faced by African countries. It emphasizes the importance of establishing efficient data collection mechanisms, enhancing data quality and completeness, and promoting data sharing and collaboration among stakeholders.
Moreover, the framework recognizes the pivotal role of technology in the integration of data from fragmented mortality data sources. It highlights the potential of innovative data capture methods, advanced analytics, and real-time reporting systems to enhance mortality data’s accuracy, efficiency, and timeliness.
The continental framework for mortality surveillance aligns with Africa CDC’s mission and strategic goal by serving as a fundamental component in strengthening public health systems, enhancing disease surveillance capacities and capabilities, informing evidence-based policies and interventions, and promoting collaboration and coordination among African countries to address health challenges and improve health outcomes on the continent.
The successful implementation of this framework requires collective commitment and concerted efforts from governments, health institutions, and the international community. We hope this document will serve as a catalyst for transformative change, enabling countries to build resilient mortality surveillance systems that protect public health, save lives, and contribute to evidence-based decision-making.
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A Public Health EOC (PHEOC) serves as a hub for coordinating the preparation for, response to, and recovery from public health emergencies. The pre
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paration includes planning, such as risk and resource mapping, development of plans and procedures, and training and exercising. The response includes all activities related to investigation, response and recovery. The PHEOC also serves as a hub for coordinating resources and information to support response actions during a public health emergency and enhances communication and collaboration among relevant stakeholders.
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Mpox is an emerging zoonotic disease caused by the mpox virus, a member of the Orthopoxvirus genus closely related to the variola virus that causes smallpox. Mpox was first discovered in 1958 when outbreaks of a pox-like
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disease occurred in monkeys kept for research. The first human case was recorded in 1970 in the Democratic Republic of the Congo (DRC) during a period of intensified effort to eliminate smallpox and since then the infection has been reported in a number of African countries. Mpox can spread in humans through close contact, usually skin-to-skin contact, including sexual contact, with an infected person or animal, as well as with materials contaminated with the virus such as clothing, beddings and towels, and respiratory droplets in prolonged face to face contact. People remain infectious from the onset of symptoms until all the lesions have scabbed and healed. The virus may spread from infected animals through handling infected meat or through bites or scratches. Diagnosis is confirmed by polymerase chain reaction (PCR) testing of material from a lesion for the virus’s DNA. Two separate clades of the mpox virus are currently circulating in Africa: Clade I, which includes subclades Ia and Ib, and Clade II, comprising subclades IIa and IIb. Clade Ia and Clade Ib have been associated with ongoing human-to-human transmission and are presently responsible for outbreaks in the Democratic Republic of the Congo (DRC), while Clade Ib is also contributing to outbreaks in Burundi and other countries.
In 2022‒2023 mpox caused a global outbreak in over 110 countries, most of which had no previous history of the disease, primarily driven by human-to-human transmission of clade II through sexual contact. In just over a year, over 90,000 cases and 150 deaths were reported to the WHO. For the second time since 2022, mpox has been declared a global health emergency as the virus spreads rapidly across the African continent. On 13 Aug 2024, Africa CDC declared the ongoing mpox outbreak a Public Health Emergency of Continental Security (PHECS), marking the first such declaration by the agency since its inception in 2017.7 This declaration empowered the Africa CDC to lead and coordinate responses to the mpox outbreak across affected African countries. On August 14, 2024, the WHO declared the resurgence of mpox a Public Health Emergency of International Concern (PHEIC) emphasizing the need for coordinated international response.
As of August 2024, Mpox has expanded beyond its traditional endemic regions, with new cases reported in countries including Sweden, Thailand, the Philippines, and Pakistan. Sweden has confirmed its first case of Clade 1 variant, which has been rapidly spreading in Africa, particularly in DRC. The emergence of this new variant raises concerns about its potential for higher lethality and transmission rates outside Africa.
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Important Guideline for Ebola prevention and control
It is designed
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for the following uses:
- for prevention through preparedness--to help African health facilities make advance preparations for responding with appropriate precautions when a VHF (including Ebola) case is suspected.
- for planning and conducting in-service training to strengthen standard precautions and VHF isolation precautions.
- as a rapid reference when a VHF (i.e. Ebola) case appears at a health facility where no previous VHF preparations have been made.
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The goal of this addendum is to help management and staff
minimize the risk of TB transmission at facilities in resource limited settings in which a.) HIV-infected persons receive diagnosis, care, treatment,
and/or support,
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and b.) there is a high prevalence of HIV infection, both known
and undiagnosed, in settings such as prisons, jails, other
detention centers, and drug rehabilitation centers.
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Event-based surveillance (EBS) is defined as the organized collection, monitoring, assessment and interpretation of mainly unstructured ad hoc information regarding health events or risks, which may represent an acute risk to health. Both indicator-
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based and event-based surveillance components serve the early warning and response (EWAR) function of the public health surveillance system. The Framework for Event-based Surveillance offers guidance to public health practitioners seeking to implement EBS at each administrative level in healthier countries.
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