Global Alert and Response (GAR)

EPR strategy and activities

Mission statement

- To support countries in preparing and responding effectively to yellow fever outbreaks
- To link outbreak response at national level with long-term efforts to control yellow fever at regional and global levels

Vision

- Effective and timely yellow fever surveillance
- Evidence-based assessment of the risk of yellow fever epidemics
- Fast and comprehensive response to yellow fever outbreaks including easy access to vaccine for mass vaccination campaigns, social mobilization, vector management and any other relevant aspects to improve outbreak response effectiveness

Objectives

  • Ensure timely and effective response to yellow fever outbreaks to prevent (i) high morbidity and mortality and (ii) international spread through :

    • Enhanced yellow fever surveillance: better quality and coverage for better detection of outbreaks
    • Elaboration of evidence-based criteria and tools to assess the risk of spread and the potential impact of the disease in given populations
    • Definition of standard operating procedures for the International Coordinating Group for Vaccine Provision ensuring effective management of the global emergency vaccine stockpile and adequate release of vaccine to support country needs
    • Improved coordination among partners within a well-defined operational framework for outbreak response

  • Bridge outbreak response and long-term strategy to control yellow fever through:

    • Well' defined mechanism of collaboration between WHO and partners
    • Strengthening of yellow fever routine activities in high-risk areas
    • Improved preparedness plan in areas at risk
    • Post-outbreak evaluation to identify strengths and weaknesses in yellow fever control

Activities

Improving surveillance

Although reporting of yellow fever cases is obligatory for WHO Member States under the International Health Regulations (IHR 1969), the statistics vastly underestimate the true incidence of the disease because only a small fraction of cases are recognized, investigated or reported. To improve recognition of yellow fever, WHO has prepared guidelines for use at district and national levels including case definitions, instructions for specimen collection and laboratory referrals as well as managing control efforts.

District guidelines for yellow fever surveillance

Surveillance can reveal trends useful in predicting epidemics and forecasting vaccine needs. Surveillance is also needed to improve understanding of the epidemiology of yellow fever, particularly concerning factors that might facilitate the transition from jungle to urban forms. Better reporting of cases can heighten awareness of the seriousness of the disease and motivate better immunization coverage.

Yellow fever epidemics: risk assessment

In order to identify risk areas within countries susceptible to yellow fever transmission and to increase preparedness measures in these areas, WHO is performing a broad review of yellow fever epidemics and outbreak responses in the past two decades.

In order to compile information from different sources (annual notification, mission reports, scientific papers), the entity "yellow fever event" has been used to characterize the reporting of at least one case of yellow fever in a geographical area over a one-year period.

Preliminary results at district level (administrative level one) are now available.

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