Global Alert and Response (GAR)

Global Consultation on Strengthening National Capacities for Surveillance, Response and Control of Communicable Diseases

Summary and Recommendations

World Health Organization, Geneva, 22-24 October 2003

Background

Strengthening national disease surveillance, response and control systems involves reinforcing the performance of the systems, building the skills and competencies of the implementers, improving the exchange and dissemination of relevant good quality information, and ensuring accessibility to the information derived from the system, in particular through networking and partnership.

Countries increasingly look at the integration of disease surveillance activities as an effective, efficient and sustainable approach to improving national capacities. In building national capacity, it is essential to constantly review existing strategies and models, identify challenges and constraints, as well as lessons learnt, and consolidate achievements.

A global consultation bringing together over 80 participants from selected Member States representing all WHO regions, WHO Regional Offices and Headquarters, technical and donor partners, training institutions and surveillance networks, was held in Geneva, from 22-24 October 2003.

Objectives

  • To share experiences, lessons learned, challenges and constraints in applying different models and approaches in strengthening national surveillance, response and control systems;
  • To define elements of a common framework for strengthening national capacity for surveillance, response and control, and recommend steps for its implementation.

Discussions

Strong sub-national and national surveillance and response capacities are critical for effective regional and global surveillance. The integrated approach to surveillance would allow for greater efficiencies, more effective and sustainable capacity building, and improved use of data at national and sub-national levels, while taking into account programme specific needs. The coordination of surveillance across programmes needs leadership at the highest levels. Pre-service, in-service and longer-term specialized training are important in considering the human resources for surveillance and response. Improvement of skills of health personnel, at the peripheral and intermediary levels, are essential for effective surveillance. Public health laboratory capacity building is a key component. There is a need for advocacy, standardization of procedures, provision of tools and supplies, and improving the numbers of trained laboratory personnel. Disease specific and multi-disease capacity strengthening and surveillance networks add value to national surveillance efforts.

Main Recommendations

  • WHO should provide leadership in the application of an integrated approach to surveillance in programme design and implementation at global and regional levels, in order to reinforce this approach at national and sub-national levels, and should promote technical consultations at all levels.
  • WHO and partners should ensure co-ordination of technical, financial and other support to surveillance, ensuring that broader national surveillance capacities are built through ongoing disease specific programmes and initiatives such as the Global Funds for Aids, Tuberculosis & Malaria (GFATM), and Global Alliance on Vaccine and Immunization (GAVI).
  • WHO should advocate for setting the highest priority to surveillance and response at policy levels. Regions should include surveillance, response and disease control strengthening strategies on the agenda of their respective Regional Committees meetings.
  • WHO and Member States should expand the documentation of country experiences, and use these to set a research agenda, including cost, cost-benefits, and cost-effectiveness analysis of different surveillance models, thus allowing countries to guide the process of improving national capacity for surveillance, response and control.
  • Member States should review existing legal frameworks to further support strengthening of surveillance including participation of the private sectors and non governmental organizations.
  • WHO and Member States should integrate surveillance into existing pre-service curricula, other in-service training, and long-term specialized public health training.
  • WHO and Member States should promote adult, competency-based training methods such as those currently employed by applied epidemiology training programmes, and that include a service component support and expand participation of fellows in multi national epidemic response teams.
  • Member States should strengthen linkages between national ministries of health and training institutions to ensure collaborative development of curricula and training materials.
  • WHO should ensure national commitment for strengthening public health laboratory services.
  • WHO should develop regional and sub-regional centres and networks for ongoing support in national capacity building.
  • WHO and partners should study the use of rapid diagnostic tests and other technologies that can contribute to strengthening national capacity for laboratory confirmation of priority health events.
  • WHO should carry out an inventory of existing surveillance networks and document their strengths and weaknesses in order to develop guidelines for improving these networks.
  • WHO should develop mechanisms for improving communication with capacity strengthening networks and work in line with the Global Outbreak Alert and Response network (GOARN).
  • WHO and partners should define standards and mechanisms for partnership at country level to promote global efforts that contribute to national capacity strengthening, and to broaden the scope of these partnerships.
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