Imagine a scenario where within a few days, four children with ties to the same school die from an unknown cause or causes. The illnesses feature similar symptoms, including fever. Are the deaths a coincidence, caused by an environmental issue or are they the result of a dangerous pathogen?
Each day headlines highlight outbreaks of dangerous diseases—MERS, avian influenza, Ebola. And each strikes fear into people around the globe because of their capacity to rapidly infect populations from Saudi Arabia to the United Kingdom or Liberia to America.
Through the Global Health Security Agenda launched in 2014, the Centers for Disease Control and Prevention (CDC) is working with 31 countries to accelerate their ability to prevent, detect and respond to infectious disease threats. Work in the West African nation of Burkina Faso shows how organizations can come together to prepare for outbreaks, protecting the local country and thereby bolstering health protection around the globe.
In Burkina Faso, CDC is working closely with the Ministry of Health and partners in four key ways to strengthen the country’s health systems, building on a multiyear plan Burkina Faso put in place with the World Health Organization (WHO).
According to Rebecca Greco Konè, MPH, CDC’s country director for Burkina Faso, “Our work supports the Ministry of Health on improving infectious disease surveillance, enhancing laboratory diagnostic capacity, strengthening of emergency management and response, and workforce development.”
Systems strengthening for disease outbreaks is essential for every nation—but not every nation recognizes this importance.
In Burkina Faso, CDC is working closely with the Ministry of Health and partners in four key ways to strengthen the country’s health systems, building on a multiyear plan Burkina Faso put in place with the World Health Organization.
“The Ministry of Health team in Burkina Faso values collaboration and is committed to continuous evaluation and improvement of the country’s systems and efforts to protect the Burkinabé population from infectious disease threats,” said Konè. “That’s why they have worked diligently with CDC, the WHO and other partners for many years building strong public health systems, including putting in place a strong integrated disease surveillance and response system to detect and respond across a number of infectious diseases, as well as to address specific high burden diseases which pose an ongoing threat to the people of Burkina Faso such as meningitis.”
This previous work is now paying dividends in Burkina Faso’s global health security efforts, including their response to what was a tragic, real-life scenario of four children with connections to one school getting ill and dying in short order. These deaths occurred in February 2017 in Bouahoun, a community near Houndé in Burkina Faso’s Tuy Province.
Fortunately, health workers at the district hospital in Houndé had participated in CDC’s Field Epidemiology Training Program (FETP) as part of global health security work in Burkina Faso. FETP trains a global workforce of field epidemiologists, also known as disease detectives. Based on this training, the health workers knew what had to be done.
“Our team took immediate action and began an investigation looking into the two initial deaths and some other illnesses that were similar,” said Pananou Daourou, who has responsibility for health information and epidemiological surveillance in the Houndé Health District. “Ultimately, two additional students died.”
By using skills gained during their recent FETP training, the Houndé team was able to respond quickly to the event in the community with an investigation, rule out a number of potential diseases using laboratory resources within the country and monitor the situation to ensure there were no further illnesses. While the students’ cause of death was not determined, this example shows how the field epidemiology skills being strengthened at the district level and the enhanced diagnostic capacity being developed at the national level under the Global Health Security Agenda work together to strengthen surveillance and response at the community level. This strategy is designed to help identify outbreaks closer to sources.
Following a training session in the village of Dougoumato, community health workers describe their roles in identifying health threats. These workers help to strengthen disease detection, response and prevention.
More than 400 residents of Dougoumato turned out for community health worker training, which featured dynamic speakers, colorful illustrations, music and dancing to emphasize the importance of disease identification.
To build on the Global Health Security work in Burkina Faso, a number of efforts are underway, including several involving the CDC Foundation and its local implementing partner, Davycas International, in support of CDC and the Ministry of Health. Among these efforts are community-based approaches to detect and respond to diseases, the strengthening of a coordinated approach to managing public health emergencies and the development of an emergency operations center for the country.
To date, the groups working together have been developing standard operating procedures for emergency responses, conducting assessments of the nation’s current surveillance and response capabilities, and working through a laborious process of documenting and supplementing emergency management policies to ensure they meet WHO and CDC standards. These groups have also conducted exercises to test and strengthen the system in advance of a public health emergency—a process that can take several years.
Ministry of Health officials also have identified a facility in the capital of Ouagadougou to serve as the centralized emergency operations center (EOC) for the country. This location will soon begin its transformation to a full-time EOC that will be used to address all public health emergencies, not just disease outbreaks.
“We’ve been able to bridge many challenges by building on each partner’s strengths and expertise, making it an exciting time to be a part of the global health security efforts,” said Catherine Zilber, MSc, CDC Foundation team lead for programs with responsibility for the Foundation’s work in Burkina Faso. “Working together, we have achieved so much more than any of us could have done alone.”
Though more work has to be done, Burkina Faso is making significant strides to protect its citizens and, thereby, the citizens of the world from dangerous health threats.
Photos: © Evelyn Hockstein/CDC Foundation
