To prevent or respond appropriately to new epidemic phenomena and other public health emergencies, the World Bank supports the Regional Disease Surveillance Systems Enhancement (REDISSE) program in West and Central Africa. The program aims to reinforce regional and national surveillance and response systems. Officially launched in 2016, it groups together a set of multisectoral projects that initially targeted the countries of the Economic Community of West African States (ECOWAS) and Mauritania. The fourth funding round began in 2020, extending into Central Africa. In both regions, the funding has a regional dimension, managed by the West African Health Organization (WAHO) in West Africa and the Economic Community of Central African States (ECCAS) in Central Africa, and a national dimension in each country.
Within the program’s regional dimension, the WAHO wants to reinforce the capacity of health districts to conduct integrated disease surveillance by setting up Epidemiological Surveillance Centers (ESC). An ESC is a concept that incorporates a laboratory unit and a surveillance unit. Setting up an ESC aims to reinforce its capacity for surveillance data analysis and management based on laboratory with training, supportive supervision, and the allocation of computer and laboratory equipment.
In the countries identified by the WAHO, ESCs are being established by the Mérieux Foundation (laboratories) and Santé Monde (surveillance), building on its experience in epidemiology training in the field, working closely with the national health authorities.
The WAHO has commissioned the Mérieux Foundation and Santé Monde three times since 2017 to set up 147 ESCs in ten ECOWAS countries and Mauritania. Building on the results already achieved, the two organizations have been mobilized by Chad’s national REDISSE program.
The purpose of the Mérieux Foundation’s mandate is to strengthen capacity at health district laboratories in ECOWAS countries to:
- Reinforce laboratory managers’ skills in diagnostics and laboratory confirmation.
- Improve the epidemiological surveillance and response capacity of district laboratories.
The Mérieux Foundation’s specific objectives are to:
- Enhance training for laboratory technicians working in the health districts of the target countries.
- Identify laboratories’ equipment needs and upgrade their technical facilities with essential surveillance equipment.
- Train staff in how to maintain laboratory equipment.
- Strengthen laboratories’ abilities to monitor analysis quality using various approaches.
- Support laboratories in the management and collection of laboratory data by setting up a computerized system called LabBook
- Set up a quality control mechanism for analyses performed in laboratories.
- Support the networking of laboratories for quality control by peers.
The project is organized around five types of activity:
- Laboratory audit and assessment: producing an assessment grid, visiting laboratories, drafting an audit report and organizing a reporting workshop with laboratories and national health authorities.
- Training laboratory technicians: using modules developed as part of the RESAOLAB project that are available in the three working languages, training national trainers and organizing training sessions delivered by these trainers to laboratory staff, with some of the sessions organized jointly with surveillance unit teams.
- Supportive supervision: supporting laboratories as they put the training into practice and submitting supervision reports to the national authorities.
- Putting quality management in place: setting up a computerized laboratory system and quality control mechanisms and creating links between laboratories for quality control purposes.
- Organizing a final meeting to report on progress to the national health authorities, including actors from environmental and animal health sectors.
Together, the Mérieux Foundation and Santé Monde have helped to set up:
- 47 ESCs in Guinea, Guinea-Bissau, Liberia, Sierra Leone, and Togo (2017-2018)
- 60 ESCs in Benin, Mali, Mauritania, Niger, and Nigeria (2020–2022)
- 40 ESCs in Togo, Benin, and Nigeria (2023)
- 20 ESCs in Chad (2023)
- World Bank via WAHO
- Ministries of Health in the countries concerned
- Santé Monde