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Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. Howe
...
ver, consolidation of CHVs position within formal health systems has proved to be complex and continues to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
more
The document “Strategic Framework for Strengthening Cross-Border Surveillance and Information Sharing in Africa” outlines a coordinated strategy developed by Africa CDC to improve public health
...
surveillance and collaboration across national borders in Africa. It addresses the challenge that infectious diseases often spread across borders due to population movement, trade, and migration, while surveillance systems and data-sharing mechanisms frequently remain nationally focused and fragmented.
The framework proposes strengthening regional coordination, harmonizing surveillance systems, enhancing information sharing between countries, and building laboratory and workforce capacity. It also emphasizes timely detection of cross-border health threats, joint outbreak investigations, and improved communication among Member States. Overall, the document aims to enhance preparedness, early warning systems, and collective response to public health threats across the African continent.
more
The document “Strategic Framework for Strengthening Cross-Border Surveillance and Information Sharing in Africa” outlines a coordinated strategy developed by Africa CDC to improve public health
...
surveillance and collaboration across national borders in Africa. It addresses the challenge that infectious diseases often spread across borders due to population movement, trade, and migration, while surveillance systems and data-sharing mechanisms frequently remain nationally focused and fragmented.
The framework proposes strengthening regional coordination, harmonizing surveillance systems, enhancing information sharing between countries, and building laboratory and workforce capacity. It also emphasizes timely detection of cross-border health threats, joint outbreak investigations, and improved communication among Member States. Overall, the document aims to enhance preparedness, early warning systems, and collective response to public health threats across the African continent.
more
The document “Strengthening the global architecture for health emergency prevention, preparedness, response and resilience” presents a report by the Director-General of the World Health Organiza
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tion (WHO) to the World Health Assembly on global efforts to improve preparedness and response to health emergencies. It reviews the implementation of the Health Emergency Prevention, Preparedness, Response and Resilience (HEPR) framework and highlights lessons learned from recent crises such as COVID-19. The report describes international initiatives to strengthen global health governance, surveillance systems, laboratory networks, community protection measures, healthcare capacity and access to medical countermeasures like vaccines and diagnostics. It also discusses coordination of emergency responses, support for countries facing outbreaks or humanitarian crises, and the importance of international cooperation. In addition, the report emphasizes the need for sustainable and coordinated financing to strengthen global health security and ensure that countries can better prevent, detect and respond to future health threats.
more
Artificial intelligence for tuberculosis control: a scoping review of applications in public health
Menon, S.; and K. Ghislein Kuro
(2025)
J Glob Health. 2025;15:04192. This scoping review highlights the potential of AI-driven predictions in national TB programmes to enhance diagnostics, track trends, and strengthen public health
...
surveillance. While promising for reducing transmission and support-
ing TB care in low-resource settings, these models require large-scale validation to ensure real-world applicability, especially for high-risk groups
more
The resurgence of mpox in multiple African countries since 2022 has highlighted urgent gaps in preparedness, detection, and response capacities across the continent. While the mpox outbreak was initially classified as a Public Health Emergency of In
...
ternational Concern (PHEIC) and a Public Health Emergency of Continental Security (PHECS), the risk of continued transmission in high-risk areas of Africa remains significant, particularly due to persistent zoonotic reservoirs, cross-border spread, and fragile surveillance systems.
more
Surveillance, prevention and control of leishmaniases in the European Union and its neighbouring countries
European Centre for disease prevention and control (ECDC)
European Centre for disease prevention and control (ECDC)
(2022)
C_CDC
This technical report presents the epidemiology of human and animal leishmaniases in the EU and its neighbouring countries and concludes that the disease remains widespread and underreported in many countries of southern Europe, northern Africa, and the Middle East and that there is a need to improv
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e leishmaniasis prevention and control based on robust surveillance in humans, animals, and vectors, and to increase public awareness following a one health approach.
more
The Mexican Constitution sets out the basis for access to health care services and the right to social protection in health for all citizens. The General
...
Health Law establishes that the MoH, together with state governments, is responsibl for the control and eradication of transmissible diseases and must establish the necessary measures to prevent and combat all threats to health.
Consequently, the National Health Plan 2019–2024 proposes universal, effective and free access to health care services, including health and epidemiological surveillance for emergencies, for all Mexicans
more
Africa’s health sector is facing an unprecedented financing crisis, driven by a sharp decline of 70% in Official Development Assistance (ODA) from 2021 to 2025 and deep-rooted structural vulnerabilities. This collapse is placing immense pressure o
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n Africa’s already fragile health systems as ODA is seen as the backbone of critical health programs: pandemic preparedness, maternal and child health services, disease control programs are all at
risk, threatening Sustainable Development Goal 3 and Universal Health Coverage. Compounding this is Africa’s spiraling debt, with countries expected to service USD 81 billion by 2025—surpassing anticipated external financing inflows—further eroding fiscal space for health investments. Level of domestic resources is low. TThe Abuja Declaration of 2001, a pivotal commitment made by African Union (AU) member states, aimed to reverse this trend by pledging to allocate at least 15% of national budgets to the health sector. However, more than two decades later, only three countries—Rwanda, Botswana, and Cabo Verde—have
consistently met or exceeded this target (WHO, 2023). In contrast, over 30 AU member states remain well below the 10% benchmark, with some allocating as little as 5–7% of their national budgets to health.
In addition, only 16 (29%) of African countries currently have updated versions of National Health Development Plan (NHDP) supported by a National Health Financing Plan (NHFP). These two documents play a critical role in driving internal resource mobilisation. At the same time, public health emergencies are surging, rising 41%—from 152 in 2022 to
213 in 2024—exposing severe under-resourcing of health infrastructure and workforce. Recurring outbreaks (Mpox, Ebola, cholera, measles, Marburg…) alongside effects of climate change and humanitarian crises in Eastern DRC, the Sahel, and Sudan, are overwhelming systems stretched by chronic underfunding. The situation is worsened by Africa’s heavy dependency with over 90% of vaccines, medicines, and diagnostics being externally sourced—leaving countries vulnerable to global supply chain shocks. Health worker shortages persist, with only 2.3 professionals
per 1,000 people (below the WHO’s recommended 4.45), and fewer than 30% of systems are digitized, undermining disease surveillance and early warning. Without decisive action, Africa CDC projects the continent could reverse two decades of health progress, face 2 to 4 million additional preventable deaths annually, and a heightened risk of a pandemic emerging from within. Furthermore, 39 million more
Africans could be pushed into poverty by 2030 due to intertwined health and economic shocks. This is not just a sectoral crisis—it is an existential threat to Africa’s political, social, and economic resilience, and global stability. In response, African leaders, under Africa CDC’s stewardship, are advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance.
more
ECDC launched the HEPSA (Health Emergency Preparedness Self-Assessment) tool, in order to support countries in improving their level of public health emergency preparedness. The tool is worksheet-ba
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sed and is targeted at professionals in public health organisations responsible for emergency planning and event management. It consists of seven domains that define the process of public health emergency preparedness and response: 1) Pre-event preparations and governance; 2) Resources: Trained workforce; 3) Support capacity: Surveillance; 4) Support capacity: Risk assessment; 5) Event response management; 6) Post-event review; 7) Implementation of lessons learned.
more
Despite the considerable improvement in global health, millions of people still lack access to quality health services, including access to effective antimicrobial medicines, or are impoverished as
...
a result of health spending. At the same time, antimicrobial resistance – a consequence of overuse and misuse of antimicrobials – is increasingly a barrier to accessing effective care. The declining effectiveness of antibiotics is driven by multiple factors, many of which can be addressed through well functioning primary health care. However, primary health care has not always had much attention in national health sector responses to
antimicrobial resistance, which often focus on tertiary care, laboratory detection and surveillance. The three pillars of primary health care (community engagement, front-line health services including primary care and essential public health, and multisectoral action on wider health determinants) are central not just to Universal Health Coverage and the Sustainable Development Goals, but also to an effective response to antimicrobial resistance.
more
According to the World Health Organization (WHO), sub-Saharan Africa has only 3% of the world’s health workers to cater for 11% of the world population, bearing over 25% of the global disease burd
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en (WHO, 2014). With a steady increase in reported cases on the African Continent, the current COVID-19 pandemic threatens to overwhelm our already taxed health infrastructure. It is, therefore, imperative to take serious and urgent measures towards disease management and monitoring especially as the need for self-quarantine and contact surveillance rises.
In view of the infrastructural and resource gaps, technology should be considered for remote management of healthcare deliver to patients during this period. As it is abundantly clear, even countries with more advanced healthcare infrastructure and resources have struggled to treat COVID-19 and non-COVID-19 patients during this pandemic.
more
Paving the Way for One Health: Highlights of the Global Programme Pandemic Prevention and Response, One Health
Haensel L., Argote K., Stübel E.
Deutsche Gesellschaft für Internationale Zusammenarbeit GIZ
(2024)
CC
The document “Paving the Way for One Health: Highlights of the Global Programme Pandemic Prevention and Response, One Health” presents the work and achievements of the global programme implement
...
ed by the German development agency GIZ to strengthen pandemic prevention using the One Health approach. The report highlights how collaboration between the human health, animal health, and environmental sectors can help detect and prevent zoonotic diseases before they spread. It describes activities carried out in partner countries, such as improving surveillance systems, strengthening laboratory capacities, supporting cross-sector cooperation, and building the skills of health professionals. The document also showcases practical examples and project results that demonstrate how integrated One Health strategies contribute to better preparedness and more effective responses to future health threats. Overall, the report illustrates how international cooperation and interdisciplinary approaches can reduce the risk of pandemics and improve global health security.
more
Healthy communities rely on well-functioning ecosystems. They provide clean air, fresh water, medicines and food security. They also limit disease and stabilize the climate. But biodiversity loss is happening at unprecedented rates, impacting human health
...
worldwide, according to a new state of knowledge review of the Convention on Biological Diversity (CBD) and WHO.
The report synthesizes the available information on the most important inter-linkages between biodiversity, ecosystem stability, and epidemic infectious diseases such as the Ebola virus; and the connection between biodiversity, nutritional diversity and health. It also covers the potential benefits of closer partnerships between conservation and health, from improved surveillance of infectious diseases in wildlife and human populations, to promoting access to green spaces to promote physical activity and mental health. It also highlights the many areas in which further research is needed.
The Joint report hopes to provide a useful reference for the Sustainable Development Goals and post-2015 development agenda, which represents an unique opportunity to promote integrated approaches to biodiversity and health by highlighting that biodiversity contributes to human well-being, and highlighting that biodiversity needs protection for development to be sustainable.
more
This manual is to assist health care providers and laboratory scientists to diagnose mycobacterium ulcerans disease (Buruli ulcer). The manual aims to achieve a better understanding of the clinical presentation and its diagnosis. The methods describ
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ed are tailored to various levels of care and available resources to improve the diagnosis and surveillance of the disease.
more
A variety of international organizations are involved in mobilizing resources from both public and private
sources and using them to extend development assistance to low-and middle-income countries around the world. They provide country-focused financial and technical assistance to developing count
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ries, and contribute to the generation of global public goods,
such as disease surveillance, norms and standards,
data and knowledge, and aid coordination
more
During the Programme Managers’ Review Meeting of Central and East Africa and South-East Asia (online meeting, June 2022), experts proposed additional regional and national subtargets related to VL incidence, as defined below. These targets can be revisited as progress is reviewed and access to dia
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gnosis and treatment and surveillance improves.
more
The Government of Malawi’s Health Sector Strategic Plan II highlights the importance of service integration; however, in practice, this has not been fully realized. We conducted a mixed methods evaluation of efforts to systematically implement int
...
egrated family planning and immunization services in all health facilities and associated community sites in Ntchisi and Dowa districts during June 2016–September 2017. Methods included secondary analysis of service statistics (pre- and postintervention), focus group discussions with mothers and fathers of children under age one, and in-depth interviews with service providers, supervisors, and managers. Results indicate statistically significant increases in family planning users and shifts in use of family planning services from health facilities to community sites. The intervention had no effect on immunization doses administered or dropout rates. According to mothers and fathers, benefits of service integration included time savings, convenience, and improved understanding of services. Provision and use of integrated services were affected by availability of human resources and commodities, community linkages, data collection procedures and availability, sociocultural barriers, organization of services, and supervision and commitment of health surveillance assistants. The integration approach was perceived to be feasible and beneficial by clients and providers.
more
Since the emergence of COVID 19 in December 2019, various public health responses measures have been implemented to control the pandemic. Among measures taken by the Africa CDC was the launch of PACT initiative to accelerate COVID 19 testing. Key to
...
the initiative is the engagement of Community Health Workers (CHWs) in risk communication and community engagement (RCCE), surveillance activities for early case identification, contacts tracing and in facilitating referrals for testing and continuum of care.
As of 31 May 2021, Through PACT support, over 17154 CHWs have been trained and locally deployed in 24 AU Member states. The PACT supported CHWs visited more than 2,568,654 households for community engagement activities, active case search and contact tracing, identified 1,618,601 Contacts, 710,167 COVID 19 suspect cases based on the standard case definition and facilitated referrals for 553053 (78%) suspect cases for testing. These efforts were crucial for early identification and isolation of cases in limiting further transmission.
more
Evolution of Ebola Virus Disease from Exotic Infection to Global Health Priority, Liberia
M. Allison Arwady, Luke Bawo, Jennifer C. Hunter et al
Centers for Disease Control and Prevention CDC
(2015)
Emerg Infect Dis. April 2015
Read online at: http://wwwnc.cdc.gov/eid/article/21/4/14-1940_article
Over the span of a few weeks during July and August 2014, events in West Africa changed perceptions of Ebola virus disease (EVD) from an exotic tropical disease to a priority for global
...
health security. We describe observations during that time of a field team from the Centers for Disease Control and Prevention and personnel of the Liberian Ministry of Health and Social Welfare. The authors outline the early epidemiology of EVD within Liberia, including the practical limitations on surveillance and the effect on the country’s health care system, such as infections among health care workers
more
