The Strategic Advisory Group of Experts (SAGE) on Immunization held a meeting on 3-6 October 2022. This report summarizes the discussions, conclusions and recommendations.
It covers the following items:
Global Reports
Immunization Agenda 2030 and Regional reports
Monkeypox
RSV
COVID-19 vacci...nes
Polio vaccination
Ebola (Sudan ebolavirus outbreak update)
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The paper sets out the specific communication challenge posed by Ebola and why it was so difficult to get to grips with this in the early months of the outbreak. It thendocuments when the health communication response became more useful and explores what that tells us about effective media and commu...nication. Finally, it offers recommendations to ensure that media and communication are used to their full potential during other disease outbreaks and humanitarian crisis
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The immediate objective of the country visit to Cameroon was to ensure that the country is as operationally ready as possible to effectively and safely detect, investigate and report potential Ebola virus disease cases and to mount an effective response that will prevent a larger outbreak. After te...chnical working group meetings, field visits, a “table-top” exercise and a hospital-based simulation exercises were undertaken.
Key strengths and weaknesses were identified, and the following areas for improvement were proposed to the Ministry of Health: coordination, surveillance, contact tracing, infection prevention and control, rapid response teams, case management, social mobilization, laboratory, points of entry, budget, logistics.
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Updated September 2021.
Provision of water and sanitation and good hygiene practices play an essential role in protecting human health during all disease outbreaks, including during Ebola Virus Disease (EVD) outbreaks. This question and answer document provides practical, evidence-based recommend...ations on minimum requirements and best practices for water, sanitation, hygiene (WASH). It was originally developed in 2014 during the West Africa Ebola Outbreak and has been updated in 2021 to reflect lessons learned and new operational research data. The key recommendations on WASH remain the same.
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In light of the decline in new Ebola cases, strategies are now needed to scale down the activities and bed capacities in Ebola care facilities. These facilities include Ebola treatment units, community care centres, Ebola treatment centres and isolation centres. The Governments of Guinea, Liberia an...d Sierra Leone; WHO; CDC; ICAN and UNICEF have jointly developed this rapid guidance and checklist to assist national governments and partners as they begin this process. This rapid guidance pertains to protecting the safety and repurposing of infrastructures and resources previously used for the Ebola outbreak to care for Ebola patients.
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La République Démocratique du Congo connait une fragilité sociale issue de divers conflits communautaires qui ont déstabilisés le tissu économique du pays sans épargner le secteur éducatif depuis plusieurs années. Les sources de fragilité sont aussi liées à la pauvreté de la population ...et à l’insécurité alimentaire (15,5 millions de personnes en 2019). De plus, le pays fait face à d’autres crises comme les catastrophes naturelles et différentes épidémies y compris le Cholera, la maladie a virus d’Ébola et COVID19.
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1 June 2020
Countries around the world are facing the challenge of increased demand for care of people with COVID-19, compounded by fear, misinformation and limitations on movement that disrupt the delivery of health care for all conditions. Maintaining essential health services: operational guidan...ce for the COVID-19 context recommends practical actions that countries can take at national, subregional and local levels to reorganize and safely maintain access to high-quality, essential health services in the pandemic context. It also outlines sample indicators for monitoring essential health services, and describes considerations on when to stop and restart services as COVID-19 transmission recedes and surges. This document expands on the content of pillar 9 of the COVID-19 strategic preparedness and response plan, supersedes the earlier Operational guidance for maintaining essential health services during an outbreak, and complements the recently-released Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic. It is intended for decision-makers and managers at the national and subnational levels.
This is an update to COVID-19: Operational guidance for maintaining essential health services during an outbreak: Interim guidance, 25 March 2020
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For the past years, Haiti has been engulfed in a socioeconomic, political, and humanitarian crisis that has reached critical levels since mid-September 2022 with the intensification of gang violence and social unrest. The widespread insecurity and
political instability have drastically affected the... country’s access to essential goods and services, including food, water, and health. The current fuel supply crisis has affected the water and electricity supply to the population, health centers, and hospitals. Due to problems of insecurity and violence, patients and health personnel have difficulty accessing hospitals and health services.
In parallel, the public health system and international partners face limited response capacity due to reduced international personnel in Haiti, logistics issues, and difficulties in importing supplies. Indeed insecurity, roadblocks, and lockdowns are affecting the importation of internationally procured goods, which may slow the arrival of essential lifesaving supplies to support cholera response efforts. This scenario is particularly problematic, as cholera recently resurfaced in early October.
Armed gangs now control over 60% of the metropolitan area of Port-au-Prince, affecting at least 1.5 million people, and have expanded their influence outside of the capital city, interrupting vital humanitarian programs in most of the national territory,
including COVID-19 vaccination campaigns.
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Multiple pandemics, numerous outbreaks, thousands of lives lost and billions of dollars of national income wiped out—all since the turn of this century, in barely 17 years—and yet the world’s investments in pandemic preparedness and response remain woefully inadequate. We know by now that the ...world will see another pandemic in the not-too-distant future; that random mutations occur often enough in microbes that help them survive and adapt; that new pathogens will inevitably find a way to break through our defenses; and that there is the increased potential for intentional or accidental release of a synthesized agent. Every expert commentary and every analysis in recent years tells us that the costs of inaction are immense. And yet, as
the havoc caused by the last outbreak turns into a fading memory, we become complacent and relegate the case for investing in preparedness on a back burner, only to bring it to the forefront when the next outbreak occurs. The result is that the world remains scarily vulnerable.
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Pathogen genomic surveillance has become a priority for public health systems in recent years. Genomic sequencing is increasingly being used to characterize pathogens and monitor important public health priorities (e.g. poliovirus, influenza virus, Mycobacterium tuberculosis and Vibrio cholerae, ant...imicrobial resistance (AMR)). The decrease in cost and time of sequencing and the exponential development of bioinformatic pipelines have played a critical role in integrating pathogen genomics into routine public health surveillance. The coronavirus disease 2019 (COVID-19) pandemic has highlighted the role that sequencing plays in the surveillance of infectious diseases. Sequencing facilitates earlier detection, more accurate investigation of outbreaks, closer real-time monitoring of pathogen evolution and tailored development and evaluation of interventions to inform local to global public health decision-making and action. However, there remains a need to coordinate efforts, leverage and link existing surveillance and laboratory networks and capabilities, and systematically integrate genetic sequence data (GSD) with clinical and epidemiological data to strengthen its utility.
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3rd edition. In 2001, Uganda adapted the Integrated Disease Surveillance and Response (IDSR) developed by World Health Organization (WHO) for member states in African region. The Ministry of Health has been implementing the IDSR strategy since then with success across the country. This strategy prov...ides the opportunity for rational use of resources and maximises investments in health surveillance systems. The 3rd edition IDSR guidelines incorporates lessons learnt from previous
epidemics, new frameworks like the Global Health Security Agenda (GHSA), One Health, Disaster Risk Management (DRM), the WHO regional strategy for health security and emergencies, and the rising non-communicable diseases, and aims to strengthen implementation of IHR (2005) core surveillance and response capacities. These guidelines have been adapted to reflect national priorities, policies and public health structures; and shall be used in conjunction with other similar
guidelines/strategies or initiatives.
Overall, the 3rd edition technical guidelines will incorporate the following:
• Strengthening Indicator Based Surveillance
• Strengthening Event Based Surveillance
• Improving community-based disease surveillance
• Improving Cross Border Surveillance and response
• Scaling up e-IDSR implementation
• Improving reporting and information sharing platforms
• Improved data sharing across sectors
• Tailoring IDSR to Emergency or Disaster contexts
The 3rd edition guidelines are intended for use as:
• A general reference for surveillance activities across all levels
• A set of definitions for thresholds that trigger some action for response
• A stand-alone reference for level-specific guidelines on surveillance and response
• A resource for developing training, supervision and evaluation of surveillance activities
• A guide for improving early detection and preparedness for outbreak response.
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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 on 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.
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El documento es una guía de bolsillo para establecer y operar un Centro de Tratamiento de Cólera (CTC). Proporciona pautas para seleccionar la ubicación, clasificar a los pacientes según la gravedad de la deshidratación, implementar medidas de control de infecciones y garantizar el suministro a...decuado de materiales médicos. La guía enfatiza la importancia de mantener la higiene, gestionar adecuadamente los desechos y garantizar la seguridad, al tiempo que ofrece protocolos detallados para tratar casos moderados y graves de cólera. Está diseñada para apoyar a los trabajadores de la salud en la gestión eficiente de los brotes de cólera.
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The document is a pocket guide for establishing and operating a Cholera Treatment Center (CTC). It provides guidelines on selecting a location, triaging patients based on dehydration severity, infection control measures, and ensuring sufficient medical supplies. The guide emphasizes maintaining hygi...ene, proper waste management, and security while offering detailed protocols for treating moderate and severe cases of cholera. It is intended to support healthcare workers in efficiently managing cholera outbreaks.
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L'article souligne que les épidémies de choléra en Syrie et au Liban menacent gravement la santé et la survie des enfants. L'UNICEF alerte sur l'augmentation rapide des cas, exacerbée par des infrastructures d'eau et d'assainissement défaillantes, ainsi que par des systèmes de santé fragilis...és. L'organisation appelle à une action urgente pour améliorer l'accès à l'eau potable, renforcer les services de santé et mener des campagnes de vaccination afin de protéger les enfants contre cette maladie potentiellement mortelle.
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The WHO webpage on cholera provides an overview of the disease, its causes, and prevention strategies. Cholera is an acute diarrheal infection caused by the bacterium Vibrio cholerae, typically spread through contaminated food or water. It remains a significant global health issue, particularly in a...reas with poor water and sanitation infrastructure.
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Le document fournit des directives complètes pour la gestion des flambées de choléra, y compris la détection, la confirmation, la réponse, le traitement et la prévention. Il met l'accent sur l'importance de la réhydratation, de l'assainissement de l'eau, de la promotion de l'hygiène et de la... mobilisation communautaire pour limiter la propagation. Ce guide est conçu pour les professionnels de la santé et les autorités publiques afin d'assurer une réponse efficace et coordonnée.
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Le document est un guide de poche pour établir et gérer un Centre de Traitement du Choléra (CTC). Il fournit des directives pour choisir l’emplacement, classer les patients selon la gravité de leur déshydratation, mettre en œuvre des mesures de contrôle des infections et garantir un approvi...sionnement adéquat en matériel médical. Le guide met l’accent sur l’importance de maintenir l’hygiène, de gérer correctement les déchets et d’assurer la sécurité, tout en offrant des protocoles détaillés pour traiter les cas modérés et graves de choléra. Il est conçu pour soutenir les professionnels de santé dans la gestion efficace des épidémies de choléra.
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The ECDC's Cholera Monthly Surveillance page provides up-to-date data on cholera cases reported in Europe and globally. It monitors outbreaks, tracks trends, and analyzes the spread of the disease to support public health responses. The page includes interactive maps, statistics, and reports to help... policymakers, researchers, and healthcare professionals understand cholera’s epidemiology and implement preventive measures.
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Le Groupe spécial mondial de lutte contre le choléra (GTFCC) a lancé Mettre fin au choléra : Une feuille de route mondiale pour 2030 (la Feuille de route mondiale. Cette stratégie vise à réduire de 90 % le nombre de décès dus au choléra dans le monde et à mettre fin à la maladie dans a...u moins 20 pays d’ici 2030. Elle est organisée selon trois axes principaux :
• assurer une détection et une réponse précoces pour contenir les épidémies
• adopter une approche multisectorielle pour prévenir et contrôler le choléra dans les
points chauds
• mettre en place un mécanisme de coordination efficace de l’appui technique, la
mobilisation des ressources et des partenariats aux niveaux local et mondial.
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