The importance of robust mortality surveillance systems cannot be overstated in an era marked by increasing global health challenges where health threats loom large and population dynamics continue to evolve. Accurate and timely mortality data is essential for identifying trends and detecting emergi...ng health threats, evaluating the impact of interventions, and guiding evidence-based policy decisions.
This framework outlines a holistic approach to strengthening routine mortality surveillance systems, considering the unique contextual factors and challenges faced by African countries. It emphasizes the importance of establishing efficient data collection mechanisms, enhancing data quality and completeness, and promoting data sharing and collaboration among stakeholders.
Moreover, the framework recognizes the pivotal role of technology in the integration of data from fragmented mortality data sources. It highlights the potential of innovative data capture methods, advanced analytics, and real-time reporting systems to enhance mortality data’s accuracy, efficiency, and timeliness.
The continental framework for mortality surveillance aligns with Africa CDC’s mission and strategic goal by serving as a fundamental component in strengthening public health systems, enhancing disease surveillance capacities and capabilities, informing evidence-based policies and interventions, and promoting collaboration and coordination among African countries to address health challenges and improve health outcomes on the continent.
The successful implementation of this framework requires collective commitment and concerted efforts from governments, health institutions, and the international community. We hope this document will serve as a catalyst for transformative change, enabling countries to build resilient mortality surveillance systems that protect public health, save lives, and contribute to evidence-based decision-making.
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 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.
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 Heal...th 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
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 a...nd 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
On 13 August 2024, the Africa Centres for Disease Control (Africa CDC) declared the multi-country mpox outbreak a public health emergency of continental security, with strong recommendations to improve surveillance and vaccine deployment in all AU Member States. On 14 August 2024, the WHO Director-G...eneral declared mpox outbreak a public health emergency of international concern (PHEIC).
more
To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries resp...onsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
more
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...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
Rabies is a fatal viral disease, but is preventable in humans. The rabies virus is transmitted to humans through virus-laden saliva from a rabid animal, mostly dogs. The virus is shed in the saliva of an infected animal and can be introduced into another body through bites, scratches and any other ...wounds that transect the skin. Contact of the infected saliva with mucous membranes is also thought to be a possible route of infection, whereas contact of infected saliva with intact skin is not considered an exposure. Rabies is preventable through pre-exposure prophylaxis (PrEP) for individuals at high and continual risk, and post-exposure prophylaxis (PEP).
more
The escalating antimicrobial resistance (AMR) pandemic is a global public health threat with extensive health, economic and societal implications. Resistance emerges because of selection pressure from rational and indiscriminate antimicrobial use in human health as well as in the veterinary, agricul...ture and environmental sectors. Infections caused by resistant bacteria result in longer duration of illness, higher mortality rates and increased costs associated with alternative treatment. AMR further constrains procedures that rely on antimicrobial prophylaxis, and AMR is recognized as a threat to theworld economy.
Journal of Public Health | Vol. 39, No. 1, pp. 8–13 | doi:10.1093/pubmed/fdw015 | Advance Access Publication March 3 2016
more
This checklist helps to identify the necessary measures to be implemented to mitigate infection transmission among travellers and ground-crossing staff in the context of the COVID-19 pandemic. It features key questions and considerations for gauging the capacity of responding to COVID-19 transmissio...n risks and informing on reducing them at and around ground crossings. It does so in the form of a structured questionnaire. The guidance will have particular relevance for National International Health Regulations Focal Points and competent authorities at the point of entry, including relevant representatives of ground crossing authority/ies of the country such as public health authorities, and representatives from other sectors, including law enforcement, customs and migration.
more
This document provides countries with recommendations for structuring a public health entomology laboratory network. The document will help countries to identify their areas of need and determine how the entomology network can be strengthened, especially in the context of a decentralized health syst...em. The recommendations also consider the different degrees of development and different entomological research needed to support disease prevention and control activities.
more
The GEHM series is an evidence-informed normative product of the WHO
Health and Migration Programme to inform policy-makers on migrationrelated public health priorities. These reviews aim to respond to policy questions identified as priorities by summarizing the best available evidence worldwide an...d proposing policy considerations. By addressing data gaps on the health status of refugees and migrants, the GEHM series aims to support evidenceinformed policy-making and targeted interventions that are impactful and make a difference in the lives of these populations.
This Report, the fourth in the GEHM series reviews the available evidence on barriers to antibiotic access and appropriate use in refugees and migrants. It finds that the available evidence on refugees’ and migrants’ access to and use of antibiotics is scarce and is largely constrained to high-income contexts.
more
This document summarizes current WHO guidance for public health surveillance of coronavirus disease 2019 (COVID-19) in humans caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
New elements include:
update of contact definitions, in line with latest cont...act tracing guidance
update of detection strategies in line with updated version of WHO SARS-CoV-2 testing guidance
reinfection evidence standardization and surveillance: molecular, genomic and immunological evidence of reinfection
inclusion of clinical case definition of Post COVID-19 condition as defined by WHO
definition of breakthrough infection
more
Actualisées dans « La surveillance de la santé publique dans le contexte de la COVID-19 », publié le 16 décembre 2020
16 December 2020. This document summarizes current WHO guidance for public health surveillance of coronavirus disease 2019 (COVID-19) in humans caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (hereafter referred to as COVID19 surveillance).
EWARS is a surveillance system developed by the World Health Organization to detect and respond quickly to disease outbreaks in emergency settings where normal health systems are disrupted. It allows health facilities to report priority diseases on a regular basis and generates alerts when unusual p...atterns or suspected outbreaks occur. The system is designed to be simple and fast to set up, even in remote areas, and supports rapid public health action to prevent the spread of disease during crises.
more
Early warning systems for disease outbreaks are surveillance systems that collect information on a selected list of epidemic-prone diseases in order to trigger prompt public health interventions. They function in humanitarian emergency situations when the routine public health surveillance systems o...f a country are underperforming, disrupted or non-existent. Early warning systems are often set up to fill such temporary gaps, while the routine systems recover from the effects of the disaster or a crisis. During humanitarian emergencies, detecting and responding swiftly to epidemics is key in order to reduce unecessary illness and death, especially among refugees and displaced people.
more