We believe that health is a basic human right. Everything we do ensures lasting health change for all.
Public health emergencies erase hard-won development gains, disrupt health systems and hinder progress, significantly reducing the resilience of both health systems and communities. Globally, approximately 362 million people are directly affected by public health emergencies annually resulting from natural and human-made hazards. Public health emergencies result from epidemics such as SARS, Ebola, COVID-19, conflicts, droughts, and floods, among others. The drivers are complex and are related to disruptive megatrends such as population growth, climate change, globalisation, urbanisation, human-wildlife interaction, among others. One of the worst modern epidemics is COVID-19 that has affected every country in the world.
The World Health Assembly (WHA) adopted the International Health Regulations (IHR) to tackle public health emergencies of global concern. The full implementation of IHR is, however, challenged by lack of political commitments by states and governments, inadequate resources and weak intra-country coordination.
Africa has faced many epidemics including Cholera, Dysentery, Ebola, Rift Valley, Crimean-Congo and Yellow Fevers, among others. The continent faces huge public health emergency challenges due to its weak institutional and health systems. Notably, most African countries have poor public health surveillance and early warning systems, poor multi-sector coordination, weak preparedness and often ineffective/inadequate first response, lack of adequate numbers of trained workers and inconsistent supply of diagnostic, treatment and prevention commodities.
Past experiences suggest that there are major gaps in responding to public health emergencies. Therefore, immediate actions are needed to enhance preparedness and response to future threats. Evidence shows that public health emergencies can push back years of progress in development gains. For example, the economic cost of public health emergencies was estimated at $6 trillion in the United States of America in the year 2020 due to COVID-19 infections. With proper and targeted investments, the world could avert major public health emergencies and build resilient community and health systems that can withstand future shocks.
Africa has made great strides in promoting preparedness and resilience to public health threats, including the development of policies that guide regional and national emergency interventions. However, the region continues to experience threats to novel and re-emerging infectious diseases as recently witnessed with the re-emergence of Ebola in West Africa as well as threats due to the global COVID-19 pandemic.
In Kenya, the government has created an enabling environment with supportive policies for public health emergency response. However, there exist significant gaps key among them inadequate human resources capacities for public health emergency preparedness, a weak public health emergency supply chain and operations management, weak leadership, accountability and governance to increase efficiency and timely response in case of emergencies.
There is broad consensus that COVID-19 will not be the last pandemic the world grapples with, making public health emergency preparedness all the more important and urgent. The need to build human resource capacities for effective preparedness and response in Africa remains high. Building the capabilities of health workers in emergencies is achievable through blended education and training models that use eLearning, mLearning as well as classroom-based training.
Amref Health Africa has been involved in various public health emergency responses focusing on strengthening the coping and recovery capacities of communities as well as strengthening health system capacities. In 2011, Amref supported over half a million people to access basic health and relief during one of the worst droughts that struck the Horn of Africa. Amref is currently involved in the African COVID-19 response.
Our work in public health emergencies aims at improving prevention, preparedness, detection, mitigation and recovery. This is through combination prevention approaches centred on (i) innovative public health surveillance (ii) community engagement (iii) Laboratory systems strengthening (iv) Building the capacity of human resources for health systems recovery and resilience.
Amref strengthens the capacities of health care workers through training, mentorship and coaching. Our Institute of Capacity Development (ICD) has developed E&M learning programs to train health care workers in the remotest parts affordably. For example, during the COVID-19 pandemic alone, our LEAP platform has supported the training of over 60,000 health care workers. The Amref International University (AMIU) offers various courses in capacity building of community health systems as well as health systems research. Our laboratory systems strengthening interventions provides technical support to national and sub-national laboratory systems to improve early detection and screening to curb transmission of novel and re-emerging infectious diseases. Amref’s Central Laboratory has various accreditations for testing of various infectious diseases.
We empower communities through effective risk communication and community engagement (RCCE) leveraging human-centred behaviour change communication models that pass knowledge on public health threats and their mitigation measures. Our interventions address public health emergency challenges holistically, combining various service areas that include water, sanitation and hygiene (WASH), nutrition, maternal and child health (MCH) services.
Our public health surveillance efforts are premised on early detection and reporting of public health threats. We leverage technological innovation for speed and cost minimisation. Our Mobile phone-based Jamii Afya Link (M-Jali) supports real-time surveillance by collecting and transmitting community health information that helps in detecting public health threats. We are also working closely with governments to scale the mDharura solution, which facilitates early detection and reporting of public health threats through an Events-Based Disease Surveillance System (EBS). Efforts to strengthen coordination in case of emergency threats are enabled through Emergency Operations Centres at both national and sub-national levels anchored on an Integrated Disease Surveillance and Response (IDSR) framework, which has been used across countries in the region for rapid public health emergency response.
Working with government, Amref focuses on ensuring continuity of health services across short-term early recovery needs and long-term healthy community goals. Our efforts help communities not only recover from a disaster but also address chronic community health concerns such as access to health care services. Our programmes are centred around policies and strategies that focus on promoting primary health care to improve health status, in turn building community resilience and a foundation to respond to epidemics and other public health emergencies.
We recognise that while public health emergencies are a key responsibility of the public health sector, a multi-sector approach is paramount for the sustainability of these efforts. We, therefore, work with likeminded multi-sector partners at global, regional, national and sub-national levels across the private and public sectors to promote resilience. We work closely with Africa CDC in informing public health strategies in sub-Saharan Africa by bringing in evidence from our interventions across in the region. Our continued engagement with think tanks and technical working groups at regional, national and sub-national levels ensures that these lessons are shared to inform public health emergency mitigation and practice to promote resilience of public health systems.
Everyone, including governments, donors, development partners, civil societies have a role and special duty of care in the prevention and control of public health emergencies. Amref seeks partnerships with these and other stakeholders to design and scale combination prevention approaches against public health emergencies.
We recognise the strength in collaboration and therefore call upon philanthropic and corporate organisations to invest in our innovative community and health systems resilience-building interventions.
We invite institutional partners and bilateral donors to join us in enriching this model. Through this investment, we shall effectively develop systems that will predict potential public health events and enable appropriate response to prevent loss of lives and socioeconomic loses. We urge every individual to contribute towards protecting and making the lives of all Kenyans better for a happier, healthier and more economically productive nation. Together we can stop the devastation from any future pandemic.