FINAL COMMUNIQUE: CROSS-BORDER MEETING BETWEEN BURKINA FASO, COTE D'IVOIRE, GUINEA, LIBERIA, MALI, NIGER AND SIERRA-LEONE ON THE SURVEILLANCE OF EPIDEMIC-PRONE DISEASES IN A BORDER CONTEXT AND THE "ONE-HEALTH" APPROACH

FINAL COMMUNIQUE

CROSS-BORDER MEETING BETWEEN BURKINA FASO, COTE D'IVOIRE, GUINEA, LIBERIA, MALI, NIGER AND SIERRA-LEONE ON THE SURVEILLANCE OF EPIDEMIC-PRONE DISEASES IN A BORDER CONTEXT AND THE "ONE-HEALTH" APPROACH

12-14 December 2016

1. From 12 to 14 December, a cross-border meeting between Burkina Faso, Côte d'Ivoire, Liberia, Niger and Sierra Leone was held in Monrovia, Liberia. Participants were representatives from the human and animal health services.
2. The meeting was also attended by representatives of the International Organization for Migration (IOM), the World Health Organization (Africa Region Office, IST-West Africa, country offices of Côte d'Ivoire, Liberia and Niger, the West African Health Organization (WAHO), West Africa Economic and Monetary Union (WAEMU), OMVS Senegal, The Africa Regional Office of the World Organization for Animal Health (CRSA/OIE), the Agence de Médecine Préventive (AMP), the Centre Centers for Disease Control and Prevention (CDC), University of Ghana, University of Ouagadougou and the Centre for International Cooperation in Health and Development (CCISD). The list of participants is attached to this communication.
3. The purpose of the meeting was to share experiences to improve the management of public health emergencies, including malaria and neglected tropical diseases (NTDs) in a cross-border context at the target country level.
4. Participants at the cross-border meeting in Monrovia noted that during the past 5 years countries in the West Africa region have faced various epidemic outbreaks and health emergencies that include:

• Ebola virus in Sierra Leone, Guinea, Liberia, Senegal, Nigeria and Mali;
• Meningitis in Togo, Ghana, Côte d'Ivoire, Mali and Niger;
• Lassa fever in Benin, Togo and Nigeria;
• Measles and polio in Nigeria;
• Epidemics of the Zika virus in Cabo Verde and Guiné-Bissau;
• Dengue fever in Burkina Faso;
• Rift Valley fever in Niger;
• The health consequences of humanitarian crises resulting from conflicts and terrorist attacks in Nigeria, Niger, Mali, Côte d'Ivoire and Burkina Faso;

In addition to the morbidity related to neglected tropical diseases and malaria.

5. They also noted that the porosity of borders coupled with the poor exchange of health information between countries and the lack of standardized procedures for common and concerted responses at the cross-border level accentuate the challenge of better response and management of Public health events in the West African region.
6. They also noted that the recent epidemic of the Ebola virus disease (EVD) in West Africa has confirmed the critical importance of strengthening national disease surveillance systems and inter-country collaboration to minimize human losses and economic costs.
7. They expressed the need to strengthen epidemiological surveillance and adequate response to these epidemics in the context of the implementation of the Integrated Disease Surveillance and Response (IDSR) and the International Health Regulations (IHR) for early detection of numerous epidemic outbreaks in West Africa, and in accordance with the protocol on cooperation in the fight against epidemics in the countries of West Africa, Algeria and Chad, signed in Ouagadougou by the Ministers of Health and Interior in October 1996, the provisions of the International Health Regulations (IHR) adopted by the Member States in 2005 and the WHO resolutions on disease control, the Ouagadougou, Algiers and Libreville declarations signed by the Member States in 2008.
8. They reaffirmed that in view of this situation and in the light of the lessons learned from the recent epidemics in the region, it is necessary to strengthen surveillance in cross-border areas and to establish cooperation protocols with standardized procedures for the management of public health emergencies at the cross-border level as indicated in the International Health Regulations (IHR 2005) taking into account the "One Health" approach.
9. The various delegations commended WHO, WAHO and IOM with the support of the World Bank, WAEMU and USAID – Office of U.S. Foreign Disaster Assistance (OFDA) for the organization in Monrovia, Liberia from 12 to 14 December 2016 of this cross-border meeting to strengthen epidemiological surveillance and response to priority diseases (epidemics, pandemics and local endemic diseases) through sharing of experiences and lessons learned from the recent EVD epidemic, particularly on border surveillance activities, to harmonize public health protection measures so as to avoid unnecessary disruptions to trade and the movement of people and goods through the development of effective surveillance, alert and response strategies for all public health priority events.
10. They appreciated the quality of the work as well as the availability and cordial ambiance that prevailed during the 3 days of work.
11. At the end of the proceedings, the participants made the following recommendations:

1. To the Health authorities at the central level:

• Sign and validate policy or legislation for cross-border initiatives using IDSR and IHR (2005) framework in the context of One Health approach (ToR, members of committee for each country, MoU for joint activities, financial mechanism for supporting the plan, etc.…);
• Develop a Joint plan of action with the following key elements: enhanced surveillance, information exchange, systems and services, networks, communication tools, preparedness and a well-coordinated investigation and rapid response etc...;
• Share information on entomological and epidemiological sentinel sites for malaria and NTDs in order to prepare coordinated responses of member states;
• Enhance  coordinated health  services  in the context of One Health approach (joint  coordination, joint implementation of IDSR at district and community level,  IHR & joint M&E);
• Integrate cross-border activities in the annual health plan and funding  including simulations exercises
• Create/update and reactivate existing protocols of cooperation and MoU between districts in 2 countries taking into account the One Health approach
• Report on the functioning of Points of Entry (POE) at the next cross-border meeting.

2. To the administrative and political authorities of the border localities:

• Institutionalize cross-border meetings involving bordering districts and local governments;
• Integrate cross-border activities into the Regional and District Annual Action Plans and the Border Communal Development Plans;
• Increase community leader engagement and awareness to facilitate detection, contact tracing  and sharing of information
• Create/update and reactivate existing protocols of cooperation and MoU between districts in 2 countries taking into account the One Health approach
• Organize joint training to ensure that surveillance and response staff on both sides of the border are familiar with the procedures, forms, ICTs used by their counterparts

3. To the technical and financial partners:

• Support the implementation of action plans for cross-border activities through  technical, financial, material and logistical support to improve the functioning of border entry points;
• Strengthen the capacity of health personnel (human, animal and environment) working at border points of entry;

12. Participants at the cross-border meeting on epidemic-prone diseases, including malaria and neglected tropical diseases, held in Monrovia from 12 to 14 December 2016, congratulated themselves for a successful meeting which was conducted in a serene and cordial environment.
13. Participants thanked the authorities of the Republic of Liberia for all the facilities granted for the organization and success of the meeting.
14. Participants also expressed their deep appreciation to WHO, WAHO and IOM for the initiative and quality of the technical support provided for the organization of this meeting and for their continued support to countries.
15. Finally, they expressed their gratitude and appreciation to the World Bank, UEMOA and USAID– Office of U.S. Foreign Disaster Assistance (OFDA) for financing the cross-border meeting and for the relevance of their support to the improvement of the health status of the region.

Dated in Monrovia, December 14, 2016

Signed by:

SPEECH BY THE DIRECTOR GENERAL OF THE WEST AFRICAN HEALTH ORGANIZATION AT THE CLOSING CEREMONY OF THE CROSS-BORDER MEETING ON EPIDEMIC-PRONE DISEASES INCLUDING MALARIA AND NEGLECTED TROPICAL DISEASES

SPEECH BY THE

DIRECTOR GENERAL OF THE WEST AFRICAN HEALTH ORGANIZATION

AT THE CLOSING CEREMONY OF THE CROSS-BORDER MEETING ON EPIDEMIC-PRONE DISEASES INCLUDING MALARIA AND NEGLECTED TROPICAL DISEASES

Monrovia, December 14, 2016

                                                             

• All protocols observed

During the three days of intense work, rich in sharing experiences, I would like to thank participants for their availability and the seriousness demonstrated.

Ladies and gentlemen,

Let me underline the particularity of this meeting which has been extended from 3 to 7 countries with the hope that we can cover all the countries in the next edition.

I am particularly happy to note that the objectives and expected results of this meeting have been achieved.

I would like to urge all countries to take ownership of the recommendations from this meeting and to implement them in order to make cross-border areas safer and serve as a means of rapprochement and all-round cooperation in which the movement of people and goods would be a reality.

With this in mind, I can reassure you that WAHO, in line with its mandate to contribute to regional health integration, works for the development of cross-border activities and makes the "One Health" approach one of the strategies to contribute to finding adequate responses to health problems in the ECOWAS region.

Ladies and gentlemen,

Allow me to reiterate my sincere thanks to:

• the World Bank Group for its support to WAHO
• the World Health Organization for agreeing to co-organize this activity with WAHO;
• the International Organization for Migration for all the efforts made to improve the health status of the people of the ECOWAS area and for its involvement in the preparation and holding of this meeting;
• the West African Economic and Monetary Union for its technical and financial support for the meeting;
• USAID for agreeing to co-finance this activity.

I would also like to use this opportunity to pay a well-deserved tribute to the Liberian Minister of Health and all the members of the local organizing committee for the important work being done in such a short time to ensure the success of this workshop.

I cannot end without thanking the staff of the Golden Gate Hotel, the hostesses, the members of the Secretariat and the interpreters who contributed to the success of this meeting.

Finally, I wish everyone a safe journey back home.

Thank you for your kind attention

SPEECH BY THE DIRECTOR GENERAL OF WEST AFRICAN HEALTH ORGANIZATION

SPEECH BY THE

DIRECTOR GENERAL OF WEST AFRICAN HEALTH ORGANIZATION

AT THE OPENING CEREMONY OF ECOWAS CROSS-MEETING ON EPIDEMIC-PRONE DISEASES INCLUDING MALARIA AND NEGLECTED TROPICAL DISEASES

Monrovia, 12 December 2016

                                                                

• All protocol observed

On behalf of His Excellency Mr. Marcel Alain DE SOUZA, the President of the ECOWAS Commission, on behalf of the Director General of WAHO, I wish to first of all thank Her Excellency the President of the Republic of Liberia, Madam Ellen Johnson Sirleaf for authorizing the holding of this cross-border meeting here in Monrovia and above all for her continuing efforts to strengthen the health systems of the ECOWAS countries in general, and Liberia in particular.

My appreciation also goes to the Minister of Health for all the attention she has given to this cross-border meeting on epidemic-prone diseases including Malaria and Neglected Tropical Diseases, and for sending a representative. This illustrates adequately the importance attached to the strengthening of surveillance and cross-border management of epidemics and to the "One Health" approach.

Ladies and gentlemen,

It is now established that zoonotic diseases can have a direct impact on public health. Thus, for twenty years, major health crisis have multiplied and new pathologies appear or reappear. This was the case of epizootics due to the Nipah virus in Asia in 1999, foot-and-mouth disease in Europe in 2001, highly pathogenic avian influenza in almost all regions of the world in 2004. Severe acute respiratory syndrome (SARS) in 2002, or vector-borne diseases such as the Ebola Virus disease in 2014-2015 and Rift Valley fever in 2016.

I would also like to recall that the recent epidemic of the Ebola virus (EVD) in the West African region, with more than 28,000 cases and more than 11,000 deaths, has revealed the critical importance of strengthening the disease surveillance systems, inter-sectoral collaboration and inter-agency and inter-agency cooperation to enable early detection of outbreaks of diseases to provide a rapid and effective response.

Lessons learned from the management of this crisis have clearly demonstrated that an epidemic can rapidly transcend local and national borders and hamper trade between countries with severe economic consequences for the affected countries. It is important to note that it is important for health institutions to focus on the cross-border issue of managing epidemics and public health emergencies, taking into account the "Single Health" approach in order to Promoting the exchange of health information among countries and developing and adopting standardized procedures for joint and concerted responses at cross-border level for better response to public health events in the West African region.

In this respect, the current cross-border meeting on disease surveillance and epidemic management in cross-border areas and taking into account the One Health approach is timely.

I would like to urge all countries to take ownership of the conclusions that will emerge from this meeting and to contribute to their implementation, so that the cross-border areas are safer and serve as a means of rapprochement and all-round cooperation, movement of people and goods is a reality.

With this in mind, I can reassure you that WAHO, in line with its mandate to contribute to regional health integration, works for the development of cross-border activities and makes the "One Health" approach one of the strategies able to contribute to finding adequate responses to health problems in the ECOWAS area.

Thus, with the support of technical and financial partners, in particular the World Bank, WAHO is committed to building national and regional inter-sectoral capacities for disease surveillance and response to epidemics in West Africa through the implementation of the West Africa Regional Disease Surveillance project (WARDS), the Regional Disease Surveillance Systems Enhancement project (REDISSE) and the Sahel Malaria and Neglected Tropical Disease (SMNTD).

Ladies and gentlemen,

Allow me to reiterate my sincere thanks to:

• the World Bank Group for its support to WAHO through the financing of the various projects in the region, including WARDS, REDISSE and SMNTD;
• the World Health Organization for accepting to co-organize this activity with WAHO within the framework of the implementation of the WARDS and SMNTD projects financed by the World Bank;
• the International Organization for Migration for all the efforts made to improve the health status of the people of the ECOWAS region and their involvement in the preparation and holding of this meeting;
• the West African Monetary Union for their technical and financial support for the meeting; and
• USAID for agreeing to fund this activity.

I cannot conclude my remarks without paying a well-deserved tribute to the Liberian Minister of Health and all the members of the local organizing committee for the important work carried out in such a short time to ensure a successful workshop.

Thank you for your attention

Cross – border meeting on Epidemic – prone diseases, including malaria and Tropical Neglected Diseases Golden Gate, Paynesville City, Monrovia December 12 – 14, 2016

Cross – border meeting on Epidemic – prone diseases, including malaria and Tropical Neglected Diseases

Golden Gate, Paynesville City, Monrovia

December 12 – 14, 2016

Distinguished delegates, ladies and gentlemen, all protocols observed.

  

Special recognition to the Health Minister, Hon. Bernice Dahn and her hard working Deputy, Hon. Tobert Nyensuah. It is an honor to form part of the official opening of this all important Cross – Border Meeting that has brought together regional epidemic responders and decision makers.

Let me begin by expressing our sincere appreciation to the Government of Liberia through the Ministry of Health, national and regional actors including my organization, IOM, who have worked tirelessly to see this meeting come to fruition.  

This meeting is an evidence that Liberia and other countries in the region (especially the sub – region – MRU countries) are still recovering from the Outbreak of the Ebola Virus and other priority diseases that threaten and breakdown our public health systems. Ebola was an enemy that fought this nation and claimed the lives of many Liberians including health workers, something we feel very sad to talk about. Meanwhile, we must appreciate the efforts of the government and partners who worked collaboratively to have seen Liberia announced Ebola free in the region more than once. It wasn’t just easy to have happened.     

In real life today, we can mention that Liberia is still recovering from the 14 years of civil unrest that claimed the lives of many Liberians, rendered a good percentage displaced and vulnerable, shattered its infrastructures and systems established at the time. The attainment of more than a decade of peace in Liberia is now seemingly irreversible; the efforts of government through the leadership of the president of Liberia, Her Excellency Madam Ellen Johnson Sirleaf, must be appreciated and supported by all, including institutions and individuals who value peace and co-existence.

IOM Liberia has supported the government in different areas of migration management including:

• It’s contribution to the DDRR processes (Disarmament, Demobilization, Repatriation and Reintegration)
• Livelihood support including marketable skills transfer to vulnerable groups
• Registration and return assistance to Third Country Nationals and Returning Liberian Migrants during the elections violence in Cote d’Ivoire in late 2010
• Return assistance to Stranded Liberian Migrants in the sub – region (Ghana, Nigeria, Guinea & Sierra Leone)
• Development of the draft national migration policy and the review of the Aliens and Nationality law
• Support to Victims of Trafficking

Although it’s considered a new marriage but our partnership with the Ministry of Health has been remarkable. We worked in establishing and managing three Ebola Treatment Units and renovated 29 health care facilities in Grand Cape Mount, Bomi and Grand Bassa Counties. The challenges were enormous but with the collaborative efforts of MOH and partners, we came out victorious in containing the virus. I say bravo to all of us who tirelessly contributed to this. I was serving as the Chief of Mission in Guinea at the time and made regular visits to the borders. I saw things there that were no different from those happening in Liberia.

Our just ended/concluded Health Border and Migration Management Project (HBMM) has helped to strengthen border and Community Event – Based Surveillance systems. The evaluation results of this project will advance key recommendations for implementation by our government counterparts. This project is complemented by the Emergency Preparedness and Response (EPR) project supported by IRC led EPR Consortium. Series of simulations and emergency planning are carried out to ensure that national capacities are built to respond to emergencies in real time.

I must say that this meeting is timely as we all endeavor to see “One Health Approach” in the region. I say thanks to WHO and WAHO for supporting this process as we all hope to have successful deliberations during the meeting. And finally, I say thanks to our donor, USAID-OFDA, for funding these activities.  

Thank you.