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: