Abstract

There is growing concern in Sub-Saharan Africa about the spread of the Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, and the public health burden that it ensues. Since 1976, there have been 885,343 suspected and laboratory confirmed cases of EVD and the disease has claimed 2,512 cases and 932 fatality in West Africa. There are certain requirements that must be met when responding to EVD outbreaks and this process could incur certain challenges. For the purposes of this paper, five have been identified: (i) the deficiency in the development and implementation of surveillance response systems against Ebola and others infectious disease outbreaks in Africa; (ii) the lack of education and knowledge resulting in an EVD outbreak triggering panic, anxiety, psychosocial trauma, isolation and dignity impounding, stigmatisation, community ostracism and resistance to associated socio-ecological and public health consequences; (iii) limited financial resources, human technical capacity and weak community and national health system operational plans for prevention and control responses, practices and management; (iv) inadequate leadership and coordination; and (v) the lack of development of new strategies, tools and approaches, such as improved diagnostics and novel therapies including vaccines which can assist in preventing, controlling and containing Ebola outbreaks as well as the spread of the disease. Hence, there is an urgent need to develop and implement an active early warning alert and surveillance response system for outbreak response and control of emerging infectious diseases. Understanding the unending risks of transmission dynamics and resurgence is essential in implementing rapid effective response interventions tailored to specific local settings and contexts.Therefore, the following actions are recommended: (i) national and regional inter-sectorial and trans-disciplinary surveillance response systems that include early warnings, as well as critical human resources development, must be quickly adopted by allied ministries and organisations in African countries in epidemic and pandemic responses; (ii) harnessing all stakeholders commitment and advocacy in sustained funding, collaboration, communication and networking including community participation to enhance a coordinated responses, as well as tracking and prompt case management to combat challenges; (iii) more research and development in new drug discovery and vaccines; and (iv) understanding the involvement of global health to promote the establishment of public health surveillance response systems with functions of early warning, as well as monitoring and evaluation in upholding research-action programmes and innovative interventions.

Highlights

  • There is growing concern in Sub-Saharan Africa about the spread of the Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, and the public health burden that it ensues

  • The growing public health concern and the burden of Ebola outbreaks In the absence of an effective drug and vaccine for the dreadful and deadly outbreak caused by the Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, there is growing concern for its public health burden in Sub-Saharan Africa

  • The prevalence, morbidity and case fatality of chronological EVD outbreaks showed the persistent resurgence in different regions in Sub-Saharan Africa

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Summary

Serum neutralisation test

DRC: Democratic Republic of Congo, Congo: Republic of Congo, ICT: Information and Communication Technology. Implementing new surveillance tools and strategies to combat Ebola outbreaks and other infectious diseases There is an urgent necessity to strengthen the primary healthcare system, and develop more sensitive serological and molecular diagnostic tools, as well as innovative methods and approaches to assess vulnerability in agreement with current practices (see Figure 3) This requires further research and development (R&D), capacity building based on international best practices for containing public outbreaks, the drafting of standard processes and operating procedures, biorisk management as samples from patients and animals are an extreme biohazard risk, thorough adherence to the WHO global alert and response operations, and outbreak communication guidelines. It is imperative to understand global health involvement and governance, establish monitoring and evaluation (M&E) of research for action programmes, as well as increase funding to support efforts of existing

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