Preparing to confront Ebola – just in case

Countries in Africa have been working on improving their preparedness in the event of an Ebola outbreak. The WHO teams have provided simulated exercises in hospitals and technical training, for immediate emergency response and communication.

WHO/N. Alexander

Mamo Jatta is a Regional Public Health and Surveillance Officer in The Gambia and, like many people living near Ebola affected countries, he is concerned the disease will enter his own country, “I recently visited the town where I grew up and wondered what would happen if Ebola were to hit us here, would we be ready for it?”
Experts at WHO have the same concerns – and they are transforming these into action. Ebola has already been exported, albeit resulting only in small outbreaks, from the three most-affected countries to the neighbouring countries of Mali, Nigeria and Senegal. Now, because of their geographic location or trading and migration patterns, 14 additional countries are considered as priority countries, in terms of risk of Ebola importation: Benin, Burkina Faso, Cameroon, Cote d’Ivoire, Central African Republic, Ethiopia, Ghana, Guinea Bissau, Mauritania, Niger, Togo, The Gambia, South Sudan and the Democratic Republic of Congo.
“The Ebola outbreaks and response in Nigeria and Senegal showed the world that the disease can be stopped if a country is adequately prepared from the outset,” observed Isabelle Nuttall, Director of the Global Capacities, Alert and Response department at WHO. “WHO is now working with all countries on the at-risk list to help them meet the same standards for preparedness.”

WHO teams help prepare for Ebola

"The Ebola outbreaks and response in Nigeria and Senegal showed the world that the disease can be stopped if a country is adequately prepared from the outset. WHO is now working with all countries on the at-risk list to help them meet the same standards for preparedness."

Isabelle Nuttall, Director, Global Capacities, Alert and Response, WHO

The WHO teams provide simulated exercises in hospitals and technical training, for immediate emergency response and communication, to help countries identify opportunities for improvement in order to strengthen their preparedness in the event of an outbreak. Mamo participated in the training and says that, “The mission is timely, as The Gambia prepares for Ebola. It has revealed a lot about our strengths and weaknesses and what we can do better, particularly in the area of coordination.”
Mamo is talking about the first component of the Ebola preparedness checklist, developed by WHO, that calls for overall emergency coordination- designating roles to all national and international agencies in case of an outbreak. The teams are using the checklist in their workshop to review with doctors, government officials, and border guards, among others, the first steps that need to be taken when a case of Ebola appears in the country. The comprehensive checklist follows WHO’s International Health Regulations and is used to identify concrete actions for countries and how they will be supported by the international community.

Lessons learned

The checklist further helps teams to make recommendations on community engagement, infection prevention and control, case management, Ebola Treatment Centres, safe dignified burials or safe alternatives, epidemiological surveillance, contact tracing, laboratory capacity, and border crossing preparedness. The recommendations of the teams can vary- from implementing rapid response teams that carry out infection, prevention, and control measures to identifying diagnostic laboratories that can efficiently test for Ebola and safely transport samples to the laboratory.
The team works closely with the country’s Ministry of Health and international partners, including the UN Mission for Emergency Ebola Response, to best incorporate the recommendations according to each specific country context.

Putting theory into practice

All 13 countries have unique health systems, and WHO is conducting training sessions in each of them to help key actors complete the tasks on the check list. In part, the training sessions involve simulated exercises – for example in hospital settings, where participants seek to meet the gold standard for infection control. There are also table-top sessions where participants do the concrete work needed to determine how national authorities will coordinate their actions with partner organizations and the UN Mission for Emergency Ebola Response.
At present, the training missions represent a race to help countries ready themselves to quickly stamp out any further Ebola outbreaks, but there are broader implications. The exercise is giving countries an opportunity to take a closer look at the functioning of their health systems overall. “Preparedness efforts in Ghana brought sharper focus on the health system and revealed strengths and weaknesses,” says Dr Magda Robalo, WHO Representative to Ghana, where a training session recently took place. “The country’s Ministry of Health will capitalize on the lessons learned during the training.” 


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Who calls for proper Hygiene Practices

The risk of contracting the hemorrhagic fevers is ever-present and it is important that basic personal hygiene practices are maintained even after Ebola disease has been contained.
Joana Ansong, Professional Officer, Health Promotion of the World Health Organization (WHO), Ghana, made this remark at a workshop in Ho for core members of Regional Risk Communication Teams on Tuesday.
Participants were from the Volta, Greater-Accra and Eastern Regions.
WHO is sponsoring the workshops for all the regions, zoned into northern, middle and southern sectors.
Ms Ansong said the risk of contracting Ebola and similar diseases was not temporary and that Ghana, with no recorded case of Ebola so far, was not out of danger.
She said besides regular washing of hands under flowing water, dead bodies must be handled by only those trained to handle them and that early treatment must be sought if symptoms of Ebola occur.
Ms Ansong said males who contract Ebola and recovered were at risk of passing on the virus to their sex mates through semen within seven weeks of being declared fit.
Mrs Grace Kafui Annan, Head of Health Promotion Department of the Ghana Health Service (GHS), said social mobilization and risk communication were crucial in tackling dire situations such as the Ebola spread.
She said an ambulance team had been trained for ferrying Ebola patients.
Mrs Annan said an active surveillance drill had been adopted, which would ensure that a patient was tracked to trace and handle all people that patient had been in contact with.
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WHO receives norwegian support for ebola activities in Ghana

Accra, 26th September, 2014 -The World Health Organization (WHO) has signed an agreement with the Norwegian Government for the release of 6,200,000 Norwegian Kroner (approximately US$ 1,000,000.00 ) to support WHO’s Action Plan for Ebola Outbreak Preparedness in Ghana.
Signing the agreement in Accra today, the WHO Country Representative to Ghana, Dr Magda Robalo recalled that WHO declared the current Ebola outbreak as a public health event of international con-cern which threatens global security. She expressed WHO’s gratitude to the Norwegian government for the support towards the fight against Ebola, especially focusing on preparedness activities in Ghana.  She also assured representatives of the Norwegian Government that the funds will be used to implement critical activities in line with the Ghana’s Preparedness Plan to Prevent an Ebola Outbreak and the WHO Ebola Response Roadmap.
In her statement, Her Excellency the Norwegian Ambassador to Ghana, Ms Hege Hertzberg stressed the commitment of her government to support Ghana in its preparedness efforts. She applauded WHO’S coordinating role in the response to the outbreak and highlighted the importance of partner-ships in tackling health emergencies such as this, which have the potential to jeopardize important de-velopment gains.
Speaking on behalf of the Honorable Minister of Health, Dr Afisah Zakariah, Director, Policy, Plan-ning, Monitoring and Evaluation at the Ministry of Health indicated that in as much as Ghana’s pre-paredness efforts were still ongoing there was the need for further support to strengthen surveillance systems, train front line health workers in early diagnosis and case management, equip treatment cen-ters and isolation wards and also intensify public sensitization.
Under the terms of the agreement, the Norwegian government will release the funds to WHO as a do-nation towards augmenting its efforts in Ebola preparedness activities in Ghana. Specifically, the do-nation will be channeled to supporting effective coordination of preparedness and response activities; strengthen capacity for active surveillance, early detection, investigation and reporting. Further appli-cation of the funding will be in the area of capacity strengthening for laboratory diagnosis, case man-agement, contact tracing and infection prevention and control. Effective risk communication, public information and education interventions will also be prioritized.
The implementation of activities is expected to commence in September, 2014 and would last for a period of one year, ending in September, 2015.


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WHO Ghana Ebola Viral Disease (EVD) Preparedness and Response Activities

Highlights in Ghana

• There is no confirmed EVD case reported in Ghana to date.
• Ongoing surveillance for EVD as part of surveillance for viral hemorrhagic fevers (VHF)

Highlights in neighbouring countries as of 31 May, 2014

• Sierra Leone: EVD outbreak declared 26th May in Kailahun District, 15 cases confirmed as at 30 May out 48 suspected cases from 7 districts. All confirmed cases are from Kailahun.
• Guinea: as at 28th May, 291 cumulative cases of EVD reported including 172 confirmed and 193 deaths (case fatality rate of 66%) from 8 districts. The last confirmed case placed in isolation on 28/05/2014.
• Liberia: One new suspected case reported 29th May who died in Foya district is under investigation. Before this latest suspect, no new case had been reported since 9th April and the total cumulative cases were 12 including 6 confirmed and 9 deaths
• No travel restrictions to any part of West Africa or rest of the world

1. Planning and Coordination

• Three meetings of National Technical Coordinating Committee held
• Initial GhC 800,000 approved by government to support the immediate needs of the Ebola Preparedness and Response Plan with GhC 50,000 released to the Ghana Health Service (GHS) so far.

2. Surveillance and Laboratory

• Twelve samples of suspected VHF from Brong Ahafo Region, Ashanti  Region, Eastern  Region, Greater Accra Region and Upper East Region sent to Noguchi Memorial Institute for Medical Research (NMIMR) for testing have been declared negative for Ebola and other VHF 
• Sixty regional surveillance and disease control officers and 90 port health staff trained on Ebola surveillance with training being cascaded to lower level
• Orientation on EVD held for all Regional Health Administrations
• GhC15,000 released to NMIMR by GHS to support laboratory activities
• Thirty PPE presented to NMIMR by WHO

3. Case Management

• First batch of 470 PPE from WHO presented to MOH and Noguchi for prepositioning.
• Fifteen copies of Clinical Management of VHF Guide and 5 sets of 3 wall charts presented to MOH by WHO
• Second consignment of 210 heavy duty PPE kits including cadaver bags presented to MOH by WHO

4. Social Mobilization

• Press briefing on EVD conducted by Minister of Health
• Advertiser’s’ announcement with information on EVD, mode of spread, signs and symptoms and prevention  placed in leading newspapers
• Radio and TV discussions and announcements on EVD ongoing
• Two thousand posters and 2000 hand fliers on EVD presented to MOH by WHO

5. Upcoming Activities

• Adaptation of VHF Clinical Management Guidelines

6. Challenges

• No isolation unit designated yet to manage cases
• Inadequate information campaign to the community level
• Limited training of health workers on infection prevention and control measures

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Stakeholders Consensus Building and Advocacy Meeting for the Reviewed National Medicines Policy

Accra, 17 October 2014 -- The review of the National Medicines Policy has been supported by the MOH/WHO/EU/ACP Renewed Partnership to Strengthen Pharmaceutical Systems to Improve Access to Good Quality and Safe Medicines.
The National Medicines Policy represents decisions based on the best current evidence, the consensus opinion of all stakeholders as well as the general direction of governance on pharmaceuticals. Stakeholder ownership and commitment is important to take the best collective decisions for Ghana and ensure optimized implementation in the coming years.
A large national stakeholder meeting has been held to build consensus and harness views of

stakeholders on various aspects of the policy. The meeting was attended by over 75 participants. These included 13 members of the parliamentary select committee on health, several senior directors from the Ministry of Health and the Ghana Health Service, Regional Directors of Health Services, representatives from the private sector, professional associations, civil society and journalists. The meeting was chaired by Mr Yileh Chireh, former Minister of Health and current chairman of the Parliamentary Select Committee on Health. At the meeting an overview of the NMP process and the current status of the draft NMP was shared. The new medicines policy aims to realize the commitment of the Government of Ghana towards the goal of ensuring universal access to affordable essential medicines of assured quality for all people living in Ghana, as well as their responsible use by health professionals and consumers.
The revision of the second edition has been informed by:

• the need to strengthen pharmaceutical systems to meet the health needs of the population,
• the need to sustain the gains made in ensuring financial access to medicines for the poor and vulnerable through the establishment of the National Health Insurance Scheme,
• the need to strengthen pharmaceutical systems as a key component of health systems,
• the need to develop the local pharmaceutical industry,
• the need to strengthen the regulation of pharmaceuticals in Ghana, and
• the need for sustainable interventions towards universal health coverage.

The policy would be finalized, with an implementation plan, advocacy and communication plan, as well as an M & E framework for cabinet endorsement and implementation.



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