On July 18, 2024, the Africa Centres for Disease Control and Prevention (Africa CDC) launched a new Strategic Framework for Strengthening Cross-Border Surveillance and Information Sharing across the African Union Member States. Available reports indicate that Africa bears the heaviest burden of public health emergencies globally.
The strategic framework addresses the increasing frequency and magnitude of cross-border public health threats in Africa, driven by population movements, globalization, and human, animal and environmental interactions within the ecosystems.
The framework proposes interventions member states should adopt and implement to strengthen cross-border surveillance, timely information, and data sharing. Implementing the framework recommendations will improve the mobile population's health and communities along the international borders, points of entry and adjoining communities by mitigating and preventing cross-border public health threats among the African Union Member States.
"Limited cross-border coordination and collaboration mechanisms are key challenges to addressing public health threats," said Africa CDC's Acting Deputy Director General, Dr Raji Tajudeen, at the launch.
African Union Member States have invested in strengthening core capacities for surveillance over the past year. However, there remain significant gaps, particularly at cross-border and points of entry, such as weak health infrastructure and services, inadequate capacity of the staff, limited skills and capacities for identifying and responding to health threats, informal border crossing points that are unmanned and unmonitored, cultural issues and language barriers, among others. Health threats due to climate change emergencies, such as floods and droughts and insecurity due to conflicts, contribute to cross-border displacements and migrations.
It is anticipated that the implementation of this framework will benefit from existing African Union policies and legal instruments, robust civil societies, technical health partners, and strong research and academic institutions. There is an opportunity to enhance infrastructure at entry points and to train and equip entry point staff, including immigration, security, and port health officers, among others.
Strengthening cross-border collaborations is paramount for effectively tackling health security challenges. Dr Tajudeen said that Africa CDC has developed this framework through a participatory and consultative process in partnership with technical and strategic partners, Regional Economic Communities and African Union member states.
"The launch of this framework today marks a significant milestone in our collective efforts to enhance public health security across the continent," Dr Tajudeen said, calling upon all member states, Regional Economic Communities, and technical partners to adapt and implement this Continental Strategic Framework.
"Africa CDC remains committed to providing the necessary support required to ensure the successful dissemination and implementation of the framework, ultimately enhancing public health security and resilience across Africa," he added.
The plan will complement existing national and regional plans on cross-border surveillance through direct technical support, coordination, collaboration, information sharing, advocacy for increased funding, community of practice, and peer review mechanisms for cross-cutting learning, monitoring and evaluation.
The framework is intended for use by ministries responsible for human, animal, and environmental health, trade, immigration, foreign affairs, and other relevant ministries, departments, organizations, agencies, and sectors involved in cross-border activities, National Public Health Institutes (NPHI), academia, and other stakeholders, including non-state actors
The framework comes against the backdrop of Africa bearing over 24% of the global disease burden while providing only 3% of the global health workforce and spending less than 1% of the world's financial resources on health. Emerging and re-emerging infectious diseases, such as Mpox, Ebola Virus Disease (EVD), Marburg, Rift Valley fever (RVF), Crimean-Congo Haemorrhagic Fever (CCHF), and COVID-19, alongside natural disasters and humanitarian crises, continue to pose substantial health, security, and economic challenges in Africa
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The framework notes that the high mobility of people, animals, and goods across the continent, considering globalization, exacerbates the spread of infectious diseases through formal and informal entry points. A robust early detection of infectious diseases, emergency preparedness and response, infection control programs, and enhanced capacity for healthcare workers at national and regional levels will improve the early warning and response systems, which will become necessary.
Dr Ninglan Wang, Unit Head for Border Health and Mass Gatherings at World Health Organisation, applauded Africa CDC for achieving such a huge milestone within a relatively short period, three months following the finalization of the Cross-Border and Information Sharing Framework by the technical working group back in April 2024.
"This feat," she said, "shows the strong determination and commitment of Africa CDC, the Member States, and all the technical partners involved to move forward with such an impactful initiative. "The priority and level of energy given to finalize this strategic framework document is evident that each of us can make a difference, but with all of us together, we can make a change," Dr Wang said.
