The project to set up 40 new ESCs in Benin, Nigeria and Togo was implemented by teams from the Mérieux Foundation and its partner Santé Monde (a Canadian NGO in charge of the surveillance part of the project), within the framework of the REDISSE program. The project concluded with the organization of reporting meetings on August 28 and 29, during which the various parties involved in the project shared results and discussed potential improvements and strategies to ensure its long-term success.

Launched in 2016 by the World Bank and ECOWAS, the REDISSE program aims to improve disease surveillance and preparation for epidemics in West Africa. Within this framework, the Mérieux Foundation and Santé Monde have already been mandated on several occasions to oversee the establishment of ESCs in countries selected by the WAHO (West African Health Organization).

The WAHO’s aim for this third mandate was to increase the number of ESCs in three countries that had already received support, by establishing a total of 40 new ESCs across Benin (10 ESCs), Nigeria (20 ESCs) and Togo (10 ESCs). An ESC is a concept that incorporates a laboratory unit and a surveillance unit within one health district. The aim of establishing ESCs is to strengthen capacity for surveillance data analysis and management.

The activities leading to the establishment of the 40 new epidemiological surveillance centers in the three countries were split into two distinct phases in the overall implementation process. The initial preparatory phase from mid-June to mid-July enables a coordination team to be set up and included meetings to organize how the mission’s activities would be run. The implementation phase then followed from the end of July to mid-August and included training sessions, supervision and the purchase of IT and laboratory equipment.

The Mérieux Foundation and Santé Monde, in collaboration with the authorities in charge of surveillance and laboratories in the three countries, started the mandate by organizing online launch meetings between June 19 and 22, 2023. These meetings were to inform the various parties involved in the countries about the new mandate assigned by the WAHO and to discuss the challenges to be addressed.

Following on from this, a joint scoping mission with the authorities and technical departments at the ministries of health in Togo, Benin and the NCDC (Nigeria Center for Disease Control) was carried out from June 27 to 30, 2023. During these missions, the mandate and the concept for the ESCs were presented, and national trainers, assessors and the districts preselected for assessment were identified.

A training session for 80 laboratory technicians (40 from Nigeria, 20 from Togo and 20 from Benin) took place simultaneously in the three countries from July 24 to August 12, 2023. Staff were given training in the following five modules: biosafety and the transport of samples, data management, diseases with potential to cause epidemics, equipment maintenance and Quality Management systems. The methodology used by the Mérieux Foundation consists of training national trainers who are then put in charge of training laboratory staff. Trainers from previous phases were therefore brought in for this new cohort, to share their experience with newly identified individuals and ensure the continuity of knowledge already acquired.

Following on from the training sessions at a central level, supportive supervision was carried out on site, again taking place simultaneously across the three countries from August 21 to 25, 2023, to assess to what extent the modules had been implemented. Staff who had already been trained in laboratory equipment maintenance during previous mandates joined the supervision teams to ensure the preventative and curative maintenance of laboratory equipment.

This ambitious mission was successfully completed thanks to close collaboration between the WAHO, the Mérieux Foundation for the laboratory section, and Santé Monde for surveillance. The strong commitment of all the parties involved in the project, and especially of local parties, enabled important achievements to be accomplished over a short period. The ESCs have been fitted out with IT equipment, laboratory software and, in some cases, solar panels to strengthen the region’s capacity to monitor diseases.

WhatsApp groups have been set up to bring the newly established ESCs together with those set up during previous phases, thus establishing a community of practice and ensuring the sustainability of actions by the sharing of documents, information on pandemics, and best practices.

About the establishment of Epidemiological Surveillance Centers

Within the regional dimension of the REDISSE program, the WAHO wants to reinforce the capacity of health districts to conduct integrated disease surveillance by setting up Epidemiological Surveillance Centers (ESCs). An ESC is a concept that incorporates laboratory units and human health surveillance units together with players active in animal and environmental health in the districts. Its capacity for surveillance data analysis and management is supported by training, supportive supervision, and the allocation of computer and laboratory equipment.

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