USAID's Key Achievements

Integrated Disease Surveillance and Response Strategy in Ghana.

The north of Ghana is particularly prone to epidemics of infectious diseases. Four wild polio cases were detected in the past year, meningitis epidemics recur annually, and the incidence of guinea worm cases has risen steeply. USAID has focused its support on implementing the WHO-developed concept of integrated disease surveillance and response (IDSR) in the country's three northern regions. USAID provided financial and technical assistance to strengthen the ability of Ghana Health Service's surveillance systems to respond quickly and effectively to the threat of epidemics. in 2003, USAID trained 376 health personnel, clinicians, and district and regional health managers; provided 83 facilities with IDSR materials; and supported the employment of a Health Service epidemiologist to supervise IDSR implementation in the north. IDSR is currently functional in eight districts and will be fully implemented in all 24 northern districts in fiscal year 2004. Full implementation is expected to have a lasting impact on the threat of infectious diseases and on polio and guinea worm eradication in Ghana.

Case Detection, Reporting, and Follow-up in Peru.

The USAID-supported surveillance system in Peru comprises 4,731 health facilities that represent 62 percent of all health facilities in the country. Weekly reports are received from virtually all participating facilities. The system detects and follows up probable and confirmed cases of infectious diseases. No cases of polio have been detected for the last 12 years, and no measles cases have been found for more than three years. The system has proved extremely sensitive, accurate, and quick in detecting and reporting cases and outbreaks of emerging and re-emerging diseases, including yellow fever, plague, dengue, and malaria.

Early Warning Reporting of Vector-Borne Diseases in Nepal.

USAID-funded activities to strengthen routine reporting of vector-borne diseases in Nepal under the Early Warning Reporting System are proving effective. The System recently enabled the government to quickly identify and respond to a malaria outbreak in a remote western region. In 2002, 13 percent of malaria outbreaks were identified and responded to, compared to fewer than 5 percent in prior years.

Integrated Disease Surveillance and Response Strategy in Africa.

In 1998, WHO's Regional Office for Africa developed a regional strategy for integrated disease surveillance and response based on data collection. USAID has provided support for staff, guidelines development, epidemic response, training workshops, and key laboratory reagents. Assessments of national disease surveillance systems have taken place in 28 countries (out of 46 countries in total). National five-year plans for developing integrated disease surveillance and response have been completed in 23 countries. In 2002, four countries adopted the guidelines, and 10 began the adaptation process. Laboratory activities are being strengthened through an external quality assurance program in bacteriology in which 36 laboratories have enrolled.

Strengthening Epidemic Preparedness in Africa.

USAID has supported efforts to strengthen Africa's regional capacity for epidemic preparedness and response. USAID has provided preparedness and response assistance to Côte d.Ivoire, Ghana, and Guinea for yellow fever outbreaks; to Angola, Benin, Burkina Faso, Democratic Republic of the Congo, Ethiopia, Mali, Niger, and The National Autonomous University of Nicaragua has developed a curriculum, and the first students have graduated from the CDC Data for Decisionmaking Course. Local universities in Costa Rica, El Salvador, Guatemala, and Nicaragua have adopted this activity.

Infectious Disease Training in the Philippines.

A stumbling block to infectious disease control in the Philippines has been the limited abilities of government health workers to identify and manage TB, malaria, and dengue fever. USAID has funded technical assistance and training for government health workers. More than 1,000 health staff from 48 municipalities and three cities have received training on disease surveillance, diagnosis, and management.