HOW CAN GOVERNMENTS RESPOND QUICKLY TO THE SPREAD OF COVID-19?

As COVID-19 hits countries across the globe at varying times, some commonalities are clear. The pace and strength within the government response can impact the outcome. Those governments with a planned endemic response are that much further ahead when aiming to flatten the curve. Below, learn how a surveillance system set up for malaria and other public health emergencies in one country is being replicated across the Greater Mekong Subregion to control the pandemic as it crosses borders.

Over the past year, the Lao government, side-by-side with PSI Laos and consortium members (including WHO/Laos and the Clinton Health Access Initiative), has worked tirelessly to strengthen the Public Health Emergency Operations Center (PHEOC). Funded by the Bill and Melinda Gates Foundation (BMGF), it was identified to be strengthened to help track endemic contagious diseases, such as malaria, and public health emergencies created by natural or man-made disasters.

In late 2018, based on a call for proposals by BMGF, PSI brought together a group of local stakeholders in Laos, as well as the US Centers for Disease Control and WHO Geneva, to address the country’s gaps in capacity for health emergency surveillance and response. The mix of local, regional and international stakeholders brought both on-the-ground and emergency operations expertise to create a comprehensive plan for establishing or strengthening legal authority, creating terms of reference and job descriptions for full-time staff for the center and updating a digital surveillance system to keep track of the spread of communicable diseases.

One year after being established, the PHEOC began regularly monitoring Laos’ 19 notifiable diseases. But in the past weeks, it has pivoted and become the focal point for COVID-19 surveillance and outbreak response in the country. Daily COVID-19 activities conducted by the government entities—including the Department of Communicable Disease Center, the National Centre for Laboratories and Epidemiology and provincial health offices—are centered within the PHEOC, which holds daily meetings to assess ongoing needs and creates daily COVID-19 situation reports for the Prime Minister’s office. The PHEOC also works with the Lao Center for Communication Education for Health to generate and distribute risk communication materials.

During the past year, consortium members also supported the Lao government with developing an updated notifiable disease database using the DHIS2 health management information system. The new system allows the PHEOC to more efficiently monitor disease surveillance for all 19 notifiable diseases in Laos. Currently being piloted around Vientiane, with support from the Australian Department of Foreign Affairs and Trade (DFAT), the plan is to expand training and rollout the new module to all 18 provinces throughout Laos. PSI is working with the PHEOC to add a new COVID-19 specific module that will augment the current system, enhancing case tracking, management and reporting specifically for COVID-19. The expected impact will be to make Laos nimbler in its pandemic response.

As COVID-19 transcends borders, and particularly in the Greater Mekong Subregion of Southeast Asia, the need for more coordinated emergency response efforts extends well beyond Laos. With funding from DFAT, the PHEOC project will soon be replicated in Cambodia and Myanmar.

The PSI team in both countries has begun working to quickly convene local stakeholders and international organizations to address the immediate needs for disease surveillance and response created by COVID-19. Once again, these efforts include technical assistance from both the US CDC and the WHO.

Using insights gained from this pandemic, both countries hope to lay the foundation for more strengthened and unified Emergency Operations Centers (EOC) for all notifiable diseases. While the COVID-19 pandemic has created a severe public health challenge, malaria has been and will continue to be a huge threat to lives across Greater Mekong Subregion long after the current pandemic has calmed. These coordinated EOCs will continue to work toward greater health for all they serve.

With the success of the PHEOC, the government of Laos has found that its emergency response efforts are more successful with stronger partnerships. As Myanmar and Cambodia follow suit and coordinate their own emergency response efforts with the support from PSI, these three countries are creating a united front against emergencies like the COVID-19 pandemic and other public health crises well into the future.

Banner image: (c)PSI/Chris James White