Partnering to Expand Public Health Emergency Operations Centers

by Pooja Magadi, EOC Associate, PSI Laos

As the COVID-19 pandemic continues to be at the forefront of everyone’s minds, public health emergency operations centers (PHEOCs) are precisely the information nodes we need. PHEOCs can provide early detection and containment of disease outbreaks and can be the key to helping national and subnational government health systems protect populations affected by threats to public health.

As part of our efforts to support malaria elimination in the Greater Mekong Subregion, in November 2018 the Bill and Melinda Gates Foundation (BMGF) awarded a grant that enabled PSI, alongside the Lao government, to pioneer a PHEOC strengthening project. The project’s focus is to improve the overall capacity for efficient disease surveillance and response while specifically accelerating malaria elimination. Given the success of the project, especially in a COVID setting, our regional expansion strategy into Cambodia and Myanmar is now well underway. We are increasingly able to respond to disease outbreaks regionally through these PHEOCs.

In this next phase, BMGF funding has been bolstered by the Australian Department of Foreign Affairs and Trade (DFAT)—an original planning partner on the project which is now contributing to on-the-ground efforts in Laos, Cambodia and Myanmar. As a joint effort between BMGF and DFAT, this regional PHEOC strengthening vision has benefited from our partners collaborating during scoping missions and the design of projects, while further aligning strategically with other regional and global partners.

This type of alignment often starts with sharing information. Below, find key learnings from PSI Laos on how to build PHEOCs in neighboring countries.

  1. Strong and sustainable PHEOCs are most successfully built through solid local and international partnerships. PSI’s consortium approach currently includes the Lao PDR Ministry of Health; local, regional and global offices of the World Health Organization (WHO); US Centers for Disease Control and Prevention (US-CDC) counterparts; and the Clinton Health Access Initiative (CHAI) country office. These partners enabled PSI Laos to leverage the multi-sectoral and technical expertise required to successfully execute the project, including adaptations for country contexts. The latter can be significantly different in each country, and requires unique partnerships, to maximize the effect of PHEOCs across the region. Partnerships with Public Health England in Myanmar and the US-CDC team in Cambodia have been invaluable in this regard.
  2. As we expanded the PHEOC strengthening initiative to other countries in the region, it became clear that we needed a dedicated internal knowledge management strategy to effectively share lessons learned. PSI created a scalable way to ramp up the transfer of internal expertise from Laos to our colleagues in Myanmar and Cambodia in the form of an internal PHEOC Learning Center. The recent creation of this collaborative learning platform, coupled with our capacity building efforts through a webinar series, allowed PSI staff in Myanmar and Cambodia to quickly gain knowledge regarding key theoretical and practical considerations for PHEOC strengthening endeavors. The overall aim is to build a cohort of PSI staff who provide thought leadership on all things related to the PHEOC and who can, where appropriate, aid other PSI country offices to support ministries of health in strengthening their national and subnational PHEOCs as well.

Through our PHEOC strengthening projects in Laos, Cambodia and Myanmar, PSI has further developed our strategic partnerships and thus created a diverse network of government, NGO, and private sector stakeholders who can work together to realize the innovative potential of these critical nerve centers of health information throughout Southeast Asia.

Due to our collaboration with the US-CDC and the WHO (specifically the WHO Department of Global Capacities, Alert, and Response) during the early stages of our PHEOC journey, we have been able to benefit from both organizations’ unique roles locally, regionally and globally. We have grown through these experiences into a valuable technical partner, well-positioned for any PHEOC strengthening project. Familiarity with the various levels within each entity has been vital to maximizing the effect on specific PHEOC strengthening agendas in each country. Insights gained from working with the US-CDC and the WHO’s operations also allow for a greater understanding of PHEOC strengthening in a broader context e.g., how it ties in with the ASEAN initiatives and the US-ASEAN Business Council objectives. As the success of PHEOC projects is highly dependent on understanding individual countries’ situations based on regional and global contexts, these partnerships are invaluable.

The results in Laos alone, thanks to this collaboration, demonstrate what is possible. With the official inclusion of malaria as a notifiable disease, the national PHEOC was given a clear mandate to accelerate malaria elimination in the country. Meanwhile, the recent COVID-19 pandemic has demonstrated the crucial role played by the PHEOC in the coordination of outbreak response. Health workers from all 148 districts nationwide are being trained on the DHIS2 Health Information Management System that feeds disease surveillance data into PHEOCs across the country. The national PHEOC as well as all 18 provinces and 9 pilot districts have been provided with essential surveillance and communication equipment, and up to 8 provincial emergency operations rooms are being refurbished. In the coming months, Incident Management Systems training will be provided to staff from all provinces and districts. Nineteen emergency response plans, one for each notifiable disease, will be delivered as part of the overarching Emergency Operating Plan. These are just some of the achievements and planned activities in Laos; the many resources that were developed as well as lessons learned along the way are already being shared through our learning center with PHEOC teams in Cambodia and Myanmar.

PSI’s track record of fostering strong relationships with regional counterparts, while working with multiple donors, has resulted in successful collaborations and maximization of investments on the ground. Also, our long-standing partnerships with national Ministries of Health combined with a strong presence rooted in local communities allows us to be an increasingly relevant key player in building the coalitions necessary for PHEOC expansion, regionally and beyond. We believe this work is critical to the future of pandemic response, and we welcome the opportunity to speak with partners who are looking to do this work.

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