A multisectoral team of various expertise from the Ministries of Health, Animal Health, Agriculture, World Health Organisation (WHO), and US Centers for Disease Prevention and Control (US CDC) gathered to pilot and review the draft 3rd edition of the Integrated Disease Surveillance and Response (IDSR) technical guidelines.
Selected with two other countries Zambia was tasked to review the new guidelines that have be revised to take into consideration new technologies, emerging, re-emerging and existing threats of public health concern, as well as new strategies including the institutionalization of a Public Health Institute to coordinate public health functions in the country.
Integrated Disease Surveillance and Response (IDSR) is a strategy for strengthening surveillance systems in the WHO African region. It collects a wealth of information that should be analysed and reported for program management, policy decisions, setting a research agenda, strategic planning and resource mobilisation. In 1998, the World Health Organization (WHO) Regional Office for Africa (AFRO) in collaboration with partners and stakeholders adopted a strategy for developing and implementing comprehensive public health surveillance and response systems in African countries. Since the adoption of IDSR in 1998 at the time known as integrated disease surveillance (IDS) two editions of the IDSR technical guidelines (TG) have been released to guide country implementation.
The 2nd edition revisions to draft the 3rd edition were informed by a number of lessons learnt in various outbreaks including Ebola Virus Disease (EVD), yellow fever, zika virus, Rift Valley fever (RVF), dengue as well as the humanitarian crises. Leveraging on the increased use of mobile phone and other wireless technologies in medical health commonly known as mHealth and outcomes of the
IDSR taskforce meeting held in September 2017 in Uganda, there was more need to revise the guidelines.

Figure 1: Participants to the workshop
The 3rd edition has undergone extensive reviews by both internal and external experts and a technical consultative meeting reviewed them in March 2018.
The review process aims to have countries provide specific feedback to WHO AFRO on the clarity, value added, gaps and enhancements that could be made to the final version of the revised draft. Zambia was the second country in Africa to be engaged in developing a shared understanding of the revised guideline including updated tools. Under this background, the Ministry of Health through the Zambia National Public Health Institute (ZNPHI) with support from WHO AFRO and Country Office (CO) held a 5-day workshop from August 27-31 to review the technical guidelines. The workshop that brought together surveillance officers and other health professionals had an objective of testing the advanced draft and discussing areas for adaptation.
The workshop further identified the need to harmonize the technical guideline with existing national policies structures and procedures for outbreak preparedness, investigation & response.
Additional Areas
The revised third edition has seen a number of areas improved and others included like the Points of Entry (PoE), risk communication, command and control centres and electronic integrated disease surveillance and response (e-IDSR). The points of Entry (PoE) as provided in the International Health Regulations (IHR) are significant in surveillance as they contribute in the international spread of diseases and if well controlled they can help countries to better prevent, prepare and respond to public health risks. Risk communication is an essential element of disaster and emergency preparedness and response as it allows authorities and experts to listen to and address people’s concerns and needs to provide advice that is relevant, trusted and acceptable.
Command and control centres that include: Emergency Operating Centre (EOCs), National Public Health Institutes (NPHIs) and Incident Management System (IMS) provides a standard framework for responding to public health events and outbreaks. The command and control centres may vary from one country to the other.
Electronic IDSR (eIDSR) is the application of electronic tools to the principles of IDSR to facilitate prevention, prediction, detection, and response. In 2013, the African region adopted an eHealth resolution (AFR/RC60/R3) to address the use of Information and Communication Technologies (ICT) for health and health-related fields, including disease surveillance. The recommended actions included the development of national policies, strategies, norms and appropriate governance mechanisms resulting in long-term strategic plans and frameworks for eHealth capacities in countries.
Way forward
After the review of the advanced draft has been completed, a roadmap and milestones towards various country adaptation of the third edition will be drawn based on the country’s needs and contexts. Piloting will be done and the document will be ready for use in various levels of health care.
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For more information contact
Mazyanga Lucy Mazaba
Head Information Systems
Zambia National Public Health Institute
Mobile: +260 977879400