CDC's Global Disease Detection Programs in South Africa
Global Disease Detection (GDD) is CDC’s principal program for strengthening global health security by developing public health capacity to rapidly identify and control disease threats around the world. The Division of Global Disease Detection and Emergency Response, which houses GDD has been designated by the World Health Organization (WHO) as a Collaborating Center for Implementation of the International Health Regulations National Surveillance and Response Capacity.
A central focus of GDD is building capacity for emerging health threats and closing existing geographic vulnerabilities through the establishment of strategically placed GDD Regional Centers in WHO regions around the world. The work at these centers is focused on helping to strengthen public health systems and improve infrastructure in host countries to identify and control emerging infectious diseases. Currently, GDD has activities in nine countries: Bangladesh, China, Egypt, Guatemala, India, Kazakhstan, Kenya, South Africa, and Thailand.
Using the WHO’s revised International Health Regulations (IHR, 2005) as an organizational framework, GDD links the strengths of overseas CDC programs with country and regional partners. This integrated approach helps reduce detection and response time by developing sustainable capacity in:
- Emerging infectious disease detection and response
- Field epidemiology and laboratory training
- Pandemic influenza preparedness and response
- Zoonotic disease investigation and control
- Laboratory capacity building
- Risk communications and emergency response
The GDD Regional Center in South Africa was established in 2010 in coordination with country partners. Based in Pretoria, South Africa, with the South Africa National Department of Health, the Regional Center provides leadership, training, and technical assistance to strengthen regional ability to confront new emerging infectious disease challenges, including influenza and other respiratory diseases.
The National Health Laboratory Service (NHLS), based in Johannesburg, is a key partner to the South African National Department of Health. NHLS’ outstanding scientists and strong regional partners provide expertise to prevent, identify, and control influenza through joint preparedness, surveillance, and rapid response activities. The GDD Regional Center in South Africa has also been fortunate to build on the many existing partnership-based activities established in South Africa by CDC’s Global AIDS Program.
The GDD Regional Center in South Africa integrates surveillance and laboratory expertise to improve public health throughout the region. In the start-up phase, GDD hopes to expand existing capacity within three key existing programs:
Emerging Infectious Disease Surveillance – The Group for Enteric, Respiratory and Meningeal Disease Surveillance (GERMS-SA) conducts laboratory-based surveillance for bacterial and fungal diseases. GERMS-SA is a network of South African clinical microbiological laboratories, academic partners and public health collaborators. Providing an infrastructure for national laboratory-based surveillance and using data to influence public health policy, they:
- Have approximately 270 public and private sector laboratories nationwide, which submit clinical isolates or specimens according to specific case definitions to the NHLS reference laboratories for further characterization.
- Employ nurses at 23 hospitals in 9 provinces to act as Surveillance Officers who collect additional clinical and epidemiological information on the laboratory-confirmed cases.
- Have formed an extensive database of cases of patients with priority communicable diseases in South Africa, which provides essential public health information to the National Department of Health and other interested parties.
The South Africa Field Epidemiology Laboratory Training Program (SA-FELTP) was officially launched in May 2006. The SA-FELTP is designed to train field epidemiology fellows and public health laboratory fellows for leadership positions in the South African National and Provincial health services and the NHLS. SA-FELTP:
- Provides epidemiologic training and mentoring to post-graduate fellows in order to augment the quality of service they provide to the National and Provincial Departments of Health and NHLS.
- Offers epidemiology and laboratory tracks together with field projects that allow fellows to transfer learning into the workplace and provide service to their institutions.
The Influenza Program works with the NHLS’ National Influenza Centre (NIC), a WHO reference laboratory, and the Regional WHO Influenza Reference Laboratory for Southern Africa. In 1984, active influenza surveillance began with 7 practitioners and has since increased to 170 practitioners in all 9 provinces. Playing a key role in pandemic preparedness and response in Southern Africa, this program:
- Characterizes influenza viruses obtained from physicians and hospitals that participate in the Severe Acute Respiratory Infection (SARI) surveillance network. This information is shared annually with WHO and the South African National Department of Health to assist in developing prevention strategies for influenza and the composition of annual influenza vaccines for the southern hemisphere.
- Strengthens national and regional laboratory capacity for the rapid diagnosis of suspected cases of novel influenza viruses.
- Participates in the Rapid Response Training for Avian and Pandemic Influenza for the provinces and provides support to a number of regional countries for pandemic preparedness.