CDC in Côte d’Ivoire

HIV Serology testing performed in Retro-CI’s Clinical Diagnostic Unit. Photo by Ouattara Moussa.

HIV Serology testing performed in Retro-CI’s Clinical Diagnostic Unit. Photo by Ouattara Moussa.

The Centers for Disease Control and Prevention (CDC) established a research station in Côte d’Ivoire in 1987 for the Retrovirus Côte d’Ivoire (CDC Retro-CI) project to address the emerging HIV epidemic. The launch of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in 2004 expanded CDC’s support. Since 2016, CDC expanded its partnership with the Government of Côte d’Ivoire to support the Global Health Security Agenda (GHSA) and increase capacities to prevent, detect, and respond to public health threats. Heath equity is embedded into all of CDC’s activities, especially as the agency focuses on supporting sustainable public health systems and provides world-class expertise and support to maintain a diverse public health workforce. CDC also develops and deploys world-class data and analytics; establishes and maintains state-of-the-art laboratories; and strengthens local capacity to quickly respond to outbreaks.

Download Côte d’Ivoire Factsheet [PDF – 199 KB]

CDC Impact in Côte d’Ivoire

Global Health Security

CDC provides expert support to the Côte d’Ivoire Ministry of Health and Public Hygiene (MSHP) to strengthen capabilities in four core global health security areas: disease surveillance systems, laboratory networks, workforce development, and emergency management. CDC also:

  • Helps establish and support Emergency Operations Centers (EOCs)
  • Supports central and regional laboratory activities for respiratory viruses and antimicrobial resistance
  • Supports Field Epidemiology Training Program (FETP) Frontline, Intermediate, and Advanced courses to build Côte d’Ivoire’s public health workforce
  • Trains healthcare workers in HIV and COVID-19 surveillance, detection, and case management
  • Trains community health workers (CHWs) in event-based surveillance and engages them in community-based disease surveillance
  • Increases preparedness for Ebola Virus Disease response through simulation exercises with staff and partners who would be involved in an Ebola response
  • Assists the Côte d’Ivoire National Public Health Institute research center
  • Collaborates with the Bill & Melinda Gates Foundation to establish the polio emergency center, train staff, and support polio vaccination
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CDC helped establish Côte d’Ivoire’s first national EOC, three EOCs in Ebola-sensitive regions, and three in regions with the highest rates of COVID-19. CDC provided equipment and technical support and trained 25 staff at each EOC

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As of December 2022, more than 400 FETP-Frontline graduates work in human, animal, and environmental sectors throughout Côte d’Ivoire’s 113 health districts

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Since 2021, CDC has supported trainings for more than 630 community health workers, 420 health workers, and 70 regional trainers on Integrated Disease Surveillance and Response (IDSR) and Event-based Surveillance

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CDC helped strengthen disease surveillance by training 390 health workers in IDSR at different facility levels in five regions

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With CDC support, community health workers investigated 420 community-based health alerts

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CDC used the Extension for Community Healthcare Outcomes (ECHO) platform to train over 1,500 healthcare workers in HIV and COVID-19 surveillance, detection, and case management

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CDC supported laboratory activities (training, reagent supply, and equipment procurement) for respiratory viruses and antimicrobial resistance at the central laboratory and 11 regional laboratories

COVID-19

The first confirmed case of COVID-19 in Côte d’Ivoire was reported in March 2020. Since the pandemic was declared, CDC has supported COVID-19 vaccination, laboratory diagnostics, data collection, case investigation, and contact tracing in Côte d’Ivoire. CDC-supported FETP graduates have been instrumental to the national COVID-19 response. Previous collaborations between CDC and the MSHP to decentralize diagnosis of epidemic disease pathogens and strengthen community-based surveillance were critical to the response. Due to these efforts, SARS-CoV-2 testing is conducted at six regional laboratories and one teaching hospital laboratory. CDC staff at the Retro-CI laboratory provided direct SARS-CoV-2 testing support early in the pandemic. CDC continues to support all eleven regional laboratories in routine microbiology testing.

Additional activities include:

  • Strengthening laboratory and non-laboratory practices by training people in biosafety and biosecurity
  • Supporting infection prevention and control (IPC) assessments and trainings and supplies
  • Supporting partners with COVID-19 vaccination scale-up (via Global VAX) through vaccine sensitization and campaign activities, communication, trainings, technical collaboration, and surveillance for adverse events following immunization (AEFI)
  • Providing technical support to the National Immunization Technical Advisory Group
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CDC worked with partners to use the ECHO platform to train regional rapid response teams and reinforce the COVID-19 response in 15 health districts

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CDC trained 23 trainers in COVID-19 rapid antigen testing, who subsequently trained 60 response staff in four regions

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CDC supported COVID-19 contact tracing training for over 320 health facility and health district workers, and trained 450 community health workers in Abidjan, Sud-Comoé, and Gbêkê

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To strengthen IPC programs, CDC supported the national IPC task force, assessed 325 health facilities and points of entry, trained 877 staff, and provided IPC materials

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CDC assisted the National Coordination Committee with COVID-19 vaccination programs, communication efforts, supervisory vaccination site visits, and surveillance and management of AEFI

HIV and Tuberculosis (TB)

CDC is a key implementer of PEPFAR and works with the MSHP and HIV service providers to build sustainable, high-impact national programs. Achieving and maintaining HIV viral suppression is crucial ­to preventing HIV-related deaths, preventing transmission, and ultimately ending HIV worldwide. To accelerate progress towards HIV epidemic control in Côte d’Ivoire, CDC and partners:

  • Prioritize HIV testing efforts among population groups with disproportionately poor health outcomes or higher risk of infection
  • Increase linkage, continuity of treatment, and quality of HIV services
  • Strengthen program monitoring and disease surveillance
  • Enhance data availability, quality, and use for decision-making
  • Strengthen laboratory systems through training, decentralized services, external quality control programs, and a national viral load dashboard
  • Collaborate with faith-based and community-based organizations to provide educational presentations and messaging to increase HIV literacy and decrease HIV-related stigma and discrimination
  • Support clinics to identify, treat, and prevent TB among people living with HIV
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In 2021, CDC’s Retro-CI laboratory was the first site in West Africa— and one of 14 worldwide— that WHO designated as a pre-qualification site for HIV molecular diagnostics evaluation

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Despite supply chain challenges related to COVID-19, 86% of people with HIV who receive treatment at CDC-supported sites also received timely viral load testing. 91% of these patients demonstrated viral suppression in 2021

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With CDC support, Côte d’Ivoire transitioned more than 85% of people living with HIV to optimal antiretroviral treatment (ART) regimens

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More than 18,100 TB cases were diagnosed at CDC-supported sites in 2022

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More than 2,300 people diagnosed with TB in 2022 were also diagnosed with HIV. 96% of these patients received ART

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CDC’s experts supported the MSHP to increase availability of TB preventive therapy (TPT), resulting in a tenfold increase in the number of people with HIV who received TPT between 2020 and 2021

Malaria

Malaria is endemic in Côte d’Ivoire throughout the entire year, with peaks during the rainy season. CDC co-implements the U.S. President’s Malaria Initiative (PMI) alongside the U.S. Agency for International Development (USAID). Côte d’Ivoire received $24 million in PMI funding in fiscal year 2022. A PMI resident advisor supports the implementation of effective malaria control and prevention interventions, such as long-lasting insecticide-treated bed nets, indoor residual spray, quality assurance of diagnostics and case management, and prevention of malaria during pregnancy.

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CDC helped train over 2,100 clinical providers in malaria prevention and case management

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Through PMI, CDC and the National Malaria Control Program (NMCP) provided more than 2.8 million LLINs in 11 districts

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CDC’s collaboration with the NMCP to provide long-lasting insecticide-treated bed nets resulted in 96% coverage of Côte d’Ivoire’s population and 96% household coverage

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In 2021, more than 60,000 structures were sprayed during the indoor residual spray campaign that helped protect more than 200,000 people from malaria

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In 6 months (2020-2021), CDC’s support led to more than 2,200 pregnant women receiving antenatal consultations in 5 districts and distribution of over 1,700 doses of malaria prevention for pregnant women

Influenza

CDC works with Côte d’Ivoire to strengthen surveillance and laboratory capacities to prevent, detect, and respond to influenza threats. Since 2007, CDC’s influenza experts have partnered with the Institute National Hygiene Publique (INHP) and the Pasteur Institute of Côte d’Ivoire (IPCI) to fund and assist influenza surveillance, detection, and pandemic preparedness. This partnership led to recognition of the IPCI as a WHO National Influenza Center. Côte d’Ivoire contributes significantly to the WHO Global Influenza Surveillance and Response System, advancing the understanding of influenza seasonality and epidemiology in West Africa.

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CDC and partners support a national influenza surveillance network across 10 sentinel sites in CHU Treichville, FSU Attecoube, MACA, HG Yopougon Attie, CHU Angre, CHR Korhogo, HG Man, HG San-Pedro, CHU Bouake, and HG Agnibilekrou

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In 2021, the INHP received CDC’s 5-year non-research cooperative agreement for enhanced surveillance and laboratory capacity to routinely monitor influenza and other respiratory pathogens of pandemic potential or public health importance

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In 2022, Côte d’Ivoire established a system to estimate the burden and severity of influenza, update protocols, and increase epidemiological surveillance in hospitals and health centers

CDC Staff in Côte d’Ivoire
  • 10 U.S. Assignees
  • 62 Locally Employed
Côte d’Ivoire at a Glance
  • Population: > 28.2 million (mid-2022)
  • Per capita income: $5,760
  • Life expectancy: F 60 / M 57 years
  • Infant mortality rate: 57/1,000 live births

Sources: Population Reference Bureau, 2022

Côte d’Ivoire Top 10 Causes of Death
  1. Malaria
  2. Neonatal disorders
  3. Lower respiratory infections
  4. HIV/AIDS
  5. Ischemic heart disease
  6. Stroke
  7. Diarrheal diseases
  8. Tuberculosis
  9. Congenital birth defects
  10. Cirrhosis and other chronic liver diseases

Source: GBD Compare 2019, Côte d’Ivoire