Message from the Country Director
Commemorating 15 years of CDC in Rwanda
What does CDC do in Rwanda?
Muraho! And a very warm welcome to both our new and longtime readers of Kabeho!
This year the U. S. Centers for Disease Control and Prevention (CDC) commemorates 15 years of working in Rwanda in partnership with its Ministry of Health (MOH). This is an important milestone. It demonstrates the U. S. government’s (USG’s) commitment to supporting the government and people of Rwanda to meet their public health goals. Since the majority of CDC’s work is done behind the scenes, I’m often asked, “Just what does CDC do in Rwanda?” Let me explain.
CDC is the primary USG health agency working to contain, control, and eliminate public health threats globally, 24 hours a day, 7 days a week. CDC currently works in more than 60 countries, including Rwanda, on more than 400 different health threats worldwide, building the capacity of countries to detect and respond to public health emergencies and epidemics.
CDC has been working with the MOH in Rwanda since 2002 on their HIV, TB, malaria, and influenza efforts. Much of CDC’s support for HIV/AIDS initiatives in Rwanda is through the President’s Emergency Plan for AIDS Relief (PEPFAR)External. PEPFAR is a major public health success story; it works around the world to help prevent, treat, and control HIV/AIDS. CDC is supporting the implementation of over 90% of PEPFAR’s programs in Rwanda. The PEPFAR program in Rwanda is carried out through strong interagency collaboration between U.S. Agency for International Development, CDC, and the U.S. Department of Defense.
CDC, through PEPFAR, has directly supported getting over 93,000 people on antiretroviral treatment in Rwanda, with 98% of pregnant women screened for HIV, reducing transmission of the virus to newborns below 2%. Through PEPFAR/CDC support, Rwanda has already achieved the UNAIDS 2020 goals of 90-90-90 at a national level, with 90% of HIV positive people already diagnosed, and 81% of those diagnosed on antiretroviral treatment.
In spite of this success, there is still critical work to do to help Rwanda sustain its successes and continue its efforts to achieve an AIDS-free generation (a time when no Rwandan child will be born with HIV). As we have seen with our efforts to eradicate polio globally, the ‘last mile’ is often the hardest.
Since 2005, CDC has responded to more than 1,900 outbreaks and discovered 12 novel dangerous pathogens. CDC actively monitors 30-40 public health threats daily. This includes responses to diseases such as HIV, TB, malaria, Ebola, SARS, polio, and Zika with programs that train frontline healthcare providers and build sustainable public health capacity, including immunization, laboratory, surveillance, health information, and emergency response systems. While CDC collaborates closely with other USG agencies on global health, CDC has unique strengths. CDC has an intrinsic connection between domestic and global health programs; deep subject matter technical expertise; scientific expertise translating research into policy; and direct partnership with MOHs. CDC also ensures the countries we work develop the infrastructure and capacity they need to respond to their own disease outbreaks before they become global threats.
To help stop diseases where they start, CDC monitors already existing and emerging infectious diseases threats (infectious diseases are diseases that are easily spread from one person to another). Avian influenza is a major public health threat and one of the most important infectious disease CDC is working with other governments to track. Each year influenza causes thousands of deaths in the U.S. and around the world. Influenza has the potential to kill tens of thousands of people, in America and around the world, in a relatively short time. A very dangerous new strain of highly pathogenic avian influenza, known as H7N9, was discovered in 2013 in China. H7N9 poses a serious threat to the public and can cause the next pandemic. CDC, in partnership with governments around the world, is closely tracking H7N9 influenza. Here in Rwanda, CDC has partnered with the MOH to establish six influenza sentinel surveillance sites at two referral and four district hospitals. CDC is also supporting efforts to continuously improve the capacity of the National Reference Laboratory (NRL) to test for influenza with well-equipped laboratories, well-trained personnel, and CDC specific laboratory reagents. This has resulted in a better early outbreak detection system, demonstrated when the pandemic influenza, also known as swine influenza, occurred in Rwanda in October 2009.
Another important area of CDC’s work is building the capacity in countries in which we work to be able to prevent, detect, and respond to infectious and chronic diseases that threaten public health (chronic diseases are diseases that last more than three months and for which there is no cure). In Rwanda, CDC is working with the MOH and the University of Rwanda’s School of Public Health to establish a Field Epidemiology Training Program (FETP) or “Disease Detectives” training program, as these programs are sometimes called. Nearly 60 trainees have enrolled in the two-year, masters-degree program, and over 400 mid-level health professionals have been trained through short courses, usually 2 weeks long. The FETP has been vital in improving the capacity of health professionals in Rwanda to detect, respond, and control potential disease outbreaks. With trained health professionals, healthcare facilities are better prepared to detect and respond to disease outbreaks like cholera, typhoid fever, measles, meningitis, and other public health emergencies. Many graduates of the advanced FETP course serve as national outbreak rapid response team members, while graduates of the short courses serve as district outbreak rapid response team members.
As CDC Rwanda commemorates 15 years of partnership with the MOH in Rwanda, we look back with great satisfaction at what we have been able to achieve together. More importantly, we look forward to future accomplishments as a result of our continued partnership with the MOH, other health and development partners, and the people of Rwanda, as we work ‘Toward a Safer, Healthier Rwanda.’
I invite you to read through the rest of this e-newsletter and find out more of what CDC is doing in Rwanda. Hear from Sherene Cora, our new Deputy Country Director, as she relates her first impressions of Rwanda. Read her maiden message to staff and partners. Welcome Dr. Emily Piercefield along with Elysee Tuyishime and Marie Umwangange, who all recently joined our team. Thanks and best wishes to Drs. Antoine Gasasira, Lisa A. Mills, and Winifred King, along with Lindsay Little, Esperance Mukantwali and Josiane Uwineza who have recently left us. Read our Staff Updates to get up to speed on our most recent staff arrivals and departures. Familiarize yourself with the scientific articles CDC and its partners published in 2017. Read our Success Stories about our achievements.
Happy 15th Anniversary.
About the author: Dr. Gene MacDonald is the Country Director, CDC Rwanda. Follow us on Twitter @CDCRwanda.