Background
Points of Entry (POEs) are at the frontline for prevention, detection and response to international spread of diseases. The objective of this assessment was to ascertain the current level of existing International Health Regulations (IHR) core capacities of designated airports, ports and ground crossings in Cameroon and identify critical gaps for capacity building for prevention, early warning and response to public health threats including COVID-19.
Methods
Data were collected from April to May 2020 in 5 designated POEs: Yaounde Nsimalen International Airport (YIA), Douala international Airport (DIA), Douala Autonomous Port (DAP), Garoua-Boulai ground crossing, Kye-Ossi ground crossing which were all selected for their high volume of passenger and goods traffic. The World Health Organization (WHO) assessment tool for core capacity requirements at designated airports, ports and ground crossings was used to collect data on three technical capacities: (i) communication and coordination, (ii) Capacities at all times and (iii) capacities to respond to Public Health Emergencies of International Concern (PHEIC).
Results
All the investigated POEs scored below 50% of capacities in place. YIA recorded the highest percentage for all groups of capacities, coordination and communication and for core capacity at all times with a percentage of 42%, 58% and 32% respectively. For core capacity to respond to PHEIC, all the POEs recorded below 50%. The DAP and all ground crossings lacked trained personnel for inspection of conveyances. Only DIA had a public health emergency plan. There is no isolation/quarantine and transport capacity at the POEs.
Conclusion
All POEs assessed did not meet IHR standards and need significant improvement to fulfill the IHR requirements. Unstructured communication channels between stakeholders make the implementation of IHR challenging. A coordination mechanism, with clear functions and structure, is necessary for well-coordinated response efforts to health emergencies at POEs. This assessment will serve as a baseline to inform planning and IHR implementation at designated POEs in Cameroon.
Objectives: The objective of this study was to present the JEE process in Cameroon’s as well as the country capacities to prevent, detect and respond to public health threats in accordance with the IHR (2005). Data for the 48 indicators within the 19 technical areas of the Joint External Evaluation (JEE) tool was examined. Results: Cameroon's overall median score was 2 (Min =1, Max=4) and 34/48 indicators (71%) had scores less than 2 on a 1 to 5 scale. The weakest technical areas in the “Prevent” category were antimicrobial resistance, biosafety and biosecurity, and National legislation, policy and financing. In the “Detect” category, the median score was 2. Technical areas with the lowest median scores were Reporting and National Laboratory System. Emergency Response Operations, Preparedness, Medical Countermeasures and Personnel Deployment had the lowest scores in the “Respond” category. Chemical Events and Points of Entry had the lowest score in “Other IHR-related hazards and Point of Entry” category. Recommendations from the JEE to address the gaps will be aligned in a costed National Action Plan for Health Security (NAPHS) and implemented using national resources, external donors and multilateral agencies. Key words: International Health Regulation, Joint External Evaluation, Health security, Cameroon.
The health security planning process transforms recommendations from various evaluations into priority actions to strengthen countries' capacity for emergency preparedness using the One Health approach. Although the World Health Organization (WHO) has developed many tools to facilitate the planning process of a National Action Plan for Health Security (NAPHS) across the various components, a series of multisectoral workshops is still needed to complete the process. In this article, we report on the process of developing Cameroon's NAPHS and propose an innovative solution to improve the process. The NAPHS development process was conducted from May to December 2018. The WHO NAPHS framework, adapted to the local context, guided the process. The WHO planning matrix was used to plan activities and the WHO NAPHS costing tool was used to facilitate the costing exercise. A total of 84 Joint External Evaluation recommendations were translated into activities included in Cameroon's NAPHS. Among these activities, the majority (56%) were of medium priority. The total cost of a 5-year NAPHS was US$87,668,356, with almost half (49%) of the budget allocated to activities in the ''Prevent'' category and more than a third (35%) allocated to the ''Detect'' category. The top 3 cost drivers were immunization (22%), the national laboratory system (21%), and antimicrobial resistance (16%). The NAPHS informed policymakers of planned activities and funding needs to fast-track the development of health security capacities. Running gaps in funding will be addressed during a resource mapping
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