Objectives / scope A framework of Company's strategic and calculated preparedness and response to outbreaks with diminished adverse outcomes is presented. It is based on Nigeria Ebola Virus Disease (EVD) outbreak and its potential impact on country oil and gas operations. It describes the model of engaging stakeholders in all stages of an outbreak, culminating in lessons learned. Methods, procedures, process The EVD outbreak had potential for cataclysmic impact on workers, families and communities in Nigeria. The Company leveraged on a hybrid of outbreak management framework based on a pre-existing infectious disease outbreak management, pandemic planning and stakeholder engagement. A series of partnerships was established to provide an effective response towards protecting workers and their families; including working partnerships with Ebola Emergency Operations Center (EEOC), International SOS, the US Centers for Disease Control and Prevention, and Baylor College of Medicine. In-house capacity building was enhanced and included training Company healthcare staff in safeguarding their health and safety, while establishing ‘fever assessment’ centers. Results, observations, conclusions The strategic preparedness and response is described with the successful partnerships and enhanced alignment of key objectives, between in-country management, internal and external stakeholders. Communication and coordination with Company headquarters and external experts resulted in extensive training of health care providers and development of risk-based educational material for workers and dependents. In total about 1400 employees and healthcare providers were trained. The Company also achieved 100% worksite screening procedures which were implemented throughout the duration of outbreak resulting in no loss time recorded due to the outbreak. Provision of support to Nigerian government including efforts on contact tracing, led to the national recognition of Company for her community investments. Positive and proactive influence by partnering with the oil and gas industry and government to respond to the outbreak, ensuring robust business continuity planning and testing, showed the company's dedication to honoring commitment to our partners and stakeholders whilst protecting the workers and families. Paper benefits The experiences and lessons learned are important to share widely. They will assist others in the industry as preparations are made to attain readiness to deal with future public health challenges (not just EVD). An effective response requires the establishment of several partnerships across a wide range of stakeholders

The Company framework of workplace infectious disease control used for our global preparedness and response to the Ebola outbreak in West Africa is presented. Results and lessons learned are described from a global perspective; including their contribution in mitigating the Ebola outbreak risk for workers and disruption to Company's global operations (not just those in Ebola affected countries). Using the existing Company emergency support approach and integrating workplace infectious disease control aspects, headquarters interfaces were established for Ebola support to locations in West Africa and globally. Company management coordinated the support to sites while working with representatives from the medical, safety, security, law, human resources, and public and government affairs departments. The World Health Organization road map for Ebola was adapted for support to affiliates and for periodic reviews with operations in West Africa. Global scalable guidance measures included awareness, travel recommendations, site screening, case management and collaboration with industry, governments, international experts and health care providers. Early in 2014, Company disease surveillance system recognized the Ebola outbreak in West Africa. The management was engaged and a global coordinated response initiated. As a result, periodic communications across Company organizations and sites were organized. Emergency Support Groups (ESG) at headquarters and locations in West Africa were convened to monitor the outbreak, prevent workplace case occurrence and prepare for the response. The implementation of recommended measures was periodically reviewed, indicating effective execution and management of identified gaps. Targeted relocation of dependents and staff was arranged. The business continuity plans (BCP) for Company sites outside West Africa were revisited. Global guidance for travelers coming from or going to affected countries was issued. Guidelines for marine terminals receiving ships were developed. External interfaces with other International Oil Companies, expert community representatives such as the US Centers for Disease Control and local health authorities were instrumental in tailoring the Company approach for Ebola, including appropriate investments to help address community needs. Engagement of Company senior management was critical, as well as working with the business community, health experts and governments. Integrating an infectious disease control program within Company systems and processes was essential for a sustained and effective response. Considering Ebola and other infectious disease risks, using standardized measures built into Company organizations and levels is essential. ESGs and management engagement are necessary for adequate internal and external coordination. Leveraging existing tools such as BCP and disease outbreak management plans facilitates readiness and response. Workforce communications are fundamental for adequate workplace preparedness which is best verified through drills. External expert engagement is critical for technical knowledge and effective interface with country health systems.

OBJECTIVES/SCOPE The development of an immunochromatographic test for quick detection of malaria preventive medicines (doxycycline, proguanil and mefloquine) in urine is described. The test integration and observed results in ExxonMobil (EM) workplace malaria program are also presented for potential adoption by organizations seeking to improve adherence to malaria prevention in workers operating in endemic locations. METHODS PROCEDURES, PROCESS In 2007, EM established a unique partnership with the French Army Biomedical Institute and two biomedical engineering manufacturers to develop a rapid detection test (RDT). Using specific drug antibodies, they created the tests detecting doxycycline, proguanil and mefloquine in urine. After the initial proof of concept in the laboratory setting, the RDTs were tested in malaria endemic locations using urine samples from workers on malaria preventive medicines and laboratory methods were used to confirm the results. Following such validation process and commercial production, the tests were integrated into ExxonMobil’s malaria program with implementation completed in all eligible sites located in endemic areas by 2013. RESULTS, OBSERVATIONS, CONCLUSIONS The first tests successfully developed were for proguanil and mefloquine, followed two years later by doxycycline. The RDT validity was tested against the standard laboratory techniques which use High-Performance Liquid Chromatography (HPLC). Using urine samples collected in Chad and Equatorial Guinea, 100% of the tests detecting the drugs were confirmed by the laboratory method. Reading and reporting issues were identified for the validation of proguanil and mefloquine and subsequently addressed by an improved test user guide. For doxycycline EM phase, two different RDTs were compared on 99 urine samples and verified with HPLC: 86.9% tested positive by both RDT’s and 91.9% by HPLC. This could be attributed to the detection level set for the RDT. Only 8 samples were truly negative. A further comparison of the strips showed that one had well-marked responses and more stable immunoglobulins for the test component. As a result of the test development and implementation, 65% of the 32,496 malaria drug prevention compliance tests performed between 2013 and 2016 were conducted by RDTs. They helped further reduce noncompliance rates, keep the number of cases as low as 15 per year and save approximately 1.6 million dollars during that period. Additional benefits are related to having immediate results and opportunity for timely counseling on malaria prevention. The use of this newly developed rapid test detecting malaria prevention medicines in urine is an additional incentive for malaria chemoprophylaxis compliance. It is affordable, practical and commercially available to help reduce malaria risk and consequences to companies and their non-immune workers going to malaria-endemic locations.