Status of Ebola Preparedness based on WHO checklist. Dr. Islam Saeed, Director for Surveillance/DEWS in ANPHI-MoPH is part of Ebola Control Task Force for developing and implementation of Ebola Action Plan

1. Progress in Implementation of Ebola Preparedness Plan of Afghanistan
Ebola Control Center Ministry of Public Health Kabul Afghanistan

2. National Disaster Management Plan-Health Sector
Ebola Task Force chaired by Deputy Minister- Health Care Services Provision
Monitoring Questionnaire 2014 on progress of IHR- 2005 implementation is filled and gaps identified
Ebola Action Plan
Meetings almost weekly on Tuesdays with updates/reviews/progress on implementation of activities for EVD Preparedness
TWGs for developing SOPs, training plan, others

3. Four international Airports- Kabul, Balkh, Herat and Kandahar
Two major ground crossings
Torkham (Afghanistan- Pakistan border) and
Islam Qala (Afghanistan-Iran border)
No Airport Health Office in organogram
Ambulance services available
Temporary arrangement of two doctors in Kabul(Hamid Karzai) International Airport
Airport contingency plan for emergency available but contingency plan for PHEIC under development
Self-declaration of travelers and IEC at POEs only
Draft SOP for infected traveler

5. Presently DEWS Plus (moving towards IDSR) is functioning effectively in early detection of outbreaks (event-based surveillance, EBS) as well as by indicator- based surveillance (IBS)
All DEWS focal points from Health facilities (about 400 Sentinel Sites) have been trained on EVD, MERS-CoV and Influenza (epidemiology, signs and symptoms, mode of transmission, early detection and case management and surveillance) during Oct-Nov 2014.
Contact tracing protocol (adapted from WHO) has been provided to all the DEWS Surveillance officers
34 Provincial RRTs being trained by 17 Dec 2014

7. Kabul city has only one Infectious Diseases Hospital (with about 200 beds).
Facility is not well equipped and would pose a significant risk to health staff and relatives of patients.
Similar isolation wards in Regional Hospitals identified for refurbishing with donor support
Renovation with WHO support as a basic Bio- Containment unit under progress
Scope for crisis expansion of beds including complete hospital
Trained staff in IPC but refresher training and simulation drills needed
Indira Gandi Children Hospital allocate one section for isolation

8. •Training of Staff
•Risk Allowance/Motivation
•Simulation exercise
•Critical care equipment

9. Current IPC guidelines developed by MoPH and partner organizations being reviewed and updated to include key components
The training will be practical, hands-on training on IPC for emerging diseases
WHO is supporting MOPH to develop the training package for IPC
Adequate PPE
Burial of dead bodies not yet addressed
Training would be by TOT at Kabul and cascaded to provinces
Presently staff at Isolation hospital have received various trainings in Hospital Infection control including Jhpiego (John Hopkins)
However once the bio- containment facility is ready a simulation exercise is planned and gaps would be identified.
The staff would be then trained to overcome the gaps identified to minimize risk

10.  BSL I with II capability (almost 10 bio-safety
cabinets, also in Regional Labs)
 PCR and ELISA testing for Measles
(WHO certified) and Influenza (WHO
NIC)
 No reagents/primers available for EVD,
MERS CoV, H5N1
 If glove box arranged could inactivate
virus and test
 CVDRL(animal Lab) similar capability
but cannot test for H5N1
 Lab training required
 Lab technicians from provinces trained
in sample collection and transportation
 No shipping trained technician with
IATA license so difficult to Courier
Rapid Diagnostic
Kit (result in 15
minutes)

11. Risk Communication strategy for Pandemic Influenza preparedness was prepared by UNICEF, WHO and MoPH and has the expected strategies for any emerging disease
IEC material on MERS-CoV distributed to all Hajj pilgrims before departure
A communication package on Ebola is under development by UNICEF, WHO and MoPH and would be kept ready for roll out
Media sensitization workshops planned in Jan- Feb 2014

12. Thanks
director.surveillance@gmail.com
Phone: 0093(0)202301366, cell: 0093700290955