This document outlines the need for and challenges of implementing integrated disease surveillance across the Eastern Mediterranean region to overcome data fragmentation. It recommends establishing governance and coordination between countries, reducing inefficiencies through resource pooling, and operationalizing integrated disease surveillance through standardized procedures, training, and use of new technologies with timelines for implementation and support from WHO. Success stories from Egypt, UAE, and Pakistan demonstrate progress toward integration at the national level.

1. A regional strategy for integrated
disease surveillance
Overcoming data fragmentation in the Eastern Mediterranean
Agenda item 3(b)
Pierre Nabeth
Programme Area Manager
Health Emergency Information and Risk Assessment (HIM)
WHO Health Emergencies Programme
With input from:
Department of Communicable Diseases
Department of Science, Information and
Dissemination
Sixty-eighth session of the WHO Regional Committee for the Eastern Mediterranean
Cairo, Egypt, 11–14 October 2021

2. Importance of integrated disease surveillance
Acknowledged since 2000 in the Region
IHR Committee
IPPPR
IOAC
Confirmed by lessons learned from COVID-
19
Resolution EM/RC47/R.4
Prevention, diagnosis
and treatment of
infectious diseases
Epidemics
Highlighted in SDGs, triple billion goals and
Vision 2023
Multisectoral collaboration
IT IS URGENT TO MOVE FORWARD RAPIDLY

3. Coordinated approach to address different
objectives
Estimate burden
Describe trends
Evaluate interventions
Guide decisions for disease control/elimination/eradication
of disease surveillance and guide decision-making
Detect outbreaks
Identify risk factors
Generate hypotheses during outbreaks
Programmes Emergencies
Routine Early warning

4. Two levels of integration needed
Integration of disease
surveillance systems
Integration of surveillance within the
national health information system
Disease surveillance systems will require
these two levels of integration to work properly
Sources of information
Data transmission, management and analysis
Dissemination of information

5. A fragmented regional context with unequal
resources available
Communicable diseases with
well-funded programmes
Epidemic/pandemic-prone
diseases
Under-funded disease
programmes
Donors and lenders
(e.g. Global Fund, Gavi)
Dedicated WHO programme
(WHE) and resources made
available for emergencies
Insufficient resources
Large burden
Cause deaths, disabilities and
disruptions
Burden affecting the poor
Opportunities for pooling resources and systems for effective and efficient
integrated disease surveillance

6. Efforts towards integrated disease
surveillance have been made
20
19
18
15
9
8
7
5
0 5 10 15 20 25
Number of countries
Linkages between electronic systems
Emergency situations – early warning
Combined event- and indicator-based
surveillance
Integrated approaches
Electronic surveillance platform
Joint External Evaluation
National Action Plan for Health Security
Regular bulletins, sitreps, dashboards
EBS IBS
NAPHS

7. Success stories from the Region
Egypt: One system for all infectious diseases
United Arab Emirates (Dubai): Hasana Programme
Pakistan: Integration by programme & geographical area

8. Insufficient political commitment Governance
CHALLENGES SOLUTIONS
Uncoordinated vertical programmes Coordination, efficiency analyses
Variable standards and systems Technical convergence and harmonization
Lack of resources, inefficiencies Pooling of resources, elimination of duplications
Insufficient data analysis Capacity-building
Weak laboratory link Public health laboratory policy, linkage
Limited monitoring and evaluation Monitoring and evaluation framework, KPIs
Limited use of information technologies Consolidated digital platform

9. What is expected from Member States?
Establish governance and coordination
Reduce inefficiencies, raise revenue
Operationalize integrated disease surveillance
• Standard operating procedures (SOPs) &
technical guidance
• Training
• Linkages with laboratory
• Use of new technologies (IT)
Monitor progress for course corrections
Report progress made

10. Support you can expect from WHO
Regional Committee resolution and strategy
Health system approach and analysis
Guidelines, SOPs, training material
Technical support
Coordination of WHO programmes

11. Timeline
2021
Regional strategy on IDS
endorsed by Member States
2022
• IT platforms used for surveillance in Region mapped
• Specificities of functional IT platform for IDS defined
• Technical guidance and training material developed
2024
2023
Progress report to
Regional Committee
2025
Progress report to
Regional Committee
Implementation/strengthening of IDS in Member States with WHO support

12. Consultation with Member States on regional
strategy for integrated disease surveillance
19 Ministries of Health represented
21 WHO country offices