Qualitative Evaluation of the Africa Malaria Task Force Symposia Effectiveness on African Partner Nations' Malaria Vector Management Capacity.

INTRODUCTION: Creating health alliances to build meaningful networks is critical to combating regional and global burdens of disease. These alliances work by uniting support for elimination efforts through cooperative engagement at the national and international levels. The reduction in malaria-related morbidity and mortality in Africa since 2001 is in part because of investments of international organizations and governments in national level malaria control and prevention-related programs and research. Investment in malaria reduction networks has contributed to this success by strengthening support to overcome the conditions that restrict or prevent change through local laboratory and epidemiological capacity building, thereby resulting in a decrease in burden of disease, increase in economic prosperity, and improvements in stability worldwide.The reformation of local military efforts to combat disease through incorporation into health security alliance networks by the provision of training and financial support is key to reinforcing this success at the national level. One such example of this is the U.S. Africa Command (USAFRICOM) established and partner nation (PN) led Africa Malaria Task Force (AMTF) program. USAFRICOM's mission for AMTF as a health security alliance was to develop sustainable African-led malaria diagnostic, vector surveillance and control capabilities, and to increase collaborations among AMTF military PNs by enabling national and international-level network capacity. MATERIALS AND METHODS: The overall objective of this evaluation of the AMTF program was to assess the implementation effectiveness of two AMTF supported symposia in improving the individual, organizational, and institutional diagnostic capacity of the Ghanaian, Ivorian, and Senegalese armed forces. The specific aims of this process evaluation were to identify procedural, contextual, and capacity-related factors that influence the effect of the symposia events on laboratory capabilities at the individual, organizational, and institutional levels through a two-phased formative evaluation approach utilizing qualitative methodologies. RESULTS AND CONCLUSIONS: Findings indicate that the AMTF program symposia positively encouraged malaria prevention and control efforts in all three countries included in the evaluation. Conclusions suggest that learning about the different types of malaria prevention and control efforts underway in other countries helped to contextualize the burden of malaria-related morbidity and mortality not only within their respective countries, but also across the African continent. Participation in the AMTF Symposia and Key Leader Events helped military leadership clarify the purpose and intention of their military objectives related to systemic malaria prevention and control while purposefully contributing to national land international-level malaria reduction capacity.

Enteric disease surveillance under the AFHSC-GEIS: current efforts, landscape analysis and vision forward.

The mission of the Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) is to support global public health and to counter infectious disease threats to the United States Armed Forces, including newly identified agents or those increasing in incidence. Enteric diseases are a growing threat to U.S. forces, which must be ready to deploy to austere environments where the risk of exposure to enteropathogens may be significant and where routine prevention efforts may be impractical. In this report, the authors review the recent activities of AFHSC-GEIS partner laboratories in regards to enteric disease surveillance, prevention and response. Each partner identified recent accomplishments, including support for regional networks. AFHSC/GEIS partners also completed a Strengths, Weaknesses, Opportunities and Threats (SWOT) survey as part of a landscape analysis of global enteric surveillance efforts. The current strengths of this network include excellent laboratory infrastructure, equipment and personnel that provide the opportunity for high-quality epidemiological studies and test platforms for point-of-care diagnostics. Weaknesses include inconsistent guidance and a splintered reporting system that hampers the comparison of data across regions or longitudinally. The newly chartered Enterics Surveillance Steering Committee (ESSC) is intended to provide clear mission guidance, a structured project review process, and central data management and analysis in support of rationally directed enteric disease surveillance efforts.