Continuity of essential health services in the context of COVID-19: the Eastern and Southern Africa Regional continuity of essential services sub-working group.

COVID-19 cases have continued to increase globally putting intense pressure on health systems, including in the East and Southern African (ESA) region, which bears the brunt of the continent´s cases, and where many health systems are already weak or overstretched. Evidence from the West Africa Ebola disease outbreak and early estimates for COVID-19 show that indirect impacts due to disruptions in access to essential health services can result in even higher mortality than that directly related to the outbreak. In March 2020, World Health Organisation (WHO) established a coordination mechanism to support ESA countries to enhance their response to COVID-19. Technical working groups were established, including a subgroup addressing continuity of essential health services. In this article, the development, activities and achievements of the subgroup over the past six months are reviewed and presented as a model for collaborative action for optimal service delivery in the context of COVID-19 and potentially, during other infectious disease outbreak responses.

Epidemiological progression of COVID-19 positive cases among transnational truck drivers in the East African Region.

COVID-19 triggered a range of border controls to curb the spread of the disease. Containment measures and restrictions were put in place to mitigate cross border transmission while maintaining the flow of essential goods and services in the East and Horn of Africa Region. The first cases of COVID-19 detection among truck drivers, triggered and strengthened cross-border collaboration for detecting and responding to COVID-19 pandemic. Infection was significantly common among truck drivers in the region. As at 13 January 2021, there were 3,457 reported cumulative cases among truck drivers in the EHoA region. About 2,879 (83.3%) of the cases were reported in Uganda, 374 (10.8%) cases reported in Kenya, 190 (5.5%) cases reported in Rwanda and 14 (0.4%) cases reported in South Sudan. The reduction in the number of documented new COVID-19 cases among truck drivers declined with collaborative, timely and cooperative border point screening, and so preventing COVID-19 spread in the region. With most East African countries setting the stage for reopening borders and air spaces, sustained comprehensive surveillance is crucial for maintaining the gains from the collaborative response.

Coordination and Management of COVID-19 in Africa through Health Operations and Technical Expertise Pillar: A Case Study from WHO AFRO One Year into Response.

Background: following the importation of the first Coronavirus disease 2019 (COVID-19) case into Africa on 14 February 2020 in Egypt, the World Health Organisation (WHO) regional office for Africa (AFRO) activated a three-level incident management support team (IMST), with technical pillars, to coordinate planning, implementing, supervision, and monitoring of the situation and progress of implementation as well as response to the pandemic in the region. At WHO AFRO, one of the pillars was the health operations and technical expertise (HOTE) pillar with five sub-pillars: case management, infection prevention and control, risk communication and community engagement, laboratory, and emergency medical team (EMT). This paper documents the learnings (both positive and negative for consideration of change) from the activities of the HOTE pillar and recommends future actions for improving its coordination for future emergencies, especially for multi-country outbreaks or pandemic emergency responses. Method: we conducted a document review of the HOTE pillar coordination meetings' minutes, reports, policy and strategy documents of the activities, and outcomes and feedback on updates on the HOTE pillar given at regular intervals to the Regional IMST. In addition, key informant interviews were conducted with 14 members of the HOTE sub pillar. Key Learnings: the pandemic response revealed that shared decision making, collaborative coordination, and planning have been significant in the COVID-19 response in Africa. The HOTE pillar's response structure contributed to attaining the IMST objectives in the African region and translated to timely support for the WHO AFRO and the member states. However, while the coordination mechanism appeared robust, some challenges included duplication of coordination efforts, communication, documentation, and information management. Recommendations: we recommend streamlining the flow of information to better understand the challenges that countries face. There is a need to define the role and responsibilities of sub-pillar team members and provide new team members with information briefs to guide them on where and how to access internal information and work under the pillar. A unified documentation system is important and could help to strengthen intra-pillar collaboration and communication. Various indicators should be developed to constantly monitor the HOTE team's deliverables, performance and its members.

Epidemiological progression of COVID-19 positive cases among transnational truck drivers in the East African Region

COVID-19 triggered a range of border controls to curb the spread of the disease. Containment measures and restrictions were put in place to mitigate cross border transmission while maintaining the flow of essential goods and services in the East and Horn of Africa Region. The first cases of COVID-19 detection among truck drivers, triggered and strengthened cross-border collaboration for detecting and responding to COVID-19 pandemic. Infection was significantly common among truck drivers in the region. As at 13 January 2021, there were 3,457 reported cumulative cases among truck drivers in the EHoA region. About 2,879 (83.3%) of the cases were reported in Uganda, 374 (10.8%) cases reported in Kenya, 190 (5.5%) cases reported in Rwanda and 14 (0.4%) cases reported in South Sudan. The reduction in the number of documented new COVID-19 cases among truck drivers declined with collaborative, timely and cooperative border point screening, and so preventing COVID-19 spread in the region. With most East African countries setting the stage for reopening borders and air spaces, sustained comprehensive surveillance is crucial for maintaining the gains from the collaborative response.