UCSF, through its Prevention Response for Outbreaks, Threats, and Emergencies through Capacitation and Training (PROTECT) project, is a lead technical assistance partner for event-based surveillance (EBS) in South America (SAM) and the Middle East and North Africa (MENA). UCSF has supported guideline development, training, monitoring and evaluation data system development and data visualization in six countries.More than 40% of large-scale emerging disease events have been linked to a lack of investment in public health infrastructure over the last three decades. PROTECT works to enhance health equity through improving integrated disease surveillance and response (IDSR) and Pan Respiratory Disease Surveillance (PRDS) efforts to coordinate local reporting and information sharing to reduce global health security risks and improve public health infrastructure.

EBS Trainings

UCSF has developed an EBS training program that features virtual and in-person activities. For the virtual modality, a mobile-friendly learning management system (LMS) encompassing six modules has been deployed in Spanish, English and Arabic. Participation included over 30 learners in Oman, 250 learners in Paraguay, and over 145 learners in Ecuador. The course covers an overview of EBS, signal detection and reporting, triage, verification, risk assessment prioritization and response. The training program includes interactive online learning activities for learners and typically requires approximately one hour to complete each module. The course has enabled Paraguay, Ecuador and Oman to train participants from community health workers to national level public health authorities to launch EBS.

EBS in South America

In the South America region, UCSF has provided comprehensive technical support for pilot EBS activities targeting respiratory diseases in Paraguay and Ecuador, in collaboration with CDC, TEPHINET, and the Ministries of Health (MOH). The pilots aim to assess the feasibility and effectiveness of EBS for early detection and response to respiratory health risks, refining implementation before scaling up EBS in each country. UCSF contributions include the development of EBS technical guidelines and training materials, along with the introduction of a Training of Trainers (TOT) model to empower MOH facilitators to facilitate training cascades for health facility staff and community health workers. Through a combination of virtual and in-person approaches, the team conducted sensitization meetings and comprehensive EBS trainings. The EBS pilots launched in two departments in Paraguay in 2022 and in four provinces in Ecuador in 2023. Additionally, UCSF is leading monitoring and evaluation efforts for the pilots, and we are currently preparing for mid-term evaluation activities.

EBS in MENA

In MENA, UCSF has supported the development of EBS technical guidelines and Training of Trainers in Morocco and Oman, and data systems in Egypt and Jordan. The UCSF Informatics team has worked with the MOH in Egypt to design an EBS system which enables data flow from the Ministry of Health, Agriculture and Environment, and has advanced features for alerts that facilitate timely reporting, risk assessment and response. Likewise, in Jordan, UCSF has been providing technical assistance to the MOH to improve their data system to improve data quality, timeliness, and reporting and visualization capabilities. With these improved data systems, countries in MENA can rapidly notify and respond to potential health threats, as well as monitor and report on the implementation of EBS programs. UCSF is currently developing online learning modules for MOH officials in Data Science in Public Health Intelligence, to capacitate them in R Studio and PowerBI to analyze, visualize and report on EBS and other surveillance data.