Background

The COVID-19 pandemic had highlighted the need to focus on improving the health system ability to respond to the special requirements of cross-border preparedness and response and address the need of the migrants and cross border population. Building on the coordination role IOM (International Organization for Migration) played at the point of entry during COVID-19 and building on the consolidated partnership with EAC (East African Community) and the continuous support of GIZ(Gesellschaft fuer Internationale Zusammenarbeit, IOM, and EAC continue to support the MSs (Member States) capacity for preparedness and response to the pandemic and epidemics and other public health emergencies across the border and along migratory routes in compliance with the IHR (International Health Regulations) (2005). The meeting presented outcomes for the IOM-EAC-GZ joint 2020-2021 Regional Project “WASH and health promotion sensitization and awareness on COVID-19 and other communicable diseases in the EAC region,”

Aim

The meeting aimed to help identify and address the gaps in strengthening cross-border preparedness and response and promote unifying regional standards and policies in accordance with IHR while presenting the achievements of the WASH project. The workshop was a platform to encourage and disseminate the best practices, promote the co-creating of new ideas for dealing with common health concerns. EAC, IOM, and GIZ served as conveners, bringing together national authorities, experts, decision-makers, and key stockholders across the EAC region.

Objectives:

1. Understand the current situation on health and WASH (Water Sanitation & Hygiene) gaps and key public health threats relevant to cross border  
2. Discuss issues, challenges, gaps, and opportunities as well as operational modalities to strengthen cross border coordination mechanisms to better respond to WASH, infection prevention and control gap, and public health threats and events across EAC countries 
3. Discuss and agree on key actions points for a bilateral and multilateral mechanism to enhance cross-border collaboration; and 
4. Develop a road map as a strategic priority to enhance the regional cross border collaboration.    

Participants:

• EAC Partner States: current technical project Focal Points, EAC Partner States Country representative.  
• MoPH-IHR focal person. 
• IOM regional and Country offices  
• EAC Secretariat (Productive sectors and health)  
• US CDC 
• CDC (Centers for Disease Control) Africa: Eastern Africa CDC Director  
• WHO (World Health Organization): Regional emergencies Program, IHR focal person, Point of entry focal person at country level, sub regional and regional.
• GIZ Support to Pandemic Preparedness in the EAC Region Unit representation  

Common Gap identified by the Member State IHR Focal Points

1. Coordination: there’s a need to reinforce the multi-sectorial Coordination within the Country but also between Countries
2. Lack of effective collaboration between countries
3. Lack of timely Information sharing at all levels including between the countries
4. Lack of adequate funding/ investment on crossborder intervention  by the Government
5. Under infrastructure development at the Border space: Appropriate infrastructure, HR, technical expertise (Port health not always present at the PoEs)
6. Lack of surveillance at an unofficial ground crossing used by Border Population and animal mobility.
7. Needs of community-centred, adapted intervention.
8. Health Security-oriented approach rather than system strengthening approach.
9. Needs of regional harmonized approach: common SoPs, guidance, ToRs etc.

Key recommendations

Governance and Coordination : Support the Partner States to deliver on their global, continental, regional and bilateral commitment in the area of PoE IHR, preparedness and response and information sharing. Mapping and harmonize existing coordination mechanism and framework under an integrated approach (Multi sectorial and whole-of-society approach) including Re-activation and/or  repurpose the existing of multi-sectoral cross- border committee to enhance on all hazard surveillance, preparedness  and response. Joint resource mobilization prioritization  and financial ownership through national budgetary process. Identify governance platform to assure regional decision making is owned and operationalize at country and local level Enhance  coordination between the relevant UN agencies to leverage on their respective comparative advantage.

2. Infrastructure and capacity building:

Investing in multi sectorial human resource development and capacity building through development of regional training curricula on cross border surveillance that can be operationalized at country level at cross borders. Infrastructure improvement and adapt the pre-existing OSBP to be all hazard sensitive infrastructure: including Port health, holding room and isolation space, appropriate wash, and sanitation facilities in line with EAC standards Harmonization and revision to develop regional  SOP for surveillance, infrastructure, IPC, case management for PoE and create a regional standard setting for a minimum package of services

3. IHR core capacity at PoE

Provide technical assistance and resources to Expand CEBS at border communities (including digitalization) Integrate PoE / Border health into OSBP include reinforcement of the infrastructure, surveillance , referral system

4. Research and digitalization

Support the countries to localize their research and development capacity on public health preparedness Digitalization and expending of the existing EAC pass functionalities to allow timely sharing of the information and reporting Geographic priorities : Map the high-risk border areas in accordance with the national multi-hazard ( including DRC borders) and inclusion of Climate change and disaster prone-areas Map and assess of ground crossing including unofficial entry points, including the impact of the climate on the population movement trends. Response mechanisms: Reinforce Mobile services along the borders (clinic, lab, wash to serve moving populations); including the establishment of rapid response teams. Develop a multi-hazard rapid response plan including early warning systems, preparedness actions and a recovery/contingency plan. Build and reinforce the capacity of the members state to deliver on their PoE IHR core capacities. Regular SIMEX to test SoPs and policies in places.

Action points

From the meeting, it was agreed on the need to develop a regional EAC road map for Point of Entry priorities and interventions.

Key priority areas and the way forward 

Governance:

To identify the EAC governance platform assuring regional decision making is owned and implemented at country and local level- Agree on the consultative process to draft the project proposal and a timeline for draft zero of a regional programme Leverage the existing countries and regional intergovernmental agreement and support the Partner States to deliver on their commitment to IHR, MoU etc.

 

Additional areas to be considered

• ·Digitalization and expending of the existing EAC pass functionalities to allow timely sharing of the information and reporting. ·Climate change and disaster prone-areas

 

Common activities identified by Partners States

·Re-activation and/or repurpose the existing of multi-sectoral cross- border committee to enhance on all hazard surveillance, preparedness and response ·Harmonization and revision of SOP for surveillance, infrastructure, IPC, case management for PoE and create a regional standard setting for a minimum package of services ·Map and assess of ground crossing including unofficial entry points ·Provide technical assistance and resources to Expand CEBS at border communities ·Invest At community level to respond to sanitation, clean water, hygiene needs ·Continue Develop community engagement and response capacity adapted to PoE ·Integrate PoE / Border health into OSBP include reinforcement of the infrastructure, surveillance, referral system

• To identify new priorities areas to complete all PoE with a minimum package of interventions

Suggested Geographic priorities

Expand the current programme to the borders of the new members DRC To continue in the existing communities expanding interventions