Surveillance

Author: Mr. Peter Carrasco, IAIM Secretariat Director

Purpose and Overview 

Purpose

The authors purposely choose the title for the section of the Toolkit to bring to the attention immunization manager the breadth and scope of what may be entailed when he/she has to manage the structures, processes, resources, activities and the information system for ensuring that the vaccine preventable disease surveillance program (VPDP) performs efficiently and effectively to assure the objectives of a country’s VPDP are achieved. It is beyond the scope of this Toolkit to discuss other management issues such as ‘integrated disease surveillance system’.  Rather this section will focus the management areas above.

Objective

Each government has decided, more or less, what is the class I or priority VPDP diseases that will receive the maximum amount of resources, time, and political and community attention in order to prevent a public health crisis and unnecessary morbidity and morbidity from happening due to a VPD. Under the International Health Organization Regulations (WHO) all countries must inform WHO of the occurrence of following VPD diseases: 1) notification of human influenza caused by a new subtype, 2) smallpox and 3) a case of poliomyelitis due to a wild poliovirus. Nevertheless, there are VPDs’ that are class II and do require both resources, time, and political and community attention but at less intense levels. Adding complexity to the above are global and/or regional eradication and or elimination disease goals, such as measles elimination goals in five of the six WHO regions.

Therefore, public health authorities at, national/state/regional/department must ensure that their VPD surveillance can perform the required level of excellence 24/7 to collect the data and information and specimens to evaluate the disease surveillance system performance for documenting the effectiveness of each vaccine used and to measure the impact of VPD diseases on the community as well as to provide evidence that VPDP is progressing and/or achieving the elimination/eradication for the targeted diseases in question. An excellent performing VPDP will also serve as the backbone for new and emerging diseases such as Ebola, Chikungunya and diseases for which vaccines maybe produced in the near future.

In many countries many VPDP activities are managed by different vertical diseases control programs. In other cases the surveillance function is far removed from the control efforts: data are collected by central statistics offices on a large number of health events, many of which do not represent priorities for the country. In some situations, surveillance for particular health events has been developed by academic or research institutes which have very specific information needs.[1]

This Toolkit will cover the following management topics:

  • Operations and processes related to sentinel and community based surveillance activities
  • Evaluating a countries VPDP for documenting its’ performance against programmatic objectives, and disease control and or elimination/eradication goals
  • Evaluating the performance of the VPDP information system against the established national metrics, including the capabilities of the hardware and the digital network to provide data, information and reports, as required both up and down the system
  • Managing the laboratory networks and assuring that they count with required resources to support surveillance operations
  • Human resources and training
  • Communication with the community
  • Preparing a plan and a budget

 



[1] WHO/CDS/CSR/ISR/99.2,  WHO Recommended Surveillance Standards; Second edition;  WHO and UNAIDS,

 

 

Common Management Taxonomy: