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Dr Benjamin Djoudalbaye, Head, Division of Policy, Health Diplomacy and Communication in Africa Centres for Disease Control and Prevention (CDC) discusses the role of CDC during the pandemic and how previous infectious diseases鈥� outbreaks in the region led to the foundation of specialised agencies to deal with future epidemics. Moreover, he talks about an innovative communication project and its aim to counter disbelief and misinformation on the virus, combat stigmatisation and provide people with the right information to stay safe.

Africa Centres for Disease Control and

Prevention (CDC) was established back in 2017. Could you tell us a bit more about its mission and what part it has had in the COVID-19 pandemic?

Thank you for the opportunity offered to me to talk you today.  Africa CDC is a specialized technical institution of the Africa Union (AU) established to support public health initiatives of Member States and strengthen the capacity of their public health institutions to detect, prevent, control and respond quickly and effectively to disease threats. Africa CDC supports African Union Member States in providing coordinated and integrated solutions to the inadequacies in their public health infrastructure, human resource capacity, disease surveillance, laboratory diagnostics, and preparedness and response to health emergencies and disasters. As the lead AU agency for public health with a mandate to safeguard the health of the continent, Africa Centres for Disease Control and Prevention (Africa CDC) supports all Member States in their preparation for and response to the pandemic. Aware of the looming threat and the need for extraordinary preparation and response efforts, the African Union Commission and Africa CDC convened an emergency meeting for Ministers of Health of Member States on 22 February 2020 to discuss and endorse the Joint Continental COVID-19 Outbreak Strategy. This strategy is guiding the continental response to the COVID-19 pandemic.

What is the role of research in CDC鈥檚 work?

Africa CDC has an entire division dedicated to public health research. The overall goal of this division is to strengthen public health science and improved public health decision-making and practice to achieve positive health outcomes. The strategic objectives are as follows:

1. Strengthen public health research capacity within public institutions, in partnership with academic institutions in Member States. 
2. Promote collaboration and coordination among existing networks for conducting research on priority public health research issues. 
3. Re-characterize the known burden of 鈥渄isease鈥� and other health concerns from a continental and/or regional perspective (core epi, clinical descriptive). 
4. Assess the effectiveness of existing public health interventions on health conditions that have been prioritized by the health policy instruments of the African Union. 
5. Support research on surveillance methodologies: quality interventions and innovative technologies. 
6. Apply multi-sectoral/cross-cutting One Health strategies to the Africa CDC public health research agenda.

"Africa CDC has an entire division dedicated to public health research."

What are some of the key challenges for researchers currently on the region? What do they need help with?

Challenges are well known and they are not new. They include things like funding, human and financial resources, infrastructures. Each of these challenges needs to be addressed in a holistic manner. It will need time.

You have previously worked in the African Union Commission as Senior Health Officer dealing with various infectious diseases including malaria and tuberculosis. Can you tell us if that past experience has offered any learnings on how to deal with the current pandemic?

Of course, the past experience has offered learnings on how to deal with the current pandemic. We learned the lessons of the Ebola outbreak in West Africa. This outbreak fast tracked the establishment of Africa CDC. The African Union Heads of State and Government established the African Volunteers Health Corps (AVoHC) to be deployed during disease outbreaks and other health emergencies. The mission of AVoHC is to support Member States with surge capacity during events or other situations with public health consequences. Most the responders deployed to support COVID-19 response in Mali, Burkina Faso, Niger, Cameroon, Nigeria, DRC, Zambia etc. are from the AVoHC roster.

"...the past experience has offered learnings on how to deal with the current pandemic. We learned the lessons of the Ebola outbreak in West Africa. This outbreak fast tracked the establishment of Africa CDC."

One of the issues we have seen over the past few months (besides the actual pandemic!) is the spread of misinformation about the virus. What is the role of the CDC and the wider research community in ensuring science and facts are communicated and various inaccuracies and myths are tackled?

I will limit myself to what we are doing to address this challenge as Africa CDC. We have in place a system to monitor, aggregate, and respond to rumours, mis- and dis-information, and misconceptions about COVID-19, to protect the health of the public. The tools we are using have value beyond rumour tracking and management 鈥� they can also help to understand community perceptions (including when areas are inaccessible or hard-to-reach, as a result of social distancing measures, insecurity, or other factors). The outputs from these tools also help us to improve the design of risk communications products (e.g. to ensure that they are designed responsively and in locally appropriate ways).

The African continent has a very high linguistic diversity with thousands of indigenous African languages. This can be an additional challenge when trying to communicate information about the virus. To that end CDC is working on an innovative communication project on COVID-19 which aims to target remote areas across Africa to help counter disbelief and misinformation. Could you provide us with more of a background on the project, its implementation and its goals?

We are working in collaboration with GIZ (Deutsche Gesellschaft f眉r Internationale Zusammenarbeit) on innovative mass messaging for citizens on COVID-19. The goal is to provide vetted and culturally relevant information to citizens and caregivers to counter disbelief and misinformation, catalyse citizens鈥� actions, solidarity and combat stigmatisation. In addition, we provide real time information towards preventive and management measures to fight COVID-19. We leverage on existing relationships with key partners such us CCHub (Co-Creation Hub) to bring critical messages, which are vetted by Africa CDC to communities in their languages using different channels such as community radios and other media across Africa; using innovative and culturally sensitive communications through the support of data-cipation programme (citizens engagement and innovative data use for Africa鈥檚 development). In addition, the messages are sent in major African languages.

How have key stakeholders (researchers, subject experts, clinical experts, government, public and private sector, other relevant institutions) work together in a continental and global level during this crisis?

After the declaration by the World Health Organization (WHO) of the novel coronavirus (COVID-19) outbreak as a Public Health Emergency of International Concern (PHEIC), following the rapid increase in confirmed cases globally and in response to this, the Chairperson of the African Union Commission convened an Emergency meeting of AU Ministers of Health on 22 February 2020 in Addis Ababa, Ethiopia.  The ministerial meeting endorsed the Africa Joint Continental Strategy for COVID-19 aiming at preventing severe illness and death from COVID-19 infection in Member States and minimizing social disruption and economic consequences of COVID-19 pandemic and the African Task Force on Coronavirus (AFTCOR), a pan-African platform for the preparation and response to COVID-19 with the aim of reaching consensus on complex technical and political issues. AFTCOR is the Africa-wide platform for COVID-19 preparedness and response with the goal of achieving consensus on complex technical and policy issues. A steering committee guides the work of AFTCOR including coordinating and convening stakeholders鈥� meetings across the continent to align with AFTCOR priorities and oversee the Technical Working Groups (TWGs). The AFTCOR has seven TWGs: 1) Surveillance, including screening at points-of-entry; 2) Infection prevention and control in healthcare facilities; 3) Clinical management of persons with severe COVID-19 infection; 4) Laboratory diagnosis and subtyping; 5) Risk communications; 6) Supply chain and stockpiling of medical commodities and 7) Science, standards and regulations. The work we are doing is inclusive, all the key stakeholders you mentioned are represented in the Taskforce.

How do these type of situations and the research produced contribute to policy changes?

We have never been confronted with such a situation before. We are learning while responding and the lessons learned will definitely contribute to policy changes. 

What are the next steps? What does the future look like?

The next steps for us are multiple. We need first and foremost to stay ahead of the epidemic curve. By doing so, we will prevent new infections, prevent deaths and limit socio-economic harms. The future will not be the same if we have not learned the lessons. At Africa CDC we are promoting the concept of National Public Health Institutes (NPHIs). An organized, well-functioning NPHI helps countries perform essential public health functions and ensure accountability for public health resources.  Public health systems function best when there is a single focal point that various public and private sector entities recognize as leading or coordinating public health activity. When public health activities are fragmented due to civil responsibility spread across multiple government ministries or sectors, the results often include: duplicated efforts or wasted resources; lack of leadership and accountability; slower response times to public health emergencies; reduced impact of programs intended to help a country鈥檚 population.  Establishing a NPHI helps address these issues by consolidating public health functions at the national level, bringing together data and expertise in order to coordinate efforts across sectors. I hope that the COVID-19 pandemic will serve as a driver for more countries in Africa to follow that path.

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All our interviews reflect the views and opinions of the interviewees.

Dr. Djoudalbaye Benjamin, MD, MSc. MPH, Pg. Dipl. Infectious Diseases is Head of Policy
and Health Diplomacy at the Africa Centres for Disease Control and Prevention. He has been
appointed in May 2020 Executive Secretary of the African Union COVID-19 Response Fund.
Prior to that, he was for more than 8 years Senior Health Officer for HIV/AIDS, Tuberculosis,
Malaria and other Infectious Diseases at the African Union Commission. Dr. Djoudalbaye was the Head of Mission of the African Union Support to Ebola Outbreak in Democratic Republic of Congo from May 2017 to October 2018. He was also the Head of Mission Support for African Union Support to Ebola in West Africa (ASEOWA) in 2014-2015 and later Head of Mission for Liberia, Sierra Leone and Guinea. He has a strong professional experience in strategic planning, administration, management and evaluation of public health policies and programs, infectious diseases programmes and projects; capacity building and operational research in Africa. He has also a good knowledge of coordination mechanisms including multidisciplinary and multi-sectoral teams, partnership development, negotiation skills, advocacy and resource mobilization, multilateral and bilateral cooperation as well as public & private sector and civil society. He is specialized in Infectious Diseases (University Claude Bernard Lyon 1), HIV/AIDS and Sexual Reproduction Health (University Denis Diderot Paris 7) and Epidemiology & Biostatistics (University Claude Bernard Lyon 1). He also holds a Master Degree in Population Studies and Public Health.
Dr. Djoudalbaye is author and co-author of several scientific articles in peer-reviewed in
journals and has published a book in psychiatry.
The organizations he has worked for include International SOS, Ministry of Health of the
Republic of Chad and SOLTHIS in Guinea.