Ebola Virus Disease (EVD) - Regional Emergency Health Response Plan 2020-2022

Regional Plan
Last updated: 31 January 2020
$40,100,000
Funding required
4,500,000
People Targeted

IOM Vision

The current Ebola outbreak in the Democratic Republic of the Congo (DRC) has been declared a public health emergency of international concern (PHEIC) under the International Health Regulations (IHR, 2005), whereby a PHEIC 'represents an extraordinary event that poses a public health risk to other countries through international spread'. In the context of the IHR 2005 and Global Health Security Agenda (GHSA), IOM – the United Nations Migration Agency – is working to prevent, detect and respond to the ongoing 2018 Ebola Virus Disease (EVD) outbreak from a human mobility-centred perspective.

IOM’s Health, Border and Mobility Management (HBMM) framework aims to empower governments and communities to prevent, detect and respond to potential health threats along the mobility continuum (at points of origin, transit, destination and return). Therefore, in line with priorities outlined in the regional Strategic Response Plan 4 (SRP4), the HBMM, GHSA, IHR 2005 and national roadmaps and preparedness plans, IOM seeks to contribute to containing the epidemic by prioritising disease surveillance and prevention, by responding to current regional needs to enhance screening and active surveillance efforts and capacity, whilst also providing direct service provision, health screening and risk communication at points of entry and points of control (POE/POC) to save lives and halt the spread of the virus. IOM aligns its priorities with Sustainable Development Goal (SDG) 3d, namely strengthening the capacity of all countries, for early warning, risk reduction and management of national and global health risks. IOM facilitates this through enhancing the overall capacity of countries to prevent, coordinate, and manage infectious disease outbreaks, continually assessing and accounting for priorities within the humanitarian-development-peace nexus, fostering overall health system strengthening and contributing to achieving universal health care (UHC) through enhancing capacity at POCs/POEs in the DRC and Priority 1 border countries, whilst also planning for transition and recovery activities.


Objective
Save lives and respond to needs through humanitarian assistance and protection

$24,600,000
Funding required
2,300,000
People Targeted
People Targeted description

Direct beneficiaries will include Ministry of Health staff supported by IOM, travellers, migrants, IDPs and refugees provided with health screening, risk communication messages and hand washing services along the mobility continuum. Indirect beneficiaries will include the local communities surrounding the points of entry and control in the two affected provinces where IOM activities are implemented.   

Health support

In the DRC in 2020, IOM will ensure the targeted support of a variety of critical health interventions, in order to save lives and help contribute to halting the spread of the Ebola outbreak.

DRC:

  1. Provide direct support at POE through surveillance with health screenings, hand washing and hygiene promotion, risk communication and community engagement (RCCE), and staffing/supervision support.
  2. Refer/isolate suspected cases, conduct secondary screening and refer suspected cases to Ebola Transit Centers or health facilities.
  3. Conduct contact tracing leading to minimising the potential spread of EVD.
  4. In partnership with other agencies, conduct informed and targeted RCCE, in order to inform communities in a culturally sensitive manner about EVD.
  5. Deploy surge teams in order to respond rapidly to cases in new locations/changes in epidemic trends.
  6. Implement community events-based surveillance (CEBS) in key identified locations and with high-risk groups, so that cases are more easily found by trained community health workers.
  7. Conduct population mobility mapping (PMM) and flow monitoring in key mobility locations to better understand mobility risk factors associated with EVD at the community, national and regional levels (especially at priority locations).
  8. Analyse mobility data and EVD epidemiological reports to produce situation reports and maps, including regional-level analysis. This will lead to the identification of key intervention areas, alongside informed and targeted public health interventions at community, national and regional levels.
  9. Share critical epidemiological and mobility information widely to support inter-agency coordination, including the mapping, updating and sharing of information at local, national and regional levels, leading to a more informed response to limit, and eventually halt, the spread of EVD.

It is estimated that in 2020, USD 24.6m is required by the DRC for Health Support in order to respond to the ongoing epidemic. Ensuring sufficient resources are available for neighbouring countries to help mitigate the risks the virus crossing borders is also critical, and discussed in the Activity Area - Strengthen Preparedness and Reduce Disaster Risk.

Funding required
$24,600,000
Plan types

Objective
Strengthen preparedness and reduce disaster risk

$15,500,000
Funding required
4,500,000
People Targeted
People Targeted description

Complementing IOM's proposed critical actions to save lives and respond to needs through humanitarian assistance and protection, IOM realises the acute need to simultaneously strengthen preparedness and reduce disaster risk so target beneficiaries will be at reduced risk of contracting EVD, along with other infectious diseases, due to enhanced prevention, detection and response efforts and to simultaneously end this - and prevent future - epidemics. Direct beneficiaries will include Ministry of Health staff supported by IOM, travellers, migrants, IDPs and refugees provided with health screening, risk communication messages and hand washing services along the mobility continuum. Indirect beneficiaries will include the local communities surrounding the points of entry and control in the prioritized territories where IOM activities are implemented. 

Health components of preparedness and risk reduction

In light of the critical need for comprehensive preparedness and risk reduction from a health-mobility centred lens, IOM will implement the following activities in the years 2020-2023 to help contribute to saving lives, halting the spread, being better prepared and reducing the risk of future epidemics in the DRC and neighbouring Priority 1 countries.

Activities conducted will be adapted to cultural and epidemiological contexts on a needs-assessed and iterative basis.

DRC:

  1. Establish, and/or rehabilitate POEs and POCs based on epidemiological trends and population mobility patterns to improve the ability to detect and find EVD cases.
  2. Provide necessary equipment to POEs to support border health surveillance, including essential supplies such as infrared thermometers, personal protective equipment (such as gloves, masks, aprons and gumboots), infection prevention and control supplies (such as chlorine, soap, alcohol-based rub, sprayers), visibility items, data collection tools, and stationery. This also includes ICT equipment, alongside water, sanitation and hygiene (WASH) and other infrastructure.
  3. Refer/isolate suspected cases, conduct secondary screening and refer suspected cases to Ebola transit centres or health facilities.
  4. Supervise POEs, and train border, security and health personnel in the DRC on screening, health border and mobility management, surveillance, risk communication and community engagement (RCCE), record keeping, referrals and cross-border notification.
  5. Bolster staff capacity to detect and trace EVD cases due to the development of EVD-related tools and guidelines (including screening, surveillance, notification, infection prevention and control (IPC), case management, contract tracing, risk communication) to improve alert and case detection at POEs/POCs.
  6. Analyse mobility data and EVD epidemiological reports to produce situation reports and maps, including regional-level analysis leading to the identification of key intervention areas, alongside informed and targeted public health interventions at local, national and regional levels that can help halt the spread of EVD.
  7. Conduct population mobility mapping (PMM) exercises and flow monitoring to better understand population mobility in the context of public health preparedness.
  8. Share critical epidemiological and mobility information widely to support inter-agency coordination, including the mapping, updating and sharing of information at local, national and regional levels, leading to a more informed response to limit the spread of EVD.
  9. Map and update information related to preparedness (including staffing, infrastructures, referrals) at border locations through POE assessments.
  10. Provide psychosocial support training (and other relevant training) to frontline health workers and those working in Ebola preparedness.
  11. Support cross border coordination mechanisms between DRC and neighbouring countries to strengthen information management, surveillance and response capacity to EVD and emerging health threats, such as through the coordination of district level and national level cross border meetings. 
  12. Undertake preparedness capacity assessments and conduct simulation exercises.

Burundi:

  1. Establish, and/or rehabilitate POEs and POCs based on epidemiological trends and population mobility patterns to improve their ability to detect and find EVD cases.
  2. Provide necessary equipment to POEs to support border health surveillance, including essential supplies such as infrared thermometers, personal protective equipment (such as gloves, masks, aprons and gumboots), infection prevention and control supplies (such as chlorine, soap, alcohol-based rub, and sprayers), visibility items, data collection tools, and stationery. This also includes ICT equipment, alongside water, sanitation and hygiene (WASH) and other infrastructure.
  3. Refer/isolate suspected cases, conduct secondary screening and refer suspected cases to Ebola transit centres or health facilities
  4. Supervise POEs, and train border, security and health personnel in the DRC on screening, health border and mobility management, surveillance, risk communication and community engagement (RCCE), record keeping, referrals and cross-border notification.
  5. Bolster staff capacity to detect and trace EVD cases due to the development of EVD-related tools and guidelines (including screening, surveillance, notification, infection prevention and control (IPC)), case management, contract tracing, risk communication to improve alertness and case detection at POEs/POCs.
  6. Analyse mobility data and EVD epidemiological reports to produce situation reports and maps, including regional-level analysis leading to the identification of key intervention areas, alongside informed and targeted public health interventions at local, national and regional levels that can help halt the spread of EVD.
  7. Conduct population mobility mapping (PMM) exercises and flow monitoring at the local level through participatory meetings in key border locations of the high priority districts that border the DRC and Rwanda to understand mobility pathways and volume in order to target and inform public health interventions at the national and regional levels.
  8. Share critical epidemiological and mobility information widely to support inter-agency coordination, including the mapping, updating and sharing of information at local, national and regional levels, leading to a more informed response to limit the spread of EVD.
  9. Map and update information related to preparedness (including staffing, infrastructures and referrals) at border locations through POE assessments.
  10. Provide psychosocial support training (and other relevant training) to frontline health workers and those working in Ebola preparedness.
  11. Support cross border coordination mechanisms between Burundi and neighbouring countries to strengthen information management, surveillance and response capacity to EVD and emerging health threats, such as through the coordination of district level and national level cross border meetings. 
  12. Undertake preparedness capacity assessments and conduct simulation exercises.

Rwanda:

  1. Conduct population mobility mapping (PMM) exercises and flow monitoring to better understand population mobility in key border locations of the Rusizi district with the DRC and Burundi in the context of public health preparedness.
  2. Ensure the daily supervision of PMM activities at border points. Four POE sites (two with the DRC and two with Burundi) reporting regularly on population mobility trends at the borders.
  3. Provide necessary equipment to POEs to support border health surveillance, including essential supplies such as infrared thermometers, personal protective equipment (such as gloves, masks, aprons and gumboots), infection prevention and control supplies (such as chlorine, soap, alcohol-based rub and sprayers), visibility items, data collection tools, and stationery. This also includes ICT equipment, alongside water, sanitation and hygiene (WASH) and other infrastructure.
  4. Maps and updated information related to preparedness (including staffing, infrastructures, referrals) at border locations through POE assessments
  5. Draft and share monthly reports on the population mobility of the Rusizi District at the border with the DRC and Burundi.
  6. Bolster capacity and train frontline staff on EVD screening activities at POEs and provide incentives where necessary.
  7. Conduct monitoring support missions with the Ministry of Health to assess the effectiveness of the screenings at the border in terms of procedures applied and human resources capacities.
  8. Support cross border coordination mechanisms between Rwanda and neighbouring countries to strengthen information management, surveillance and response capacity to EVD and emerging health threats, such as through the coordination of district level and national level cross border meetings. 
  9. Undertake preparedness capacity assessments and conduct simulation exercises.

Uganda:

  1. Provide direct support at POEs by supporting POE surveillance with health screenings, hand washing and hygiene promotion, and supervision support to enhance awareness of EVD.
  2. Provide necessary equipment to POEs to support border health surveillance, including essential supplies such as infrared thermometers, personal protective equipment (such as gloves, masks, aprons and gumboots), infection prevention and control supplies (such as chlorine, soap, alcohol-based rub and sprayers), visibility items, data collection tools, and stationery. This also includes ICT equipment, alongside water, sanitation and hygiene (WASH) and other infrastructure.
  3. Refer/isolate suspected cases, conduct secondary screening and refer suspected cases to Ebola transit centres or health facilities.
  4. Conduct population mobility mapping (PMM) and flow monitoring in priority locations to better understand mobility pathways and volume in order to target and inform public health interventions at the national and regional levels.
  5. Capacity building of health and non-health workers on conducting screening including border agencies on integrated border management.
  6. Training of health workers and screeners on EVD screening and POE toolkit content.
  7. Analyse mobility data and EVD epidemiological reports to produce situation reports and maps, including regional-level analysis leading to the identification of key intervention areas, alongside informed and targeted public health interventions at local, national and regional levels that can help halt the spread of EVD.
  8. Share critical epidemiological and mobility information widely to support inter-agency coordination, including the mapping, updating and sharing of information at local, national and regional levels, leading to a more informed response to limit the spread of EVD.
  9. Draft and share monthly reports on the population mobility in the high-risk districts bordering Uganda and the DRC.
  10. Support cross border coordination mechanisms between Uganda and neighbouring countries to strengthen information management, surveillance and response capacity to EVD and emerging health threats, such as through the coordination of district level and national level cross border meetings. 
  11. Undertake preparedness capacity assessments and conduct simulation exercises.

South Sudan:

  1. Establish and rehabilitate POEs and POCs based on epidemiological trends and population mobility patterns to improve the ability to detect suspected EVD cases.
  2. Provide necessary equipment to POEs to support border health surveillance, including essential supplies such as infrared thermometers, personal protective equipment (such as gloves, masks, aprons, and gumboots), infection prevention and control supplies (such as chlorine, soap, alcohol-based rub and sprayers), visibility items, data collection tools, and stationery. This also includes ICT equipment, alongside water, sanitation and hygiene (WASH) and other infrastructure.
  3. Supervise POEs, and train border, security and health personnel on health screening, health border and mobility management, surveillance, risk communication and community engagement, record keeping, referrals and cross-border notification.
  4. Bolster staff capacity to detect and trace EVD cases due to the development and validation of EVD-related standard operating procedures, tools and guidelines (such as screening, surveillance, infection prevention and control (IPC), case management, contract tracing, risk communication) to improve alertness and suspected case detection at POEs/POCs.
  5. Analyse mobility data and EVD epidemiological reports to produce situation reports and maps, including regional-level analysis leading to the identification of key intervention areas, alongside informed and targeted public health interventions at local, national and regional levels that can help halt the spread of EVD.
  6. Conduct population mobility mapping exercises (PMM) and flow monitoring to better understand population mobility in the context of public health preparedness.
  7. Share critical epidemiological and mobility information widely to support inter-agency coordination, including the mapping, updating and sharing of information at local, national and regional levels, leading to a more informed response to limit the spread of EVD.
  8. Support cross border coordination mechanisms between South Sudan and neighbouring countries to strengthen information management, surveillance and response capacity to EVD and emerging health threats, such as through the coordination of district level and national level cross border meetings. 
  9. Undertake preparedness capacity assessments and conduct simulation exercises.

Tanzania:

  1. Establish and enhance disease surveillance and prevention activities at POE:
    • Conduct health screening based on the case definition for event/community alerts as per standard operating procedures;
    • Deployment of 10 mobile teams to six high risks districts (Kigoma Ujiji MC, Kasulu DC, Buhigwe, Misenyi, Kyerwa and Tunduma districts) to assess population movement and mobility trends in areas that might be at high risk of transmission, initiate POE surveillance and prevention measures that assist in the recruitment and capacity building and training of local staff, establish and equip the POE, and supervise initiation of activities;
    • Establishment of 10 flow monitoring points to identify mobility-affected priority locations for priority public health interventions. The locations for points may include Kigoma Ujiji, Kagunga, Manyovu, Mabamba, Mwangongo, Rusumo, Kabanga, Murusagamba, Mtukula and Murongo.
  2. Strengthening the capacity of POE on EVD surveillance activities:
    • Train front line workers including port and border health official on surveillance, infection prevention and control (IPC) and risk communication and community engagement (RCCE) to strengthen the screening of travellers and response capacities at the points of entry;
    • Provide necessary equipment to POEs to support border health surveillance, including essential supplies such as infrared thermometers, personal protective equipment (such as gloves, masks, aprons and gumboots), infection prevention and control supplies (such as chlorine, soap, alcohol-based rub and sprayers), visibility items, data collection tools, and stationery. This also includes ICT equipment, alongside water, sanitation and hygiene (WASH) and other infrastructure;
    • Undertake preparedness capacity assessments focusing on POEs, health facilities in border health zones, and referral pathways;
    • Deploy mobile teams to 6 high risks districts (Kigoma Ujiji MC, Kasulu DC, Buhigwe, Misenyi, Kyerwa and Tunduma).
  3. Enhance preparedness and prevention activities in moderate and high-risk districts:
    • Orient community health workers, volunteers, community leaders, traditional healers and NGOs volunteers on surveillance, IPC and RCCE;
    • Train multi-sectoral local government authorities from high risks districts on disease preparedness and prevention;
    • Conduct risk communication, community engagement and social mobilisation activities on EVD preparedness and prevention;
    • Provision of EVD awareness-raising and WASH activities in Bukoba MC, Kigoma DC, Kasulu TC, Kibondo, Bukoba DC, Karagwe, Ngara and Uvinza districts;
    • Distribute relevant information, education and communication (IEC) materials.

In 2020, it is estimated that USD 15.5m is needed for health components of preparedness and risk reduction, and is composed of Burundi requiring USD 3.1m; Uganda USD 2.8m; Rwanda USD 2m; South Sudan USD 6m; and Tanzania USD 2m, alongside the required USD 24.6m required for health support for the DRC.

Funding required
$15,500,000
Plan types
Operational presence in

Democratic Republic of the Congo, South Sudan, Uganda, Rwanda, Burundi, United Republic of Tanzania

 

Figures are as of 31 December 2019. For more details of IOM's operational capacity in country, please see the IOM Capacity section.