Guinea’s response to syndemic hotspots

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Delphin Kolie, Remco Van De Pas, Thierno Oumar Fofana, Alexandre Delamou, Willem Van De Put, Wim Van Damme

Summary box

  • Guinea is an ecological locus for epidemic-prone diseases including meningitis, yellow fever and Lassa and Ebola haemorrhagic fevers.

  • In the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, substantial efforts were made to strengthen the national health system and improve future epidemic preparedness and response.

  • A syndemic hotspot is a place where social vulnerabilities, poor ecological, living and nutritional conditions, and re-emerging epidemics interact and cluster in marginalised populations.

  • Guinea, and other low-income countries, are increasingly confronted with syndemic hotspots that inevitably hinder economic development and exacerbate inequities in access and utilisation of health services.

  • Unlike during the 2014–2016 EVD outbreak response, several preconditions for epidemic preparedness and response were met in 2021 including the existence of governing bodies across levels of the health system, diagnostic capabilities and the promptness of international support.

  • However, the current response to the several ongoing epidemics in Guinea is rather limited with a disproportional attention given to Ebola and the COVID-19 pandemic.

  • Actors are facing challenges in the governance of epidemic response and in adapting essential public health functions (eg, alertness, surveillance, diagnostic subelements) to the epidemiological and social situation.

  • Ensuring an effective epidemic preparedness and response mechanism will require a comprehensive system approach including addressing social determinants of health and the neglect of the health system in Guinea.