15 September 2021 -- Somalia is one of the few countries in WHO Eastern Mediterranean Region without a functioning surveillance system for seasonal influenza. The electronic-based Early Warning Alert and Response Network (EWARN) surveillance system used in Somalia enables health workers, as well as state and national surveillance teams, to conduct real-time surveillance and promptly respond to epidemic-prone diseases. However, the system provided limited information required for epidemiological surveillance and the country lacked the capacity to conduct virological surveillance for seasonal influenza and other common respiratory viruses.
In April 2019, the WHO RegionalOffice for the Eastern Mediterranean conducted a technical mission to Somalia and assessed the suitability of 3 sentinel sites for conducting surveillance for severe acute respiratory infection (SARI). The mission also visited a number of primary health care centres to assess the feasibility of conducting surveillance for influenza-like illness (ILI). Some of the major gaps identified included the limited capacity of health workers to conduct influenza surveillance and the lack of capacity of the laboratories to conduct molecular tests for influenza viruses.
During the COVID-19 pandemic, WHO helped the Government of Somalia establish 3 molecular laboratories with biosafety level 2, which are capable of testing COVID-19 using\ rt-PCR assay. Currently, under the European Union-funded project titled "*Emergency operational response to COVID 19 in Somalia to support the prevention of large-scale community spread through public health systems strengthening*", building on WHO's investment in enhancing country's capacity for detection of COVID-19, WHO is now supporting the Federal Government of Somalia and Federal Member States and expand the existing system of epidemiological and virological surveillance for COVID-19 to include sentinel-based surveillance system for severe acute respiratory infection and influenza-like-illness. In order to build the system for surveillance of seasonal influenza, leveraging on current system for COVID-19, WHO organized a series of trainings, whereby 60 frontline health workers (20 females and 40 males) from the 3 selected sentinel sites were trained on conducting epidemiological surveillance for seasonal influenza and reporting; four virologists from the public health laboratories of Somaliland and the National Public Health Reference Laboratory in Mogadishu were trained on the detection and diagnosis of seasonal influenza using molecular test. In addition, 5 data managers were trained to collect and report ILI/SARI epidemiological information. WHO also equipped the 3 public health laboratories across the country in Mogadishu, Hargeisa and Garowe with necessary equipment and provided laboratory supplies for molecular detection of seasonal influenza.
"Working alongside the Federal Government of Somalia, we have taken bold steps to ensure Somalia makes progress for the detection and diagnosis of seasonal influenza and contributes to the WHO's network of Global Influenza Surveillance and Response System (GISRS) whose main function is to monitor the circulation of novel influenza viruses as well as seasonal and zoonotic influenza viruses with epidemic and pandemic potentials," said Dr Mamunur Rahman Malik, WHO Representative to Somalia and Head of Mission. "The support of the European Union (EU) Delegation to Somalia in establishing this surveillance system for seasonal influenza as part of our ongoing COVID-19 response will build back better and prepare the country's readiness to face future pandemic from influenza and other respiratory viruses."
In the coming months, and with support from the EU, the WHO country office for Somalia plans to continue to support the Government to establish this sentinel-based surveillance system for seasonal influenza during the coming months of winter. WHO will also continue to support in the areas of epidemiological and virological surveillance for influenza and other epidemic- and pandemic-prone respiratory viruses and ensure the sharing of viral isolates with WHO collaborating centres across the world for vaccine strain selection.
The WHO country office for Somalia will continue to work with the Gvernment of Somalia to strengthen the health system in the country and provide essential health and nutrition services to the most vulnerable populations across the country with funding support from the EU Delegation to Somalia.
Note to editors
This important multi-year partnership stems from a Bilateral Technical Coordination Mechanism previously established between WHO Somalia and the EU Delegation to Somalia, which sought to strengthen joint operational response capacities for COVID-19 and other health emergencies. In addition to providing in-kind flight support to transport vital medical equipment, supplies and COVID-19 samples for testing during the flight lockdowns, the EU also provided WHO with US $5.8 million to support COVID-19 response and health systems strengthening initiatives, while an additional US$ 1.9 million was provided by the European Civil Protection and Humanitarian Aid Operations (ECHO) to WHO in January 2020, in support of WHO's COVID-19 emergency preparedness and response operations in Somalia.
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