The Robert Koch Institute (RKI): main building in Berlin. more
Germany’s Public Health institute RKI monitors the population’s health and wellbeing. more
The Robert Koch Institute is the German government's central institution for the identification, surveillance and prevention of infectious diseases in the Portfolio of the German Ministry of Health. more
Assessing and Building Capacities: Madagascar Public Health System
Duration: 2023 - 2025
Partner country: Madagascar
Partner institutions:
Involved RKI units: ZIG 2, ZIG 4, ZBS 2
Latest updates:
ZIG 2, ZIG 4, ZBS 2, ZIG RKI WHO HUB Office and Madagascan colleagues from Ministry of Health, INSPC, LA2M. Source: RKI
Poor laboratory infrastructures, unreliable health data management systems, lack of epidemiologically trained regional and district health workforce prevent Madagascar’s public health system from implementing its essential functions and make it unable to promptly react to public health emergencies and outbreaks of diseases with epidemic and pandemic potential. As a result of this, Madagascar has been repeatedly struck by epidemics of several infectious tropical diseases.
The Ministry of Health in Madagascar has officially requested the support of the Robert Koch Institute to develop a Centre for Disease Control (CDC) and to build up capacities for the diagnostics of infectious tropical diseases (ITD) of relevance to Madagascar, specifically plague, neglected tropical diseases (NTDs), and malaria.
Our goal is to build a roadmap for a stronger Malagasy public health system (MPHS) by assessing its current status and functions, and strengthening its diagnostic capacities.
Thereby, in our assessment, we will follow a lens that accounts for two global-level emerging and intertwined problems that require new adaptations of public health systems: pandemic preparedness and climate change. Using social science and epidemiological methods, we intend to identify the strengths and weakness of the MPHS to protect the lives of the Malagasy population. In parallel, we will assess the capacities for the detection and surveillance of major infectious tropical diseases in Madagascar though a cross cutting One Health approach. This One Health surveillance approach would serve as a blueprint for establishing a future early warning system in Madagascar for plague, and other diseases of epidemic or pandemic potential. Hence the overall goal of this project is to assess the MPHS and solidify its diagnostic capacity.
The ABCM project will serve to develop a roadmap to a stronger and more resilient MPHS based on the collected evidence and the achieved results.
Through the whole project, scientists from the RKI, the Institut National de Santé Publique et Communautaire (INSPC) and the Laboratoire d’Analyses Médicales Malagasy (LA2M) will work closely with politicians and decision makers in Madagascar to ensure their input in the development of Madagascar’s new public health system.
This project is a joint consortium between RKI, Bernhard Nocht Institute for Tropical Medicine Germany (BNITM) and the Malagasy public health system (MPHS). All activities will be co-designed and co-implemented between German and Malagasy partners.
In a first stance, we will conduct a desk review, and engage relevant Malagasy stakeholders and networks to investigate the documented and perceived needs around MPHS. During this phase, leads of different public health functions will rotate through RKI’s parallel functions in Berlin. This will foster the development of new ideas on how to assess, and how to improve the current MPHS.
Following this initial assessment, we will carry out an in-depth study to assess the infrastructure, as well as the functionality of each of the current public health core functions. This investigation will follow a pandemic preparedness, as well as a climate change lens. Additional emphasis will be on the public health surveillance system. In parallel, we will aim to build an integrative One Health approach for diagnosing and monitoring vector-borne diseases (VBD) in Madagascar. We will pursue the liaison of the clinical partners within the veterinary and entomological sectors, identify key sentinel sites for VBD, and tailor sensitive detection systems.
All along, we will strengthen the diagnostic capacities, and introduce new methodologies including but not limited to genomic sequencing, specifically around plague, malaria, as well as other relevant VBDs and integrate the results into existing surveillance systems. Through the project, and up until its end, we will synthesize all data and experiences gained to develop a roadmap for the future of a strengthened and resilient public health system. This process will take form of continued data analysis, and in-person workshops for policy making through consensus panels with relevant stakeholders.
Date: 29.01.2024
