Why Africa must treat disease surveillance as infrastructure
Improving disease surveillance is not simply a question of buying better software. A sophisticated digital platform cannot compensate for laboratories that lack capacity, health workers who are overstretched, weak reporting channels or data that cannot move between institutions.
Disease surveillance is often viewed as a technical aspect of public health, but it should be treated as essential infrastructure. A sophisticated digital platform cannot compensate for factors such as insufficient laboratory capacity, overstretched health workers, weak reporting channels, or incompatible data systems. Surveillance is the organized collection, analysis, and interpretation of health information to detect unusual patterns and enable appropriate action.
It connects various entities, including community reports, health facilities, laboratories, epidemiologists, data systems, and decision-makers. When these components work together, a cluster of unusual illnesses can be identified as a signal rather than a surprise. When they do not, authorities may only recognize a threat after transmission has already expanded.
The World Health Organization’s International Health Regulations mandate that countries maintain capacities to prevent, detect, assess, report, and respond to public health risks, making surveillance an integral part of health security. However, surveillance is frequently treated as a specialized program attached to a specific disease or temporarily strengthened during emergencies, rather than being discussed with the same importance as other infrastructure like roads, electricity, telecommunications, or water.
This approach is counterproductive, as a surveillance system cannot be effectively assembled after an outbreak has begun. Epidemiologists require training, laboratories need equipment and quality systems, data platforms must be functional, and community reporting channels must gain trust before they can be effectively utilized.
In Africa, progress has been made, but significant gaps remain, highlighting the necessity of viewing surveillance as long-term infrastructure. The Africa Centres for Disease Control and Prevention (Africa CDC) has made strides in this area, but challenges persist in addressing infrastructure, workforce development, governance, and technology.
It is not merely about acquiring superior software; a high-tech digital platform cannot overcome laboratory capacity deficiencies, health worker shortages, weak reporting channels, or data incompatibility issues.
Similarly, event-based surveillance, which relies on less conventional signals such as community reports, media monitoring, hotlines, or unusual events noticed by frontline workers, proves invaluable in detecting emerging threats early. Africa CDC’s initiatives in this realm emphasize the growing significance of these approaches across the continent. Their value lies in the ability to alert public health authorities to unusual situations before they escalate into large datasets.
Surveillance must extend beyond national borders, as pathogens do not respect immigration checkpoints. Public health intelligence should encompass information that transcends political boundaries. People travel across African nations for trade, employment, education, tourism, and in response to conflict and displacement. Consequently, a disease signal detected in one country may have implications for its neighbors. This further strengthens the argument for robust surveillance infrastructure.
When considering laboratories and genomic surveillance, the infrastructure argument becomes even more compelling. Identifying a suspected outbreak is one thing; determining the responsible pathogen, its evolution, and the relationships between cases necessitates laboratory and genomic capabilities. Africa has been bolstering this capacity, with the Africa CDC launching Agari, a continent-wide genomic data platform designed to facilitate information sharing and analysis for swifter public health decision-making.
Additionally, the Africa CDC’s Africa Pathogen Genomics Initiative aims to strengthen molecular diagnostics, genomic surveillance, and epidemiology across the continent. These investments are valuable not only during outbreaks but also serve as useful assets before emergencies and remain relevant afterward.
From a financial standpoint, early detection does not guarantee outbreak containment, but it does provide crucial time. That time can be employed for investigations, confirmation, communication, resource deployment, protection of health workers, and intervention before a manageable event escalates into a much larger emergency. Treating surveillance as infrastructure implies more than simply increasing a budget line. It entails constructing systems that are resilient and sustainable.
Written by urgent.news from Daily Maverick's reporting — not their text. Machine-written — it may contain errors, so check the original before relying on it.
