The Rise of African National Public Health Institutes and Lessons Learned from Stakeholder Involvement in their Operationalization

Over the past two years, NPHIs in African countries have been under varying degrees of pressure to respond to COVID-19 and other health crises. Their role in health security management is becoming clearer. Some NPHIs have acquired a maturity and solid experience in the management of health crises that can help feed initiatives for the creation and operationalization of new NPHIs.

In this session, our panelists discussed how NPHIs can capitalize on the influence of national stakeholders (NGOs, ministries, public health associations, technical and financial partners) and the political will of the countries' leaders to succeed in their process of operationalization and maturation.

Panelists:

• Dr. Nathalie Mayet, Deputy Director, National Institute for Communicable Diseases, South Africa (see her slides)
• Prof. Roma Chilengi, Director, Zambia National Public Health Institute (see his slides)
• Haftom Taame, Principal Technical Officer, Africa Centres for Disease Control and Prevention (see his slides)

With the participation of:

• Dr. Alex Riolexus Ario, Director, Uganda National Public Health Institute, Chair, IANPHI African Network
• Prof. Hervé Hien, Director, Burkina Faso National Public Health Institute, Vice Chair, IANPHI African Network

Developing a Network Matrix to Expand Public Health Activities at a National and International Range

By Dr. Natalie Mayet, Deputy Director of the National Institute for Communicable Diseases of South Africa

Dr. Natalie Mayet addressed some of the lessons learned by the National Institute for Communicable Diseases (NICD) in terms of stakeholder engagement since the start of the COVID-19 pandemic and how to use those lessons to advance NPHIs on the continent. She shared the importance for African NPHIs to increase their external focus, move to a greater openness and focus on enabling interactions. “What we haven’t done very well,” she said, “is adopting interaction-centered metrics as public health institutions.” She compared NPHIs to bridge connectors, which are key and central to network communications, and added they needed to expand their sphere of influence and trusted relationships.

NICD successfully developed its genomic surveillance capability during the pandemic thanks to an extensive network of stakeholders across academia, communities of scientists, institutions, partners, donors, supra national institutes, and the private sector, which all brought something to the table. In order to expand its modeling capabilities with limited resources available, the institute also created a consortium, the South African COVID-19 Modelling Consortium. The work produced collectively brought experience, expertise and different perspectives to guide the country to produce models for COVID-19 and other diseases.

Dr. Mayet also touched on the importance of stakeholder communications tools. NICD is working to streamline its tools to generate analytics and make them more relevant to NICD’s audiences. The institute is also working with U.S. Centers for Disease Control and Prevention to establish a Public Health Bulletin and has been doing some social listening. “We need to start creating bi-directional flows of communications to enhance our stakeholder engagement,” said Dr. Mayet.  “That is a work in progress for many of us.”

Dr. Mayet concluded her presentation with the way forward for African NPHIs, which involves community dialogue with a focus on marginalized communities; leveraging “our collective network platforms (…) to create our common vision for the continent”; utilizing “the power of the collective (…) to harness and switch from ownership to curatorship”; building leadership capacity and encouraging diverse decision-making, and thinking globally but acting locally.

Operationalization of the Zambia National Public Health Institute with the Help of Stakeholders

By Dr. Roma Chilengi, Director of the Zambia Public Health Institute

Dr. Roma Chilengi spoke about the Zambia National Public Health Institute (ZNPHI)’s mandate, establishment, structure, milestones, lessons learned, and challenges. ZNPHI is a young NPHI, which was created in 2015 as a unit under the Department of Public Health and Research of the Ministry of Health with support from the U.S. Centers for Disease Control and Prevention and IANPHI. In 2017, Zambia started hosting the Africa CDC Regional Collaborating Centre for Southern Africa. In March 2022, the institute became an autonomous statutory body, governed by a board of directors and was given its own fiduciary fund functions and administrative obligations thanks to committed government funding. 

ZNPHI developed a strong network of stakeholders to support the development of a One Health approach. The institute engages predominantly with the livestock and Fisheries Ministry, the Environment Ministry, as well as the water and sanitation authorities. ZNPHI also hosts the secretariat for antimicrobial resistance activities in the country. Dr. Chilengi also mentioned resource mobilization as a critical activity. “Having a coordinated multi-sectoral approach is incredibly important, especially in times like these (…) when we are battling multiple disasters,” he said. Like other NPHIs in the region, ZNPHI works to mobilize resources to complement government funding, support its evolution toward the desired structures and systems and fulfill its health security mandate. ZNPHI negotiates with partners and donors using strategic plans to identify objectives that may require support and funding. 

Africa CDC Study: the Development of African National Public Health Institutes

By Haaftom T. Desta, Principal Technical Officer, Africa Centres for Disease Control and Prevention

Haftom Desta presented the findings of an online survey and a desktop assessment conductedby the Africa Centres for Disease Control and Prevention to map the development of NPHIs on the African continent. Sent to the 55 member states of the African Union, the survey was answered by 73% of them (40 member states). 

The findings were analyzed by Africa CDC, South Africa NICD and the IANPHI African Network in a research article entitled ‘Role of National Public Health Institutes for a Stronger Health System in Africa’, published in Fortune Journal of Health Science. 

The results of the studies highlighted the need for strong support and advocacy from existing NPHIs to encourage countries to develop similar structures. Africa CDC laid out eight key recommendations for NPHI development to improve public health systems on the African continent: 

1. Reviewing existing public health acts 
2. Ensuring political buy-in for NPHI development 
3. Identifying a national champion to drive the NPHI agenda 
4. Facilitating a peer-to-peer collaboration and staff exchange programs among NPHI in Africa and globally 
5. Setting up partners forum for NPHIs to map out NPHI actions and to harmonize efforts, avoid duplication of efforts and address critical gaps 
6. Engaging key stakeholders to create consensus and have a shared vision about the need for NPHIs 
7. Conducting continuous assessment and monitoring of NPHI development and share finding with relevant stakeholders.
8. Building NPHIs capacity for essential public health functions

Read the full findings: Role of National Public Health Institutes for a Stronger Health System in Africa, Fortune Journal of Health Science