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Accelerating Decision-making to save Lives: How Mali’s Public Health Operations Center Is Responding to the Covid-19 Crisis

In a global pandemic, no country is safe until everyone is safe. Lockdowns, restricting border crossings, and general disruption to commerce and trade are only sustainable for short bursts of time, if at all. In many low-income countries, economies, communities, and households are structured in such a way that makes social distancing unfeasible or impossible altogether, especially in urban areas. So how can governments build solutions that keep their populations safe while accounting for their unique circumstances and needs? Public Health Emergency Operations Centers (PHEOCs) are a crucial starting point.

PHEOCs help to monitor disease outbreaks and provide governments with the critical data they need to respond quickly. When functioning well, PHEOCs detect and contain dangerous diseases by conducting routine syndromic surveillance and deploying rapid response teams to investigate and manage threats. A PHEOC enables the country to scale its response proportionately to the size of the threat and keep local outbreaks from becoming epidemics or worse still, pandemics. In short, PHEOCs are nerve centers that make sense of what is happening on the ground and connect to the people and institutions that can provide help.

When Covid-19 was first detected in Africa in February 2020, Mali’s PHEOC was in its infancy, and staff numbers and resources were lacking.

“At first I was the one and only individual in the center. I was fighting on all fronts. It was very difficult to be just one person running a whole PHEOC,” said Dr. Malick Kone, head of the Mali PHEOC. It is in this context that The Rockefeller Foundation provided a grant to Dalberg Advisors, a social impact advisory firm, to provide surge capacity and technical expertise for Mali’s PHEOC, and PHEOCs in five other West African countries—The Gambia, Guinea, Guinea-Bissau, Mauritania, and Senegal.

Working hand-in-hand with Dalberg, Dr. Kone and other PHEOC leaders were able to improve the country’s overall Covid-19 response and ensure that Mali’s public health emergency plans and procedures are on par with international standards.

“The current need for a PHEOC in Mali is clear: There is a pandemic at hand, and we must do all that we can to alleviate the challenges of the present day. And within this work, important pieces are being put into place that will help the country weather any future crises that might occur. We are helping develop institutions that will help public health systems evolve to better meet the needs of the people they serve,” said Madji Sock, a Dalberg Partner based in the firm’s Senegal office.

With the collaboration, Mali’s PHEOC became optimized for disease surveillance and control, and stronger links were established to the country’s National Public Health Institution, which functions as the long-term center for infection tracking, control, and prevention.

“We know that a contagious disease threat anywhere poses a threat everywhere,” said Dr. Nana Twum-Danso, Managing Director for Health at The Rockefeller Foundation. “The expected outcome of this collaboration is not only enabling these West African governments to strengthen their systems for identifying and responding to disease outbreaks locally, including Covid, and thereby protecting their populations, but it is also making a substantial contribution to global health security.”

Today, the Mali PHEOC’s activities have picked up momentum, and the center is delivering on its role as part of the country’s public health emergency management system by coordinating the key country partners involved in the Covid-19 response. It is also the main public institution capable today of training and deploying rapid response teams to investigate and manage Covid-19 cases. The Mali PHEOC has developed to a point where it can now build out its national scope to scale its efforts across the country and plan for the decentralization of the PHEOC on regional and district levels—positioning it to be ready to respond to any crisis, at any time, across multiple localities.

Mali’s PHEOC staff also feel well-positioned to take forward the work in a way that works for Mali in the long term: “The autonomy of the PHEOC in its technical and operational organization is a key factor of success,” said Dr. Kone. “Through this dialogue with the consultants and the other heads of PHEOCs, we realized what we can achieve.”

With this mindset in place across the Mali PHEOC team, the center is now playing a key role in building the country’s Covid-19 response capacity at central and district levels, and planning for the next phase of work is at hand. Early alert systems, a more effective surveillance at terresterial entry points, and two-way communication with communities will contribute to building a stronger backbone for effective preparation and response to any public health emergency in Mali.

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