A matter of time

Across the globe, the coronavirus pandemic is serving as a wake-up call to improve the coordination of epidemic prevention measures. Cooperation with the ECOWAS region shows how it can be done.

Brigitte Spitz

Peter Iko knows what really matters when it comes to epidemic control. The right people need the right information as rapidly as possible. Iko is Community Health Extension Worker and focal point for surveillance at Dei Dei Comprehensive Health Centre at Bwari Area Council in Abuja, the federal capital of Nigeria. He regularly visits villages in the area, and the people who live there know and trust him. They come to him to talk about their health problems and Peter Iko listens carefully to what they say. In particular, he looks out for any indication that people might have an infectious disease – and not just since the outbreak of the coronavirus pandemic. Although COVID-19 is currently dominating the headlines, West Africa is often rife with other serious epidemics such as Ebola or Lassa fever.

Surveillance officer Peter Iko (right) ©GIZ/Brooks Photography
Surveillance officer Peter Iko (right) ©GIZ/Brooks Photography

In the past, Peter Iko had to note down any suspected cases of an epidemic- prone disease meticulously on paper and forward the information to the relevant authorities via the health centre. ‘This is how precious time passed,’ he tells us. Now he uses a tablet computer. What symptoms does the patient have? Do they have a fever? Are there any particular risk factors? Do they need to be hospitalised? Have blood samples already been taken? Iko carefully works his way through a predefined list and enters all the personal and epidemiological information about the relevant patient into an app called SORMAS.

Improved health protection for more than 130 million people

Iko, a civil servant, has been using this special application software since 2018. The app marks a quantum leap in pandemic preparedness and the control of infectious diseases in the West African states. The digital management system SORMAS (Surveillance, Outbreak Response Management and Analysis System) has vastly improved the monitoring and control of epidemics and the task and process management for disease control mechanisms. The app was developed at the Helmholtz Centre for Infection Research (HZI) in collaboration with national and international partners in response to the Ebola outbreak in West Africa in 2014. GIZ subsequently helped turn it into open source software. In 2019, SORMAS achieved ‘digital public good’ status. Digital public goods are open source digital solutions that are considered to be particularly relevant to efforts to achieve the United Nation’s Sustainable Development Goals by 2030.

Gérard Krause, Head of the Department of Epidemiology at HZI (centre), played a leading role in developing the SORMAS app. ©
Gérard Krause, Head of the Department of Epidemiology at HZI (centre), played a leading role in developing the SORMAS app. ©

Currently, SORMAS is now being used successfully in 25 federal states in Nigeria and in 16 regions in Ghana to prevent and control more than 20 infectious diseases, covering a population of more than 130 million people.

App even works in remote villages

The system even works in remote areas without mobile data access. The data are synchronised as soon a network signal is available. If the data are uploaded using a smartphone and tablet computer app, everyone involved in epidemic preparedness and response – hospital staff, laboratory teams, epidemiologists – can see, validate and analyse the data, forge networks and coordinate epidemic control steps. The information about infectious diseases is fully digitised and can therefore be made available immediately to national and regional agencies and to the World Health Organization (WHO).

In Nigeria, surveillance officer Peter Iko sends his information to a server at the Nigeria Centre for Disease Control (NCDC), a Nigerian Federal Government Agency under the Federal Ministry of Health in Abuja. The server is maintained by a special SORMAS team, which also ensures compliance with data protection requirements.

Elsie Ilori, Head of Surveillance and Epidemiology at the Nigeria Centre for Disease Control (NCDC), presents data on disease outbreaks from the SORMAS dashboard. ©GIZ/Brooks Photography
Elsie Ilori, Head of Surveillance and Epidemiology at the Nigeria Centre for Disease Control (NCDC), presents data on disease outbreaks from the SORMAS dashboard. ©GIZ/Brooks Photography

EU promotes health initiatives in West Africa

The digital epidemic management tool is an example of how pandemic preparedness can be enhanced and infectious diseases can be controlled more effectively. SORMAS is part of a project co-financed by the European Union and implemented by GIZ. It is integrated into the Regional Programme Support to Pandemic Prevention in the Economic Community of West African States (ECOWAS) Region, financed by the German Government through the Federal Ministry for Economic Cooperation and Development (BMZ).

Epidemic control was already a key part of this initiative even before the onset of the coronavirus pandemic. As part of an EU Action, GIZ is supporting the work of the Regional Centre for Surveillance and Disease Control based in Abuja. This regional coordination body was set up in 2015 by ECOWAS members. Led by the West African Health Organization (WAHO), its mandate is to prepare this part of sub-Saharan Africa better for public health emergencies. Around 300 million people live in the 15 ECOWAS member states. The countries are very diverse, in terms of size for instance. Nigeria accounts for more than half of the community’s population and economic power.

‘COVID-19 has not changed what we do. On the contrary, it shows everyone involved just how relevant our collaboration is,’ stresses Programme Manager Sabine Ablefoni. ‘And we need to operate regionally, because the diseases that we are fighting don’t care about borders.’

GIZ Programme Manager Sabine Ablefoni ©GIZ/Brooks Photography
GIZ Programme Manager Sabine Ablefoni ©GIZ/Brooks Photography

Co-financed by BMZ and the EU, the programme cooperates closely with other international actors in the region and with bilateral development cooperation health programmes. All the measures are tailored to the One Health approach, which recognises how the health of humans, animals and the environment is interconnected.

Surveillance officer Peter Iko in Nigeria is particularly motivated in his work by the new digital tools. ‘I can see the results of a laboratory test quickly, which means I can help patients swiftly and hopefully prevent the spread of diseases,’ he explains enthusiastically, ‘because we have no time to lose.’

Contact: Sabine Ablefoni,

Published: August 2020