Dr Ed Newman, Director of the UK Public Health Rapid Support Team (UK-PHRST) has recently been elected as co-deputy chair of the Global Outbreak Alert and Response Network (GOARN) Steering Committee. Dr Mohannad Al-Nsour, Eastern Mediterranean Public Health Network (EMPHNET) was appointed as Chair, with Ed, alongside Dr Daniela Garone, Médecins Sans Frontieres (MSF) elected as co-deputy chairs.

Under the new leadership, the Steering Committee and GOARN partners will continue advancing health security, strategic partnerships and communication, and strengthening the emergency public health workforce capacity.

In this interview, Ed explains more about GOARN, what his new role will entail and UK-PHRST’s involvement in the network.

What is GOARN and why is UK-PHRST involved?

GOARN is a network of over 310 global technical institutions and organisations that respond to acute public health events with the deployment of staff and resources to affected countries. The network delivers rapid and effective support to prevent and control infectious diseases outbreaks and public health emergencies when requested.

UK-PHRST is a GOARN network partner and regularly deploys to outbreaks of infectious disease in response to requests for assistance made by low- and middle-income countries. I’m really proud that UK-PHRST is one of GOARN’s most active deployment partners, meaning we’ve responded to  more requests for assistance from GOARN in the last year or two than most other partners in the network.

What does a typical deployment through GOARN look like?

Typically, GOARN will request technical assistance from its network on behalf of a partner who are supporting the national response to an infectious disease outbreak or other public health emergency, such as WHO or UNICEF. This will be a request for assistance in a particular public health discipline such as epidemiology, community engagement, infection prevention and control etc. or for an emergency coordination role such as incident manager, or health coordinator. Where it can, UK-PHRST puts forward offers of assistance to meet the needs of the request. If our offers are selected, we then deploy our experts to join the requesting GOARN partner’s in-country team. This often means being involved in technical advice and coordination at a national level for WHO or UNICEF, whilst working closely with the host country's government on their response. But deployments vary in nature and can involve working within a country office or incident management team in the capital city, to visiting local communities and health centres affected by the outbreak. Typically, we deploy between one to four experts, and deployments usually last for around six to 10 weeks.

What will your role as co-deputy chair of the GOARN Steering Committee involve?

I will form part of the Senior Leadership Team of GOARN alongside my co-deputy chair, and the chair. We will work with other members of the steering committee and the WHO’s GOARN Operational Support Team to ensure GOARN delivers its remit of providing public health response workforce and strengthening national response. We also represent the GOARN Steering Committee and its 300+ partners within the WHO’s Health Emergencies Programme and the wider evolving global health response architecture, as well as at key international meetings where we advocate for GOARN as a network and the important work all its partners contribute to in improving global health security.

Why is this important and what opportunities are there for UK-PHRST?

The Global Health response architecture is going through a period of change with the formation of initiatives such as the Global Health Emergency Corps bringing networks such as GOARN, the Emergency Medical Teams initiative, International Association of National Public Health Institutes (IANPHI), and others together. At the same time, the emphasis on improving readiness to respond to public health emergencies is quite rightly focusing on local and national capacities. During this time of change it is essential that GOARN has strong leadership to ensure the network does its part and maintains its international reputation as a leader in public health emergency response and coordination.

For the UK Public Health Rapid Support Team, this gives us an opportunity to build on our strong reputation in this area and increase our influence on the global stage, further securing our status as key partners in global health security.  

What are you most excited for as Co-Deputy Chair?

I am passionate about the power of the GOARN network having first deployed through GOARN in 2012 as a scientist for the UK’s Health Protection Agency, where I supported Uganda’s response to an outbreak of Marburg. I also completed several deployments during the West Africa Ebola outbreak.

I’m excited and privileged to be able to represent this great network and its amazing partners, ensuing it stays at the forefront of global public health emergency response. The level of collaboration and humility within the GOARN partners is inspirational and it is a great team to be part of – where you are constantly reminded of the difference to the lives of those affected by infectious disease outbreaks in some of the most challenging settings in the world.

View our quarterly map to see our activities between July and September 2024.

The UK-PHRST team and partners are currently delivering 10 research projects. In this update, read about a brand-new ethnographic toolkit for outbreak response produced as part of the online and offline COVID-19 rumours project. You can also read about the Rapid Response to Virus Outbreak (RaViG) project's stakeholder consultation workshop in Kenya.

Ongoing research projects

Community feedback triage toolkit available – Online and offline COVID-19 rumours in Sierra Leone and Tanzania

As part of the UK-PHRST’s research study in Sierra Leone and Tanzania to track rumours and concerns about COVID-19, the project team have now developed an ethnographic toolkit, which can be used to facilitate community workshops and focus group discussions. The toolkit can also be adapted for use in any outbreak.

The toolkit forms part of the final outputs from the research project which also included a series of dissemination workshops across Tanzania and Sierra Leone earlier in the year. The workshops brought together key stakeholders in each country to discuss the study’s findings, gather feedback and initiate conversations with policy makers, governments and communities to improve future community-led interventions in outbreak responses.

Download the toolkits on the UK-PHRST's Global Health Network site

Rapid virus genomics for outbreak investigation stakeholder workshop

In July 2024 the Rapid Response to Virus Outbreaks (RaViG) research team convened a stakeholder consultative workshop with the KEMRI-Welcome Trust Research Programme, Kenyan Ministry of Health, representatives from The East African Mobile Laboratory team, representatives of six Kenyan coastal counties and UK-PHRST to discuss the study’s protocol and familiarise them with the project as a whole.

Led by national stakeholders and the RaViG Team, workshop participants examined coastal counties existing mechanisms to rapidly respond to disease outbreaks and whether adding a portable sequencing system would be logistically feasible and add value during future viral outbreaks.
 

The UK-PHRST team has been busy delivering capacity strengthening activities, advancing partnerships and contributing to the global discourse around outbreak response. Highlights below:

Supporting Mental Health and Psychosocial Support preparedness to public health emergencies in Africa

The UK-PHRST’s Mental Health and Psychosocial Support (MHPSS) team has been working with the African Public Mental Health Consortium to strengthen public mental health in Africa and deepen the integration of MHPSS into increasingly frequent public health emergencies across the continent.

As part of this work, in collaboration with Africa CDC, the UK-PHRST MHPSS team organised a regional stakeholder workshop in Namibia in September which was attended by emergency preparedness and response (EPR) and MHPSS focal persons representing nine southern African countries. Partners from the WHO, UNICEF and regional NGOs also participated.

The workshop aimed to help the countries develop a comprehensive roadmap of how MHPSS integration would happen in the short, medium and long-term to contribute to the overall goal of strengthening mental health systems for emergency response in the southern Africa region. There was a particular focus on mpox preparedness and response due to the current epidemic.

To make action in this area a reality, the next phase of this work will be to support the countries who have committed to integration of MHPSS into these plans, so that we are able to attend to the comprehensive needs of populations during emergencies. 

Technical case study: Conducting cross-border Risk Communication and Community Engagement scenario-based training

The UK-PHRST is pleased to share a technical case study describing the successful collaborative delivery of the first-of-its-kind cross-border RCCE training to the Ministry of Health, Red Cross/Crescent National Society, UNICEF and WHO staff from seven East African countries - Kenya, Somalia, Ethiopia, South Sudan, Uganda, Rwanda, and Tanzania.

The case study outlines how the technical partners jointly convened public health focal points, including Surveillance, Case Management, Infection Prevention and Control (IPC), RCCE and Points of Entry, from the seven member states in eastern Africa for a practical scenario-based training using a fictitious unknown viral haemorraghic fever outbreak.

The RCCE Collective hope that, by sharing learnings through the technical case study and other workshop outputs, the model could be used to help strengthen national and cross-border RCCE readiness across other global regions facing disease outbreaks.

We've previously shared the report which can be found on the Collective Service website, with further resources to be uploaded in due course.

Read the technical case study.

The UK-PHRST has deployed two of its experts to Kinshasa in the Democratic Republic of the Congo (DRC) to support Africa CDC in its response to the ongoing mpox epidemic.

The deployment is supported by the British Embassy in Kinshasa and will involve a UK-PHRST field epidemiologist and an Infection Prevention and Control specialist. Under the direction of the Africa Centres for Disease Control (CDC), the UK-PHRST experts will work in collaboration with other partners to provide a wide range of technical, strategic and tactical inputs to the joint World Health Organization (WHO)-Africa CDC continental incident management team.

Dr Ed Newman, UK-PHRST Director said:

“The UK Public Health Rapid Support team ensures that our expertise in tackling infectious disease outbreaks is rapidly available to support countries who are responding to public health emergencies.

“Our staff will provide specialist support to colleagues at Africa-CDC and the joint continental incident management team as they work to manage the ongoing mpox epidemic, as well as using this learning to further strengthen UK preparedness.”

Africa CDC Director General, H.E Dr. Jean Kaseya said:

"Africa is facing significant public health challenges with the mpox and Marburg virus outbreaks. The UK’s vital support—through both financial assistance and technical expertise—comes at a crucial moment.

This partnership will bolster our efforts to contain these outbreaks, enhance disease surveillance, and strengthen healthcare systems in the Democratic Republic of Congo, Rwanda, and beyond.

Together, we are not just responding to immediate threats, but building stronger, more resilient systems to safeguard the health of millions across the continent."

The deployment comes following the declaration of mpox as a Public Health Emergency of Continental Security by Africa CDC and a Public Health Emergency of International Concern by the World Health Organization (WHO). A recent report from the WHO estimated that there have been over 36,000 suspected cases of mpox in Africa since the beginning of 2024, resulting in almost 1,000 deaths.  

This deployment continues the UK-PHRST’s long-standing experience in supporting countries during disease outbreaks at the invitation of a host government or in response to requests made by multinational partners such as Africa CDC, the WHO or via the Global Outbreak Alert and Response Network (GOARN). For example, in recent years, UK-PHRST staff have been deployed to several countries across Africa – including the Democratic Republic of the Congo – to support a range of infectious disease outbreak responses, including Ebola, cholera and yellow fever outbreaks.

The UK-PHRST has also worked closely with Africa CDC over almost a decade to support the creation of its own public health response team – the Africa Volunteer Health Corps.

In addition to the deployment, the UK has announced a financial package of support up to £9million unlocked from the existing Official Development Assistance (ODA) budget, to bolster the national response to mpox in DRC, the epicentre of the mpox outbreak, and across the wider affected region. This includes additional funds to strengthen the UK's existing partnership with UNICEF in DRC. Funds will assist partners to strengthen surveillance systems, reinforce health services and work with communities to raise awareness of risks and personal protective measures, in line with Africa CDC and WHO’s Continental Preparedness and Response Plan.

Read the full announcement.

View our quarterly map to see our activities between April and June 2024.

The UK-PHRST team and partners are currently delivering 10 research projects. In this edition, read about the Community Leader Event Based Surveillance project's launch, training workshops and first mini-guides for health professionals. You can also read about the Marburg project's recent prize at London School of Hygiene & Tropical Medicine Centre for Epidemic Preparedness and Response Awards. 

Ongoing research projects

Project launch for Community Leader Event Based Surveillance study in Brazil and The Republic of Cabo Verde, Brasília

The Guardians of Health – Community Leaders research project, officially launched in Brasília and on-line in April 2024, is piloting an early warning system for infectious disease outbreaks in Brazil and Cabo Verde that is developed with and relies on the participation of community leaders.

The study is investigating whether a community-led event-based surveillance system is feasible and more effective at detecting outbreaks of infectious disease than conventional surveillance systems. It also aims to understand how sustainable this approach could be, and whether the involvement of community leaders in the design of the data reporting system from the beginning can help the system to be integrated into local and national public health surveillance in the longer-term.

The launch event included speakers from contributing partners and organisers, including:

• The Brazilian and Cabo Verdean Ministries of Health
• Melanie Hopkins, the British Deputy Head of Mission in Brazil
• José Pedro Máximo Chantre D’Oliveira, the Ambassador of The Republic of Cabo Verde in Brazil
• National Institute of Public Health of Cabo Verde
• Association of Field Epidemiology Professionals (ProEpi)
• Health Situation Room of the University of Brasília (SDS UnB),
• Pan American Health Organization (PAHO)
• Africa CDC
• UK Public Health Rapid Support Team (UK-PHRST)

Read the full story in Portuguese.

Watch the launch event recording.

Community Leader Event Based Surveillance: Study workshops in Cabo Verde

Since the launch event in April, the National Institute of Public Health (INSP) and the Brazilian Association of Field Epidemiology Professionals (ProEpi) held the first training session on the use of the electronic Public Health Emergency Management (ePHEM) software in Cabo Verde in June as part of the Guardians of Health: Community Leaders project.

The workshop was attended by key community health leaders in Cabo Verde who were able to learn about the concept of Event-Based Surveillance and test the ePHEM system in person. Following this workshop, two large user workshops will be held (Santiago South and Santiago North) to test the application throughout the island of Santiago. 

Read the full round-up in Portuguese.

Community Leader Event Based Surveillance: Mini-guides for health professionals

The project team have also developed two mini-guides for health professionals and those interested in event-based surveillance with community leaders and approaches to mapping local community leaders as part of public health surveillance projects and/or for programme planning. 

Mini guide: Mapping community leaders for local public health surveillance.

Mini guide: Event based surveillance in public health.

London School of Hygiene & Tropical Medicine Centre for Epidemic Preparedness & Response Prizes 2024 - Collaboration Prize winner 

We're pleased to share that a UK-PHRST research project recently won LSHTM’s Centre for Epidemic Preparedness and Response 2024 Collaboration Prize.

The project, “A novel One Health approach to develop an early warning system to improve preparedness for and response to Marburg virus disease outbreaks”, involves a multi-disciplinary team of researchers is led by Dr Joseph Akoi Boré at the Centre de Recherche et d'Analyse Médicale (CRAM) in Guinea and involves the UK-PHRST, the University of Oxford, CEFORPAG (Center of Research on Priority Diseases) Guinea, the National Viral Haemorrhagic Fever Reference Laboratory Guinea, the University of Glasgow, Universidad Peruana Cayetano and the MRC Unit The Gambia at LSHTM. The entire team and project was recognised for showcasing the best of contemporary work in the field of epidemic preparedness.

The team has used the award to invest in solar panels for Dr Joseph Akoi Boré’s laboratory, further enhancing sustainability and team capacity to continue researching viral outbreaks in Guinea.

Read more about the winning research.

The UK-PHRST team has been busy delivering capacity strengthening activities, advancing partnerships and contributing to the global discourse around outbreak response. Highlights below:

UK-PHRST successfully delivers its latest Deployment Training

The UK-PHRST’s Capacity Strengthening Team recently delivered the latest edition of its Deployment Training programme to 29 participants from across public health disciplines and institutions, including the UK-PHRST’s Reservist Cadre and six representatives from Africa CDC, from both Head Office and the Regional Coordinating Centres from across the continent.

The training aims to strengthen participants’ knowledge of the UK-PHRST ways of working during deployments, share existing knowledge and experience with peers to deepen awareness and skills, enabling them to work effectively alongside partners and preparing them for deployments by encouraging them to consider the type of challenges and situations they may face.

The training is immersive and structured around a comprehensive scenario that covers different phases of a deployment - from call for assistance, assessment, recommendations and country exit - ensuring a holistic approach to learning.

Read a reflective blog from this year’s organiser.

UK-PHRST assists in multi-country Risk Communication and Community Engagement readiness training in Kenya

To strengthen regional cross-border Risk Communication and Community Engagement (RCCE) readiness during public health emergencies, Africa CDC, UNICEF, International Federation of the Red Cross and the World Health Organization (the Collective Service core partners) as well as International Organization for Migration, READY Initiative and the UK-PHRST, organised a scenario-based training in April 2024 in Mombasa, Kenya.

The UK-PHRST’s RCCE Specialist, Sophie Everest, provided technical support and helped facilitate the sessions which aimed to help strengthen national and cross-border RCCE readiness for outbreak response in Kenya, Somalia, Ethiopia, South Sudan, Uganda, Rwanda and Tanzania.

A summary report and technical case study of the training and associated learnings are available on the Collective Service website.

Read the full story.

Somaliland Ministry of Health and Development delegation visit

Following the three-month UK-PHRST bilateral deployment with the Somaliland Ministry of Health Development (MoHD), their Director General and delegates made a visit to London to meet with the UK-PHRST and other UK-based partners.

During the meeting, the Director General, UK-PHRST’s Director Ed Newman and other senior UK Health Security Health Agency officials discussed the public health situation in Somaliland, the recent deployment and explored areas for potential future collaboration.

Fostering community readiness to respond to public health emergencies in Ghana 

In Ghana, a three-day community readiness simulation exercise, co-organized by the Ministry of Health, Ghana, the World Health Organization, and the UK-PHRST brought together stakeholders from health, local government, disaster management, animal and environment sectors, drawn from the Eastern region of Ghana to test communities’ preparedness and emergency procedures and response plans.

The community readiness simulation exercise was aimed at enabling stakeholders to identify strengths, gaps and reflect on priorities that will help strengthens communities’ readiness, working with the health workforce to detect, notify and respond to public health threats before they escalate.

Dr Claire Bayntun, UK-PHRST Head of Capacity Strengthening said: “We are delighted to be part of this exciting collaboration between the World Health Organization, the Ministry of Health in Ghana and other partners. We have contributed our technical expertise to this tabletop simulation exercise which will ultimately help local communities be better prepared for outbreaks in the future.

The outcome of this exercise will not only benefit Ghana - the learnings will also be relevant for the public health responses for communities in many other countries.”

Read the news story from WHO Ghana here.

RRML IFX Round-up 

The UK-PHRST microbiology team recently took part in the first ever Interregional Field Simulation Exercise (IFX): a three-part exercise to review and test the proposed minimum standards across the whole RRML life cycle, from pre-deployment, during outbreak response and end-of-mission phases. The team worked alongside other international teams to test-run co-deploying mobile lab equipment and expertise through exercises in Germany, Türkiye and Georgia. The exercise also tested how RRMLs work alongside other WHO health emergency workforce assets, such as Emergency Medical Teams (EMTs), just as in a real outbreak.

Read the full story on the The Global Health Network.

Rapid virus genomics for outbreak investigation (RaViG) - proof of principle in Coastal Kenya 

In February, members of the UK-PHRST’s research team joined collaborators at the KEMRI-Wellcome Trust Research Project in Kenya to launch a new research project: Rapid virus genomics for outbreak investigation (RaViG) - proof of principle in Coastal Kenya.  
The project, a collaboration between the KEMRI-Wellcome Trust Research Programme in Kilifi, Kenya (KWTRP), the UK-PHRST, the Kenya Ministry of Health and six coastal counties, will assess whether deploying portable whole genome sequencing in real-time during outbreaks is feasible, and if this provides added value to conventional outbreak response approaches.
Coastal Kenya has experienced recurrent outbreaks of various diseases including dengue, measles, norovirus, influenza, and COVID-19. However, there is limited knowledge regarding the origin, transmission patterns, and dispersal dynamics of these outbreaks. Furthermore, there is limited existing for real-time analysis.

To build the evidence base, the project team will co-ordinate with county public health teams in coastal Kenya to trial deploying a portable whole genome sequencing system alongside their conventional outbreak responses to diseases of suspected or confirmed viral origin.  
 
The UK-PHRST will support and advise on setting up portable whole genome sequencing in the field during outbreak response and support scientific evaluation and interpretation throughout the study.

Professor Gwenda Hughes, UK-PHRST Director of Research said: “We are delighted to be part of this exciting research collaboration with the KEMRI-Wellcome Trust Research Programme, Kenya Ministry of Health and county public health teams to assess if using a portable sequencing system to uncover the genome of pathogens in real-time can strengthen outbreak response in Kenya.”

Sharing the findings of our research on COVID-19 rumours to improve community trust and engagement in future disease outbreaks

Between 2021 and 2024, the UK-PHRST undertook a study in Sierra Leone and Tanzania to track rumours and concerns about COVID-19, with the aim to better understand the relative influence and mechanisms of online and offline rumours regarding COVID-19 and to identify solutions to address community concerns during health emergencies. The study used qualitative social science research techniques including community ethnography, interactive workshops, and key informant interviews to gain a deep insight into circulating rumours, how they are shared in social networks and to explore communities’ perspectives of and trust in different sources of information.

Marking the conclusion of the project, three dissemination workshops took place in Tanzania and Sierra Leone in March 2024. The workshops brought together key stakeholders in each country to discuss the study’s findings, gather feedback and initiate conversations with policy makers, governments and communities to improve future community-led interventions in outbreak responses.

In Dodoma, Tanzania, the workshop was opened by Ministry of Health (MoH) and National Institute of Medical Research (NIMR) senior staff. Project results and draft conclusions were presented and there was broader discussion of social science, community engagement and infodemic management in Tanzania after the study-specific presentations and discussions.

Two workshops were held in Sierra Leone, the first of which was held at held in Freetown targeting national level stakeholders from the MoH, the National Public Health Agency (NPHA), WHO and international and local NGO’s and CSOs actively involved in Risk Communications and in Community Engagement (RCCE) interventions in Sierra Loene. The second workshop in Kambia brought together district level stakeholders including officials from the District Health Management Team (DHMT), local authorities, traditional healers, study participants, religious leaders, university students and ordinary citizens. In both workshops, findings from the study were shared with participants followed by plenary sessions to discuss findings and kick start conversations about how the findings can be utilised to inform local RCCE programmes and future research. In addition, the workshops established next steps to address these challenges using innovative methods based on the research project’s data.

View our quarterly map to see our activities between January and March 2024. 

UK-PHRST attends CPHIA Conference 2023: Repositioning Africa in the global health architecture

In November, UK-PHRST members attended the 3rd 2023 International Conference on Public Health in Africa (CPHIA) in Lusaka, Zambia alongside thousands of delegates from across Africa and further afield. They launched a Global Health Diplomacy course which was developed with Africa CDC, discussed how best to respond to infectious disease outbreaks and strengthened our partnership with Africa CDC to support mental health across the continent. This annual conference provides a unique African-led platform for public health leaders across the continent to reflect on lessons learned in health and science and align on a way forward for creating more resilient health systems.

Dr Ed Newman, UK-PHRST Director said:

“This year’s International Conference on Public Health in Africa was a great opportunity for the UK-PHRST to support our Africa-CDC colleagues with their events and partake in some critical side events ourselves – further building on the excellent relationships we have in the region. I was especially pleased to see the emphasis on African health leadership to build solutions for the continent’s public health challenges, particularly exemplified by the close alliance demonstrated by Africa CDC and WHO Senior leadership. We support their clear call for nationally driven, local responses to public health threats - further emphasising the value that both organisations place on collaboration."

See the pictures from the event.

Read the blog piece. 

Interregional One Health cross-border simulation exercise

At the request of the World Health Organization (WHO) Ethiopia country office, UKHSA teams including the UK-PHRST, mobilised to help deliver a unique and complex One Health cross-border simulation exercise between Ethiopia, Somalia and Kenya, that was held in Addis Ababa in October 2023. 
UK-PHRST colleagues alongside others from the UKHSA’s International Health Regulations Strengthening Project (IHR-SP) based in both the UK and Ethiopia, and UKHSA’s Global Health Consultants joined forces with stakeholders from across the three countries and other international partners to test preparedness, operational readiness, and cross-border and cross-sector coordination in the event of a One Health-related threat – in this case, anthrax.  

Hibo Asad a Field Epidemiologist with the UK-PHRST, reflected on her experience:

“A key highlight for me was the inclusion of the community representatives across Ethiopia, Kenya and Somalia – facilitated by Risk Communication and Community Engagement (RCCE) Colleagues in the UK-PHRST. This is the first time we have held a workshop of this magnitude with community representatives involved and contributing to discussions on cross-border preparedness and coordination against One Health threats. Their shared perspectives significantly strengthened the One Health discussions, bringing to the table very insightful on the ground experience and wisdom.”

The simulation exercise was well received by all participants, with community experts applauding “the sharing of expertise and resources to collaborate in achieving a common goal”. 

Dr Lilian Wambua, Regional One Health Coordinator at the World Organization for Animal Health, also praised the cross-organisational work in her closing remarks, saying:

“Thanks to colleagues from WHO, UKHSA, PANDORA and other organisers. The level of inclusivity has been phenomenal, from community to high-level policy makers, all allowing for smooth partnership working.”

The findings from the exercise are currently being evaluated and written up. These will be shared with key country stakeholders to start taking the next steps towards cross-border health security using a One Health approach.

UK-PHRST team and partners are currently delivering ten research projects, a selection of which are highlighted below.

UK-PHRST Panel Discussion and Q&A: Working with family caregivers to improve infection prevention and control in hospitals

This discussion and Q&A event, aimed at those working in health service delivery, policy development, health workers, Infection Prevention and Control teams and other academics, examined the role of caregivers in African healthcare systems, an often integral but largely unrecognised part of the health team. 

The event began with presentations focusing on the healthcare situation in Cameroon and Malawi specifically delivered by researchers from a variety of organisations including the UK-Public Health Rapid Support Team, the Cameroon Baptist Convention Health Service/Infection Control Africa Network, WaterAid and London School of Hygiene & Tropical Medicine. 

There followed a chaired panel Q&A session with leading experts in the field, chaired by Professor Wendy Graham, an LSHTM Professor of Obstetric Epidemiology. The event was an opportunity to find out about the next steps for the research and its real-world implementation.

Watch the recording.

Event Based Surveillance Study - Cape Verde and Brazil workshops

Throughout November and December 2023, the project team held workshops in both Cape Verde and Brazil. In Cape Verde, the team met with ten community leaders who helped test the project app Guardians of Health that will be used to record the event-based disease surveillance information collected directly from communities.

The team held two workshops in Brasilia working with local community leaders to introduce the study and map out potential local individuals who could participate in data collection. Both workshops were an opportunity to engage local leaders in the project, creating a bond with the local community to enable their full participation and ensure they lead the nomination of participants using their understanding of regional dynamics. The team now intend to invite the nominated leaders to a future project development workshop as well as visiting the local territories and building stronger community bonds within the study regions.

View our quarterly map to see our activities between October and December 2023. 

The UK-PHRST team and partners are currently delivering 10 research projects, a selection of which are included below:

Nigeria mpox research collaboration launches

Researchers from the Nigeria Centre for Disease Control (NCDC) and the UK-Public Health Rapid Support Team (UK-PHRST) are teaming up with multiple partners for a new project to study mpox in Nigeria. Since it re-emerged in Nigeria in 2017, the mpox virus has caused numerous outbreaks globally. This research aims to increase understanding of how it spreads and affects communities in Nigeria. 

NCDC, alongside partners including the UK-PHRST, the National Veterinary Research Institute (NVRI), the Niger Delta University Teaching Hospital (NDUTH), the Pandemic Sciences Institute at the University of Oxford and stakeholders in Lagos and Rivers States, launched the collaborative project at an event in Abuja on 16 October. Distinguished guests included senior national and state representatives from collaborating stakeholders and partners across Nigeria and from the UK. 

The co-created research project – titled “Epidemiological and clinical investigation of mpox in Nigeria: A multi-disciplinary research project to inform case management and outbreak prevention and control” - will help address the current significant gaps in clinical and epidemiological knowledge of the virus in Nigeria. Its findings have the potential to not only strengthen detection, prevention, response, and control in Nigeria, but also inform practice in other countries across the world where mpox is endemic. 

Following the launch of the research project, the UK-PHRST will continue to support Nigerian partners in the co-ordination and implementation of the study, lab capacity strengthening and data analysis. 

Professor Gwenda Hughes, co-project lead, Deputy Director for Research for UK-PHRST, and Professor of Epidemiology and Public Health at LSHTM said:

“The UK Public Health Rapid Support Team is delighted to be part of this exciting collaboration between Nigeria Centre for Disease Control and other partners to better understand the clinical characteristics, pattern of infection and spread of mpox in Nigeria – a disease that has greatly affected Nigerian communities, especially in recent years. 

“The UK-PHRST will support Nigerian colleagues to answer important scientific questions through this extensive research programme and will also help deliver training of local laboratory staff and field teams. Our microbiology specialists have already provided lab equipment and shared expertise to help build local diagnostic capabilities for mpox.  Ultimately, through co-creation and by taking a partner-led approach with our Nigerian colleagues, our aim is to support improved case and contact management and inform the development of effective control measures for mpox both in Nigeria and globally.”

Read the full NCDC press release.

Online and offline COVID-19 rumours in Sierra Leone and Tanzania

In August 2023, the research team completed both data collection and analysis in Sierra Leone and Tanzania. The project team are currently developing an ethnographic toolkit and writing up results. Project dissemination will take place in the New Year.

Rapid Virus Genomics for Outbreak Investigation (RAViG) – Assessing the feasibility and added value in Coastal Kenya

A new study, in partnership with the KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya began in October. The central aim of the project is to assess the implementation of real-time field genomics (“portable sequencing”) to support investigation and management of suspected viral outbreaks in coastal Kenya. The investigating team aim to add to the evidence base on the added value and sustainability of in-field rapid genomic sequencing relative to conventional surveillance in low resource settings. The team will explore how genomic data can help identify the cause of an outbreak or factors associated with it, and whether this information can influence policy or outbreak control measures. The project team will also work with the Kenyan Ministry of Health, Africa CDC, and the Regional WHO in delivering this research. 

The UK-PHRST team has been busy delivering capacity strengthening activities advancing partnerships and contributing to the global discourse around outbreak response. A selection are highlighted below:

UK-PHRST supports Africa CDC’s Regional Francophone workshop on Mental Health and Psychosocial Support (MHPSS) Emergency Preparedness and Response

In September 2023, Africa CDC arranged a third regional workshop in Togo as it continues to build recognition for the importance of MHPSS in outbreaks across the African continent, focusing this time on Francophone countries in Central and West Africa. The event was part of a series of workshops, previously held in Liberia and Kenya, and was attended by 49 individuals spanning 20 countries including national leads in mental health and Emergency Preparedness and Response alongside input from the Inter-Agency Standing Committee, the UK-PHRST, UNICEF, and other regional bodies.

Julian Eaton, Co-Lead, UK-PHRST Mental Health Psychosocial Support Group attended the workshop on behalf of the UK-PHRST and said:

“National health and other sector leaders deserve coordinated and evidence-based information to drive effective response. Our international partnership with Africa CDC, WHO and regional public health institutes has proven an incredibly valuable way to support national emergency preparedness in mental health and psychosocial support.”

The workshop provided a unique opportunity to invest in learning and sharing specific evidence in French. Although around 300 million people in Africa live in Francophone countries, there is a relative lack of investment in mental health and psychosocial support in this community, something this workshop aimed to start addressing. 
The series are based around a Theory of Change model, with learnings incorporated iteratively through each workshop as well as using evidence systematically gathered from other sources – ultimately aiming to support national mental health and Emergency Preparedness and Response (EPR) teams to better plan and build stronger systems for response in the event of future emergencies.

Build Better Before: Scaling up capacities for Mental Health and Psychosocial Support Preparedness and Risk Reduction

Biksegn Yirdaw, Assistant Professor in Mental Health and a member of our Mental Health and Psychosocial Support (MHPSS) team, attended a World Health Organisation international workshop held in collaboration with the Estonian government: “Build Better Before: Scaling up capacities for Mental Health and Psychosocial Support (MHPSS) Preparedness and Risk Reduction” on behalf of the UK-PHRST in September. The workshop lasted several days and included lecture session and a full-scale simulation exercise on MHPSS preparedness and response, disaster risk management (DRM) and emergency preparedness and response (EPR) in humanitarian/emergency situations.

Biksegn was involved in facilitating MHPSS need assessments, writing a standard operating procedure and developing a response plan during the simulation exercise.  As a result, he deepened his expertise in conducting rapid need assessments, risk analysis, and planning during emergency situations. Using this knowledge, he will help the UK-PHRST further strengthen its MHPSS component of its outbreak response work in Overseas Development Assistance eligible countries around the world. 

Bringing together more than 80 MHPSS and humanitarian experts from 35 countries, the workshop aimed to strengthen the capacities of responding organisations to integrate MHPSS into national emergency plans and to include MHPSS as part of real-world emergency response including to infectious disease outbreaks. In particular, the workshop’s approach could be used to inform the UK-PHRST’s work to design, implement and evaluate integrated MHPSS interventions in infectious disease outbreaks – ultimately progressing the team’s research portfolio and ensuring the UK-PHRST’s work can have a global impact. 

Find out more about the UK-PHRST's MHPSS work.

International Conference on Infection Prevention and Control (IPC), Geneva 

IPC colleagues Emilio Hornsey and Lipi Begum recently presented their poster on the review of IPC activities during outbreak response deployments by UKPHRST in 2022 at the biennial, International Conference on Infection Prevention and Control in Geneva, Switzerland. The event not only allowed international networking with academic and operational IPC colleagues but also highlighted how other governments, NGOs & civil societies manage health sector resilience and patient safety via IPC during normal and emergency outbreak responses.

View our quarterly map to see our activities between July and September 2023. 

Researchers from the Nigeria Centre for Disease Control (NCDC) and the UK-Public Health Rapid Support Team (UK-PHRST) are teaming up with multiple partners for a new project to study mpox in Nigeria. The virus has caused a number of outbreaks since it re-emerged in Nigeria in 2017, and this research aims to increase understanding of how it spreads and affects people among Nigerian communities.

Nigeria Centre for Disease Control (NCDC), alongside partners including the UK-PHRST, the National Veterinary Research Institute (NVRI), the Niger Delta University Teaching Hospital (NDUTH), the Pandemic Sciences Institute at the University of Oxford and stakeholders in Lagos and Rivers States, launched the collaborative project at an event in Abuja on 16 October. Distinguished guests included senior national and state representatives from collaborating stakeholders and partners across Nigeria and from the UK. 
 

The co-created research project – titled “Epidemiological and clinical investigation of mpox in Nigeria: A multi-disciplinary research project to inform case management and outbreak prevention and control” - will help address the current significant gaps in clinical and epidemiological knowledge that surround the virus. Its findings have the potential to not only strengthen detection, prevention, response, and control in Nigeria, but also inform practice in other countries across the world where mpox is endemic.

The research will be split into two linked studies: a clinical study and a One Health study. These will be implemented concurrently to understand the clinical characteristics, patterns and routes of infection and associated risk factors, and the experiences of people with confirmed mpox and those close to them.

Dr Ifedayo Adetifa, Director General of the NCDC, said: "Today, we begin the journey of knowledge, unity, and determination. In partnership with dedicated researchers and institutions, we set out to unravel the unknowns of the mpox virus through bridging clinical and One Health studies. This project symbolises our unwavering commitment to protecting the health of Nigerians, and in turn the world, embracing the power of research, and the strength of collaboration. As we work together, may we move closer to a world free from the threat of mpox that ensures the wellbeing of generations to come."

Using £1.6 million funding provided by the UK Department of Health and Social Care through UK Aid, the UK-PHRST – an innovative partnership between the UK Health Security Agency and the London School of Hygiene & Tropical Medicine (LSHTM) - has worked closely with the partners to co-create the research project. The collaborating organisations first met in early 2022, prior to the global mpox outbreak, to agree to co-develop a preparedness-and-response research programme on mpox in Nigeria. Following the launch of the research project, the UK-PHRST will continue to support Nigerian partners in various parts of the study from design, co-ordination and implementation, lab capacity strengthening to data analysis and publication. This will ultimately enable Nigerian partners to provide the necessary long-term laboratory support and promote sustainable mpox diagnostics in Nigeria.

Professor Gwenda Hughes, co-project lead, Deputy Director for Research for UK-PHRST, and Professor of Epidemiology and Public Health at LSHTM, said: “The UK Public Health Rapid Support Team is delighted to be part of this exciting collaboration between Nigeria Centre for Disease Control and other partners to better understand the clinical characteristics, pattern of infection and spread of mpox in Nigeria – a disease that has greatly affected Nigerian communities, especially in recent years. 

“The UK-PHRST will support Nigerian colleagues to answer important scientific questions through this extensive research programme and will also help deliver training of local laboratory staff and field teams. Our microbiology specialists have already provided lab equipment and shared expertise to help build local diagnostic capabilities for mpox.  Ultimately, through co-creation and by taking a partner-led approach with our Nigerian colleagues, our aim is to support improved case and contact management and inform the development of effective control measures for mpox both in Nigeria and globally.”

In his address at the launch event, Dr Edmund Newman, Director of the UK-PHRST, said: “It is great to see this project and collaboration between UK-PHRST and our Nigerian partners progressing to a point where we can launch our co-created mpox study. This has been possible thanks to significant work from all sides and builds upon the long history of the UK-PHRST’s successful work with Nigerian partners including Nigeria CDC which has evolved from bilateral support missions and more recent capacity strengthening work. We will continue to support our Nigerian colleagues as they lead the way on this flagship project to answer the important research questions about mpox in Nigeria.”

Mpox virus, formerly known as monkeypox, causes the most important global human orthopoxvirus disease since smallpox was eradicated in 1979. Since the virus re-emerged in Nigeria in 2017, reported cases have continued to increase annually. From 2017 until now, there have been 2668 suspected cases, 975 confirmed cases and 14 deaths, with Lagos and Rivers States accounting for the highest burden of the disease. As such, the research project will be implemented in Lagos and Rivers states in the first instance.

The 2022 global outbreak which affected over 100 countries coincided with Nigeria’s largest outbreak with 762 confirmed from more than 2000 suspected cases. While this sharp rise in cases is likely linked to improved surveillance and testing, for Nigeria and other endemic countries, the surge of mpox attention and information only further highlighted important gaps in clinical and epidemiological knowledge and the effect of this deficit on developing effective measures to prevent further cases. The research project aims to answer the co-identified research questions for Nigeria, while also informing practice in similar endemic settings.

Read the full NCDC press release about the event.

About NCDC

The Nigeria Centre for Disease Control and Prevention (NCDC) is the country’s national public health institute, with the mandate to lead the preparedness, detection, and response to public health emergencies. The Bill for an Act to establish NCDC was signed into law in November 2018 by President Muhammadu Buhari. The mission of the NCDC is to protect the health of Nigerians through evidence-based prevention, integrated disease surveillance and response, using a One Health approach, guided by research, and led by a skilled workforce.

Launch event attendees

The project launch event took place on 16 October 2023 in Abuja and included the following key guests amongst many others:

• Representatives of:
  • Director General of Nigeria CDC
  • British High Commissioner to Nigeria
  • Federal Ministry of Agriculture and Food Security
  • Federal Ministry of Environment
  • Chief Veterinary Officer of Nigeria
  • University of Port Harcourt Teaching Hospital
  • Ministry of Defence Health Implementation Programme
  • UK Health Security Agency (UKHSA) and UKHSA IHR Strengthening Programme
  • Wild Aid
  • Walter Reed Program - Nigeria/Henry Jackson Foundation Medical Research Institute
  • Director of Public Health, Rivers State Ministry of Health
• The Honourable Coordinating Minister for Health and Social Welfare
• The Honourable Commissioner of Rivers State Ministry of Health
• The Chief Medical Directors of Rivers State University Teaching Hospital and Lagos University Teaching Hospital 
• The President and the Acting Registrar of Veterinary Council of Nigeria
• The Director/Chief Executive of National Veterinary Research Institute, 
• The Directors of Veterinary Services of Lagos State Ministry of Agriculture and Rivers State Ministry of Agriculture 
• The Conservator General of National Park Service Abuja
• The Director, Public Health Laboratory Services
• The Director of Public Health, Rivers State Ministry of Health
• The State Epidemiologist, Rivers State Ministry of Health
• Disease Surveillance and Notification Officers and Clinical Health Workers from Lagos and Rivers States
• UK-PHRST speakers included:
  • Co-principal Investigator
  • UK-PHRST Director

Julian Eaton. Co-Lead, UK-PHRST Mental Health Psychosocial Support Group

In the face of a public health emergency such as a major disease outbreak, governments and responding organisations know they must implement public health measures to quickly control the situation and prevent loss of life. As we know all too well from COVID-19, cholera, Ebola and other disease outbreaks, infections which spread rapidly can have devastating physical impacts. There is, however, a less visible effect of these outbreaks on people’s mental health, something which is beginning to be addressed by specialists in Mental Health and Psychosocial Support (MHPSS) like the UK-Public Health Rapid Support Team’s dedicated MHPSS team.

Even outside of an emergency situation, mental health is often not part of public health measures and services are often not on par with the standard of care given to those with physical injuries. Emergencies of all kinds can increase the risk of physical and mental health problems, especially if people are displaced, so it is imperative that mental health is addressed in these circumstances.

World Mental Health Day is an opportunity to remember the importance of mental health as an essential component of global public health in both everyday and emergency situations. Although huge strides have been made to make sure mental health is not left out of outbreak response, there's still more to do before it's integrated into every health emergency response; from outbreak preparedness activities, climate change and other natural hazards and conflicts.

This year’s theme of ‘Mental health is a universal human right’, reaffirms the importance of understanding how central mental health is to achieving Universal Health Coverage - to ensure that everyone, especially the most vulnerable, has access to the care they need, even during a public health emergency.

The road to establishing best practice in MHPSS

Almost 20 years ago, the Inter-Agency Standing Committee Guidelines on MHPSS in Emergency Settings, laid the foundations for best practice in MHPSS, stimulated by the need to apply global best practice standards in times when people are most vulnerable. The principles it laid down have served the field well, and the MHPSS community has an increasing range of evidence-based tools, including the Minimum Service Package (hosted at the Mental Health Innovation Network at London School of Hygiene and Tropical Medicine). A new research agenda for 2021-2030 was recently outlined, which demonstrated how far we have come, particularly in understanding the extent of needs and the basic elements of what works to reduce suffering. A mechanism is in place to quickly provide effective coordination in emergencies under Inter-agency Standing Committee (IASC), a surge support capacity is run by the Dutch government on behalf of the MHPSS community, and other key public health agencies like Africa CDC are also putting this in place alongside their response to physical health needs.

Learning lessons from COVID-19 and beyond

The COVID-19 pandemic demonstrated both increased mental health needs, and the importance of a range of health responses; from the value of neighbours looking out for each other’s basic needs, to health organisations having to protect access to essential mental health care services that were at risk. Despite the development of good quality guidance during COVID-19, when the MHPSS community was very nimble in its response, there remain substantial gaps in evidence of what works, and in sufficient political buy-in to invest in and act on risks to mental wellbeing in emergencies. People with pre-existing mental health conditions are far more negatively impacted by outbreaks than others, and there is always a huge increase in distress and mental health needs during outbreaks among the general population, and importantly, health and other sector response organisations. There are a number of reasons behind this: anxiety about contracting infection or getting vaccinated; some direct physical, emotional and cognitive effects (for example as part of long COVID); stigma and social exclusion associated with infection; and probably most significantly, the impact of social changes like isolation, economic loss, or educational disruption, especially when these are over prolonged periods.

How the UK-PHRST is making MHPSS part of outbreak response

The UK-PHRST strives in all areas of its work to create lasting change in response to infectious disease outbreaks across the globe by putting emphasis on knowledge co-creation, global partnerships and real-world action. This is no different for the UK-PHRST’s MHPSS team. Through our innovative research, capacity strengthening efforts and advocacy for on-the-ground response work, the MHPSS team works to bring mental health interventions to the fore of outbreak response and empower countries across Africa, Official Development Assistance (ODA) eligible countries and the wider global community to create real and lasting positive change for those affected by mental health problems following an infectious disease outbreak.

The UK-Public Health Rapid Support team has a dedicated MHPSS group, focused on research, capacity building, and deployment in the intersection of mental health, wellbeing and infectious disease outbreaks. Our work includes:

• Strengthening MHPSS preparedness and response at national level through collaborating with public health institutions like Africa CDC, WHO, Inter Agency Standing Committee, West African Health Organization, East Central and Southern Africa Health Community and other agencies 
• Research, with a specific focus on understanding what works in MHPSS preparedness and response at country level, through participatory implementation research. Our aim is to equip decision-makers with clear, evidence-based guidance for integration MHPSS into outbreak response. To date we have published assessments of strength of outbreak preparedness across Africa, reviews of literature, and are planning implementation research in Africa. 
• Strengthening deployment mechanisms for rapid response, through collaboration with the African Volunteer Health Corps and IASC/Dutch Surge Support mechanisms
• Building networks of MHPSS and Emergency Preparedness and Response partners for ongoing peer support, learning and coordination
• Supporting responder wellbeing within the RST and across other outbreak response partners

All of these workstreams contribute to one overall aim; to understand better the factors that influence how people respond to crisis, and to equip government and non-governmental organisations to be prepared and able to respond effectively to the mental health needs of people that come about from future public health emergencies like infectious disease outbreaks. 

With so much progress in recent years around the world on mental health, the UK-PHRST MHPSS team is working hard to keep up the momentum and integrate mental health measures into outbreak response so that no one is forgotten, especially during an emergency.

Work with the UK-PHRST MHPSS team

Find out more about the MHPSS team within the UK-PHRST.

If you or your organization would like to collaborate or request MHPSS help during an outbreak, please contact uk-phrst@lshtm.ac.uk.

The UK-PHRST and its international partners came together to review their previous work, evaluating its strengths and weaknesses as part of a three-day Learning Review Session in Cape Town, South Africa. The discussions, in September 2022, acknowledged the ongoing success and enthusiasm for the UK-PHRST’s partnership working approach and also pointed to key issues that potentially affect the work of the UK-PHRST and international partners. These included strengthening public health leadership, narrowing the North-South technological gap, ensuring deployments create impact for host countries and embedding greater levels of equity across all working relationships. 

The newly published UK-PHRST and Partners Learning Review Post Review Reflections & Actions Report highlights case studies from the discussions, and provides 35 recommendations for improved ways of working. The UK-PHRST senior leadership responded to 20 of the recommendations which the attendees felt were priority areas.

Learning and improvement are fundamental to the UK-PHRST’s international activities. The Learning Review and associated report will help the UK-PHRST to better understand our partners, their opportunities and challenges, and empower us to collectively address partner identified problems - a sentiment emphasised by UK-PHRST’s Director Ed Newman.

He said: “By giving a voice to our staff and partners to capture and share some of the lessons we identified, and by being candid about the difficulties we encountered - as well as highlighting our many successes - we can continue to work well with our partners, but also learn from those lessons and grow stronger in our collaboration and in the activities we jointly undertake.”
 

Not only was the Learning Review an opportunity for the UK-PHRST and partners to reflect on their previous work and achievements, but it also provided a vital space for mutual and multi-directional learning and capacity strengthening outside of an emergency infectious disease outbreak situation.

Dr Maryirene Ibeto and Dr Femi Nzegwu from the UK-PHRST emphasised that: “The review highlights how by having these continuous conversations, low- and middle- income countries and support agencies like the UK-PHRST can share best practice and learn from each other constantly. This will mean that they can more effectively deal with a crisis when it hits – ultimately creating a safer and more secure global health situation for everyone.” 

South Africa Learning Review 2022 attendees. Credit: lightlounge.co.za

South Africa Learning Review 2022 attendee. Credit: lightlounge.co.za

South Africa Learning Review 2022 attendee. Credit: lightlounge.co.za

Attendees in group discussion. Credit: lightlounge.co.za

Brainstorming session. Credit: lightlounge.co.za

South Africa Western Cape Minister addressing attendees of the South Africa Learning Review 2022. Credit: lightlounge.co.za

Read the full UK-PHRST and Partners Learning Review Post Review Reflections & Actions Report  

Ongoing research projects

The UK-PHRST are currently delivering eight ongoing research projects, a selection of which are included below:

Developing a mental health and psychosocial support (MHPSS) package for infectious disease outbreaks

A collaboration between UK-PHRST and Saint Joseph University of Beirut, this research project aims to identify, through expert consensus, a list of interventions to support people’s mental and psychosocial health as part of a complex package for an infectious disease outbreak context.

As part of this project, a consultation workshop was held in Cairo, Egypt from 8-10 May 2023 hosted by the Egyptian Red Crescent (ERC). Participants, including people with lived experience from the Global Mental Health Peer Network, shared their experiences of mental health and psychosocial support (MHPSS), and experts identified barriers and facilitators for MHPSS in outbreaks. The workshop provided valuable learning allowing the project team to focus on developing MHPSS priorities with country partners.

Epidemiological and clinical review of mpox in Nigeria: A multi-disciplinary research project to inform outbreak control measures (with Nigeria CDC)

The UK-PHRST team continue to collaborate with Nigeria CDC to develop two interlocking research studies. Using a OneHealth approach, the project aims to better understand the factors behind the spread of mpox across different Nigerian states. 
 
A UK-PHRST research team travelled to Abuja in May to finalise project details prior to the study implementation later this year. Researchers from the UK-PHRST, including colleagues from the University of Oxford also assisted Nigeria CDC colleagues to further strengthen their laboratory systems ahead of the studies. For instance, one workshop provided attendees with hands-on experience of preparing, running and analysing blood sample analysis assays as well as the transfer of scientific methods to build local skills capacity for the upcoming studies.

Completed research projects

New briefing paper flags priority research questions to improve cleaning practices in resource-limited hospital settings

The CLEAN research group, first convened in mid-2022 within a UK-PHRST project, have produced a briefing report that outlines the need for additional research work in the field of environmental cleaning in resource-limited healthcare settings. The report details their 12 recommended key research questions and associated considerations to facilitate effective hospital cleaning in resource-limited healthcare settings and to help reduce the spread of infections and antimicrobial resistance.

They hope the research priorities will encourage the eventual implementation of low-resource tailored and cost-effective cleaning practices in resource-limited settings which will benefit the health of both patients and staff and ensure a respectful environment for patients. They are now calling on funders, policymakers and advocates to drive forward implementation research into cleaning practices in these healthcare settings.
 

Operational research framework workshop at Africa CDC 

March - Members of the research team supported the facilitation of a consultative workshop held in Addis Ababa on developing an operational research framework in emergency preparedness and response at Africa CDC. The workshop built on remote support provided by the research team in developing the concept, format and agenda in previous months. The team will continue to support Africa CDC as the framework develops.

Field Deployment Training course

This year’s Field Deployment Training (FDT) course took 18 participants on the 'journey' of pre-deployment, deployment, needs assessment, intervention recommendations and exit planning thanks to the expertise of the co-ordinators in humanitarian scenarios, health, operations and capacity strengthening. 

The training, jointly delivered by UK-MED (a humanitarian health organization), UK-PHRST and UK Health Security Agency across four days in Bedfordshire, is a mandatory component for all deployable members of the UK-PHRST team to ensure they can deploy safely and effectively. 

To make sure the participants would be equipped for situations, the components typical of real deployments were condensed into a micro time scale (ie. experienced across four days rather than the usual deployment of six weeks), using forum theatre techniques such as being accosted by media, being challenged for breaches in security protocol and safe-guarding issues.

Workshop on mpox antibodies detection

There was an opportunity to learn more about tools for detecting mpox at a workshop during the UK-PHRST research team’s visit to Abuja, Nigeria in March focusing on the clinical characteristics and outcomes of mpox disease in Nigeria. The MVA (modified vaccinia Ankara) ELISA assay workshop and technology transfer session was held with colleagues from the Nigeria Centre for Disease Control (NCDC) and National Veterinary Research Institute (NVRI).

The workshop, hosted by The MRC Unit The Gambia at LSHTM, included training and advice from a University of Oxford expert on how to use the MVA ELISA to detect mpox antibodies for different aspects of the study. Colleagues from NCDC – Abuja, NCDC – Lagos, NVRI – Vom, the MRC Unit The Gambia at LSHTM and the National Public Health Laboratory Gambia who attended found the workshop informative, enjoyable and worthwhile.

Caribbean collaboration visit

In March, our Director Ed Newman, was invited to meet counterparts from the Caribbean Public Health Agency (CARPHA). Together, the two organisations hope to develop a strong collaborative relationship which could include the co-deployment of staff at CARPHA’s request - UK-PHRST deploying staff to CARPHA to enhance their public health emergency response and CARPHA deploying staff outside the Caribbean to gain response experience. 

The meetings were well received by the CARPHA Senior Leadership who were very keen to work further with the UK-PHRST and develop future areas of collaboration. Additionally, Anita Shah, a UK-PHRST Field Epidemiologist who had seconded to CARPHA, shared the findings of her work with the organisation regarding its Field Epidemiology and Laboratory Training programme and future expansion plans. 

View our quarterly map to see our activities between January and March 2023. 

Cleaners must be viewed as a key part of the health system to reduce infections and antimicrobial resistance among staff and patients, according to a report by experts from the CLEAN research group.

The group produced the briefing paper as part of a UK-PHRST project. It sets out 12 priority research questions to improve hospital cleaning and highlights the challenges facing resource-limited settings, as well as factors that need to be considered to support the implementation of tailored and effective cleaning practices. These include, for example, ensuring capacity strengthening of cleaners and the need for financial support to cement cleaning in the healthcare system.

The Group is now calling on investors, policymakers and advocates to drive forward implementation research into cleaning practices in hospitals with limited resources.

The CLEAN Group was first convened in mid-2022 within a UK-PHRST project to identify the most urgent research questions to inform or enhance the implementation of best practices in surface and non-critical equipment cleaning in healthcare facilities in resource-limited settings. It includes experts from Africa, Europe, Asia, Australia, North and South America, with expertise in infection prevention and control, hospital cleaning and disinfection, water, sanitation and hygiene (WASH), health policy, implementation science and clinical research in resource-limited settings.

Read the full blog and the CLEAN Briefing Paper on the UK-PHRST Knowledge Hub.

The UK Public Health Rapid Support Team invites you to join our new drive to evaluate the definition, value and impact of our partnerships and capacity strengthening activities.  

Fill out our Market Consultation Survey to indicate your interest in the competition to receive a contract. The contract will involve conducting the evaluation and generating significant learning and understanding of our partners' perspectives, identifying challenges and how these have and can be addressed in real time over the lifespan of UK-PHRST's project cycle. 

Some key considerations for the evaluation include:

Partnerships

• Understanding of the "nuance of relationship" by different partners
• The degree to which they are perceived as beneficial and equitable by the people we work with
• What factors appear to enable or detract from "ideal partnerships" –what does the much-used phrase "power dynamics" mean in our context?
• Is it constraining in crafting equitable and useful partnerships?
• Does it play a facilitative role, or is it neutral in its perception by partners?
• What impacts have our partnerships had? 

Capacity strengthening

• How can we gauge a deeper understanding of capacity strengthening in the context of UK-PHRST's work?
• What are the impacts realised by partners in their work with the UK-PHRST? 

Information session

For more information, please join us online at our Market Engagement Session on 15 December 2022 at 10:00 am GMT. Join here  

In order to be considered, please complete the Market Consultation Survey here.

This should be completed by the supplier or a partner or an authorised representative in his / her own name and on behalf of the company / organisation completing this questionnaire.

Registration is free and open to all. The deadline to complete the survey is 13 January 2023. 

More information

Find out more

For further information, please refer to the documents attached, including:

download Attachment 2 - How to Bid including Evaluation Criteria v1.0.pdf

download Attachment 1 - About the Procurement Competition v1.0.pdf

download Market Consultation Survey - Evaluation of UK-PHRST Partnerships Capacity.docx

download Pre-sourcing event Zoom meeting invite link.docx

Please contact Zahra.Bhatti@ukhsa.gov.uk if you have any questions. 

 The UK Public Health Rapid Support Team and partners are currently working on seven research projects, and we have also developed our Research Plan for 2022-2025. Within the plan, we have described 17 new cross-discipline research projects that were co-identified and will be co-led with low-and-middle income partners, and three of these have recently started. Projects in the plan have been grouped into themes covering preparedness and prevention, detection, response, and impact and evaluation, however, the plan also enables flexibility to begin new projects that address urgent research questions arising during outbreaks or during deployments. Most of the 14 projects yet to be approved by Technical Steering Committee (TSC) are expected to be reviewed and begin over the next six months.  

We are also delighted to announce a new research collaboration on Monkeypox with the Nigeria Centre for Disease Control, University of Oxford and partners. This new collaboration will cover key priorities in Monkeypox research in Nigeria and will have clinical, epidemiological, One Health, laboratory, and social science components. Priorities for the Monkeypox research programme were identified during a workshop in Abuja in August 2022, during which participants proposed several multi-disciplinary studies with Nigerian leads. The group also recommended strengthening laboratory operations at Nigeria CDC in preparation for the research, and this work is currently underway. The Monkeypox research programme is included in our research plan.  

Among our currently running studies, one is developing an early warning system that can identify “hot spots” in remote regions of Guinea where Marburg virus outbreaks are likely, based on interactions between human and bat populations. In recent months, the study team have completed a community sensitisation (awareness raising) and a risk communication campaign across study villages in Macenta, led by the Guinean project lead in collaboration with a local NGO. They have also collected pilot data for surveillance tools from study villages and generated preliminary biodiversity indicators and machine learning algorithms. The next stage of the project will include in-depth investigations of zoonotic exposure and bushmeat hunting practises among the target population using qualitative methods.  

Since the last research update, three research projects have been completed, including two Infection Prevention and Control (IPC) studies and a pilot study of a non-whole genome sequencing approach for monitoring SARS-CoV-2 variants in Burkina and Kenya. Find out more below. 

Development and evaluation of resources to support IPC engagement with caregivers in hospitals  

This study, which began in February 2021, aimed to develop and evaluate resources to support informal caregivers in Cameroon to engage with IPC .  The project was co-led by the UK-PHRST and Cameroon Baptist Convention Health Services (CBCHS) in partnership with the Infection Control Africa Network (ICAN), the not-for-profit visual resource charity Medical Aid Films (MAF) and the Africa Task Force for Corona Virus Response (AFTCOR) IPC technical working group.  

Thee study described the role and function of caregivers in a tertiary referral hospital in Cameroon, developed training resources to support their engagement with IPC, including context-appropriate audio-visual materials, piloted delivery of a multimodal intervention, and evaluated the effectiveness of the intervention.   

The evaluation demonstrated the feasibility of delivering the intervention in the health system and that it was well-received by caregivers and health workers. Six local research assistants were also trained. The study findings have been and are being shared with all relevant stakeholders, including ICAN, MAF, Africa Centres for Disease Control and Prevention (Africa CDC), and the Cameroon Public Health Institute. The study team  plans to present the findings at the bi-annual ICAN conference in 2023 via partner networks  and in an open access, peer reviewed journal. The team will support further engagement of informal caregivers with a ‘toolkit’ of resources that will be transferable to other LMIC healthcare settings.   

What is the current level of cleaning in LMIC health systems and what interventions are effective at improving it?  

Formal training for cleaners in health settings may be inadequate in many LMICs and is of particular concern during outbreaks when there is additional urgency for rapid interventions.  

In this study, the team led a systematic review of cleaning interventions in LMIC health settings and convened a workshop with diverse international stakeholders to develop recommendations and a roadmap of future research priorities. Stakeholders included leading IPC researchers in Africa, Asia and high-income countries, and representatives from public health institutes, relevant networks and the World Health Organization.  

Unsurprisingly, most evidence from LMICs came from areas with greater resources, such as tertiary referral centres in large cities. Standard outcome definitions for cleanliness were found to be lacking, and results were reported inconsistently, hampering the synthesis and meta-analysis of aggregate data. Preliminary systematic review findings have been presented in a Webber teleclass and are being submitted for presentation to the ICAN conference and International Conference on Infection Prevention and Control in 2023. A blog and research prioritisation paper have been submitted to The Global Health Network, and the systematic review will be submitted for publication in a peer-reviewed journal.  

A non-whole genome sequencing approach for monitoring SARS-CoV-2 variants in Burkina Faso and Kenya 

This study, which started in November 2021 and was a collaboration between UK-PHRST/LSHTM and Groupe de Recherche-Action en Santé in Burkina Faso (GRAS), Kenya Medical Research Institute (KEMRI), MRC Unit Gambia (MRCG) and Liverpool School of Tropical Medicine (LSTM), aimed to understand the feasibility of running the HRM assay in LMIC settings through pilots in Burkina Faso and Kenya. These sites were selected because the research team had established partnerships through the Gates Foundation-funded Malaria as a Risk Factor for COVID-19 (MALCOV) SStudy. UK-PHRST Rapid Research funding enabled the team to leverage real-time access to MALCOV study specimens.  

The study team developed and updated their high-resolution melt (HRM) assay in response to the emergence of new SARS-CoV-2 VOCs. Following training, researchers from Burkina Faso and Kenya analysed samples using the assay at laboratories in The Gambia and Kenya and validated assay performance against whole genome sequencing (WGS). This project demonstrated the utility of a non-WGS method in lower resource settings for tracking SARS-CoV-2 variants and may provide a lower-cost approach for understanding molecular epidemiology in settings where access to WGS is absent or limited. The project built new and developed existing collaborative working relationships between researchers from LSHTM, Groupe de Recherche Action Santé (GRAS), Kenya Medical Research Institute (KEMRI), MRC Unit The Gambia at LSHTM (MRCG) and Liverpool School of Tropical Medicine (LSTM). The findings have been presented at LSHTM and external meetings and conferences. One peer-reviewed article is nearing publication in the Scientific Reports journal, and a further article will be submitted in December 2022. Find out more about the field visit to The Gambia here.  

In the coming months, the UK Public Health Rapid Support Team (UK-PHRST) will focus on establishing a refreshed and enhanced capacity strengthening pillar. Dr Claire Bayntun has been appointed to lead this work as the Head of Capacity Strengthening and will expand the team to take forward new strategic spheres of opportunities, reflecting the values of the UK-PHRST and aiming to secure trusted, sustainable partnerships for the future.  

View UK-PHRST's capacity strengthening pillar
 
Over the last quarter, the UK Public Health Rapid Support Team (UK-PHRST) conducted eight capacity strengthening activities, including a learning review in Cape Town, South Africa, and R training* in Ethiopia and Nigeria, respectively.  
 
*R is an open-source software environment for statistical computing and is used for data analysis and visualisation.  

In September, we met with many of our partners in Cape Town, South Africa, to reflect on our working practices and exchange lessons on improving outbreak response, research and capacity strengthening. Experts at UK-PHRST co-led sessions on gender equity, capacity strengthening, policy and practice in research, outbreak response and equitable partnerships. These discussions will inform a summary of recommendations and actions we can implement to enhance our equitable partnerships and foster sustainable ways of working. 
 
Watch the highlights of the learning review 
 

 R Training 

UK-PHRST facilitated R-Training with Africa Centre for Disease Control and Prevention in Ethiopia in July, capturing lessons learned to strengthen future training, planning and delivery. The UK-PHRST epidemiology team co-facilitated two workshops with the African Volunteer Health Corps (AVoHC). This included prioritising key programme activities for 2022-23, reviewing and refining content for an induction course, and training new AVoHC roster members. 

Equitable partnerships with infection prevention and control (IPC) stakeholders 

The infection prevention and control (IPC) team shared preliminary results for developing and evaluating resources to support a study with Cameroonian partners in July. It delivered a workshop with key global stakeholders reviewing evidence and prioritising research needs for cleaning and disinfection interventions. 

The team is contributing to reviewing a World Health Organization course for environmental cleaning and infection prevention control. The team is supporting the WHO Emergencies IPC team, offering technical support for Ebola and Monkeypox, and developing specific IPC implementation tools, including an IPC outbreak implementation package and updated IPC assessment tools will be provided in addition.  

Mental health 

As part of the Strengthening Public Mental Health in Africa in response to COVID-19 (SPACE) programme’s phase two delivery, the team involved representatives from Sierra Leone and Cameroon in a workshop in Liberia with partners Africa Centre for Disease Control, World Health Organization Regional Office for Africa (WHO AFRO), WHO Regional Office for the Eastern Mediterranean (WHO EMRO), West Africa Health Organisation (WAHO), and East Central and Southern Africa Health Community (ECSA-HC). 

We have summarised the latest UK-PHRST deployment, research and capacity development activities from July – September 2022 in a quarterly map. Many of our activities across the triple remit overlap, and some will continue into the next quarter. The map demonstrates ongoing or completed activities during the quarter, and the year stated is when the project commenced.

View the UK-PHRST quarterly activity map. 

The Strategic Framework 2022 to 2025 sets out UK-PHRST’s objectives to build on the commitment, impact and effectiveness of the past six years of our operations.  

The UK-PHRST strategy is underpinned by three principles: learning, partnerships and impact. It outlines how the UK-PHRST will deliver on this commitment through activities across the triple remit in outbreak response, research and capacity strengthening. 

View the UK-PHRST Strategic Framework 2022-2025

On the week that the UK Public Health Rapid Support Team (UK-PHRST) celebrates its 6^th sixth year anniversary, and with staff currently deployed to the Ebola outbreak in Uganda, UK-PHRST Director, Dr Ed Newman, shares the team’s ambitions for the next three years and our continued commitment to respond to disease outbreaks in the countries we work with.  
 
Published by the UK Health Security Agency.  Read more.
 
We are an innovative partnership between the UK Health Security Agency and the London School of Hygiene & Tropical Medicine, funded with UK aid by the UK Department of Health and Social Care.

In celebration of World Field Epidemiology Day on 7 September, the UK Public Health Rapid Support Team spoke to UK Field Epidemiology Training Program (UK-FETP) fellows Megan Bardsley and Mona Dave, who recently deployed with the UK Public Health Rapid Support Team (UK-PHRST). Field epidemiologists support the UK-PHRST to prevent and control infectious disease outbreaks, before they develop into global emergencies. The UK Field Epidemiology Training Programme recruits seven to eight UK-FETP fellows a year.

Megan Bardsley

Megan completed her undergraduate degree in biological sciences and studied an MSc in Control of Infectious Diseases at the London School of Hygiene & Tropical Medicine. She is in her second year of the Field Epidemiology Training Programme based in Field Service South West with the UK Health Security Agency (UKHSA). Before joining UK-FETP, she had prior experience in UKHSA’s human immunodeficiency virus / sexually transmitted infections (HIV/STI) department, worked as a research assistant at LSHTM and gained experience in Malaysia at a breastfeeding NGO. She recently deployed with UK-PHRST to Papua New Guinea via the Global Outbreak Alert and Response Network.

Mona Dave 

Mona gained an undergraduate degree in biomedical sciences at Warwick University, and a Master's in Public Health with International Health at the University of Nottingham. She began her journey into global health after spending three months in the Philippines on a health education programme with the Voluntary Service Overseas (VSO) as part of the International Citizen Service (ICS) in 2013. Before joining the UK-FETP, she worked as a research assistant in non-communicable disease research at Newcastle University and as a scientist in the South West Field Service. Mona recently deployed with UK-PHRST and is currently based at a training site at UKHSA's Midlands Field Service.

What is epidemiology?

Mona: I would describe epidemiology as 'detective work' - building and piecing together an evidence base for public health recommendations and actions. 

How do epidemiologists contribute to outbreak response?

Megan: Responding to an outbreak of disease in epidemiology involves providing and interpreting data to understand the severity of the situation, affected groups, what people are being infected by, and the impact and burden. You then highlight particular risk factors and groups that need targeting for intervention. One key role of the epidemiologist in an outbreak is getting everybody to agree on the case definition.

Mona: Contributing to regular disease surveillance allows us to understand 'normal' patterns and trends of disease spread. In other words, we can spot, investigate, and act when something looks out of the ordinary. Descriptive epidemiology (describing a disease in time, person and place) and analytical epidemiology (conducting statistical analysis to test a hypothesis) can explain how an infection might spread. However, you may not always know the true cause. As an epidemiologist, being able to interpret findings, make evidence-based recommendations and tailor these to your audience can help to ensure recommendations are actioned by the right stakeholders and, therefore, control further infections from spreading. 

What does the role involve?

Megan: It involves working with many different people and using your technical expertise and scientific background to identify trends in surveillance data and present the strengths and limitations to various stakeholders. When investigating a public health outbreak, I am responsible for managing the data, writing code to analyse the data, and working with people to identify and describe cases and do detective work to investigate the source.  

Mona: I support UKHSA's Midlands Field Service infectious disease surveillance and outbreak response work as part of a rota. This can involve producing or reviewing epidemiological summaries, attending outbreak control meetings and providing feedback and recommendations. I also work on specific projects that enable me to enhance existing and develop new skills while meeting my UK-FETP competencies.

What is a highlight of your job?

Megan: I worked on an investigation into an outbreak of Salmonella where I rang patients to complete questionnaires and conducted an analytical study, also known as a case-control study. Secondly, I enjoy being part of a global epidemiology network - it's a community of people who are interested in the spread of infectious diseases and you learn from people across the world. 

What challenges do you experience in your role?

Megan: I think a lack of awareness of epidemiology can be challenging as some of the fantastic work we produce can go unacknowledged. I think increased awareness of epidemiology will attract more people who are interested in helping people through the use of science.

What led you to apply for UK-FETP?

Mona: As challenging as it was, contributing to the COVID-19 response, seeing the impact and working alongside dedicated individuals is incredibly rewarding. That was when I realised I wanted to continue working in and developing my skills in this field, and I applied for the UK Field Epidemiology Training Programme (UK-FETP).

About UK-FETP

The United Kingdom Field Epidemiology Training Program (UK-FETP) was founded in 2011 as a program associated with the European Program for Intervention Epidemiology Training (EPIET), and it was accredited by TEPHINET in the first accreditation round. Since EU-Exit the UKFETP has run as an independent programme for the UK.

About UK-PHRST

The UK-PHRST is an innovative partnership between the UK Health Security Agency and the London School of Hygiene & Tropical Medicine, funded with UK aid by the UK Department of Health and Social Care.

The UK Public Health Rapid Support Team (UK-PHRST) and partners are currently delivering nine research projects, including two new studies bolstering UK-PHRST's research in outbreak preparedness and response:

1. 'A novel One Health approach to develop an early warning system to improve preparedness for and response to Marburg virus disease outbreaks'. This innovative study combines serological sampling of humans and Marburg virus detection from faecal bat samples to confirm target populations and uses remote audio-monitoring devices (AudioMoth) to assess humans and bat population interaction in target regions in Guinea. The team will use these findings to develop an early warning system to allow public health systems to recognise MARV outbreak threats with greater precision and prepare response measures tailored to affected areas. The study is being co-delivered with University of Oxford, the National Viral Haemorrhagic Fever Reference Laboratory, Guinea and MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine (LSHTM). 
    
2. 'A novel early warning system involving local community leaders for early detection of health-related events indicative of outbreaks: A pilot in Cape Verde and Brazil'. This project, a collaboration between Brasília University, the Ministry of Health in Cape Verde and the UK-PHRST, investigates whether an event based surveillance (EBS) system - developed with and relying on the participation of community leaders - is more effective at detecting infectious disease outbreaks than indicator-based surveillance or centralised EBS systems. The study team will focus on two contrasting outbreak prone lower middle-income countries (LMICs), Cape Verde and Brazil, respectively. 

In other active studies in the UK-PHRST portfolio, the project team delivering a pilot of a non-whole genome sequencing approach for monitoring SARS-CoV-2 variants in Burkina Faso conducted a successful research and laboratory visit to MRC Gambia Unit The Gambia at LSHTM in July 2022. See further details of the visit. The team had needed to move sequencing and assay development to two new sites, at MRC Gambia and Kenya, following a coup in Burkina Faso earlier in the year. The project team will submit a final report in October. 

The study 'Rapid response molecular diagnostics for Crimean-Congo Haemorrhagic Fever (CCHF)', which aims to assist the economic development and welfare of CCHF endemic populations in LMICs, particularly those in marginalised areas with limited laboratory capacity, conducted its final visit to the Ministry of Health virology laboratory in Turkey in June 2022. A UK-PHRST-hosted CCHF workshop in September 2022 is in preparation to disseminate results to key stakeholders. 

The UK-PHRST also convened a two day hybrid research workshop in June 2022 in partnership with Stellenbosch University as part of the UK-PRHST study investigating 'evidence on levels of, and interventions to improve, healthcare cleaning in low-and middle-income countries. Over 30 regional and international organisations attended, including experts in water, sanitation and hygiene (WASH), Infection prevention and control (IPC) and environmental hygiene. A report and roadmap are currently in preparation and will be published in due course as outputs. 

A closing ceremony for the IPC Caregivers study in Cameroon, which focused on the development and evaluation of resources to support IPC engagement with caregivers in LMIC hospitals, was held at Banso Hospital on 24 June 2022 to mark the contribution of the research team and the conclusion of field research. As part of the study, a series of IPC instructional/orientation animated videos were developed in partnership with Medical Aid Films and designed for caregivers of patients. See the animations in English and in Pidgin. A short version of the film was also produced. The project team are writing the final project report currently, and will also present findings within the Infection Control Africa Network (ICAN) webinar series and at the upcoming Global Health Network Conference.

Three research projects have also been completed since the last research update. These include the study which examined excess mortalities associated with COVID-19 in The Gambia, as well as two rapid studies; one to improve the application of oral fluid filovirus surveillance methods in Africa, and one focused on the development of mental health and psychosocial support (MHPSS) in outbreak preparedness and response in Africa.

The study team investigating excess mortality in The Gambia associated with COVID-19 and other causes concluded there was an unexpected decline in recorded mortality during the COVID-19 pandemic, but that mortality rates increased in the second wave and reached excess mortality of 22.6 per 100,000 compared to 2016-2019. Foetal complications constituted the highest proportion of deaths, while sepsis, COVID-19 and stroke were also important. A report written by UK-PHRST, MRC Unit The Gambia at LSHTM and Ministry of Health Gambia has been shared with regional health centres and health facilities participating in the study. Results will also be disseminated through a policy briefing, Ministry of Health meetings, and presentations at national and regional meetings.   

The second completed study, conducted in partnership with University of Oxford and the Fondation sante et développement durable (FOSAD) Guinea, set out to understand if the Lola population in Guinea exhibited signatures indicative of non-Ebola filovirus infections that impact upon individual and population-level seroepidemiological inference, and if so, if this information could be used to refine strategies for both oral fluid and serum-based seroepidemiological investigations in filovirus-endemic LMICs in Africa. The study demonstrated that oral fluid samples showed discordant responses with blood and concluded that at population scale, and despite prior validation of the assay in an Ebola virus survivor cohort, surveillance for Ebola virus and likely other filoviruses appeared unfeasible with oral fluid-based assays due to insufficient specificity. These limitations are important for public health professionals and researchers using oral fluid tools for the surveillance of filoviruses as they were widely used during and after the outbreak of Ebola in West Africa and have been suggested as more acceptable tools for surveillance in endemic settings. Results from the study were disseminated in Guinea through the national health security agency (ANSS), who lead operations and research strategy related to emerging infectious diseases including filoviruses. The study highlights the limitations of relying on oral fluid based surveillance for filoviruses and suggest dried blood spot (DBS) based sampling as a viable alternative.

The study ‘Evidence to practice: research and capacity development for mental health and psychosocial support (MHPSS) in outbreak preparedness and response in Africa: SPACE 2.0’, sought to support national actors in Liberia, Sierra Leone, Cameroon and Nigeria prone to outbreaks to integrate mental health interventions in emergency preparedness and response (EPR). An umbrella review on the effectiveness of mental health and psychosocial support (MHPSS) interventions during infectious disease outbreaks was conducted, and a hybrid workshop was held in Liberia which brought together mental health experts from African public health institutions. This included World Health Organization Regional Office for Africa (WHO Afro), Africa Centres for Disease Control and Prevention (Africa CDC), West African Health Organization (WAHO), East, Central and Southern Africa Health Community (ECSA-HC) and mental health leaders in Liberia, Sierra Leone, Cameroon, and Nigeria to share expertise and develop a theory of change (ToC) for integrating mental health into national EPR plans. Capacity building activities included introducing the newly developed Minimum Services Package for MHPSS in emergency response, and related MHPSS resources. The UK-PHRST mental health consortium convened a further webinar on 18 May 2022 at which results from the study were shared, and next steps discussed, including:

• How best to facilitate sharing expertise and lessons learned from different countries responses to the COVID-19 pandemic and other emergencies
• How to further improve and refine the ToC for MHPSS integration into emergency response
• Identification of research and capacity strengthening priorities for the next phase of the consortium’s work.

We have summarised the latest UK-PHRST deployment, research and capacity development activities from April – June 2022 in a quarterly map. Many of our activities across the triple remit overlap, and some will continue into the next quarter. The map demonstrates ongoing or completed activities during the quarter, and the year stated is when the project commenced.

View the UK-PHRST quarterly map

The UK-PHRST team and partners are currently delivering 11 research projects, including two new studies:

• ‘Integrating Social Science into Africa CDC’s Public Health Operations’, which examines the status and use of social science at Africa CDC and how it can be further integrated into public health preparedness and response.
   
• ‘What is the current level of cleaning in LMIC health systems and what interventions are effective at improving it?’ which strengthens UK-PHRST's research in Infection Prevention and Control (IPC) and environmental hygiene and aims to improve the evidence base for cleaning implementation and investment in cleaners, a vulnerable and neglected group in the health system in many Lower Middle-Income Countries (LMICs).

We are also delighted to welcome Nasser Fardousi to the UK-PHRST, who joined us as a Research Fellow in Environmental Hygiene in January. Nasser is working with the IPC team, investigating the current level of cleaning in LMIC health systems and what interventions are effective at improving it.

We have several research projects that are concluding. These include two rapid research studies, one of which aims to improve the application of oral fluid filovirus surveillance methods in Africa, and the other to develop mental health and psychosocial support (MHPSS) in outbreak preparedness and response in Africa. The team investigating the extent of excess mortality in health facilities in The Gambia associated with the COVID-19 pandemic is also in the final stages of writing up their results.

In February, as part of the MHPSS study, the team delivered a workshop in Liberia in partnership with Africa CDC hosted by the Liberian Ministry of Health. The workshop brought together a consortium of mental health experts from African public health institutions to share experiences and lessons learned from COVID-19 and other crises in the region. The workshop also mapped out processes for strengthening MHPSS in outbreak preparedness and response in Africa.

A military Coup in Burkina Faso in January 2022 threatened to affect the delivery of the rapid study piloting a non-whole genome sequencing approach for monitoring SARS-CoV-2 variants in Burkina Faso, however, the team were able to move sequencing and assay development to The MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine and a new field site in Kenya.

Our study on COVID-19 vaccine strategies implementation in partnership with Gates Exemplars in Global Health has been published online and will soon be published in French. Read more here.

The research management team are also preparing the programme’s six-month report for National Institute for Health and Care Research (NIHR), including quarterly and annual finance reports.

Our newly developed research strategy for 2022-2025 is currently in review by our key stakeholders. The strategy has been informed by an evidence gap analysis complemented by stakeholder interviews and feedback from partners and formal reviews and aims to deliver a coherent, structured, partner-led research programme informed by public health need.

We have summarised the latest UK-PHRST deployment, research and capacity development activities from January – March 2022 in a quarterly map. Many of our activities across the triple remit overlap, and some will continue into the next quarter. The map demonstrates ongoing or completed activities during the quarter, and the year stated is when the project commenced.

View the UK-PHRST quarterly map

We are looking for an external consultant with ethnographic experience, public health, outbreaks training or experience, and experience working within or closely with Ministries of Health, National Public Health Agencies, or relevant multilateral bodies.

This consultant will support the UK-PHRST in conducting an institutional ethnography of Africa CDC, to support the development of a social science integration strategy and roadmap within the organisation; to conduct analysis of data collected; to write up operational and academic findings in partnership with Africa CDC.

Skills and experience:

• Relevant PhD or MA/MSc
• Social science training and substantial experience with primary data collection of qualitative data
• Project management skills
• Ability to work independently and as part of a team
• Excellent written and verbal English language communication skills
• Confident presentation skills

Preferred start date: 15 April 2022

Expected duration (days): 84 days

Expected hours per day: 7. Flexible working patterns can be considered during the project’s analysis phase.

Daily rate: £350-500/day, dependent on skills/experience

Interested candidates should submit their CVs and a cover letter outlining how they are suitable for the role, along with their expectations for a daily rate. Please send these to Hana.Rohan@lshtm.ac.uk  and Thom.Banks@lshtm.ac.uk.

The UK-PHRST team and partners are currently working on ten research projects, two of which have newly started since our last quarterly newsletter:

• a rapid systematic review, building on the UK-PHRST infection prevention and control (IPC) caregivers study, of the evidence on the levels of, and interventions to improve, cleanliness in health facilities in LMICs and specifically relating to outbreak preparedness and response.
   
• a rapid study to validate and improve the application of oral fluid-based immunoassays for filovirus surveillance in West and Central Africa, building on previous UK-PHRST research on Ebola Virus immunoassays.

The team have also recently completed two research projects. One of these explored how serosurveillance of healthcare workers might be used to strengthen viral haemorrhagic fever preparedness in Uganda. The findings suggested that increased PPE training is needed to increase awareness and reduce potential exposure to Ebola Virus (EBOV) in healthcare workers and to Rift Valley Fever in abattoir workers. The other investigated the feasibility of using oral fluid-based anti-EBOV immunoassays to identify previously undetected EBOV infections in Guinea. It provided strong evidence that this approach can detect previously unidentified EBOV exposures many years after infection and demonstrated its feasibility in targeted surveillance and preparedness activities where EBOV is endemic.

In our last research update in July, we shared the collaborative research project with Gates Ventures that explored the barriers, enablers, and lessons from the previous implementation of vaccines during epidemics in LMICs that can be applied to COVID-19. The findings of this research were presented in our latest webinar on COVID-19 vaccination in low and middle-income countries: lessons from past and current campaigns.

We are also in the process of developing our new 3-year research strategy. This work is being informed by an evidence gap analysis to identify key areas where evidence from impact evaluations and systematic reviews in outbreak prevention, detection and response in LMICs is most limited. This resource is being complemented by stakeholder interviews and together these efforts will provide a strategic approach for identifying our research priorities in the coming years. We hope to provide more details on our new research strategy in the next research update.

We are seeking an outstanding Research Fellow or Assistant Professor to support the UK Public Health Rapid Support Team (UK-PHRST). The post-holder will contribute epidemiological and analytical expertise to support UK-PHRST’s strategic objectives in outbreak response, operational research, and capacity building, working in partnership with local and regional stakeholders. The role will also include representing the UK-PHRST at relevant external events, conferences and workshops.

The UK-PHRST is a collaborative partnership between the London School of Hygiene and Tropical Medicine (LSHTM) and Public Health England (PHE) that rapidly deploys a team of multidisciplinary public health professionals and researchers on behalf of the UK Government to areas of need in low and middle-income countries (LMICs). Application details here.

Deadline: Tuesday 28 September

Between September and November 2020, Itad conducted a number of Key Informant Interviews with stakeholders to gather evidence for the end-point evaluation of the UK Public Health Rapid Support Team (UK-PHRST) programme.

The purpose of the evaluation is to ensure independent monitoring and quality assurance of programme delivery, documentation of lessons learned, and robust tracking of results, providing assessment of the effectiveness of official development assistance (ODA) funds.

We are delighted to share these with you;

• Executive Summary 
• Final Report (plus annexes)
• Management Response

We are delighted to announce that Dr Ben Gannon has been appointed as the Interim Director of the UK Public Health Rapid Support Team (UK-PHRST). Ben has taken over the role from Professor Dan Bausch, who has accepted a post as Director of Global Health Security at the Foundation for Innovative New Diagnostics in Geneva. We would like to take this opportunity to thank Dan for his leadership of the UK-PHRST over the past four years.

Ben has worked in the UK-PHRST as the Microbiology Lead for the last five years, deploying on multiple occasions and building an extensive portfolio of overseas research and capacity development projects. He comes from an academic background, including specialising in zoonotic disease transmission and diagnostics at the University of Bristol. Later he joined the PHE Rare and Imported Pathogens Laboratory where he deployed to Sierra Leone on multiple occasions to support the Ebola diagnostic laboratory programme. Ben’s appointment is strongly supported by the Department of Health and Social care, as well as Public Health England and the London School of Hygiene & Tropical Medicine, the joint lead UK-PHRST partner organisations.

We are confident that the UK-PHRST is in excellent hands at this critical time.

Adapted by UK-PHRST staff, Dr Alice Walker, this course shows front-line responders how to recognise when people affected by the COVID-19 pandemic are in distress, and how to provide them with Psychological First Aid (PFA). It is specifically designed for first responders in Africa and reflects the different healthcare situations of African countries, drawing on guidance from the World Health Organisation and the United Nations, and has been adapted for the context by the UK-Public Health Rapid Support Team (PHE/LSHTM) with input by experts from WHO AFRO, WHO EMRO, Africa CDC, the West African Health Organization, and the East, Central and Southern Africa Health Community (ECSA-HC).

Take the course.

We are seeking an outstanding academic leader to serve as Deputy Director for Research for the UK Public Health Rapid Support Team (UK-PHRST). The post-holder will oversee and deliver the UK-PHRST research programme, building the evidence base for international disease outbreak response and interventions. The UK-PHRST is a high-profile collaboration between the London School of Hygiene and Tropical Medicine (LSHTM) and Public Health England (PHE), with a 5-year £20m grant from the UK government to support a triple mandate of outbreak response, outbreak-related research, and capacity building in low and middle-income countries (LMICs).  Application details here. 

Deadline: Sunday 03 January

Prof Bausch has served on ASTMH’s executive committee as scientific program chair for the last six years, and was recently voted President-elect by the society’s members. ASTMH is the largest international scientific organisation of experts dedicated to reducing the worldwide burden of tropical infectious diseases and improving global health. Prof Bausch will serve a three-year term comprised of one year each as President-Elect, President, and Immediate Past-President.

As president, he will be responsible for steering the important work of ASTMH, which includes generating and sharing scientific evidence, informing health policies and practices around the world and advocating for investment in tropical medicine and global health research.

Prof Bausch said “I feel so fortunate to be elected to lead such a great and talented group of people at ASTMH who are so dedicated to making the world a better place. Furthermore, being based in London and engaging with the Royal Society over the past few years, I’m excited about the potential for ASTMH-RSTMH collaborations.”

Read the full story here.

The UK Public Health Rapid Support Team (UK-PHRST) is conducting an online survey (until 25^th October 2020) open to public health and healthcare professionals worldwide to understand their professional assessment of current and future COVID-19 interventions, specifically the practicality of, and barriers to, implementation in their context.   

Your participation is important to share learning to inform the COVID-19 response in your country and in others. The survey is available in English, French and Portuguese and is anonymous.  

For more information on how to complete the survey, please click here. 

Please help to share this with relevant professionals - many thanks for your valued support!

The UK-PHRST are pleased to announce the launch of their new Knowledge Hub, where practitioners and researchers can find and share the most useful information for their work in outbreak response. Hosted on The Global Health Network, the Knowledge Hub aims to:

• Bridge the gap between the fast-paced world of online discussion forums and maintain long-term access to useful resources.
• Share up-to-date research and policy, as well as a dedicated education and training area with resources to support learning and inform effective outbreak response.
• Connect UK-based researchers with specialists in LMICs, creating a flow of information exchange and localised adaptations to outbreaks.

The new UK-PHRST Knowledge Hub provides a community function, allowing members to start group conversations around key topics, such as this timely post on contact tracing technology and comment on current issues, as shown in this blog on the importance of looking after Mental Health in COVID-19

We look forward to you joining, contributing and using our Knowledge Hub as a reliable and up-to-date source on outbreak response! Please do give us feedback on how you would like to see the UK-PHRST Knowledge Hub evolve in our discussion forum here.

Welcoming Ashley Sharp, a medical doctor before moving into public health and completing the UK Public Health Specialty Training Programme and the UK Field Epidemiology Training Programme (FETP). 

He has worked in a variety of public health roles at local, regional, national and international levels in the UK, Eswatini, Sierra Leone, Haiti and Bangladesh, with a focus on health protection and health systems development. He is also a member of the UK Faculty of Public Health, the standard setting body for public health specialists within the United Kingdom. 

Ashley joins the team as the Senior Epidemiologist and Deputy Director for Operations, replacing Olivier le Polain. 

The UK-PHRST notes that April 28^th 2020 marks 20 years since the inception of the Global Outbreak Alert and Response Network (GOARN). For 20 years GOARN has facilitated and promoted partners to work together in tackling disease outbreaks across the world and by doing so, ensuring that the response can be greater than the sum of its parts. We congratulate GOARN for two decades of dedicated service, making the world a safer place. The UK-PHRST is proud to support GOARN, both through deployments in the field and strategic support through membership on the GOARN Steering Committee.  

The UK-PHRST deploys specialist experts to outbreaks of infectious diseases overseas, to help increase and improve the response and reduce their risk of becoming global threats. As COVID-19 has shown, diseases don’t respect borders. In February and March the UK-PHRST deployed, both through GOARN and bilateral agreements, to combat COVID-19, working alongside colleagues from the World Health Organisation (WHO), Ministries of Health and others in the WHO Western Pacific Regional Office in the Philippines, WHO Country Office in Nepal, Nigeria CDC, and Africa CDC in Ethiopia to deliver expertise in epidemiology, data analysis, infection prevention and control, clinical care, laboratory diagnostics, social science, logistics, and strategic guidance.

Although global travel restrictions have now necessitated recalling all personnel back to the UK, the UK-PHRST continues to provide support remotely to the aforementioned partners, as well as to the WHO African Regional Office in the Republic of the Congo and WHO Country Office and Ministry of Health in Bangladesh. In addition to their support to partners overseas, many UK-PHRST team members are also supporting the domestic response, providing clinical care and epidemiologic support. The UK-PHRST is also engaged in developing and implementing several research projects on COVID-19 and has organized a Massive Open Online Course (MOOC) on COVID-19 through LSHTM, which has nearly 200,000 registrants. 

At any time, an emerging, lethal, and highly transmissible pathogen might pose a risk of being spread globally because of the interconnectedness of the global population.^{1, 2} Emerging epidemic threats are occurring with increasing scale, duration, and effect, often disrupting travel and trade, and damaging both national and regional economies.^{3, 4} Even geographically limited outbreaks such as the Ebola virus disease in Africa might have a global effect.

Read the full comment

The UK-PHRST has been working closely with the Nigeria Centre for Disease Control (NCDC) to improve knowledge on Lassa fever by identifying other pathogens that may be causing similar illnesses. A recent Weekly Epidemiological Report from NCDC features an update on this work, which is taking place at the NCDC National Reference Laboratory.

It's hoped the work could lead to improved patient care, better surveillance data, and will inform public health policy. As well as broadening the scientific knowledge base on the topic, this collaboration is supporting the growth of in-country capacity for genetic sequencing in Nigeria and leadership by local experts.

Building in-country Capacity for Genetic Sequencing

Experts from the UK Public Health Rapid Support Team have contributed to a new Massive Online Open Course (MOOC) from the London School of Hygiene & Tropical Medicine.

This course is for those interested in, studying or working in global and public health. This includes government stakeholders; health practitioners and NGO employees - particularly those working in countries regularly affected by infectious disease outbreaks.

Recent outbreaks of emerging and re-emerging infectious diseases have shown we need to be able to coordinate responses to disease outbreaks at the regional, country and global level. On this free course, participants will explore disease outbreaks, discovering what outbreaks are and why they matter as well as the different responses to such outbreaks. They will also consider the future of outbreak preparedness.

Disease Outbreaks in Low and Middle Income Countries

Public health specialists from the UK Public Health Rapid Support Team are supporting the Democratic Republic of Congo to tackle the country’s Ebola outbreak as it reaches the one-year mark.

Those deploying to the country include a data scientist, an expert in tracking outbreaks (epidemiologist), and an infection and prevention control expert who will work with local scientists. The deployment is at the request of the World Health Organization’s Global Outbreak Alert and Response Network following the recent decision to declare the outbreak a Public Health Emergency of International Concern.

Read the full announcement

In her final annual report before leaving the role, Dame Sally Davies – Chief Medical Officer, England, and Chief Medical Advisor to the UK – chose to ‘address the UK’s engagement with health at a global level’. Her report showcases the work of the UK Public Health Rapid Support Team and includes a case study of the team’s work to support Nigeria in tackling Lassa Fever.

Read the full report

Q&A with UK-PHRST’s Dr Olivier le Polain. 

Olivier le Polain is the senior epidemiologist and deputy director for operations of the UK Public Health Rapid Support Team.

He has been a member of the team for just under two years and in that time has deployed to Madagascar to respond to an outbreak of pneumonic plague, to Bangladesh amidst the Rohingya refugee crisis and most recently to the Democratic Republic of Congo. The latter was to support the response to two consecutive Ebola virus disease (EVD) epidemics, one in Equateur Province (May – July 2018) as well as the ongoing large outbreak which has affected the Eastern provinces of North Kivu and Ituri since August 2018.

Olivier talks about his experience on the ground in the DRC during the ongoing Ebola epidemic, the importance of working in partnership with other countries and organisations and his experience on the UK-PHRST so far. 

Read the interview

A new online resource which aims to strengthen the control response to disease outbreaks has been developed by the London School of Hygiene & Tropical Medicine (LSHTM) and the Institute of Development Studies. The Epidemic Response Anthropology Platform is funded by the UK-PHRST and will work with, and build, networks of anthropologists and other social scientists with regional or subject expertise, and connect them to policymakers, scientists and humanitarian response workers involved in responding to epidemics.

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On 8 May 2018, the Democratic Republic of Congo (DRC) Government declared a new outbreak of Ebola Virus Disease (EVD)—the country’s ninth outbreak. The UK-PHRST is deploying to the Democratic Republic of Congo to help control the outbreak. The three UK-PHRST team members deploying include two experts in tracking outbreaks, LSHTM’s Hilary Bower and Olivier le Polain from Public Health England, and data scientist Patrick Keating from LSHTM.

The team is expected to remain in the DRC for around six weeks, during which time they will help track the spread of the outbreak, and will also support in establishing robust data systems that will help align crucial information gathering. The UK-PHRST also has expertise in various other key areas for Ebola response, such as laboratory diagnostics, that can be deployed should they be needed.

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Q&A with team Director, Prof Dan Bausch.

In April 2017, Professor Daniel Bausch was appointed Director of the UK-PHRST. Prof Bausch is a specialist in emerging infectious diseases trained in internal medicine, infectious diseases, tropical medicine, and public health. He has extensive experience in sub-Saharan Africa, Latin America, and Asia combatting deadly global health threats such as Ebola virus, hantavirus, and SARS coronavirus.

A year on from the team's first deployment, Prof Bausch tells us more about the team and how they work to assist in managing disease outbreaks.

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The UK Public Health Rapid Support Team (UK-PHRST) is deploying to Sierra Leone to help reduce the risk of a disease outbreak following the deadly landslides in Freetown.

Following natural disasters, outbreaks of water-borne diseases such as cholera can occur, particularly where there is a lack of access to clean water and sanitation. Given the scale of the disaster in Freetown, the local capacity to detect and control a disease outbreak is limited and the Government of Sierra Leone has requested international support.

The UK-PHRST team deployed to Sierra Leone includes experts in tracking the progress of an outbreak and diagnosing its cause, as well as a logistician. It will be working alongside Sierra Leone health system professionals and other experts in disaster relief to support the Sierra Leone Government’s response. As the UK-PHRST’s deployment progresses, it will continue to provide support and share expertise with our partners in Sierra Leone to strengthen the health system beyond the immediate response.

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Professor Daniel Bausch has been appointed Director of the new UK Public Health Rapid Support Team (UK-PHRST).

Prof Daniel Bausch, a specialist in emerging infectious diseases trained in internal medicine, infectious diseases, tropical medicine, and public health, will take up the position of Director of the UK-PHRST in April. He has extensive experience in sub-Saharan Africa, Latin America, and Asia combatting deadly global health threats such as Ebola virus, hantavirus, and SARS coronavirus.

His most recent role was as the Technical Lead for the Epidemic Clinical Management Unit in the World Health Organization's (WHO) Pandemic and Epidemic Diseases Department. He is a tenured Professor at the Tulane University Health Sciences Center in the United States and has served as a regular consultant for the WHO, the United Nations and the US National Institutes of Health. In addition to his expertise in the sciences, Prof Bausch places a strong emphasis on capacity building in all his projects and also has a keen interest in the role of the scientist in promoting health and human rights.

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