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Integrated Disease Surveillance and Response (IDSR) strategy: current status, challenges and perspectives for the future in Africa
  1. Ibrahima Socé Fall1,
  2. Soatiana Rajatonirina1,
  3. Ali Ahmed Yahaya1,
  4. Yoti Zabulon1,
  5. Peter Nsubuga2,
  6. Miriam Nanyunja3,
  7. Joseph Wamala4,
  8. Charles Njuguna5,
  9. Charles Okot Lukoya1,
  10. Wondimagegnehu Alemu6,
  11. Francis Chisaka Kasolo7,
  12. Ambrose Otau Talisuna1
  1. 1World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
  2. 2Global Public Health Solutions, Atlanta, Georgia, USA
  3. 3World Health Organization, Country Office, Kampala, Uganda
  4. 4World Health Organization, Country Office, Juba, South Sudan
  5. 5World Health Organization, Country Office, Free Town, Sierra Leone
  6. 6World Health Organization, Country Office, Abuja, Nigeria
  7. 7World Health Organization, Regional Office for Africa, Country Support, Brazzaville, Congo
  1. Correspondence to Dr Ambrose Otau Talisuna; talisunaa{at}


In 1998, the WHO African region adopted a strategy called Integrated Disease Surveillance and Response (IDSR). Here, we present the current status of IDSR implementation; and provide some future perspectives for enhancing the IDSR strategy in Africa.

In 2017, we used two data sources to compile information on the status of IDSR implementation: a pretested rapid assessment questionnaire sent out biannually to all countries and quarterly compilation of data for two IDSR key performance indicators (KPI). The first KPI measures country IDSR performance and the second KPI tracks the number of countries that the WHO secretariat supports to scale up IDSR. The KPI data for 2017 were compared with a retrospective baseline for 2014.

By December 2017, 44 of 47 African countries (94%) were implementing IDSR. Of the 44 countries implementing IDSR, 40 (85%) had initiated IDSR training at subnational level; 32 (68%) had commenced community-based surveillance; 35 (74%) had event-based surveillance; 33 (70%) had electronic IDSR; and 32 (68%) had a weekly/monthly bulletin for sharing IDSR data. Thirty-two countries (68%) had achieved the timeliness and completeness threshold of at least 80% of the reporting units. However, only 12 countries (26%) had the desired target of at least 90% IDSR implementation coverage at the peripheral level.

After 20 years of implementing IDSR, there are major achievements in the indicator-based surveillance systems. However, major gaps were identified in event-based surveillance. All African countries should enhance IDSR everywhere.

  • African region
  • Integrated Disease Surveillance and Response
  • International Health Regulations
  • key performance indicators
  • World Health Organisation

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Handling editor Seye Abimbola

  • Contributors ISF, SCR, AAY, ZY, PN, MN, ON, JW, CN, CLO, WA, FCK and AOT planned, coordinated, conducted and supervised the IDSR rapid assessment and monitoring and evaluation of IDSR using the KPIs. All authors contributed to the manuscript, and read and approved the final manuscript.

  • Funding We acknowledge ongoing financial support for IDSR implementation from the US CDC and through a cooperation grant from the US Agency for International Development, Bureau for Africa (USAID/AFR), Washington, DC.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No additional data are available.

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