1. Disease surveillance MP.WAT/WG.4/2005/5

2. Context DRINKING WATER QUALITY HEALTH OUTCOME ENVIRONMENTAL QUALITY ADMINISTRATIVE/ LEGAL REPORTING

3. Inadequate surveillance Inadequate surveillance systems Lack of diagnostic detection capacity Lack of epidemiological data interpretation Economic sustainability in question

4. Agenda Recall of the Protocol provisions Core functions of surveillance Assessing surveillance systems Elements of the work plan

5. Protocol provisions Article 8 para 3: ensure establishment of comprehensive national and/or local surveillance and early-warning systems Articles 10, 12, 13 and 14 Multi-functionality of the systems (multi-disease surveillance, water pollution incident, extreme weather events)

6. Core functions of surveillance systems Case detection Reporting Investigation and confirmation Analysis and interpretation Action –Control/response –Policy –Feedback/communication

7. Support functions of surveillance systems Setting standards (case definitions) Training and supervision Laboratory support Communications Resource management

8. Why assessing surveillance systems Optimization of the system for the task at hand –Institutional dispersion –Surveillance removed from control –Inconsistent approach to detection, reporting Economic performance and efficiency Sustainability of the system

9. Outcome of assessment Obtain baseline information to implement a co-ordinated multi-disease approach to disease surveillance that allows measurement of progress made in surveillance strengthening Identify gaps in capacity to meet core and support needs Determine country needs for improvement Develop prioritised action plans

10. HOW TO 1: Priorities Does the disease result in a high disease impact? Does it have significant epidemiological potential? Is it a specific target of a national, regional or international control program? Does the collected information lead to action?

11. Priority diseases … Cholera Shigellosis Viral hepatitis A Typhoid Paratyphoid Malaria EHEC

12. QUESTION 1 Does the working group still confirm these as the priority diseases? Does the working group/ Parties want to flag alternative/ additional diseases?

13. HOW TO 2: Structure Peripheral: diagnosis and case management, reporting, simple tabulation and graphing Intermediate: case management, analysis of data, lab diagnosis, investigation, feedback down, reporting up Central: national coordination, lab analysis, epi studies, support outbreak control, report to WHO

14. HOW TO 3: Core and support Detection Registration Confirmation Reporting Analysis Response Feedback Evaluation Standards (case definitions) Training Supervision Communication systems Resources

15. HOW TO 4 Assessing output Assessing integration and coordination Laboratories Health mapping Communication

16. Timeline 1. Planning 2. Pre-assessmentDays 1 – 3 3. TrainingDays 4 – 6 4. Field assessmentDays 7 – 12 5. Analysis and reportDays 13 – 16 6. Findings & follow-upDays 17 7. National Action Plan4 – 8 weeks

17. Requested from WGWH Endorsement of list of priority water- related diseases or amendment/ completion Review current surveillance systems for priority water-related diseases –Work plan element for int cooperation –Report through Secretariat to 1-MOP- PWH