The Ministry of Health and Wellness (MoHW) hosted the implementation of sentinel surveillance for influenza meeting supported by the World Health Organization (WHO) Country Office in Botswana on the 24th of September 2021.

The objective of the multi-stakeholder meeting held in Gaborone was to create awareness of the Global Influenza Program and its objectives and to inform the process of defining the national objectives for the influenza sentinel surveillance program. In addition, the meeting aimed to synthesize the national Standard Operating Procedures and integrate them into the national Integrated Disease Surveillance and Response (IDSR) programme. Among the participants at the training were laboratory technologists and scientists, medical technologists, epidemiologists and surveillance experts, IDSR focal points, veterinary diseases epidemiology experts, and data managers.

The  African region has seen substantial advances in influenza surveillance over the past decade. To date, 28 countries members of the African Regional Influenza Laboratory network are not only implementing sentinel surveillance for influenza-like illness (ILI) and/or severe acute respiratory infection (SARI) using WHO standards but they are also contributing to weekly influenza surveillance reporting at the regional and global levels. 

WHO Regional Office for Africa deployed to Botswana a Laboratory Expert Dr Belinda Herring to support and train relevant stakeholders on the establishment of an influenza surveillance system. Dr Belinda pointed out during the training sessions that the current coronavirus outbreak has taught us that respiratory disease can have catastrophic effects on morbidity, mortality, and livelihoods as it can spread rapidly in populations without discrimination. “This emphasizes the need to put in place respiratory disease surveillance to rapidly identify and respond to and prevent the spread of the next pandemic, both within a country and also outside its borders”, she added. Over the past century, the world has experienced four influenza pandemics highlighting the need for influenza surveillance to rapidly detect viruses with pandemic potential. One of these influenza pandemics was the 2009 H1N1 pandemic commonly referred to as swine flu which spread worldwide including in Botswana where it was confirmed in July 2009.

Despite significant progress made in the African region on establishing sentinel influenza surveillance in the countries, there is still a paucity of influenza epidemiological and virological data as not all countries have sentinel surveillance for influenza in place. The establishment and maintenance of sentinel surveillance systems for influenza in the Member State countries enable the collection of valuable epidemiological data that strengthen responses to influenza outbreaks in the region. A national sentinel surveillance system can support pandemic planning by providing country-specific data, supporting laboratory and epidemiologic infrastructure for alert and response activities, and by providing the established means to monitor the severity, intensity, and progression of pandemic cases.

Speaking at the meeting, the acting Advisor of Integrated Health Services at MoHW, Dr. Karabo Thokwane indicated that one of the relevant initiatives that are being established by the MoHW is the Botswana Public Health Institute (PHI). “This training and all the future work to strengthen the national systems to respond to Influenza outbreaks in the country will contribute to the IDSR and data management pillar of the Botswana PHI,” said Dr Thokwane.

The workshop consisted of presentations by the Laboratory Expert Dr Herring including discussions to a better understanding of the influenza virus, epidemics, pandemics, and avian influenza. Representing the WHO country office, the focal point for laboratories, Dr Tebogo Madidimalo indicated in his remarks that “Botswana seems to have a lot of pieces of what’s required to implement this SARI/ILI sentinel surveillance in place. We just need to care the guidance, see how we bring it all together, and ensure the qualitative standards are adhered to”. The data being generated would be very useful to the country to inform policy decisions on relevant interventions. “Let’s also remember that this is not a once-off exercise. We need to get it right, to embrace the support pledged, so Botswana is also counted among those countries heeding the best for the people” Dr Madidimalo added.