Perspectives on the Department of Defense Global Emerging Infections Surveillance and Response System A Program Review (2001) / Chapter Skim
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3 GEIS at Naval Medical Research Unit 2, Indonesia
3 GEIS at Naval Medical Research Unit 2, Indonesia
Pages 47-64
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From page 47... ...
NAMRU-2 projects receive funding from numerous sources including the Military Infectious Disease Research Program (MIDRP) , GEIS, Pacific Command (PACOM)
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From page 48... ...
Committee to Review the Department of Defense Global Emerging Infections Surveillance and Response System visited NAMRU-2 from October 2 to 5, 2000. The subcommittee also visited a newly developed extension facility in Phnom Penh, Cambodia, that NAMRU-2 operates jointly with the Armed Forces Research Institute of Medical Sciences (AFRIMS)
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From page 49... ...
A planned central public health laboratory within the Indonesian CDC would serve to establish national norms, guidelines, and standards and would provide basic skills training for workers in the decentralized laboratory network. During an interview with the subcommittee team, Dr.
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CDC. Conclusions Laboratory capacity in lakarta is sufficient to support current GEIS activities in Indonesia.
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From page 51... ...
The subcommittee noted the absence of a training officer to coordinate formal training programs. In addition, no staff are assigned responsibilities for communicating or disseminating surveillance information to other partners.
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From page 52... ...
The NAMRU-2 GEIS is conceptually organized around the four pillars defined by the GEIS Central Hub. These pillars are · acute febrile illness surveillance, · drug-resistant malaria surveillance, · surveillance for enteric pathogens, and · influenza surveillance.
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From page 53... ...
Because the MoH considers EWORSbased surveillance to be extremely important for timely reporting of outbreaks, EWORS computers are being installed directly in both Litbangkes and the Indonesian CDC with linkages to the EWORS server for direct national access to the raw data. Drug-Resistant Malaria Surveillance Overall, GEIS goals related to malaria include surveillance, drug resistance monitoring, technology transfer, training of local personnel, and in some instances, provision of supplies and materials to implement specific projects.
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From page 54... ...
Specimens infected with influenza virus are sent to Australia for characterization, and efforts are not closely coordinated with the DoD Laboratory-Based Influenza Surveillance Program, at Brooks Air Force Base, San Antonio, Texas. Influenza surveillance is conducted under the auspices of GEIS through four sentinel specimen collection sites at two different hospitals and primary health care centers for virus isolation and characterization.
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From page 55... ...
Conclusions The Indonesian government's laboratory decentralization policy, along with attempts to build both surveillance and laboratory capacity, will bring challenges for NAMRU-2 and GEIS, which may be called upon to provide training for capacity building as well as continuing its current essential support of the MoH. Improved monitoring of infectious diseases with corresponding epidemic control is a national goal that coincides with the objectives of GEIS.
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From page 56... ...
The subcommittee questions whether the current annual review and funding process allows sufficient time for surveillance project maturation and planning between reviews. Annual review appears to rush the proposal preparation process and can culminate in the making of decisions about the merits of projects on the basis of incomplete information.
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From page 57... ...
GEIS activities are transparent to the Indonesian MoH, and most projects are jointly conducted. GEIS-funded NAMRU-2 activities serve the Indonesian MoH in important ways, including support of surveillance, assistance with epidemic response, provision of laboratory diagnosis and reference testing services, and training of personnel.
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From page 58... ...
Conclusions NAMRU-2 staff currently involved with GEIS understand and accommodate the need to establish collaborative and collegial networks within the Indonesian and Cambodian scientific and public health communities, and their efforts to do so are producing many positive results. Special credit needs to be given to the energy and vitality that NAMRU-2 FSN and military staff bring to the program.
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From page 59... ...
· The reporting of data to Indonesian authorities is being done well. In collaboration with the Indonesian MoH, GEIS should make a more concerted effort to share surveillance information with USAID, the WHO, and other relevant institutions working in Indonesia.
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From page 60... ...
As a sentinel surveillance system, it needs to be evaluated before decisions are made to greatly expand its use. In addition, greater use of established laboratory capacity to verify the etiology of EWORS-defined syndromes should be initiated to enhance EWORS's utility for the monitoring of emerging infectious diseases.
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From page 61... ...
Anthony Oyofo, director, Bacterial Disease Program, and head, Microbiology Department & Ultrastructure Division CDR Michael Bangs, head, Entomology Department, Parasitic Disease Program LCDR Mark D Lacy, head, Clinical Studies Department, Parasitic Disease Program HM1 Dennis I
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From page 62... ...
Tour of the NAMRU-2 facility. NAMRU-2 GEIS presentations, including presentations on EWORS, outbreak response activities, enteric surveillance, monitoring, malaria drug resistance, influenza surveillance, and regional surveillance of hemorrhagic diseases.
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From page 63... ...
Wednesday, October 4 Continued visits to infectious disease surveillance partners and collaborators. Follow-up meetings with NAMRU-2 staff involved with GEIS projects.
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From page 64... ...
Conclusions The value of NAMRU-3 laboratory capacities is widely acknowledged by all public health partners, such as the MOHP. NAMRU-3 facilities play an essential role in supporting operational research in infectious diseases and infectious disease surveillance in Egypt and in the region.
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