The World Health Organization (WHO) declared the current COVID-19 a public health emergency of international concern on January 30, 2020. Countries in the Eastern Mediterranean Region (EMR) have a high vulnerability and variable capacity to respond to outbreaks. Many of these countries addressed the need for increasing capacity in the areas of surveillance and rapid response to public health threats. Moreover, countries addressed the need for communication strategies that direct the public to actions for self- and community protection. This viewpoint article aims to highlight the contribution of the Global Health Development (GHD)/Eastern Mediterranean Public Health Network (EMPHNET) and the EMR’s Field Epidemiology Training Program (FETPs) to prepare for and respond to the current COVID-19 threat. GHD/EMPHNET has the scientific expertise to contribute to elevating the level of country alert and preparedness in the EMR and to provide technical support through health promotion, training and training materials, guidelines, coordination, and communication. The FETPs are currently actively participating in surveillance and screening at the ports of entry, development of communication materials and guidelines, and sharing information to health professionals and the public. However, some countries remain ill-equipped, have poor diagnostic capacity, and are in need of further capacity development in response to public health threats. It is essential that GHD/EMPHNET and FETPs continue building the capacity to respond to COVID-19 and intensify support for preparedness and response to public health emergencies.

Background: The surveillance system of infectious diseases and events is recognized as the cornerstone of public health decision-making and practice additionally the International Health Regulation requested counties implement other types of surveillance to support the routine surveillance system and to increase the detection rate and sensitivity in reporting the diseases, event, or any public health emergency with international concern (PHEIC). This study aimed to assess the implementation level of community-based surveillance systems to ensure that the system is implemented efficiently and effectively. Methods This was a descriptive cross-sectional community-based study conducted in Algableen locality White Nile states –from 2017 to 2020 involved 40 community volunteers to identify the effect of community–based surveillance in the locality as an initiative approach, Data was collected by using a per-prepared and pretested questionnaire followed WHO/EMRO tools for community volunteers at villages level felt through phone calls. Data were analyzed by using Statistical Packages for Social Sciences (SPSS) (version 20). Written and verbal consent were obtained from all participants as appropriate. Results Community-based surveillance started in 2016 endorsement and approval of guidelines Standard Operation Procedures (SOPs) and training materials has been developed in 2017, there were significant positive changes in the implementation of this system the system was implemented in 17 states with a percentage of 94.4%, the evidence for this is the result revealed availability of guidelines and SOPs was 94.1% and 88.2%, completeness, and timeliness of system data was 94.1% the system database and shared the system finding with partners at the state level were 70.6% At the community level, the result revealed that the community volunteers had a clear contribution in reporting the cases and events this supported the indicator-based surveillance and increased the system sensitivity in the study area, 35% of them report syndromic diseases, disasters, and animals deaths, 57% of them they report syndromic diseases and disaster, related to that, the result revealed97% of them they had the reporting format available and 75% reporting signal to locality level regularly. From the analysis of biological events, the volunteer reported 54% of the signal as diarrheal diseases and 81% of signals reported as floods from natural events, also they have reported increases in mosquitoes in the study area. Conclusion The study revealed a significant positive impact when the implementation of a community-based surveillance system this system helps in reflection of the epidemiological situation in the villages and locality, based on these findings the study recommended that, rapid and early response for the reported cases and rumors or any other event from the locality and state level reported by community volunteers, Regular refresh and basic training for community volunteers and secure the communication facilities and running cost.

Background: Surveillance system of infectious diseases and event is recognized as the cornerstone of public health decision-making and practice additionally, the international health regulation requested counties to implement other type of surveillance to support the routine surveillance system and to increase the detection rate and sensitivity in reporting the diseases, event, or any public health emergency with international concern (PHEIC). The aim of this study to assess the implementation level of event-based surveillance systems to ensuring that the system implemented efficiently and effectively. Methods descriptive cross sectional institutional based study conducted for all 18 surveillance officer at states to assess the implementation level of event-based surveillance system as core capacity under the international health regulation 2005 (IHR), Data was collected using a per-prepared and pretested questionnaire followed WHO/EMRO tools for surveillance staff at state level felt through field visit and phone calls, data collection also cover the community based surveillance and surveillance system at point of entry as part of event based surveillance, interview done for surveillance focal person at federal level. Data were analyzed using Statistical Packages for Social Sciences (SPSS) (version 20). Written and verbal consents were obtained from all participants as appropriate. Results Event based surveillance started in 2016 endorsement and approval of guidelines SOPs and training materials has been develop in 2017 so the study showed significant positive changes in implementation of this system for that the results showed the system implemented in all 18 states, availability of guidelines and SOPs at state level 72.2%, completeness, and timeliness of system data 94.4%, designated focal person in the surveillance structure at state level 94.4%. community Based Surveillance (CBS) implementation Results at states level -Sudan from 2017 – 2020 the result showed the system has been implemented in 17 states (94.4%), the percentage of assigned focal person for the system was 94.1 – trained volunteer at community level 94.4% and availability of system guidelines was 94.1%, the availability of system SOPs 88.2% The study results also showed the percentage of 94.4 for definition of CBS syndromes, immediate response for event reported was 94.4%, Daily and weekly reports completed send by community volunteers was 94.4% and availability of reporting forms was 94.1% also percentage of 70.6% for system data base and shared the report with the partners. point of entry Surveillance (PoE) implementation at the states level Results showed that the surveillance at points of entry has been fully implemented in 6 state 46.1% which it had point of entry and it has been designated by IHR, the system had focal person, the training done for all staff with availability of system guidelines and SOPs all this done by 100% 83.3% of point of entry reported Daily and weekly reports, the percentage of report completeness and timeliness was 66.7% with 83.3% for the zero report when no event of cases reported, availability of system data base and documentation for the events and cases reported through the system was 83.3% Conclusion The study showed significant positive changes in implementation of event-based surveillance system under the international health regulation, based on the finding the study recommended that, rapid and early response for the reported cases and rumors or any other event from the locality and state level, Regular refresh, and basic training for surveillance staff internally and external training and strengthen the data management mechanism.

UNSTRUCTURED The World Health Organization (WHO) declared the current COVID-19 a public health emergency of international concern on January 30, 2020. Countries in the Eastern Mediterranean Region (EMR) have a high vulnerability and variable capacity to respond to outbreaks. Many of these countries addressed the need for increasing capacity in the areas of surveillance and rapid response to public health threats. Moreover, countries addressed the need for communication strategies that direct the public to actions for self- and community protection. This viewpoint article aims to highlight the contribution of the Global Health Development (GHD)/Eastern Mediterranean Public Health Network (EMPHNET) and the EMR’s Field Epidemiology Training Program (FETPs) to prepare for and respond to the current COVID-19 threat. GHD/EMPHNET has the scientific expertise to contribute to elevating the level of country alert and preparedness in the EMR and to provide technical support through health promotion, training and training materials, guidelines, coordination, and communication. The FETPs are currently actively participating in surveillance and screening at the ports of entry, development of communication materials and guidelines, and sharing information to health professionals and the public. However, some countries remain ill-equipped, have poor diagnostic capacity, and are in need of further capacity development in response to public health threats. It is essential that GHD/EMPHNET and FETPs continue building the capacity to respond to COVID-19 and intensify support for preparedness and response to public health emergencies.