Johannesburg, South Africa – June 19th, 2025. by Moses Nyambalo Phiri in collaboration with Happy Abraham Manda and Settie Kanyanda.
Eight Southern African countries recently convened in Johannesburg for a critical One Health Field Epidemiology Training Program (FETP) Curriculum Trainer of Trainers (TOT) workshop. Organized by the African Epidemiology Network (AFENET), the five-day intensive, held from June 2nd to 6th, 2025, aimed to equip mentors with an updated curriculum to enhance regional collaboration in detecting, investigating, and responding to public health threats. The workshop brought together representatives from human, animal, and environmental health sectors across South Africa, Botswana, Eswatini, Lesotho, Malawi, Zambia, Zimbabwe, and Mozambique. The primary objective was to update mentors on the new “One Health” FETP curriculum contents and identify gaps to improve its implementation across the continent. This initiative is expected to significantly bolster collaboration in tackling disease outbreaks and other public health challenges by strengthening the integrated “One Health” concept.
FETP IN MALAWI
Malawi, a nation that has been implementing FETP since April 2016 with support from the U.S. Centers for Disease Control and Prevention (CDC) and the International Training and Education Center for Health (I-TECH), sent a five-person team to the workshop. The delegation included Mrs. Flora Tembo and Mr. Happy Manda from the Public Health Institute of Malawi (PHIM), Dr. Wamaka Msopole from Mzimba North District Health Office, Miss Maria Luwani from the Environmental Affairs Department, and Mr. Collins Chioko from the Veterinary Department. Mrs. Grace Funsani, Chief Epidemiologist coordinating FETP in Malawi, highlighted the program’s success in building sustainable capacity for timely detection and response to health threats.
Discussions during the training underscored the challenges in implementing the “One Health” concept in many participating countries. Participants emphasized that improved collaboration among sectors, particularly in data sharing and outbreak response, is crucial. Suggestions included cross-sectional visits to learn about surveillance practices in other sectors and sharing experiences.
“…Our program has successfully built a sustainable capacity for the timely detection and response to health threats….”
The Malawian team, in particular, brainstormed actionable strategies for integrating the “One Health” approach more deeply within their FETP. Their suggestions included engaging and sensitizing environmental sectors on the FETP-One Health program, recruiting trainees from the environmental sector, and incorporating case studies from environmental events into the curriculum. They also advocated for cross-sectional surveillance visits, joint outbreak investigations as field work, and multi-sectoral surveillance data collection requiring trainees to collect data from at least two sectors simultaneously.
The team from Malawi, standing from left to right: Mr Collings Chioko, Miss Maria Luwani, Dr Wamaka Musopople, Mrs Flora Tembo and Mr Happy Manda
The FETP, a three-tier training approach comprising basic, intermediate, and advanced levels, is currently implemented at the basic and intermediate levels in Malawi, targeting animal and human health practitioners. This recent TOT workshop is a significant step towards a more unified and effective approach to public health surveillance and response across Southern Africa.
Lilongwe, Malawi – May 30th, 2025. by Moses Nyambalo Phiri in collaboration with Happy Abraham Manda and Settie Kanyanda.
Centre for International Health, Education, and Biosecurity (CIHEB), a locally-led organization established in 2023 as a successor to Maryland Global Initiatives Corporation (MGIC) Malawi, recently briefed the National Public Health Laboratory (NPHL) management on its new initiative: Accelerating Malawi’s PEPFAR Laboratory Logistics and Infrastructure for Quality 2.0 (AMPLIFY 2.0). This project is set to significantly enhance Malawi’s diagnostic and treatment monitoring services, biosafety measures, and overall laboratory capabilities.
The NPHL, a core pillar of the Public Health Institute of Malawi (PHIM), serves as the national reference laboratory, supporting a vast network of laboratories across the country. It comprises specialized subsections, including Genomic Sequencing, Tuberculosis, Parasitology, HIV, Microbiology, Biochemistry, Haematology, Nutrition, and Viral/Influenza. While the NPHL receives support from various partners, including CIHEB, a key challenge highlighted during the meeting was the lack of adequate space for reference laboratories at PHIM. This concern was voiced by Mr. Joseph Bitilinyu Bangoh, who chaired the meeting, and Dr. Mirriam Nyenje, and echoed by Chiefs Henry Limula, Sheinton Kacheche, Mabvuto Chiwaula, and Dorothy Donata Kalata. Chief Dorothy Kalata specifically advocated for support for the Gene Xpert system and urged CIHEB to incorporate these activities into the project plan.
PHIM-NPHL management team listening to the presentation
AMPLIFY 2.0: Key Objectives and Proposed Activities AMPLIFY 2.0 aims to achieve several critical objectives to strengthen Malawi’s public health laboratory system:
a. Scaling Up Multi-Disease and Integrated Diagnosis and Treatment Monitoring Services:
This includes developing and reviewing testing procedures, creating training packages and curricula for ECHO sessions focused on emerging, re-emerging, and priority diseases. CIHEB plans to conduct virtual immersion training for subject matter experts, support laboratories with benchmarking and twinning programs for capacity building, and strengthen the Ministry of Health’s (MOH) ability to coordinate and oversee national diagnostic services. Furthermore, the project will support training for district lab technicians in all aspects of testing and data use, assist in developing Standard Operating Procedures (SOPs) to enhance the proficiency testing (PT) program, and aid PHIM in reviewing and developing method validation/verification procedures. CIHEB will also facilitate the resolution of corrective actions, track validated methods, disseminate results, and collaborate with PHIM QA, HTSS-D, and PAM to develop tools for monitoring method validation/verification, post-market surveillance, and equipment maintenance. The project will also review and disseminate the national quality assurance framework.
b. Strengthening Biosafety, Biosecurity, and Waste Management:
Strengthening MOH Capacity for Coordination and Oversight: This objective focuses on bolstering the MOH’s ability to coordinate and oversee national diagnostic services effectively.
c. Scaling Up Continuous Quality Improvement (CQI) in Laboratories and Point-of-Care Testing (POCT) Services:
CIHEB will support PHIM’s PT program with virtual audit training, conduct national External Quality Assurance (EQA) quarterly review meetings, and enroll laboratories in PT and inter-lab comparisons. The project will also facilitate international training for PT scheme managers for new schemes (e.g., TB culture, CD4, emerging diseases) and support PHIM in HIV RT, Syphilis, and Hepatitis B PT and Quality Control (QC) production. Building local capacity for ePT management is also a key component.
d. Scaling Up POCT CQI:
This involves training HIV Testing Services (HTS) providers on CQI tools and data use to increase the uptake of quality management systems, conducting biannual SPI-RRT audits, and performing SWOT analyses on CQI tool scalability. Additionally, the project will review and disseminate the national certification framework, facilitate a virtual benchmarking meeting with Tanzania on HIV RT CQI and site-level online PT results submission, and build local capacity for SPI-RRT management.
f. Scaling Up ECHO Sessions:
CIHEB will conduct HIV RT ECHO exit assessments, perform desk reviews to identify gaps for ECHO teleconferences, and organize ECHO sessions for HIV RT, EQA, emerging/priority diseases, equipment service, and data use programs. The project will also support the review and development of ECHO curricula for various programs and conduct baseline and exit assessments for new ECHO programs.
g. Strengthening Genomic Sequencing Capacity:
CIHEB will link the Genomic Lab LIMS with Africa CDC NIMS, engage with lab training institutions to update curricula to include genomic sequencing, support bioinformatics training, establish a local equipment calibration center, and conduct engagement meetings with stakeholders on genomics and other services.
h. Establishing a National Accreditation Body:
CIHEB will support the MOH in establishing a national accreditation body through stakeholder engagement meetings.
Dr. Miriam Nyenje taking on Genomics concerns in the projects
Integrated Activities for CQI and Multi-Disease Services AMPLIFY 2.0 incorporates several integrated activities to achieve its objectives, including:
District-Level Support: Quarterly supervisions, mentorships, assessments, and review meetings. National Oversight: Spot check visits on district supervision, mentorship, meetings, training, and assessments, along with national corrective actions on method verification/post-market surveillance. Data Review: National monthly, quarterly, biannual, and annual data review meetings (virtual and in-person). Knowledge Sharing: Regional biannual best practices workshops. Targeted Training: District trainings where applicable. Virtual Learning: Virtual Immersion ECHO training and IECHO registration for teleconference participants. Awareness: District Health Management Team (DHMT) sensitization on new ECHO programs.
Dr. Oscar Divala making a presentation on CIHEB’s AMPLIFY 2.0 Project
Essential Procurements and PHIM’s Role
To facilitate these activities, CIHEB will procure essential supplies, including materials for 13 local PT schemes’ panels, HIV RT QC production, HIV RRT supplies (e.g., digital timers, thermometers), and chemistry and FBC PT materials. The project will also cover NHLS PT subscriptions, facilitate accreditation of the PT program, and support ECHO, ePT, and SPI-RRT registration, including providing ECHO data bundles and courier services.
CIHEB emphasizes the need for PHIM’s support to successfully implement AMPLIFY 2.0. This includes:
Facilitating CIHEB’s Introduction to Facilities: Ensuring smooth access and collaboration. Coordination on Activity Implementation: Allowing for simultaneous implementation of project activities. Identification of Space: Facilitating the identification of space for PT lab renovation or collaboration with other partners on renovations. Resource Lobbying: Lobbying for resources from the Ministry of Health for sustainable strategies.
Dr. Thokozani Kalua answering and clarifying some questions and points raised during the meeting.
The meeting concluded with Dr. Thokozani Kalua and Dr. Oscar Divala providing further clarifications and presentations on the AMPLIFY 2.0 project and its procurement plans. The collaboration between CIHEB and PHIM is poised to significantly strengthen Malawi’s public health laboratory infrastructure and contribute to improved diagnostic and treatment outcomes across the nation.
Lilongwe, Malawi – May 28th, 2025. by Moses Nyambalo Phiri in collaboration withGrace Choo and Settie Kanyanda.
On 26th May, a crucial workshop kicked off in Mponera, Dowa district, marking a significant step forward in Malawi’s health security. The Public Health Institute of Malawi (PHIM), with support from the World Bank and the Tackling Deadly Diseases in Africa Program (TDDAP), hosted a fundamental workshop focused on developing the nation’s National Action Plan for Health Security (NAPHS).
A Unified Approach to Public Health, The NAPHS is a strategic framework that ensures a unified and comprehensive approach to public health, directly aligning with the International Health Regulations (IHR 2005). This current workshop built upon insights gained from a Joint External Evaluation (JEE) conducted in December 2024, which assessed Malawi’s health security across 19 technical areas, including prevention, detection, response, and other hazard management. Dr. Wilfred Chalamira on behalf of the Director for PHIM welcomed the participants and emphasised the importance of the event as it will have overall impact of the nations health.
Multi-Sectoral Collaboration for “One Health” A diverse group of representatives from key government ministries and departments participated in the four-day orientation. Officials from the Ministries of Justice, Agriculture, Natural Resources and Climate Change, Gender, Community Development and Social Welfare, Treasury, and the Malawi Police Service, among others, highlighted the essential multisectoral nature of health security. This wide-ranging engagement directly addresses the identified need to strengthen coordination structures across different sectors at national and sub-national levels to implement a “One Health” framework.
Deep Dive into Health Security On the first day, participants were introduced to the NAPHS processes, tools, and overall context. Dr. Gertrude Chapotera from WHO provided an introduction to the NAPHS, while Dr. Herbert Bakiika from the Infectious Diseases Institute (IDI), Uganda, demonstrated the application of NAPHS development templates. The afternoon was dedicated to the critical task of selecting and identifying priority activities, informed by various assessment reports, including the JEE and COVID-19 reports. The JEE from December 2024 praised Malawi’s strengths, such as the establishment of PHIM and the operationalization of Public Health Emergency Operations Centers (PHEOCs). Strong capacities in disease surveillance, laboratory services, and multi-sectoral collaboration were also noted. However, the JEE also pinpointed critical areas needing immediate attention, including strengthening legal and regulatory frameworks, ensuring sustainable financing, and expanding training and capacity-building. This workshop directly aimed to address the recommendation to develop a costed NAPHS to outline national IHR gaps and priorities and facilitate resource mobilization. Addressing Climate Change and Prioritizing Actions The second day saw participants continue to identify and prioritize activities based on comprehensive assessment reports. A significant session integrated Climate Change and Health into the National Action Plan for Health Security, led by Halcycon from Uganda. This integration acknowledges Malawi’s high vulnerability to climate threats, being ranked 5th on the Global Climate Risk Index (2021) and having faced numerous climate-related disasters in recent years. The majority of the day was spent in group work, prioritizing NAPHS activities by technical area, taking into account recommendations from the JEE. For instance, the need to develop and implement a national multi-sectoral strategic plan for Points of Entry (PoEs) was discussed, and efforts to fast-track the enactment of the Public Health Act were highlighted as crucial for strengthening legal instruments.
Synergies, Coordination, and Costing The third day was primarily dedicated to extensive group work, where participants aligned priority actions to identify synergies, prevent duplication, and efficiently compile detailed NAPHS activities. This is especially relevant given the JEE’s findings on fragmented legal instruments for biosafety and biosecurity and the need for a consolidated inventory of high-consequence pathogens. Strengthening multi-sectoral coordination mechanisms was identified as a key priority to promote effective collaboration across different sectors, including developing and formalizing a One Health platform structure.
On the final day, participants compiled detailed cost assumptions per technical area for each detailed NAPHS activity. The workshop officially concluded with the submission of completed NAPHS templates to the NAPHS Secretariat. This directly addresses the urgent need for a costed NAPHS to facilitate resource mobilization and ensure various sectors mainstream and leverage their resources to address identified gaps. Looking ahead, strategic actions for “Legal Instruments” include engagement meetings with stakeholders and lobbying parliamentary committees for the enactment of the Public Health Act. Further plans include conducting Infection Prevention and Control (IPC), Vaccination & Risk Communication and Community Engagement (RCCE) trainings, extending training for early warning surveillance functions, and increasing national coverage for electronic laboratory information management systems (LIMS).
Efforts in Biosafety and Biosecurity will focus on consolidating the inventory of high-consequence pathogens and finalizing legal frameworks, ultimately aiming to strengthen the linkage between public health and security authorities for a rapid multisectoral response to suspected or confirmed biological, chemical, or radiological events.
