Submission ID 117083
| Issue/Objective | In an era of pandemics, climate-linked emergencies, and misinformation, countries urgently need real-time, integrated surveillance systems for early outbreak detection and rapid response. Until 2016, Pakistan relied on fragmented, disease-specific surveillance systems, resulting in weeks-long delays and underreporting of diseases like hepatitis A/E, cholera, and animal bites. To address this, the UK Health Security Agency (UKHSA), in collaboration with Pakistan's government, initiated a structured rollout of Integrated Disease Surveillance and Response (IDSR), aligned with WHO guidance and grounded in the 2016 Joint External Evaluation (JEE). The system was developed using Anne Wilson's Three-Pillar Model; Structure/Infrastructure, Surveillance functions, and support systems. |
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| Methodology/Approach | Pakistan's adaptation of IDSR introduced key innovations: • Digital Integration: DHIS-2 was deployed as a cost-effective tool for real-time, district-level reporting across all 160 districts. • Adaptive Syndromic Approach: National disease priorities were revised using data trends, removing less relevant conditions (e.g., anthrax) and adding locally prevalent threats (e.g.Jaundice, Dog bites, Snake bites). • AI-Enabled Event Detection: Event-based surveillance utilizing non-traditional data sources for expanded capture of outbreaks. • Multi-Sectoral Response Planning: Protocols were established for joint outbreak responses across human, animal, and environmental sectors. • Laboratory Network Development: Public health labs were introduced to strengthen outbreak confirmation and build national lab network. • Crisis Application: During the 2022 floods, IDSR enabled real-time surveillance among displaced populations, showcasing its emergency value |
| Results | • Over 10,000 healthcare workers trained nationwide. • In 2024, IDSR recorded 2,341 suspected cases, 816 alerts, and 108 confirmed outbreaks (up from 65 in 2023). • Provincial scale-up: Sindh outbreaks rose from 30 to 137; KP alerts increased from 104 to 979; Balochistan saw a sixfold rise in alerts. • Pakistan's JEE score improved from "Developed" to "Demonstrated" capacity (2016-2023). |
| Discussion/Conclusion | Pakistan's IDSR demonstrates how LMICs can build resilient, scalable surveillance using existing systems and minimal external funding. By utilizing digital tools, laboratory systems, local data, existing resources and multi-sectoral coordination, it provides a replicable model for strengthening global health security. For countries navigating fragile systems, this approach offers a sustainable path forward, blending innovation with grounded public health practice. |
| Presenters and affiliations | Muhammad Asif Khan UK Health Security Agency Muhammad Asif Khan UK Health Security Agency Muhammad Sartaj UK Health Security Agency |
