ZAMBIA EBOLA PREPAREDNESS AND RESPONSE PLAN-2015
Infectious Disease Isolation Facility under Construction in Mwembeshi and Ebola Treatment Training -Zambia
Table of Contents
List of Abbreviations ............................................................................................................................... iii
1.
BACKGROUND ..................................................................................................................................... 1
1.1 Zambia: Ebola Risk Assessment .................................................................................................. 1
2.
RATIONALE FOR PREPAREDNESS PLAN ......................................................................................... 2
3. STAKEHOLDERS ..................................................................................................................................... 2
4. COMMAND STRUCTURE ........................................................................................................................ 3
5. PHASES .................................................................................................................................................... 3
5.1 PRE-EPIDEMIC PERIOD ................................................................................................................... 3
5.2 EPIDEMIC PERIOD.......................................................................................................................... 10
5.3 POST-EPIDEMIC PERIOD .............................................................................................................. 13
6.
GRADING SYSTEM ............................................................................................................................. 14
7.
BUDGET .............................................................................................................................................. 16
References ................................................................................................................................................ 17
Annex I: Roles and Responsibilities –Ministries and other Key Stakeholders ........................... 18
Annex II: Budget ...................................................................................................................................... 36
ii
List of Abbreviations
MAL
Ministry of Agriculture and Livestock
MCDMCH
Ministry of Community Development, Mother and Child Health
MCTA
Ministry of Chiefs and Traditional Affairs
MCTI
Ministry of Commerce Trade and Industry
MoD
Ministry of Defense
MESVTEE
Ministry of Education, Science, Vocational and Early Education
MoFA
Ministry of Foreign Affairs
MoF
Ministry of Finance
MoH
Ministry of Health
MoHA
Ministry of Home Affairs
MoIBS
Ministry of Information and Broadcasting Services
MLGH
Ministry of Local Government and Housing
MLNREP
Ministry of Land, Natural Resources and Environmental Protection
MLSS
Ministry of Labour and Social Security
MTWSC
Ministry of Transport, Works, Supply and Communication
MTA
Ministry of Tourism and Arts
MYS
Ministry of Youth and Sport
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1. BACKGROUND
Ebola Virus Disease (EVD), formerly known as Ebola hemorrhagic fever, is a severe,
often fatal illness in humans. The virus is transmitted to people from wild animals and
spreads in the human population through human-to-human transmission.
Ebola Virus Disease (EVD) first appeared in 1976 in 2 simultaneous outbreaks, one in
Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo (DRC). The
outbreak in the DRC occurred in a village near the Ebola River, from which the disease
derives its name.
The Democratic Republic of Congo reported six outbreaks of Ebola Virus Disease
between 1976 and 2012. Uganda, Gabon and Sudan have also reported more than one
outbreak each of Ebola Virus Disease over the same period. South Africa and Cote
d’Ivoire reported single cases of Ebola in 1996 and 1994 respectively. The case fatality
rates of Ebola Virus Disease outbreaks have varied from between 25% to 90%, with the
average case fatality rate hovering around 50%.
Good outbreak control relies on applying a package of interventions that include
surveillance, contact tracing, case management, good laboratory services, safe burial
techniques, community engagement and social mobilization.
Early supportive care of Ebola patients, with rehydration and symptomatic treatment
has been shown to improve outcomes and survival. There is as yet no licensed
treatment proven to control the virus, but a range of blood, immunological and drug
therapies are under development.
Just as there are currently no licensed treatments, there are also no licensed Ebola
vaccines. However, some potential candidate vaccines are undergoing evaluation.
1.1 Zambia: Ebola Risk Assessment
Zambia has never had a case of Ebola Virus Disease. However, the ease of travel
between any two countries on the African continent and the world at large implies
that Zambia remains susceptible to the risk of importation of Ebola Virus Disease.
Although Zambia does not have direct flights to West Africa the epicenter of the
current Ebola Virus Disease outbreak, the four international airports in Lusaka, Ndola,
Mfuwe and Livingstone open Zambia up to travelers from across the globe. The risk is
further accentuated by Zambia’s proximity to the Democratic Republic of Congo
where there have been a number of outbreaks over the years. Our towns along the
line of rail often have large sprawling shanty townships with many overcrowded
households, ideal areas for the amplification of diseases such as EVD.
The world –famous annual migration of millions of fruit bats to Kasanka National Park
in Mkushi district, Central Province has been the focus of intensified Surveillance
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activities by the Ministry of Agriculture and Livestock and the University of Zambia
School of Veterinary Medicine. While the Ebola virus has never been identified in any
of the bats, antibodies to Ebola were detected in one fruit bat.
2. RATIONALE FOR PREPAREDNESS PLAN
The objective of the Ebola Preparedness and Response Plan is to ensure that the
country has the capacity to prevent, detect, report, investigate and respond to any
potential case of Ebola Virus Disease in a coordinated and timely manner.
The Key focus areas of the plan are as follows:
1.
2.
3.
4.
5.
6.
Coordination and Resource mobilization
Epidemiology, surveillance and Laboratory
Case Management and Infection Prevention
Social mobilization and Media communication
Logistics
Recovery
3. STAKEHOLDERS
All Government Ministries have designated roles within this plan. The Ministry of
Health will take the lead in the execution of the Plan. Other stake-holders outside the
Government include:
World Health Organization (WHO)
Centers for Disease Control and Prevention (CDC)
United Nations Children’s Emergency Fund (UNICEF)
Japanese International Cooperative Agency (JICA)
World Bank (WB)
United Nations World Tourism Organization (UNWTO)
Non Governmental Organizations (NGO) and Faith Based Organizations (FBO)
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4. COMMAND STRUCTURE
An inter-ministerial liaison committee of Permanent secretaries will function as the
highest coordinating body in the country. The Secretary to Cabinet shall chair the
committee and meetings will be held weekly at which each Ministry will provide an
update on progress made in its mandated area within the context of Ebola Virus
Disease. The Disaster Management and Mitigation Unit under the Vice President’s
Office will offer the coordinating and secretariat role with the Ministry of Health as
the lead technical advisor during outbreaks. The Ministry of Health will also ensure
that legislation and communication mechanisms are put in place to facilitate smooth
response under the International Health Regulations (2005) and Public Health Act
(CAP 295).
This whole process will work through the existing structures at National, Provincial
and District levels namely the Provincial Development Coordinating Committee (PDCC)
and the District Development Coordinating Committee (DDCC).
The table defining the roles of Line Ministries and other key stakeholders are outlined
in Annex I.
5. PHASES
The EVD Preparedness and Response Plan takes into account the three phases of the
epidemic namely; the pre-epidemic, epidemic and post –epidemic phase as shown
below:
5.1 PRE-EPIDEMIC PERIOD
1. Coordination and Resource mobilization
1.1.1. An inter-ministerial liaison committee of Permanent secretaries will
function as the highest coordinating body in the country. It has defined the
roles of each ministry in the prevention and control of Ebola Virus Disease.
The Secretary to Cabinet chairs the committee and meetings are held
weekly, each Ministry provides an update on progress made in its
mandated area within the context of Ebola Virus Disease.
1.1.2. The Directorate of Disease Surveillance control and research within the
Ministry of Health convenes meetings of National Multi-sectoral Rapid
Response Team consisting of specialists in the five key areas above. Other
stakeholders in the Health sector such as WHO, CDC, UNICEF etc. are
incorporated into this taskforce as need arises. The Rapid Response Team
shall be replicated at Provincial and district level.
3
The National Multi-sectoral Rapid Response Team has Tasks and Terms of
Reference as listed below:
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Report on a weekly basis to the inter-ministerial liaison committee of
Permanent secretaries.
Review current policy and legislative frameworks to ensure that they
will provide the authorization for the preparedness (including financing)
that are proposed.
Adopt the updated Ebola epidemic control strategies.
Define and monitor the responsibilities of the different committees.
Define the channels of information during operations in response to the
epidemic.
Communicate regularly with the national and international press.
Assess the economic and social impact of the epidemic.
Identify funding sources, including allocation of domestic resources and
mechanisms to raise additional resources when necessary.
Organize the mobilization and allocation of resources in collaboration
with partners.
Ensure that there is no cash-flow problem and a contract-facilitation
mechanism.
Conduct simulation exercises as need arises to maintain response
capacity within the country.
Prepare the end of epidemic report.
1.1.3. The National Epidemic Preparedness Prevention Management and
Control Committee (NEPPMC) shall maintain Ebola Preparedness at the top
of the agenda of its monthly meetings. The NEPPMC shall provide overall
leadership at the technical level for the national response to EVD. Other
stakeholders shall provide their input to this committee. Adhoc meetings
will be held as necessary.
1.1.4. The following committees of the NEPPMC shall be reactivated:
1.1.4.1. Coordination and resource mobilization
1.1.4.2. Social mobilization and media
1.1.4.3. Case management and Infection Prevention
1.1.4.4. Epidemiology, surveillance and laboratory
1.1.4.5. Logistics and security
1.1.5. The Disaster Management and Mitigation Unit in the Office of the vice
president are responsible for coordination of the multi-sectoral interministerial Committee and will facilitate the securing of resources for the
initial response. The Ministry of Finance and Planning will release
resources to support the response to EVD.
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The following structure shall support the operationalization of the
preparedness and response plan:
 Human Resources:
o National level:
 National coordinator of the Disaster Management and
Mitigation Unit in the Vice President’s Office.
 The Ministry of Health high level representation.
 The Ministry of Community Development Mother and Child
Health high level representation.
 Dedicated representation from Ministries of information,
education, interior/local government, health, defense,
agriculture, rural development.
 Community representation through religious/ opinion/
youth/ women/ leaders.
o Provincial level. The country is subdivided into 10 provinces
 The Provincial Minister shall lead the Provincial
Coordinating unit.
 The Permanent Secretary shall function as the provincial
coordinator.
 1 local focal person from ministries of information,
education, interior/local government, health, defense,
agriculture, rural development.
 1 representative of community/ religious/opinion/
youth/women/leaders.
 The WHO representing the partners in each province.
 Equipment Materials
 National emergency preparedness plan.
 Operational plan.
 Logistics: office, vehicles, supplies, communication
equipment, computers, Personal Protection Equipment
(PPE).
 Strategic stock (mattresses, blankets and others; general
fuel, food, drugs).
 Materials for the operational emergency center.
2. Epidemiology, surveillance and Laboratory
2.1.1. An effective disease surveillance system that immediately detects
suspected EVD is the key to rapid containment of an EVD outbreak. EVD
surveillance is conducted within the context of the Integrated Disease
Surveillance and Response strategy allowing for prompt case
identification, reporting and confirmation.
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2.1.2. Case definitions and guidelines shall be distributed to all public and
private institutions providing patient care. Health facilities, district and
provincial health teams and all hospitals shall report and investigate all
suspected cases.
2.1.3. Key members of the community will be trained to identify potential
cases of EVD.
2.1.4. The Ministry of Health shall collaborate closely with the Ministry of
Agriculture and Livestock, Ministry of Tourism and Arts, the Zambia
Wildlife Authority (ZAWA) and the University Of Zambia School of
Veterinary Medicine to ensure that changes in trends of animal deaths
detected by the Early Warning System are promptly investigated for Ebola
Virus Disease before human cases are recorded.
2.1.5. Point of Entry surveillance shall be conducted to identify individuals at
risk of importing Ebola into the country.
2.2.Laboratory
2.2.1. All samples from suspected cases shall be sent to the National Reference
Virology Laboratory at the University Teaching Hospital. Samples received
at National Reference Virology Laboratory at the University Teaching
Hospital will then be sent to the Virology Laboratory at the University Of
Zambia School Of Veterinary Medicine, which has the capacity to test
samples for Ebola.
2.2.2. Clinical and Laboratory staff shall receive refresher training in collection
and packaging, storage and shipment of specimens from an EVD suspect.
2.2.3. Samples requiring further testing shall be sent to the National Institute
of Communicable Diseases in South Africa for further testing.
As a minimum, the following shall be the team at National level:
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2 lab coordinators
2 biologist/virologists
4 lab technicians
1 data manager
1 data clerk
Equipment Materials
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1 Biosafety level 3 available laboratory and/or an identified WHO
designated reference laboratories
20 sets of triple packaging materials, available at RRT’s
100 kits of PPEs
2 incinerators
2 vehicles identified
Consumables
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2.3. Screening at Ports of Entry(PoE) and other border crossings
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PoE teams will be identified to cover 24/7, to assist travelers and ensure correct
isolation if required.
The team will deliver supplies (9 PPE full sets at each PoE )
o Medical equipment to survey cases
 3 Infrared Hand held Thermometers,
 1 Scanner,
o 2 Observation room/ 2 Health facilities and supplies for safe isolation and
observation of suspect cases if possible separation room, if not, a
separated area.
o 1 specialized Ambulance to be prepositioned at every major PoE.
o Every PoE will have a separation room or dedicated area for holding
suspected cases
Staff at PoE will be trained in Infection Prevention Control by provincial Trainers.
The team will ensure that a health emergency contingency plan is in place at
high risk PoE; ports, airports, and ground crossings.
The team will ensure that the PoE are equipped and appropriately staff sites for
health assessments and management of suspected ill travelers at all times.
The team will review and test current communication system between health
authorities and conveyance operators at PoE, and national health surveillance
systems.
The teams will sensitize public health authorities at PoE to EVD, review their
roles and processes for handling, reporting and for referral of suspected cases of
EVD.
Human Resources
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The PoE will be manned at all operational times.
There shall be a minimum of 2 nurses or, if not available, trained staff in suspect
case identification, at least
o one of them trained in disinfection
o 1 immigration officer
o 1 security personnel
Equipment Materials
For each Point of Entry and official border crossing, there shall be:
 Basic hygiene, sanitation, disinfection and protective equipment such as
gloves, soaps, chlorinated water, disinfectant, and waste disposal
 At least 9 kits of PPE
 Medical equipment to survey cases
o 3 infrared hand-held thermometers
o 1 scanner
 2 observation rooms
 A designated health facility and supplies for safe isolation and observation of
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suspect cases; if possible a separation room, if not, a separated area
 1 specialized ambulance
3. Case Management and Infection Prevention
3.1.1. Case definitions and treatment guidelines shall be distributed to all
public and private institutions providing patient care.
3.1.2. Maina Soko Military Hospital has been identified as the primary isolation
and treatment center for Zambia.
3.1.3. The Ministry of Transport, Works, Supply and Communication has
provided drawings and Bill of Quantities for Ebola Treatment Centers. Each
district shall identify a facility where EVD patients may be isolated. All
Ebola Treatment Centers will be equipped with all the equipment and
supplies required for them to be fully operational.
3.1.4. All hospitals shall designate an isolation ward where suspected cases
may be isolated before transfer to a substantive treatment center.
All Provincial health offices will identify a competent team of specialists that
will hold any EVD case before transporting such a case to the National
Treatment Center. This will include doctors, nurses, laboratory staff and
cleaners. All hospitals will have teams that will assist with the response. The
National Treatment Center will have at any given time a minimum of the
following Human Resources:
At least 1 RRT at national level comprising:
 2 clinicians
 1 psychosocial support expert
 2 epidemiologists
 1 data manager
 7 burial staff (1 burial team)
 1 social mobilization/anthropologist
 1 media expert
 1 logistician
 1 admin. Officer for contracting and execution of finances
At
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least 1 RRT at Provincial level comprising:
2 clinicians
1 social worker, psychiatric nurse
2 epidemiologists
1 data clerk
1 laboratory technician
7 burial staff (1 burial team)
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1 social mob/anthropologist
1 local media person
1 logistician
3.1.5. Infection Prevention Protocols shall be updated and strictly adhered to
in the care of EVD patients to ensure that health care workers are
adequately protected from any occupational risk.
3.1.6. The Ministry of Health shall facilitate training of Rapid Response teams.
The training shall be cascaded down to all districts and hospitals.
3.1.7. Adequate Personal Protective Equipment (PPE) shall be provided to all
health facilities and Points of Entry in “at risk areas”.
4. Social mobilization and Media communication
4.1.1. The objective of Social mobilization and media communication is to
create awareness about EVD and thereby enhance behaviors that support
the prevention and reduced transmission of the disease.
4.1.2. The Health Communications Committee of the Rapid Response team
shall disseminate messages in English and local languages using electronic
and print media, road shows and other effective means to disseminate
information on the risk factors, prevention and control of EVD
5. Logistics and safety
5.1.1. Adequate and appropriate logistics required for EVD prevention and
control will be procured centrally and distributed by Medical Stores.
Stockpiles will be maintained at Central level and all facilities identified
as potential EVD treatment centers.
5.1.2. Each health facility will stock adequate supplies for treatment of ten
patients. All hospitals will prepare logistics for management of the first
fifty cases. Each institution will ensure appropriate stock management
occurs to avoid expiration of products and prevent stock outs.
A National Ebola hotline has been established. It will consist of 14 people (2 hotlines
with 2 people for 3 shifts; 2 supervisors; first hotline as first contact/info, with
escalation to second hotline for suspected cases.
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PRE-EPIDEMIC PERIOD: ALERT
When a case is suspected or a rumor is reported, an epidemiological investigation
shall be instituted. The Ministry of Health shall lead the epidemiological investigation.
The following steps shall be taken:
1. Surveillance
1.1.The district, hospital and Provincial Rapid response team shall access the
suspected case. They shall elicit a comprehensive medical, social,
occupational and travel history to identify presenting complaints and ascertain
the level of risk.
1.2.Active surveillance for other suspected cases shall be conducted.
2. Specimen collection
Indicated specimens shall be collected following specified laboratory SOPs or
Protocols. PPE shall be worn before blood is drawn. Appropriate triple packaging
will be used for transportation of the sample to the University Teaching Hospital
and onward transmission to the UNZA School of Veterinary Medicine. The results
will be communicated to the Virology Laboratory and the Ministry of Health
simultaneously.
3. Assess local resources
The resources available shall be assessed to ensure their availability if a case is
confirmed.
5.2 EPIDEMIC PERIOD
1. Coordination and Resource mobilization
1.1.1. If a case is confirmed, the DMMU will re-affirm leadership of the
National Coordination Committee at Permanent Secretary Level. The
Ministry of Health will provide the technical direction. Other key Ministries
are the Ministries of Defence, Home Affairs, Transport and Communication
and Agriculture and Livestock. The roles of the ministries outlined in the
Pre-epidemic Phase will be accentuated to address the situation at hand.
1.1.2. Other key technical partners such as WHO, UNICEF and JICA would be
opted into the management of the outbreak.
1.1.3. The measures outlined in the alert threshold shall be effected
immediately.
1.1.4. A 24 hour Central Command post will be established at the Ministry of
Health Headquarters.
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2. Epidemiology, surveillance and Laboratory
Objective: To interrupt transmission of EVD
2.1.1. Once a case is confirmed the Laboratory shall inform the Virology
Laboratory who will subsequently inform the Ministry of Health. The
Ministry of Health shall inform the Provincial and District Health Offices
and shall immediately notify the WHO Country Office.
2.1.2. Active surveillance for cases fitting the case definition shall be pursued.
Mobile surveillance teams will be trained and deployed. Cases meeting the
case definition will be referred to the treatment centers for assessment
and management.
2.1.3. Contact tracing shall be initiated for all contacts of an EVD case.
Contacts will be followed up for signs of illness for 21 days from the last
day of exposure to an Ebola patient. Those that develop symptoms will be
referred to an Ebola treatment center.
2.1.4. Person, Place and Time shall institute an epidemiological investigation in
collaboration with Animal Health experts to ascertain the source of the
infection and characterize the outbreak. The investigation shall identify
potential risk factors.
2.2.
Laboratory
Objective: To provide laboratory confirmation expeditiously
2.2.1. Once a case is confirmed the Laboratory shall inform the Virology
Laboratory who will subsequently inform the Ministry of Health. The
National Reference Virology Lab at the University Teaching Hospital shall
coordinate the testing of samples by the Virology Laboratory at the
University of Zambia School of Veterinary Medicine. All positive samples
shall be sent to the National Institute of Communicable Diseases in South
Africa for confirmatory testing.
2.2.2. Depending on the scale of the outbreak, mobile laboratories will be
deployed to maintain an acceptable turn-around-time for results.
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3. Case Management and Infection Prevention
Objective: To ensure that patients receive appropriate care and that
health care workers are adequately protected from occupational risk for
EVD.
3.1.1. Patients will be transported to Ebola Treatment centers in specialized
ambulances manned by qualified and adequately protected staff.
3.1.2. All patients will be isolated in separate individual care units where
available. Where this is not possible patients will be isolated by category
i.e. suspected, probable and confirmed.
3.1.3. Patients will be treated with honor and dignity while maintaining barrier
nursing and the highest standards of Infection prevention.
3.1.4. Trained staff will conduct supervised burials with sensitivity to the
grieving families and local culture and traditions.
3.1.5. Psychosocial assistance shall be offered to patients, families and health
care workers.
4. Social mobilization and Media communication
Objective: Address community concerns and promote behaviors that minimize
the risk of transmission in the community.
4.1.1. Community engagement will continue using all acceptable means.
Community leaders, government, politicians, religious leaders and other
opinion makers will be targeted. Messages will continue to be given in the
cultural context.
4.1.2. The media will be provided with appropriate regular and timely
messages on efforts to control the outbreak in order to win public trust
and allay anxieties.
5. Logistics
5.1.1. Objective: To provide logistical support for maximal operation of
epidemic response field activities
5.1.2. Supplies will be purchased for all response activities. Personal Protective
Equipment, drugs emergency kits, transport media and stationary will be
procured. Strict inventory and supply chain management will be practiced
to prevent stock-outs.
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5.1.3. Airtime and internet bundles will be provided to key field staff to
facilitate communication
5.1.4. Food will be purchased for Ebola Treatment Centers.
5.1.5. Vehicles will be mobilized to transport field supplies, staff to health
facilities, for transfer of patients and for burial teams. Transport will also
be required for teams conducting supervisory activities to the provinces,
districts and health facilities.
5.1.6. Security will be provided to Ebola Treatment Centers and where
necessary to staff conducting outreach activities.
5.1.7. Daily Subsistence Allowance (DSA) will be required both for staff
operating in Ebola Treatment Centers away from usual areas of operation
and for staff conducting supervisory visits.
5.3 POST-EPIDEMIC PERIOD
The outbreak will be declared over 42 days after the last confirmed case tests
negative for EVD. The Government will declare the outbreak over in collaboration
with WHO. The following specific activities shall be done:
1. Announcement of the end of the outbreak
1.1.1. The Ministry of Health will prepare a statement for submission to the
Office of the Vice President on the end of the outbreak. The Secretary to
Cabinet will announce the end of the outbreak.
1.1.2. All activities suspended under the Epidemic period will be allowed to
resume following the announcement of the end of the outbreak.
2. Preparation of the end of epidemic report
2.1.1. All Ministries and Government institutions shall compile a report on all
preparedness and response activities undertaken. The Disaster
Management Unit and the Ministry of Health shall consolidate all the
reports into a single End of Epidemic Report.
2.1.1.1. Electronic and hard copies of all documentation related to the
management of the outbreak shall be kept on file for future
reference.
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3. Evaluation of the Epidemic Response
3.1.1. An evaluation of the response will be conducted to assess the
effectiveness of the response and the degree of implementation of the
preparedness plan. The findings will provide a basis for strengthening the
preparedness plan and refining the responses to any future outbreaks. A
team comprising of representatives from selected line Ministries and other
key stakeholders will be constituted to do the evaluation report.
4. Resumption of Preparedness Activities
4.1.Epidemic preparedness activities shall be emphasized to ensure that the
country is prepared to respond to any future outbreaks. Activities shall
continue in the general context of epidemic preparedness and prevention of
not just Ebola but other epidemic prone infectious diseases under the
following themes:
 Coordination and Resource mobilization
 Epidemiology, surveillance and Laboratory strengthening
 Case Management and Infection Prevention
 Social Mobilization and Media communication
 Logistics and safety
 Recovery
6. GRADING SYSTEM
The Ebola Alert threshold and response plan
The Ebola Alert threshold and response plan outlines the actions that will be taken in
each of the phases of the epidemic. It is dived into 3 phases and clearly outlines the
actions in each phase.
1. Phase 1 or the Pre-Epidemic phase, is the phase in which Zambia current is.
This is the phase before we have any cases of Ebola.
2. Phase 2 or the Epidemic phase. This phase kicks in if we have a confirmed
case of Ebola in Zambia.
3. Phase 3 or the Post-Epidemic phase. This is the phase after the outbreak is
controlled.
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The actions to be taken at each phase of the plan are listed below.
Zambia is currently in Phase 1 (Pre-Epidemic phase), where there are no cases of
Ebola in the Country. All the actions related to phase 1 have been done.
Phase 1: Pre-epidemic phase
1. Co-ordination by inter-Ministerial committee of PSs
2. Ebola is top of agenda in National Epidemic Preparedness, Prevention &
Management Committee (NEPP & MC)
3. National Response team Constituted
4. Provincial & District Rapid Response teams activated
5. Health Care providers & other stakeholders at Points Of Entry oriented
6. Possible isolation facilities across the country have been identified
7. IEC materials have been developed and printed to create community awareness
8. Personal Protective Equipment for use by health Care providers has been procured
9. A National response plan & budget to support response has been drawn up
10. Capacity for diagnosis of Ebola in the country has been identified and Mapped
11. Ambulances to all major points of entry have been assigned
12. Surveillance has been strengthened
12.1.
Screening at Points of Entry has been strengthened
12.2.
Health personnel at points of entry have been deployed
12.3.
Equipment for screening has been procured
12.4.
Screening tools have been developed
12.5.
Public Health Laboratory system being established
12.6.
Planning for training of man power
Phase 2: Epidemic phase.
This phase only kicks in if the Ministry of Health confirms a case of Ebola.
All the measures in phase 1 will continue and in addition there will be specific phase
two (2) measures.
Phase 2:
Stage 1: One (1) or more cases of Ebola in the same district
1.1.
1.2.
1.3.
1.4.
Contact tracing
Stop all mass gatherings in the district
Close all schools and colleges in the district
Stop travel to and from the affected district
Stage 2. Ebola Cases in more than one (1) district, but confined to the same
province
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2.1
2.2
2.3
2.4
2.5
Contact tracing
Stop all mass gatherings in the district
Close all schools and colleges in province
Stop all movement between towns in Province
Stop travel to affected province
Stage 3. Cases in more one province
3.1 A state of Emergency will be declared country wide
3.2 No movements within towns in those provinces
3.3 No movements into and out of the affected Provinces
Phase 3: Post-epidemic phase
Phase 3 kicks in 42 days after the last reported case of Ebola (in the case of an
outbreak)
1. All measures will continue until no cases have been reported for 2 months.
Then the state of Emergency declaration will be reversed.
2. A postmortem of epidemic will be carried out and a terminal evaluation report
will be written
3. Disease Surveillance will continue to be strengthened
3.1.Continue strengthening of Public Health Laboratory system
3.2.Health personnel to man the Public Health Laboratory system will continue
to be trained
7. BUDGET
7.1.
The total budget required to implement the plan is K129, 278,
625.95($20,534,483.17) (See Annex II).
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References
Standard Operating Procedures for Controlling Ebola and Marburg Virus Epidemics
WHO AFRO May 2014
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Annex I: Roles and Responsibilities –Ministries and other Key Stakeholders
PHASES
Ministry/Institution
Foreign Affairs
Pre-epidemic
Dissemination of Zambia Ebola Preparedness
and Response Plan (ZEPRP) to foreign Missions
accredited to Zambia.
Epidemic
Provide regular updates to Foreign
Missions
in
Zambia
on
the
government response plans and
actions.
Dissemination of ZEPRP to Zambian Mission
abroad.
Provide regular updates to Zambian
Missions abroad on the government
response plans and actions.
Dissemination of ZEPRP to staff at HQ.
Screen
travel
requests
and
restrict/stop international travelers
from affected areas.
Disseminate appropriate health messages to
staff at HQ and abroad.
Monitor and facilitate to address
concerns from the diplomatic corps.
Disseminate the travel advisory to foreign
missions in Zambia and Zambian missions
abroad.
Inform respective consulate if
confirmed case has foreign
citizenship.
Intensify the dissemination
health messages to staff.
Post -epidemic
To
provide
information
regarding end of outbreak to
foreign missions in Zambia
and Zambian Missions abroad.
of
Establish focal point desk to deal
with emergencies at place of work.
18
Ministry/Institution
Transport, Works,
Supply and
Communications
Pre-epidemic
Quick temporary isolation facilities (Tent based
structures).
Epidemic
Putting up of temporary isolation
facilities.
Post -epidemic
Storage of temporary isolation
tents.
Quick temporary isolation facilities (Conversion
of existing building).
Converting existing infrastructure
(e.g. closed schools) into temporary
isolation facilities.
Maintenance
of
temporary
isolations facilities and treatment
centres.
Coordination of other stakeholders
that may want to put up treatment
centres in order to ensure that they
comply to set standards and
regulations.
Maintenance
centres.
Shall be involved in contact tracing.
Shall participate in the
preparation of the end of
epidemic report.
Shall participate in the
evaluation of the epidemic
response.
Treatment Centres (Permanent structures).
Design of quick temporally isolation facilities.
of
treatment
Develop work plan on conversion of existing
structures into isolation centres.
Defence
Supervision of construction of
centres.
Provide primary isolation and
centre.
Provide case
prevention.
management
treatment
treatment
and
Provide logistical support.
Provide security to treatment centres.
infection
Shall provide movement
logistical support.
and
Shall Provide treatment of
patients and isolation.
Shall assist in the safe burial.
Shall provide support in the
investigation and control measures
Shall write detailed report to
inform MoH on the situation at
hand.
19
Ministry/Institution
Pre-epidemic
Epidemic
Ensure optimal clinical care and
early clinical management are
provided for those affected by the
Ebola.
Post -epidemic
Agriculture and
Livestock
Procure PPEs kits.
Continue surveillance.
End of outbreak report.
To obtain licenses and permit to sample
wildlife.
To procure, capture and culling equipment.
Reporting of the diseased animals
to OIE.
Dissemination of an outbreak of
disease to the public.
Inform OIE to evaluate.
Issuance of relevant circulars
regarding outbreak.
Ensure intensified sensitization of
staff
Ensure weekly meetings are held to
update the Secretary to Cabinet on
the epidemic.
Advocate for resource mobilization.
Draw up circulars on the end
of epidemic.
Advocate
for
resource
mobilization.
Continued surveillance.
Induction of staff at provincial and district
levels.
Procurement of motor vehicles.
Surveillance in animals known to carry Ebola
virus.
Procurement of laboratory re-agents and
equipment.
Develop Ebola disease strategy in animals.
Incinerator to be installed at border points.
Test the Ebola preparedness plans (simulation
conducted).
Sample analysis at P3 laboratory (UNZA).
Training of trainers.
Develop P3 laboratory.
Sensitization of the public.
Ensure Committee meetings are held weekly.
Cabinet Office
Ensure circulars are drawn regarding a
particular phase.
Emphasize on sensitization of staff regarding
travel abroad.
Ensure sensitization programmes are
undertaken for staff under cabinet office.
20
Ministry/Institution
Pre-epidemic
Advocate for resource mobilization.
Epidemic
Post -epidemic
Chiefs and Traditional
Affairs
Mobilize communities in the Chiefdoms in
readiness for the sensitization on danger,
causes and effects of EVD.
Continue with transmission
messages in the Chiefdoms.
Caution communities in the Chiefdoms on
practices that may aid in spreading the EVD;
e.g:
Caution on unnecessary movements
of people form affected Chiefdoms
to another.
of
Traditional funeral rites-such as handling of
dead bodies during funerals.
Continue cautioning people not to
touch or wash dead bodies at
funerals of Ebola victims.
Eating meat from wild animals (e.g. fruit
bats, monkeys).
Continue sensitization on EVD
and also other communicable
diseases(e.g
cholera,
malaria).
Caution the usage of dugout
water well and reservoirs
which carries such the virus
such as monkeys.
Continue
sensitizing
the
community not to eat meat
from dead wild animals
despite phasing out of the
disease.
Target community/clientele
especially inhabitants who
cannot read or write.
.
ral
Ceremonies.
Engage/ Utilize Traditional Leaders in
educating the communities on seriousness and
prevention of EVD by selecting responsible
persons (Chiefs /Chieftainesses, Headwomen/
Headmen and indunas to take an active role in
encouraging
responsible
and
preventive
behaviors.
If Chiefdom is a PoE, liaise with
relevant authorities on strengthen
control on entry.
Create awareness on EVD by recording of voice
messages
of
Chiefs/Chieftainesses
and
facilitate dissemination of information on risk
factors, prevention and control in apt local
languages through local radio stations as well
as village group meetings.
21
Ministry/Institution
Finance
MCDMCH
Pre-epidemic
Ensure adequate domestic resources are
available.
Resource mobilisation (domestic and in
collaboration with other partners).
Epidemic
Prompt disbursement of funds.
Post -epidemic
Expenditure tracking (M & E).
Mobilise resources (domestic and in
collaboration with other partners).
Disseminate information to health facilities,
child care centres, residential care homes for
the elderly and persons with disabilities and
rehabilitation centres on the prevention of
spread of Ebola virus disease.
Social mobilisation to create awareness and
enhance community participation in Ebola
prevention and control using both media and
interpersonal communication channels.
Continue with social mobilisation,
community education and ensuring
community participation on EVD
prevention.
Mobilise resources (domestic
and in collaboration with
other partners).
Assess
management
of
epidemic at District and
facility levels.
Conduct disinfection of all isolation
facilities (holding facilities) in
provinces.
Report writing.
Identification of isolation facilities.
In liaison with MoH, procure incinerators for
bio-medical waste management.
Conduct contact tracing in the
communities.
Conduct safe burials in conjunction
with the MLGH.
Disinfection
of
isolation
facilities.
Continue Surveillance of any
Ebola cases.
Improve Capacity building of human resource
for Ebola preparedness.
Continue
activities.
Continue with
dissemination
sensitization.
Inspection of food and trading premises and
conduct food safety activities to prevent
consumption of contaminated food especially
meat products.
Provision
of
psychosocial
counselling
and
support
(Psychological First Aid) to families
and survivors of the epidemic.
Strengthen communication systems
facility level to national level.
Continue screening at points of
entry.
from
with
food
safety
information
and
Ongoing preparedness
prevention activities.
and
Conduct screening activities at points of entry.
22
Ministry/Institution
Youth and Sport
Pre-epidemic
Constituting an Intra- Ministerial Response
Team on Ebola Viral Diseases (EVD).
Epidemic
Report any suspected case of Ebola
to the relevant authorities for
action.
Develop a consolidated calendar of sports
events for all local and International sports
engagements and circulate it to all
stakeholders (for EVD sensitization purposes).
Conduct sports activities and
tournaments
according
to
guidelines provided by the Health
Authorities.
Sensitize
the
Youth
Groups,
Sports
Administrators and Athletes on the dangers of
EVD before participating in the Youth
Conferences and sports tournaments locally
and internationally.
Provide regular updates on EVD to the members
of staff at HQ, Provinces, Youth Resource
Centers, NSCZ and National Sports Associations.
Intensify
the
sensitization
programme to stop further spread
of the disease.
Post -epidemic
Communicate to National
Sport Council of Zambia
(NSCZ),
National
Youth
Development Council (NYDC),
All Sports Association, Youth
Groups and the Provinces the
end of Ebola.
Submit a report on the
situation.
Setting up an information Desk on EVD at OYDC
and in all youth resource centres.
Distribution of IEC materials during the Sports
Events to create awareness to the athletes and
the spectators during the event.
Engage MOH Officials to Sensitize the public
before and during the sports events.
Develop a pragmatic Action Plan on the
sensitization programme on EVD for all Youth
and Sports Administrators across the country.
Identify First Aid rooms within the facilities
(e.g. Stadia, sports complexes).
Training of personnel to man the information
desk in the centers.
23
Ministry/Institution
Lands, Natural
Resources and
Environmental
Protection
Pre-epidemic
Facilitate identification of suitable land for
isolation and treatment facilities.
Epidemic
Implementing Environmental laws
and policies aiming at reducing or
removing
the
possibilities
of
epidemics
breaking
out
and
spreading out in the country.
Post -epidemic
To control and restrict access
to established disposal sites
for wastes and bodies.
Formulation and strengthening of policies on
environmental management that promotes
good health in the country.
Through ZEMA to regulate waste
disposal and burial sites in manner
that does not pose a risk to the
general environment and the
handlers of such.
Through ZEMA to regulate
waste disposal and burial sites
in manner that does not pose
a risk to the general
environment and the handlers
of such.
Sensitizations of institutions, communities,
societies and nation at large on safe
environmental
and
natural
resources
management and utilization so as to reduce or
remove the possibility of transmission of the
disease emanating as a result any individuals
or communities managing or utilizing natural
resources such as water, wildlife, fish, insects
etc.
To control establishment of sites
designated for disposal of wastes
and bodies
Sensitizations of institutions,
communities, societies and
nation at large on safe
environmental and natural
resources management and
utilization so as to reduce or
remove the possibility of
transmission of the disease
emanating as a result any
individuals or communities
managing or utilizing natural
resources such as water,
wildlife, fish, insects etc.
Through ZEMA to regulate the handling and
disposal of wastes and or dead bodies in
manner that does not pose a risk to the general
environment and the handlers of such.
To
prevent
pollution
of
underground
water
through
regulating and control of burial
procedures.
24
Ministry/Institution
Pre-epidemic
1. Strengthen Enforcement of hygiene laws
 Strengthen enforcement of legal &
regulatory instruments on hygiene and
sanitation in public places including
markets and bus stations, learning
institutions, public conveniences,
churches, shopping malls, food
establishments and residential areas.
Local Government and
Housing
2. Public and Media awareness raising
activities:
 Messages on good hygiene practices
 Precautionary measures on EVD
 Early Warning signs alert for EVD
3. Establish EVD Outbreak Response Teams
 Constitute teams to undertake the
burials of EVD victims
 Constitute
teams
to
undertake
monitoring for possible outbreaks in
potential risk areas(EHO and Police
officers)
 Train teams in norms and burial
practices to reduce the risk of
transmission of the EVD.
Epidemic
1. Coordinate Safe Burials
 Assign a team for burial of
EVD victims
 Designate epidemic burial
places
 Timely preparation of
burials spaces
 Control of assemblies such
as places of worshiping,
funerals gatherings, sports
arenas, clubs and parties,
(Councils and Zambia
Police)
2. Conduct disinfections
 Disinfection of bodies for
victims of EVD prior to
burial.
 Disinfection of all affected
articles, places, vehicles
and personnel (Councils &
Defense Forces).
 Distribution of hand
sanitizing soap and water
disinfectants
Post -epidemic
1. Regular monitoring
Continue regular
monitoring for hygiene
and sanitation standards
in all public places
Regularly monitoring for
hygiene and sanitation
standards in public places
3. Improve water supply and
sanitation
 Provision of safe water
supply
and
sanitation
services to the affected
areas e.g. water bowsers
 Enhance refuse collection
(Councils
and
Defense
Forces)
3. Evaluation
 Evaluate activities for
efficiency and
effectiveness of the
plan
2. Continued public
awareness activities
 Continue educating the
public on risk factors
25
Ministry/Institution
Epidemic
Post -epidemic
Labour and Social
Security
Pre-epidemic
4. Mobilization of resources
 Procurement of logistics: Special
purpose vehicle and enforcement
vehicles, Cadaver bags, PPEs, lime,
disinfectants, soaps, fuels, sprayers, PA
systems, wheel burrows and small hand
held tools.
 Establish
personnel
temporal
disinfection facilities.
Equipped with person hygiene facilities such as
foot bath, resting room, change room, shower
and sanitary facilities.
Sensitize
employee
through
their
representatives such as ZCTU, FFTUZ and ZFE.
Disseminate preventive information
to employees about the Ebola
Disease.
Disseminate
information
about the outbreak having
been contained.
Re-enforcement of labour laws that
boarder on occupational safety and
hazards.
Education
Advocate for the employers of health personnel
to register with Workers Compensation Board in
order to cover the employees from occupation
risks.
Re-enforcement of labour laws that boarder on
occupational hazards.
1. Material Development
Development of age appropriate sensitization
materials for school going children.
Strengthen the Implementation of
reporting systems on the possible
outbreak of Ebola to relevant
Health and Education Institutions.
Strengthen the implementation
safety rules and Regulations on the
prevention of the Ebola epidemic.
Carry
out
sensitization
programmes
to
teachers,
learners and parents on
assurances of the end of
Ebola.
Conduct evaluation of the
impact of the epidemic in
Institutions of learning and
submit reports to relevant
Health
and
Education
Authorities.
26
Ministry/Institution
Pre-epidemic
Development of Educational materials on Ebola
Epidemic to support the school curriculum
under communicable diseases.
Epidemic
Strengthen
Sensitization
programmes in all Institutions of
learning.
Post -epidemic
Carryout
psycho-social
counselling
to
affected
teachers,
learners
and
parents.
Strengthen the teaching and
learning of the Ebola epidemic in
schools.
2.Training
Train
14
provincial
Resource
Centre
Coordinators (PRCCs), 106 District Resource
Centre Coordinators (DRCCs) and 10 Education
Officers (TED) as Trainers of Trainers for 9,484
schools with a population of 3,818,336
learners.
Train 46 lecturers from 23 colleges of
Education and 30 lecturers as trainers from 10
universities with a total population of 18, 976
students.
Training of Science Teachers on the use of the
developed materials for use in the classroom.
3. Sensitization
Conduct sensitization programmes for staff at
provincial, district and school levels.
Monitoring and evaluation of
programmes at all levels.
sensitization
27
Ministry/Institution
Pre-epidemic
4. Establishment of Coordinating committees
Epidemic
Post -epidemic
Establish Coordinating Committees at all levels.
5. Improve water and sanitation in schools.
Provide safe water in schools through the DWASH committees.
Construction of sanitation facilities in schools
through the infrastructure unit.
Gender and Child
Development
Sensitization of employees, stakeholders and
vulnerable groups such as women, children,
persons with disabilities.
Advocate for Gender mainstreaming at all
levels.
Dissemination of appropriate information to the
public.
Intensify
appropriate
public.
dissemination
information to
of
the
Assure the public on the end
of the epidemic.
Information and
Broadcasting Services
Induction programmes for media personnel.
Build logistical capacity for the media houses.
Mines, Energy and
Water Development
Sensitization of employees in the mining
industry.
Sensitize employees in the mining
industry on the outbreak.
Provision of power for the isolation facility and
treatment centres.
Provision of power for the isolation
facility and treatment centres.
Provision of water in liaison with
MLGH.
Sensation within work place.
Report writing.
28
Ministry/Institution
Pre-epidemic
Alert to all tourist enterprises authorized and
licensed by the ministry.
Epidemic
Halt all tourist
tourist facilities.
Surveillance
Stop all tour operations
Obtain financing for
Tourism Recovery Plan.
Provide surveillance on possible outbreak(s) of
Ebola Virus Disease (EVD) in Game management
Areas (GMA’s).
Ensure screening of all tourists at
points of Entry in conjunction with
MHA and MOH.
Mount a Tourism Marketing
Campaign to Key Tourism
source markets.
Design and develop Surveillance of wild animal
diseases in National Parks and GMA’s and Local
Communities and Open Areas with Wildlife
Populations.
Halt all movements of wild animals
i.e. Game Capture etc.
Make
bilateral
tourism
campaign visits to bilateral
tourism
countries
for
restoration of tourism.
Specimen Collection
Stop all issuance of special licenses
except for wildlife disease Special
Licenses to be issued.
Continue
to
strengthen
wildlife and tourism research
laboratories development
Collect if required specimen from wildlife in
infection prone areas.
Continuous messages on Ebola
through Community Radio Stations
and
ZAWA
integral
Radio
Communications.
Awareness meetings in key
tourism
centers
(Lusaka,
Livingstone, Ndola, Mfuwe,
Siavonga, Itezhi-tezhi, Kasama
, Mansa, Solwezi) in Hotels.
Strengthen Specimen Collection Systems from
wild animals.
Intensify surveillance for poaching
(illegal offtake) by poachers for
Game meat.
Continue to organize and host
ministerial Ebola Information
and
awareness
Meetings
including staff of the new
Dept. of National Parks and
Wildlife Management.
movements
to
Post -epidemic
Prepare a Tourism Recovery
Plan with costings.
Tourism and Arts
the
29
Ministry/Institution
Pre-epidemic
All Ministry of Tourism and Arts Statutory
bodies/agency alerted by the ministry and
requested/directed
to
alert
their
constituencies.
Epidemic
Frequent (weekly) and periodic
radio communications to Game
Management Areas, Wildlife Camps
via ZAWA/National Parks Dept radio
links.
National Tourism Disaster, Epidemic Diseases
Preparedness and Recovery Committee reestablished and strengthened.
Conduct contact tracing in GMA’s
and National parks in remote areas
with no health facilities.
Monitoring wildlife populations in National
Parks, Game management Areas and Open
Areas with wildlife for wildlife epidemic
diseases.
Intensify anti poaching activities
and wildlife law enforcement.
Awareness meetings in key tourism centers
(Lusaka, Livingstone, Ndola, Mfuwe, Siavonga,
Itezhi-tezhi, Kasama, Mansa, Solwezi) in
Hotels.
If warranted (MOH) stop /close
down public events and activities in
GMA’s.
Awareness meetings and information meetings
held in local communities organized as
Community Resources Boards (CRB’s) in GMA’s
and other Tourism and wildlife stakeholders
such as NGO’s and CBO’s / Civil Society in
Tourism.
If warranted stop / close down
public community activities or
events in game management areas.
Preparation of a protocol for Tourism Ebola
Response and Recovery in the Tourism Sector.
Stop giving special licenses for
wildlife
traditional
ceremonies
(Game meat).
Post -epidemic
Continue awareness meetings
and information meetings
held in local communities
organized
as
Community
Resources Boards (CRB’s) in
GMA’s and other Tourism and
wildlife stakeholders such as
NGO’s and CBO’s / Civil
Society in Tourism.
30
Ministry/Institution
Pre-epidemic
Organize and host ministerial Ebola Information
and awareness Meetings including staff of the
new Dept. of National Parks and Wildlife
Management.
Epidemic
Post -epidemic
Preparation of establishment of Wildlife
laboratories at national Level and National
Parks based Laboratories.
Disseminate information targeting tourists, the
travel and tourism transport sub sectors on
hygiene and infection control.
Carry out periodic, regular and surprise
inspections
to
hotels
and
tourist
accommodation and catering facilities licensed
and /or authorized by the Ministry to ensure
that licensed and authorized tourism operators.
Establishing and fully develop wildlife and
tourism research facilities and capacities in the
new department of national Parks and Wildlife
and Department of Tourism.
Information
dissemination
to
tourism
enterprises, hotels, motels and other tourism
accommodation establishments /facilities, car
hire, air charters and tour operations through
Regional Tourism Development Offices.
Prepare a Tourism and Wildlife Ebola Plan with
costings/budget
31
Ministry/Institution
Pre-epidemic
National
Wildlife
Development
Epidemic
Research
Post -epidemic
Laboratory
Disseminate information and awareness through
the Tourism Planning processes including
Greater Livingstone Development Zonal Master
Plan and the National Tourism Development
Master Plan and regional circuit development.
Identification and building of Separation
facilities /or areas in remote Game
Management Areas without health facilities
nearby.
Awareness
meetings
and information
dissemination to local communities in
Transfrontier Conservation Areas (TFCA’S)
especially the KAZA and Bilateral TFCA’s such
as Malawi –Zambia TFCA.
Develop full Game Capture Capacities at
National and Provincial /National Park levels.
Hold and undertake sensitization meetings with
local community entities e.g. Community
Trusts, Residential Trusts and Community
Resource Boards.
32
Ministry/Institution
Home Affairs
Pre-epidemic
Facilitate proper screening and man the porous
borders.
Facilitate
proper
immigrants.
Sensitisation
stakeholders.
screening
among
of
employees
Epidemic
Post -epidemic
illegal
and
Improve water and sanitation in prisons.
Commerce, Trade and
industry



Carryout sensitization among the trade
and business associations such Zambia
Chamber of Commerce and Industry,
SIASS, Cross border traders

Engage the Trade and Investment
Officers both home and abroad on
Ebola issues.
Mainstream Ebola issues in the
Provincial consultative tour that the
ministry will be undertaking during the
review of the Commercial, Trade and
Industrial Policy.

Hold Sector Advisory Group meeting to
specifically sensitize the stakeholders
on Ebola.

The
Disability
mainstreaming
Committee to sensitize the disabled
business community on Ebola.
Engage
the
business
community such as ZACCI,
SIAZ, ZAM, Cross border
traders and many others
and advise them on the
areas where not to conduct
business.

To temporarily stop the
issuance of export and
import permits.

To work in collaboration
with MoF to cross some
border posts so as to
contain
the
epidemic
among
the
business
community.

Place advert in one leading
newspapers
to
communicate the epidemic
amongst
the
business
community in Zambia.



The
ministry
to
continue conducting
sensitizing
the
business community
through the Sector
Advisory group.
Work closely with the
Private
sector
Development
Programme
(PSDRP)
to reach as many
business
community
as
possible
in
sensitizing the private
sector on ways of
avoiding infection and
spreading the disease
To encourage the
business
community
to strictly follow and
adhere the guidance
given by the ministry
of health.
33
Ministry/Institution
Pre-epidemic
 To engage and sensitize the buss, truck
drivers at the border post on Ebola.

To constitute a committee on Ebola
and identify an Ebola focal point
person in the Ministry.

Encourage HRA department through its
HIV Work place Policy to include the
Ebola issues to sensitize members of
staff.

Do an article in the Ministerial
quarterly magazine on Ebola.

Conduct a sensitization meeting with
women in business during the
commemoration
of
International
Women’s Day.

Sensitize the business
companies
during the Domestic Trade Survey on
Ebola

To visit and sensitise the traders under
the Simplified Trade Regime at
Chirundu Border Post, at ZambiaMalawi Border Post, Kasumbalesa
border post, at Tunduma border post
between Zambia and Tanzania
Epidemic

To
encourage
business
members
to
report
suspecting cases of Ebola
to the ministry of health.

To engage stator bodies
such as ZDA, PACRA to talk
to the marketers to avoid
crowding in the markets
and to and follow the
health advice from the
Ministry of health and the
DMMU.

Liaise with COMESA and
SADC secretariat on how
best to sensitize the
member states and traders
on Ebola in the country.
Post -epidemic
 Make use of the Trade
and
Investment
Officers (TIPOs) in
continuing sensitizing
would- be and other
people
interested
coming to Zambia.
34
Ministry/Institution
Faith Based
Organisation
Pre-epidemic



Sensitisation of the congregants
Supplementing government efforts
Distribution of IEC materials in
churches.

Training of Trainers - church leaders

Private Sector
NGOs/Civil Society
Sensitisation of target groups such as
women, and children within the church
and the neighbouring community.
Epidemic


Supplementing government
efforts
Strengthen Sensitization
programmes in the
churches.

Strengthen the teaching
and learning of the Ebola
epidemic in churches
/communities.

Intensify dissemination of
appropriate information to
the target groups and the
communities with the
church catchment area.
Supplementing government efforts.
Supplementing government efforts.
Post -epidemic



Supplementing
government efforts
Provide psychosocial counseling to
affected families
Assure the churches/
communities on the
end of the epidemic.
Supplementing
efforts.
government
Supplementing government efforts.
Supplementing
efforts.
government
Supplementing government efforts.
35
Annex II: Budget
THEMATIC
AREA
ACTIVITY
1.
Coordination,
finance and
logistics
1.1.1 Reactivate a multisectoral
EPPC&MC to include EVD at all levels.
RESPONSIBLE
ORGANISATION
DVS/UNZA/ZAWA
MEASURABLE
INDICATOR/
VERIFICATION MEANS
National, Provincial
and District Epidemic
Committee
reactivated to include
EVD.
Coordination meetings
conducted and
minutes available
EVD preparedness and
response plans in
place
Preparedness Plan
developed
DMMU/EPPC&MC/DVS
Simulations exercises
conducted
MOH
1.1.2 Hold weekly EPPC&MC to
include EVD at all levels
MOH
1.1.3 Develop EVD preparedness and
response plans at all level
EPPC&MC
1.1.4 Development of emergency
preparedness plan for EVD
1.1.4 Test the EVD preparedness and
response plans
Sub-total
1.2.1 Conduct meetings to launch and
disseminate EVD preparedness and
response plan to partners and donors
1.2.2 Map critical resources required
for adequate EVD preparedness and
response e.g. PPEs, disinfectants, lab
supplies, human resources
1.2.3 Monitoring and supervision of
EVD preparedness and response
activities by the taskforce members
response
EPPC&MC
EPPC&MC
EPPC&MC
Sub-total
1. Coordination, finance and logistics Total
Partners and donors
briefed on EVD
preparedness strategy
Logistics essential for
adequate EVD
preparedness and
response
prepositioned
Monitoring/supervision
visits conducted
AMOUNT (ZMW)
AMOUNT (US$)
10,000.00
1,612.90
90,000.00
14,516.13
102,000.00
16,451.61
300,000.00
48,387.10
580,000.00
93,548.39
1,082,000.00
174,516.13
17,500.00
2,822.58
152,000.00
24,516.13
568,000.00
91,612.90
737,500.00
467,983.87
36
THEMATIC
AREA
ACTIVITY
RESPONSIBLE
ORGANISATION
2.
Epidemiology,
surveillance
and
laboratory
2.1.1 Identify and train health
workers from all districts with
international ports of entry and train
them to conduct screening at port of
entry, KK, Simon Mwansa Kapwepwe,
Harry Mwaanga Nkumbula and Mfuwe
International Airports in particular
2.1.2 Procure medical supplies to
support the screening: Patient
screens, examination couch, blood
pressure machines, thermometers,
Stethoscopes, Thermal scanners
2.1.3 Procure PPE kits and
disinfectants for the screening team
at the airport.
MOH/ MCDMCH/
Partners
2.1.4 Conduct screening of
international travellers for EVD at
International Airports
2.1.5 Avail a standby ambulance at
the airport to facilitate rapid
evacuation of suspect cases to the
designated EVD isolation facility
2.1.6 Establish EVD emergency desks
at select border crossing points as
indicated by the prevailing
epidemiological trends and risk of
importation.
2.1.7 Conduct verification of rumours
and outbreak investigation.
2.1.8 Conduct regular data
management and produce
epidemiological Reports (Situation
Reports - SitReps)
MOH/ MCDMCH/
Partners
MEASURABLE
INDICATOR/
VERIFICATION MEANS
Number of Health
Wokers trained
MOH/ MCDMCH/
Partners
Medical supplies
procured to facilitate
screening at the
Airport
MOH/ MCDMCH/
Partners
Adequate PPEs &
disinfectants in place
to support screening &
evacuation of suspects
Screening of
international travelers
conducted
Ambulance in place at
the Airports
MOH/ MCDMCH/
Partners
MOH/ MCDMCH/
Partners
Screening desks
established at
selected high risk
ground crossings
MOH/ MCDMCH/
Partners
MOH/ MCDMCH/
Partners
Alert communication
done
Epidemiological
reports available
AMOUNT (ZMW)
AMOUNT (US$)
1,201,200.00
193,741.94
3,623,624.00
584,455.48
1,433,885.00
231,271.77
240,000.00
38,709.68
447,200.00
72,129.03
540,000.00
87,096.77
52,500.00
8,467.74
5,000.00
806.45
37
THEMATIC
AREA
ACTIVITY
RESPONSIBLE
ORGANISATION
2.1.9 Alert all levels to strengthen
surveillance for VHF
MOH/ MCDMCH/
Partners
2.1.10 Risk analysis and mapping and
development of data collection tools
DVS (NALEIC & CVRI )
ZAWA & UNZA
2.1.11 Virus and Sero-surveillance in
animals
DVS (NALEIC & CVRI )
ZAWA & UNZA
Sub-total
2.2.1 Orient rapid response teams on
EVD case definition, case
investigation, PPE use, sample
collection, and contact listing and
follow-up
MEASURABLE
INDICATOR/
VERIFICATION MEANS
Rumours verified and
outbreak investigated
to confirm or discard
Reports and data
collection tools
available
Reports in animals
available
MOH/ MCDMCH/
Partners
National, province and
district rapid response
teams trained to
support case
verifications
2.2.2 Procure 14 motor vehicles for
surveillance activities in the
provinces, Laboratory and National
levels
MOH/ MCDMCH/
Partners
Goods Received Notes
for Motor vehicles in
provinces, UTH Lab
and MoH HQ
2.2.3 Procurement of 10 Motor
Vehicles to support field activities (2
Land Cruisers for UNZA and 8 for 4x4
twine cabs for surveillance in 5
wildlife)
DVS Public Health
Unit/MAL PSU
Motors vehicles
procured and
available
2.2.4 Maintenance for vehicles
DVS
Vehicle fleet at DVS
field operational
AMOUNT (ZMW)
AMOUNT (US$)
100,000.00
16,129.03
180,000.00
29,032.26
750,000.00
120,967.74
7,643,409.00
1,382,807.90
192,000.00
30,967.74
6,000,000.00
967,741.94
3,300,000.00
532,258.06
120,000.00
19,354.84
38
THEMATIC
AREA
ACTIVITY
RESPONSIBLE
ORGANISATION
MEASURABLE
INDICATOR/
VERIFICATION MEANS
Adequate PPES &
disinfectants in place
to support screening
of animals and sample
collection
2.2.5 Procure PPE Kits for field staff
& prerequisites
DVS HQ
2.2.6 Procure capture and culling
(ammunition) equipment for the
activity
DVS (NALEIC) &
ZAWA
Culling and Capture
equipment procured
and available
2.2.7 Support the rapid response
teams to conduct EVD case
verifications, contact follow-ups, and
capacity building for priority groups
MOH/ MCDMCH/
Partners
EVD case verifications
promptly conducted
by RRTs
Sub-total
2.3.1 Update and disseminated EVD
surveillance guidelines including case
definitions, case investigation forms,
& contact listing and follow-up forms
2.3.2 Conduct orientation of health
workers on Ebola surveillance:
guidelines and data collection tools
2.3.3 Support creation of the Ebola
alert desk with a hotline at the
Ministry of Health to facilitate daily
reporting of suspected EVD cases
from the districts
2.3.4 Train community volunteers in
selected high risk districts &
provinces to conduct active case
finding, contact tracing and follow-up
MOH/ MCDMCH/
Partners
MOH/ MCDMCH/
Partners
Surveillance
guidelines updated
and disseminated to
support EVD
surveillance
HW oriented on Ebola
surveillance
(integrated 2.1.1)
AMOUNT (ZMW)
AMOUNT (US$)
1,400,000.00
225,806.45
110,000.00
17,741.94
100,000.00
16,129.03
450,000.00
72,580.65
720,000.00
116,129.03
78,120.00
12,600.00
598,120.00
96,470.97
MOH/ MCDMCH/
Partners
MOH/ MCDMCH/
Partners
Ebola alert desk
created at the MoH
Community volunteers
trained to conduct
EVD active
surveillance in
39
THEMATIC
AREA
ACTIVITY
2.3.5 Support community volunteers
to conduct active case finding,
contact tracing and follow-up
Sub-total
2.4.1 Establish collaborative
laboratory network links to confirm
suspected cases in the African region
RESPONSIBLE
ORGANISATION
MOH/ MCDMCH/
Partners
MOH/ MCDMCH/
Partners
2.4.2 Procure and preposition
specimen collection and triple
packaging materials at all levels
MOH/ MCDMCH/
Partners
2.4.3 Avail adequate infection
prevention and control supplies
including PPEs and disinfectants to
facilitate safe collection of specimen
from suspected cases
MOH/ MCDMCH/
Partners
2.4.4Conduct trainings for laboratory
personnel on specimen collection,
processing, & shipments at province
and national levels
MOH/ MCDMCH/
Partners
2.4.5 Induction and Orientation of
Provincial and District Field Staff
DVS/UNZA
2.4.6 Induction and Orientation of
National Field Officers (TOT)
DVS/MOH/UNZA
MEASURABLE
INDICATOR/
VERIFICATION MEANS
selected high risk
areas
Community volunteers
supported to conduct
active case search in
high risk areas
Collaboration links
established to ensure
samples from
suspected cases are
promptly tested
Adequate laboratory
supplies in place to
support investigation
of EVD cases
Adequate infection
prevention and
control supplies in
place to support safe
sample collection and
packaging
Adequate capacities
for EVD sample
collection established
(integrated in item
2.1.3)
Training workshops
held and reports
available
Number of TOT
workshops held and
reports availability
AMOUNT (ZMW)
AMOUNT (US$)
130,000.00
20,967.74
13,198,240.00
2,128,748.39
180,000.00
29,032.26
110,000.00
17,741.94
98,010.00
15,808.06
50,000.00
8,064.52
600,000.00
96,774.19
110,000.00
17,741.94
40
THEMATIC
AREA
ACTIVITY
RESPONSIBLE
ORGANISATION
2.4.7 Orient and train field staff in
sample collection , storage,
packaging and transportation
2.4.8 Disseminate lab SOPs and
supplies to all districts
DVS ( NALEIC & CVRI)
UNZA & ZAWA
2.4.9. Development of SOPs and
guidelines for animal health
2.4.10
Incorporation
of
EBOLA
materials in the Curriculum of MOE
2.4.11 Training of MESVTEE officials ,
Lecturers and science Teachers as
TOTs on EBOLA
DVS (CVRI )
UNZA/ZAWA
MOE
Sub-total
2.5.1 Identify & train the following
teams: Health Workers to provide
clinical care; ambulance teams;
janitors; contact tracing teams &
burial teams
2.5.2 Provide adequate infection
prevention and control supplies
including PPEs, disinfectants, spray
pumps to the case management,
contact tracing, burial, and
ambulance teams
2.5.3 Provide medical equipment for
clinical care in the designated EVD
isolation facilities
2.5.4 Assign health workers, contact
tracing, ambulance teams, and burial
teams at the designated EVD isolation
facilities
MOH/ MCDMCH/
Partners
MOE
MOH/ MCDMCH/
Partners
MEASURABLE
INDICATOR/
VERIFICATION MEANS
Training report
available
Lab SoPs in place
(integrated in item
2.1.3)
Presence of guidelines
and SOPs
Presence of EBOLA
materials
Training
reports
available
AMOUNT (ZMW)
AMOUNT (US$)
530,000.00
85,483.87
45,000.00
7,258.06
160,000.00
25,806.45
477,717.28
77,051.17
9,036,243.79
1,457,458.68
2,360,727.28
277,904.84
15,000.00
2,419.35
2,160,000.00
348,387.10
-
-
1,440,000.00
232,258.06
Health care workers
trained to manage
EVD suspected cases
MOH/ MCDMCH/
Partners
MOH/ MCDMCH/
Partners
MOH/ MCDMCH/
Partners
Adequate supplies in
place to facilitate
barrier nursing
Medical equipment in
place to support
screening of travelers
(integrated in item
2.1.2)
Clinical care provided
at the designated
isolation facility
41
THEMATIC
AREA
ACTIVITY
RESPONSIBLE
ORGANISATION
2.5.5 Support border, quarantine and
road checkpoint staff
NALEIC
2.5.6 Procure food and linen for
patients and health workers in the
EVD isolation facilities
2.5.7 Ensure all EVD medical waste
from the isolation facilities is
incinerated
2.5.8 Regulate the handling and
disposal of wastes and or dead bodies
in manner that does not pose a risk to
the general environment and the
handlers of such
MOH /MCDMCH/
Partners
Sub-total
2.6.1 Conduct orientation of health
workers in the high risk states on
case management and infection
control practices and use of PPEs
MOH/ MCDMCH/
Partners
MoLNREP/ZEMA
MOH/ MCDMCH/
Partners
2.6.2
Procure
and
preposition
infection prevention and control
supplies
MOH/ MCDMCH/
Partners
Procurement of reagents ,test kits
and equipment for animal health
DVS (CVRI)
2.6.3 Support ambulance services to
facilitate referral of suspected cases
from community to isolation facilities
2.6.4 Conduct support supervision to
strengthen infection prevention and
control practices
MOH/ MCDMCH/
Partners
MOH/ MCDMCH/
Partners
MEASURABLE
INDICATOR/
VERIFICATION MEANS
Road checkpoints
provided
EVD suspects and HW
provided with food
and linen
Proper waste
management in place
AMOUNT (ZMW)
AMOUNT (US$)
300,000.00
48,387.10
1,080,000.00
174,193.55
900,000.00
145,161.29
705,000.00
113,709.68
5,895,000.00
950,806.45
-
-
2,700,000.00
435,483.87
1,417,350.00
228,604.84
132,500.00
21,370.97
78,000.00
12,580.65
number of
supervisions
conducted
Health
workers
trained on infection
control,
case
management, and use
of PPEs (integrated in
item 2.1.1)
Adequate
infection
prevention
and
control
supplies
procured for health
facilities to facilitate
routine patient care
Reagents, Test Kits
and
Equipment
available
Ambulance services in
place
Supervision conducted
42
THEMATIC
AREA
ACTIVITY
RESPONSIBLE
ORGANISATION
MEASURABLE
INDICATOR/
VERIFICATION MEANS
Sub-total
2. Epidemiology, surveillance and laboratory Total
3. Advocacy,
social
mobilization,
psycho-social
support and
education
3.1.1 Adapt the national risk
communication strategy to the
prevailing EVD risks
All Ministries and
Partners
3.1.2 Orient members of the national
and state EVD taskforce with basic
information on Ebola to enable them
participate in social mobilization/
community sensitization
3.1.3 Support social mobilization
using the film van (community
film/talk shows)
3.1.4 Conduct advocacy meetings &
orientation with political leaders &
parliamentary health committee
3.1.5 Community sensitization
through IEC materials, radio and TV
programs
3.1.6 Orientation of the media on
Ebola prevention and control
MOH/ MCDMCH/
Partners
3.1.7 Community dialogue
All Ministries and
Partners
3.1.8 Enhance capacities in
interpersonal communication and
counseling
3.1.9 Sensitization of community
volunteers in selected high risk states
to ensure dissemination of public
information/ health education
3.1.10 Sensitization of ZACCI at
MOH/ MCDMCH/
Partners
MOH/ MCDMCH/
Partners/MoIBS/MOE
All Ministries and
Partners
MOH/ MCDMCH/ DVS
/MoYS /Partners
MOH/ MCDMCH/
Partners/MoIBS
AMOUNT (ZMW)
AMOUNT (US$)
4,327,850.00
698,040.32
National risk
communication
strategy for EVD in
place
-
-
EPPC&MC members
oriented on Ebola
prevention and
control
-
-
50,000.00
8,064.52
100,000.00
16,129.03
7,408,567.00
1,194,930.16
463,420.00
74,745.16
60,000.00
9,677.42
87,000.00
14,032.26
number of community
volunteers sensitized
395,000.00
63,709.68
Number of
107,100.00
17,274.19
Film van shows
conducted
Advocacy meetings
conducted with local
leaders
Community
sensitizations
conducted
Media oriented on
Ebola
Number of community
dialogue meetings
conducted
Counselors trained &
Interpersonal
counseling conducted
MOH/ MCDMCH/
MCTA/ Partners/
Ministry Of
43
THEMATIC
AREA
ACTIVITY
RESPONSIBLE
ORGANISATION
border posts
Commerce
3.3.11 Dissemination of information
on EBOLA to foreign missions and
consulates
3.1.12 Development and translation
of Health education messages, and
radio spots
3.1.13 Orientation of opinion leaders
(religious leaders, cultural leaders,
teachers, traditional healers, etc) on
Ebola prevention and control
3.1.14 Establish and orient
community health committees in
selected high risk states on Ebola
prevention and control
3.1.15 Conduct regular press briefings
MoFA
3.1.16 Monitoring and supervision of
ongoing community interventions
MEASURABLE
INDICATOR/
VERIFICATION MEANS
Sensitization meetings
held
Dissemination reports
available
MOH/ MCDMCH/
Partners/MoIBS/MOE
Health messages
translated
AMOUNT (US$)
240,300.00
38,758.06
25,000.00
4,032.26
50,000.00
8,064.52
23,000.00
3,709.68
17,500.00
2,822.58
28,000.00
4,516.13
130,000.00
20,967.74
9,054,887.00
1,460,465.65
14,261,466.67
2,300,236.56
38,296,433.00
6,176,844.03
MOH/ MCDMCH/
MCTA/Partners
MOH/ MCDMCH/
Partners
MOH/ MCDMCH/
Partners
MOH/ MCDMCH/
Partners
Number of opinion
leaders sensitized
Community health
committees sensitized
on Ebola
Number of press
briefings
Supervision conducted
and reports shared
3.1.17 Monitoring of Sensitization
All Ministries and
Reports of
programmes at all levels
Partners
sensitization meetings
3. Advocacy, social mobilization, psycho-social support and education Total
4. Cross
cutting issues
AMOUNT (ZMW)
4.1.1 Support to provinces
MOH/ MCDMCH/
Partners
Provinces supported
4.1.2 Lab infrastructure development
MOH/ MCDMCH/
Partners
Lab infrastructure in
place
44
THEMATIC
AREA
ACTIVITY
RESPONSIBLE
ORGANISATION
4.1.3 Isolation facilities
MOH/ MCDMCH/
Partners
4.1.4 Installation of Incinerators at
high risk border entry points with
high volume of livestock and products
4.1.5 Construction of a P3 Laboratory
at CVRI
4.1.6 Facilitate identification of
suitable land for isolation and
treatment facilities
4.1.7 Regulate
NALEIC PSU
MEASURABLE
INDICATOR/
VERIFICATION MEANS
Isolation facilities in
place
DVS (CVRI )
Incinerators installed
at international hubs
in high risk provinces
Laboratory established
MoLNREP
Reports of field visits
4. Cross Cutting Issues Sub-total
GRAND TOTAL FOR THE EBOLA PREPAREDNESS AND RESPONSE
AMOUNT (ZMW)
AMOUNT (US$)
28,000,000.00
4,516,129.03
520,000.00
83,870.97
12,500,000.00
2,016,129.03
456,000.00
73,548.39
94,033,899.67
12,993,209.62
129,278,625.95
20,534,483.17
Note:
Exchange rate = K6.2
45