For years, Rwanda’s human health sector had been tracking diseases digitally, but the animal and wildlife sectors lagged behind. That changed on November 3, when the country observed World One Health Day by launching the Integrated Disease Surveillance and Response (e-IDSR) system. ALSO READ: Rwanda unveils real-time health monitoring hub The new platform enables the country to detect, report, and respond to threats affecting humans, livestock, and wildlife in real time. One Health is an approach that recognises the interconnectedness of human, animal, and environmental health. ALSO READ: $4 billion needed to digitalise healthcare in Rwanda and other low, middle-income countries In an interview with The New Times, Dr. Léandre Ishema, Acting Director of One Health at Rwanda Biomedical Center (RBC), discussed the system’s history, the reasons for its multi-sector integration, the priority diseases it targets, how reporting and data flow operate, training initiatives, and challenges, among others. Excerpts; What led to the decision to expand the e-IDSR system to include animals, wildlife, and environmental health? The e-IDSR isn’t entirely new. It was first adopted in Rwanda in 2002 for the human health sector to improve preparedness for epidemics and pandemics. By 2013, Rwanda became the first low-income country to implement the system nationwide using mobile technology, covering all 521 health facilities. However, we noticed gaps in the animal health sector. Veterinarians often relied on paper-based reports or informal, on-the-spot communication, which delayed responses and slowed information sharing. The impact was felt most during outbreaks like Rift Valley fever, when slow reporting from animals delayed critical measures to protect people. To address this, we integrated the system into the animal health sector, covering domestic animals and wildlife, with plans to include climate and health indicators. The system aims to provide early alerts for diseases that can spread between humans and animals. How was the e-IDSR system rolled out in the animal health sector, and who has been trained to use it? In 2022, we identified the animal diseases that needed monitoring and began developing the system. By 2023, it was ready for training. The first group included 60 veterinarians from districts and ministries, who then helped train sector-level vets across the country. Private veterinarians under the Veterinary Sanitary Mandate, who assist district and sector-level vets, were also trained, about 100 so far. We also trained around 30 veterinarians from the Rwanda Development Board, which oversees wildlife, as well as park rangers, to ensure disease detection in wildlife. Overall, approximately 573 animal health professionals now use the system. Can you explain which diseases the system monitors? The government has identified six priority zoonotic diseases (illnesses that can be transmitted between animals and humans, including rabies, Rift Valley fever, trypanosomiasis, viral hemorrhagic fevers, brucellosis, and avian influenza). However, the system also tracks other diseases that could threaten people, animals, or the economy, even if they aren’t directly transmissible to humans. By doing so, it provides a more complete picture of health risks, helping authorities act quickly to protect both public health and livelihoods. How does the system capture and follow up on reports from villages and local communities? The system enables rapid reporting through the web, mobile app, or SMS alerts, including a community-level platform called “Impuruza”. Community health workers and animal health workers can quickly notify authorities about incidents such as dog bites, suspected infections, or unusual animal deaths and others using SMS, but the system can also be accessed via web or as an app. Each notification includes main details, like the village, sector, district, and reporter contact, allowing authorities to follow up promptly. For instance, a message might read: ‘Dear national e-IDSR team, a new case of (disease) has been registered at Kinyinya Health center with ID number (xxx). How does the data flow from the community to the national level? Data flows from the village level up through the cell, sector, district, provincial, and national levels. Provincial Public Health Emergency Operations Centers track the information, while the national team oversees all reported events. Once a notification is received, teams are deployed immediately to investigate and contain emerging threats. The system is designed for rapid action, with reporting and initial response expected to occur within a single day. Can you describe some of the obstacles in rolling out the system, especially for rural veterinarians, and how RBC is supporting them? Many veterinarians in rural areas at the start lacked the equipment needed for digital reporting. To bridge this gap, WHO provided more than 300 tablets, while FAO supplied an additional 275 to the Rwanda Agricultural and Animal Resources Board, ensuring timely reporting even in remote areas. Early on, the human health sector was more advanced than other sectors, creating disparities in adoption. Challenges also included infrastructure gaps, limited equipment, and varying levels of ownership of the system, mostly among veterinarians juggling multiple responsibilities. To overcome these obstacles, RBC and RAB are carrying out supportive supervision, data review meetings, and refresher trainings. These efforts help maintain consistent use of the system and ensure all sectors remain up to date and capable of reporting effectively How is sustainability ensured for training and system use? All human health workers in Rwanda are now fully trained, while training for animal health staff is ongoing with partners including RAB, RDB, WHO, FAO, and Clinton Health Access Initiative (CHAI). RBC also supports their work through supervision, yearly refresher courses, and mentorship, ensuring the system is used effectively and that all sectors remain fully involved over the long term. How is information from the e-IDSR shared with the public to raise awareness? Community health workers serve as the first point of contact for reporting health related events such as dog and snake bites, malaria cases, among others. To keep the public informed, RBC publishes weekly epidemiological bulletins on its website that detail reported diseases and potential outbreaks. Hospitals, health centers, and community health workers work together to share this information widely, ensuring communities are aware and prepared.
