 And thank you and welcome everyone to the last session today about COVID. It's been very exciting to see all the presentations earlier and I hope many of you have caught those. But I know there's been parallel sessions and there's actually so much of interest that has been presented, especially from countries. So I hope you will have a chance to catch those because they're already recorded. They're all be available on YouTube and the links are in the sked and on the website. Also, I'd like to remind everyone that we have a Q&A set up in our community of practice forum. And I just posted the link to that in the chat. The link should also be in your schedule. So without further ado, I'd really like to introduce the presenters in this session. We're very fortunate to have our key global collaborators and partners. Thus, Karin Gashen from Gavi, who will talk about, of course, the impact of COVID. But I think also the much longer collaboration that we've already enjoyed for a number of years with Gavi for immunization and also some perspectives beyond COVID. And then we'll have Michelle Monroe from the Global Fund. Obviously again, the COVID response is very central, but we should not forget that all the impact of COVID on the health systems in general. A bit like the Ebola crisis has also affected all other vital health programs. So I'm sure Michelle will go into that. Today, Carl Kinkade from CDC will present not only about the work we've been doing with CDC over the years, but an exciting recent development, which allows, will allow us to work very closely with CDC in the coming years. So with all that, let me hand over to Karin Gashen from Gavi. Good afternoon. Hello to everyone. Let me share my screen. So I think you should be able to see. So thank you very much for the opportunity to come and speak during that plenary to close the day. Of course, we are all missing to be together in a slow, but let's take the opportunity to reach more people. So I was asked to come and speak about how to strengthen surveillance and COVID-19 and beyond, but actually won't really twilight that the partnership has started before COVID-19. And I want to share with you how we decided to collaborate to strengthen integrated national surveillance information system. And of course, at the end, we can open it and see how beyond COVID-19 we can scale up and sustain that effort together. So quickly, I will present to you about the DHIS2 and immunization and we have that Gavi partnership with the University of Oslo and of course with WHO and UNICEF for some other aspect. Rapidly, Gavi is in support of DHIS2. And I just wanted to remind that Gavi is a signatory to the principle of donor alignment for digital health. You can see the whole list of activities we are doing. I just wanted to acknowledge that Gavi and all the alliance partner, including UNICEF, WHO and CDC, we are all software platform provider agnostic. However, we have to acknowledge the adoption of DHIS2 in over more than 60 countries. And we have also to acknowledge the leadership of University of Oslo and all the ISP network in providing guidance and technical support to countries. So it's how we engage further with that specific application and those partner. You can see Gavi has started to engage with DHIS2 and University of Oslo via the partners from 2016, the laboratory in UNICEF and then directly with the direct partnership since three years started in 2018. And this was really following the demand from the country. We have a wide range of activities to support DHIS2 can really be of help in a lot of areas. We have been talking about aggregate data for immunization campaigns, how to really work now also on the individual tracker for electronic immunization registry. We have a lot of work to do on interoperability and on GIS based on link with LMIS, but today we'll be focusing on the surveillance data. And really, I will never emphasize enough how surveillance data is really a life saving intervention. And actually, the vaccine preventable disease surveillance information system is really essential. Of course, and really a saving life start by preventing outbreak and improving the detection and response against outbreak. But also in another area that is very important for us is that the information from the surveillance help us to identify areas with immunity gap by using triangulation and we can then target area with the highest number of what we call the zero dose of the children who never been vaccinated in routine immunization. So then as that is also very important for us to understand the disease burden and therefore understand how what is the level of coverage of vaccination says the efficiency of the immunization program. And of course, we are all waiting the moment when COVID-19 will become a vaccine preventable disease. Very, very soon now and as soon as COVID-19 will be a VPD, we'll have to all work together for the introduction of that COVID-19 the COVAX and then VPD surveillance system will be critical. So what is happening with DHIS2 as a platform for surveillance data. So I'm presenting really, you know, we supported the project but all the work was done by WTO and I want to acknowledge Oliver and Katia and also by all the team in Oslo and in East, especially East, West and Central Africa. So you may know that the VPD and the Vaccine Preventable Disease Surveillance Investment Case for Africa have six major components. And one of this is really the information system is an ambitious work to be doing. So why we decided to support the work on DHIS2 and we actually just listened what the country and the Parliament were saying and we heard it very loud and clear. We understood that APN4 was no longer to be supported and this will be really, really a huge problem for the countries if there was no other solution to come up. There was more at the time there was already more than 40 countries in the WHO are for regions that were already using DHIS2. And actually, a lot of countries already installed the WHO DHIS2 package for immunization coverage and DHIS2 started to be used by in surveillance and immunization program for surveillance and also the country and the panel were really asking web system to have real time data. So the proposal came to really have an integrated information system for VPD and all the epidemic prone disease surveillance in DHIS2. So the scope is at both level at the global level to really work to have an information system design and to evolve the DHIS2 development and then there is a specific work on Africa for now to have to follow up and support implementation at country and at regional level. The feature is to really try to replace the existing Excel tool for IDSA and several countries talk about it and also all the EPN4 work for reporting system. And we wanted also to have this link to the regional platform to have a kind of DHIS2 for VPD at the regional level and to have a country focus. To have systems that are really adaptable to country surveillance specificities for country can still choose indicators and disease and the system should be interoperable with all the other existing system in the country. So it was quite ambitious to start. We're not just supporting two or three diseases, but you can see more than 15 different diseases and all of this you know with a specific partners, a specific entities, a specific modalities. So it's quite ambitious. So the package, the DHIS2 package for integrated surveillance came with that different list that is in front of you for both aggregate and case-based. But of course, you know, any other disease can be added based on the national recommendation for each country for both aggregate and case-based surveillance. So because there was a lot of diseases, a lot of people to coordinate and Rebecca mentioned it. There was this high-level support that was really needed to solve several issues and kick off that work. And there was this big consensus meeting with a lot of people from a lot of different sections in WHO and from HQ, from AFOL level, a lot of partners, CDC, ISP were all represented. And the objective was really to develop several package, a package with several documents to really work on the data element documents who have all the standards and norms very clear for everyone to work on the dashboard. It could be this specific to also present alert, epidemic to all together agree on the system requirement and specificity. And of course, all of this will not be useful if we don't use the data. If so, it was also important to come up with a facility analysis guidance document and to our knowledge CDC, especially on that piece of work. So the regional work was really important and you can look at the diagram. It was also mentioned by Alain, a bit earlier. So there is a WHO piece, but there is also a collaboration with WAU ECOAS in Africa. We had already a functional DHS2 platform for aggregate disease surveillance and an existing collaboration so there is a way forward to make sure that the aggregate package is in all the WAU countries and the database from both WAU and AFOL will be speaking together. Just a quick update where it is now, so Mali and Togo and Rwanda have started to work on this and Camun is about to start. Some of the countries have shown already the interest and the interest can still be expressed, of course. And no pressure, but by May 2021, during a couple of months and in the middle of the pandemic, we will say that this project will have been a success if you know the DHS2 surveillance package for both will be operational. And if the serverless data are really collected, reported to the DHS2 platform and you. So we are targeting 20 AFOL countries and for the aggregate package and at least three AFOL countries for the entire case-based project. And then we'll have to make sure all integration is considered and also all the region and partner are kept informed and we have a plan for further implementation. After that initial planning, now we are going to talk about scaling and sustaining this for all the country. I mentioned some of the challenges of course coordination is really talking about many, I mean, so many different, you need division organization. So it could be a challenge, but it's also a great opportunity to learn how to work better. And then we have a lot of staff distortion with COVID-19 response. Not easy to implement to support country to work at distance and also for the communication between developers and all the technician. I want to highlight the fact that there is especially due to the pandemic, a lot of funding diversion, multiplication of tools and sometimes I think the interest of the country is a bit lost in all of this. And you will see the coming step of that project to a lot of dissemination training and making these resources available to the country. So just to finish, yes, it started before COVID-19. And now I can just tell you how the pandemic had just like given a strong sense that so what we started before was extremely relevant, really, really important. And honestly, no one want another pandemic, but if another happened, but already all the surveillance information system are strong. And if many countries are using such system, like we have seen on DHS2 is a WHO package will be way more ready for the next pandemic. So thank you again very much for all the partner you see the contacts and all the people who should be acknowledged for for that work and all the team beyond that work. And I'm happy to hand over to you. Thank you so much, Karin. That's an excellent overview of the work that Gavi's been doing as well as the key partner from WHO. I must say, as the University of Oslo, we were also very grateful to the flexibility that the key partners like Gavi and also Global Fund have shown in this very turbulent period. And I think together this partnership has shown its value in this period and hopefully very much beyond. So please, Michelle Monroe from Global Fund. Please share your screen and present. Okay, sharing my screen. Hello, everybody. Can you see it well enough if I do it this way because I always have issues with presentation mode. Yeah, I think that's also fine. Okay, so it's great to follow Karin and Gavi because we have a lot of similarities and and ways that we've been coordinating with each other so a lot of the information that Karin has just shared on the support and the standards and the packages that are used for the vaccine preventable diseases. It's been a very similar approach on HIV, TB and malaria, and in fact with both DHS, two and WHO across more multiple disease and programs. So I'm going to skip some of the pieces that Karin has already gone through about the kind of development of these packages and this pieces of the support. But know that those pieces have been have been going on for each of these modules as well. I also want to introduce some of the areas that we've been supporting and then how that also had recent results impact and then also how that has strengthened the response to COVID-19. For the first slide you'll see it's actually quite similar to Karin's as well and we coordinate between Gavi and Global Fund and the other partners working in these different areas but using the same packages and systems. So for the Global Fund, we have investments in DHS to base systems in of our 5053 highest burden countries, 41 of those plus a few others that are also piloting and rolling out now. There's three more are using DHS to base systems, at least for their national aggregate at GMS, if not also as well for using tracker for case base surveillance for HIV, TB or malaria elimination. So this is mostly funded through the Global Fund grant investments to the specific countries and that's maintaining and strengthening the quality of the DHS to base HMIS. And then now in this next we're entering into our next three year cycle and we're seeing so far a large increase in the country's funding as well more national scale community health information systems and linking those to the DHS to HMIS. And then also for case based reporting for HIV, TB and malaria for elimination settings. And, you know, it's a we can't say for sure yet at this point but a breath estimate you know it's about 65% of those are DHS to tracker based those requests so far for funding. So similar to Gavi, it's a this is a for us that the countries are using DHS to base system we are also system agnostic, but essentially we're able when we support these these improvements to essentially and also to the packages and the country investments were able to support many countries efficiently at once. So we have some much smaller but central investments. Not through the grants, and that's really about increasing the efficiency so that each country and each grant does not have to invest in some of the core cross cutting work in DHS to systems. So, exactly what Karen was talking about in this development with W. A. Joe of the implementation of the data analysis and use toolkit and the accompanying packages that current share very well for for EPI and the vaccine diseases that we have for HIV, TB, malaria and other disease programs. Also a good segue I think for tomorrow because that's one of the big focuses for tomorrow's sessions. And really trying to also increase local and regional and country level availability and and also the coordination of technical assistance and other support for strengthening countries not to my HMS and getting to our own strategic goals and targets around that. So, next slide is just to show a few results from this. Most recently, I will say these results are on this chart here are pre over there from in 2019 we expect things will have dropped for this year but we expect actually that will be temporary. We've seen through supporting and this is not only DHS to base systems here but as we said about 75% of these systems are DHS to base that are included in these results shown here. So we have seen actually a pretty significant increase in the one the integration of especially for aggregate reporting of the three diseases into the national HMIS so that's moving away from having siloed TV system and a siloed TV system and a siloed malaria system and into one national HMIS which of course creates a lot of efficiencies, then the quality piece of that, making sure that when it's integrated that there is still the needs addressed for each of those diseases monitoring in the national HMIS that the standards that are in these WHO and DHS to packages really helps to ensure that. Also, I think really important to see is that there has been an increase that we see at a global reporting from HIV, TB and malaria and in completeness of reports, you know the percentage of facility reports and especially in timeliness it's still low timeliness averaging across the three diseases across our one year and increase from 47 to 63%, which is very exciting to see, especially as people start looking at this concept of even faster than before. And then of course looking into into how this has supported for COVID-19. So my last slide here, what I want to highlight that we have found one having this existing partnership with DHS to with WHO and other partners facilitated a rapid response just in a way that we could move funding quickly but also this piece about having the standard and established systems in place that could be adapted rapidly to add surveillance for COVID-19. And one of the items around that that has come up is that because these packages were for the diseases were already installed in so many countries. And one when these packages same similar, the similar model was used for COVID-19 it for that DHS to and the network has used to to create those, you know, packages that can then be quickly added into the country's HMS. And so, so we see that having had that model there and then also countries having had the experience of installing those packages and adjusting, you know, adapting their system to them, enabled them to very rapidly develop this system, essentially implement it in countries, of course, with a lot of different partner supports, including global funds, but several others as well. And then we also, again, it provides a efficient way for us, you know, we can put some fairly minimal funding at a global level to strengthen the COVID-19 surveillance and also the virtual means of disseminating and training folks and to have that have an effect across many of our high priority countries. And then a very important part of this is that in addition to having the increased COVID-19 surveillance and ability to react to those data for the pandemic is really, you know, trying to ensure that the HIV TB and malaria reporting as well as services but but the reporting is still strengthened and for us to be able to have countries adapt their existing systems and in this case for many countries DHS to systems that they're using for HIV TB and malaria reporting to adapt that to COVID-19 really makes it easier to keep up the HIV TB and malaria reporting, not adding systems and parallel training and and then efficiencies that would cause their actually strengthens the disease reporting as well. The last thing I'd want to highlight is that it also has, and I think there was, you know, there was, I think there was a session on this already today is that having this in place has helped countries to to monitor the impact on the disease programs of COVID-19. And we are starting to pilot here as well ways that we can take advantage of so many countries using standardized systems and the standardized packages to make it easier for them to report to us to global fund directly from their systems. And so we're starting to pilot activities on that, especially as we're asking countries to to give us indications more frequently what's happening to the program services. And so this is a new area as well that we lost the expanding as we move forward monitoring COVID-19. So those are the key things I wanted to highlight and I'll hand it back to you. Thank you so much, Michelle. I really like your emphasis on on the importance of having having systems in place but not just systems it's the whole approach and procedures that the teams on the ground are familiar with and that has really helped I think with the COVID rollout. And I also also like what you mentioned about, you know, monitoring your last point about facilitating the monitoring of the impact on the other diseases or the health system overall. We saw that with Ebola actually that in Liberia they were still able to continue reporting we could see the impact. And we very much hope that that the established HMIS systems out there will will allow us to really do the same with the code. So last we hand over to Kalkin Kade very happy to have CDC also present on the collaboration. Please crowd. Hi, thank you. Let me pull my screen up. All right, can you see it okay? Yes. So hi everyone it's, I'm happy to be here and and it's been interesting, you know, throughout this response I've been wearing two hats, you know, one I'm currently on the CDC COVID-19 international task force where I'm on the surveillance and information system team, looking at at surveillance activities across the globe. And on my, my day job I've been I'm on the surveillance information system team in the division of global health protection which of course is focused on on the global health security agenda, and how we support countries for ideas are any ideas are and the like. And so, as I see these activities occurring, I see the overlap of both my response responsibilities and my day job and and see the the benefit of what, if any benefits and come out of COVID. It will be that will have strengthened our systems, and I'm hoping that we can leverage those activities. And so what is it you know what does that mean. And I think that we all talk about surveillance in different ways, you know, and we talk about sustainability. But what does that mean. And, you know, we need to create sustainable systems. And, you know, we again throw that word around. But at the end of the day, we should be working toward as in donors and implementing partners. We should be working toward working ourselves out of a job in the country. And so that means that that, you know, ministries of health will have the capacity to implement and maintain their systems. And it's theirs. It's not ours. And we're donors, we're implementing partners, etc, supporting countries to do their jobs and take care of their population. And our jobs is to work ourselves out of a job. And so how do we support countries and how do countries support their population by creating a sustainable capacity to detect diseases and you can read the rest. I'm not going to read it to you but the point is how do we do our day jobs well enough as a public health community to then respond to things. So, you know, COVID-19 is right now. Ebola was, you know, a few years ago and currently in DRC. Things will continue to pop up. And so we shouldn't just build systems to support the current thing, whatever that is, we support systems to help day to day work that enabled the saving of lives in each country. That's our goal. And help our decision makers make good decisions. And so that's, that's what we're trying to do. We're also helping countries to meet their international health regulation, you know, disease detection and reporting. So we all sort of know that and those countries that are part of the joint external evaluation see their scores and where they're at and what they need to do. And for us from a global health security agenda perspective, hope to support countries to meet those, you know, those top scores, you know, be a four or a five, you know, five being for surveillance that you're supporting. You've already done in your country, and now you're supporting countries around you. And so that move to, you know, real time and near real time case based surveillance with lab integration I think is critical. So, you know, so what do we do? How do we get there? First off, we've got to, you know, respond and deal with the current outbreak of COVID-19. And most countries at this point have, you know, something in place. And then how do we take that investment and move it on? And this whole idea of COVID and beyond means how do we leverage this current investment into people and systems and improve the next time and improve the day to day work. How do we, how do we ensure that this work is interoperable or integrated? You know, one of the challenges we always have are lab results. You know, I was in Liberia for Ebola and then, of course, post Ebola for many years. And one of the challenges during the Ebola response was that integration of lab results into, you know, the suspect data. And then post Ebola, when you look at the IDSR, you know, for Liberia, they've been, you know, have been brought up a few times during this, during this conference so far. They wanted to continue their case-based surveillance for their IDSR and it's still been Excel based. And so, so here you have the surveillance system collecting data on case-based data and you have a lab system reporting case-based lab results. And then they have to match those up. Sometimes they match well, sometimes they don't. If you have a few cases, that's okay. If you have thousands of cases, it's not manageable. And so, as you look at the current, the current pandemic, we know this data in many countries isn't manageable to sit there and manually match data. So, how do we fix that? And how do we work across and coordinate with partners and systems to make sure that the lab results, for one, are going in, you know, automatically, but bigger than that. How do we work with other parts of the health information system? You know, how do we make sure that we know stock out? How do we make sure that we have a workforce, you know, proper workforce and we're protecting them? And then how do we have collaboration across investors? You know, to me, this is critical. My time in Liberia taught me that I need to work closely with Global Fund. I need to work closely with USCID. I need to work closely with WHO. We all need to be in those conversations together on how these structures are supported. You know, countries oftentimes are putting out fires and they're sort of responding to one donor and respond to another donor, respond to this need and that need. And oftentimes, you know, they're burdened by reporting, it's done for reporting's sake, because the donor needs a report. And then that document goes on a shelf. So that document ideally would be used to improve the health system, not just to meet the need of the donor. And so how do we take those processes and work with countries and ministries of health and improving their health systems so they don't need us? That's the goal. And how do we have a common vision of what surveillance is? You know, right now we have HMIS, which oftentimes sits, of course, in the ministry of health and the M&E unit. But then IDSR may be in a different organization. So IDSR may be in the MPI. So in Liberia's instance, it's an infill, the National Center for National Public Health Institute of Liberia, and then the M&E aggregate data is collected through the Ministry of Health. And so those ideally are together. It's not into the end users and the end recipient of the workload, which is at the health facility level, it shouldn't matter to them. They should only need to understand that they have something that need to report on certain timelines and whether it goes into an IDSR or HMIS or some other system and to the MOH or to the MPI or wherever it goes, that shouldn't matter. It should just be how do we make the people at the bottom end who do the work, how do we make it easier for them to do reporting and then leverage those results across groups. And then of course, we need to leverage standards and past investments. You know, oftentimes people want to build their own stuff or build new systems because it's bigger or better or whatever. When you put systems into countries, it's not just technology, it's processes, it's people training, it's all these things that go into the structure and setup that ultimately make up the system. And that investment is large in human time. And that's hard to replace. So leveraging those investments, leveraging partnerships, leveraging collaboration are critical to get to a sustainable component of surveillance. So what is CDC trying to do to sort of help this? You know, one is we of course work with partners and work with different software vendors and universities and the like through funding mechanisms. One of our funding mechanisms is a cooperative agreement. You know, people have been recipients of grants where basically money is just given to someone to do lion item activities. A cooperative agreement isn't that a cooperative agreement is a funding source that CDC pushes out to our partners. We have many cooperative agreements between ministries of health and CDC and WTO and CDC and. But now we have a new one, which we haven't had in the past, which is with the University of Oslo. It's a five year cooperative agreement. And in this, the idea is that the CDC and University of Oslo work together on these outcomes that will support the globe. You know, the nice part about this investment and others have said it before me is that by investing in University of Oslo, it's the most bang for the buck, so to speak. I would invest in one place and it gets pushed out globally. So now we're helping Asia and we're helping Africa and we're helping Central and South America. And so all these things are these investments get pushed out globally and sort of a one point of investment, but it doesn't mean that we're forgetting what the HISPs are doing and what the country work is doing because there's also funding going to HISPs and there also is activities directly with countries. And so it says three prong approach of how do we support the University of Oslo to develop what you see on the screen. And then also HISPs to assist countries and then countries to do their immediate needs based on their specific activities. You know, so one of the highlights in our cooperative agreement work, you know, one of course is to continue the work around the COVID package and extend that work. Number two is to look at interoperability, especially with lab. I think that's the biggest thing that we have to address is how do we sort of standardize that process of lab integration surveillance. And then this move toward regional surveillance. And I'll talk more about that coming up. But in addition to that, you know, other components of this, you know, are, you know, how to be continued to build on their system of educational tools. And at the end of the day, excuse me, at the end of the day, Ministry of Health staff will be the ones who own this system and they should have people trained and more they're trained the more successful they'll be. So CDC has been involved with University of Oslo through many different mechanisms and other partners, you know, one through PEPFAR through Datum and then with GAVI and WHO with the VPD work, which we just talked, we just just heard about. That work is incredibly important. Because as we look at how how that system is used across countries and how can CDC and other partners team up with them to expand that work or to extend that work to stuff like EIDSR. So how do we work with USA and Global Fund and others on HMIS, you know, oftentimes the PMI work is sort of getting the output of that system and CDC and may or may not always be in conversations around HMIS. But it's important that we're all talking together. It's one should be one surveillance structure of HMIS in case they save it. And so they will collaborate across HISPs and countries to support IDSR and EIDSR. Again, if you look at Liberia's example of IDSR, they would because during Ebola, they were doing case-based surveillance, they stayed with case-based surveillance for all their IDSR but in Excel spreadsheets. And so on their IDSR side, they were doing case-based surveillance via Excel, which means emailing Excel spreadsheets and merging them. And then every week, there's a team of people and believe me, I have sat in this room, I know how painful this is, sitting in the room going through and merging spreadsheets from across all their counties or 15 counties into one spreadsheet to represent the nation and then make their weekly epi-bulletin. And that staff shouldn't spend, you know, two and three days of their week making epi-bulletage. That staff should be helping implement what those bulletins represent. And that's what we've got to get to. How do we spend less time reporting and more time doing the public health work? So, and that falls in then to why EIDSR is so important. How do we build structures so that that reporting can do the work, the reporting the system can do the work and that people can implement what the system is telling us. And from an EIDSR perspective, from the Liberia's example, they went to a case-based EIDSR, it's rolled out in five counties, it's real time from the health facility level where they send an SMS and it triggers the system. The alert goes to the health facility and triggers the whole system of response. And that work came out of Ebola. And that early Ebola work, you know, was in Liberia and we were, you know, at the info was being used early on. We've seen it was not necessarily doing what we had hoped it would do for the country. And then, of course, the Ministry of Health and us and others worked with the University of Oslo and started using DHS to track her for the Ebola data in response. So on the right is sort of that picture of what many of you have seen Luke Bowell represent, you know, show in many conferences, in many conferences. But the idea is that how do we, you know, move these forward? How do we have integrated systems? We need both aggregate and case-based data. We need to have lab results integrated. We need to have this information timely so that so that leadership can respond. And we need to understand the rest of the picture. We can't just understand that we have a disease in this place. And yes, it was confirmed, but then not know if you have meds to respond with it. You need to know stock. You need to know workforce. Do we have qualified people? Do we have stock? Do we have the ability, you know, finances? You know, I know a lot of us, it's like, oh, well, it's finance systems, you know, but they're important, of course, you know, nothing, nothing happens without money. And so all these have to be integrated into response. And oftentimes from a CDC perspective, we're not always in those other conversations. You know, that's usually paid for by other organizations. Sorry, Carl, two minutes. Okay, thank you. And so, and so we need to look at how we integrate across health information systems. The way you do that right now is leveraging this response right now a lot of countries have implemented the COVID package. And so how do we take that investment and then move it toward the rest of their prior diseases post COVID or right now, they should already be on their timeline, they should already be thinking, we're doing this for COVID how do we do this for the rest of our prior diseases. And then once you think about how you respond from the perspective of, all right, we're doing this now we're doing it for COVID, we're integrating lab is one disease. Now let's move it to the other party diseases. And then how do we move this to regional and global. And this is important, because, you know, we have to look at cross countries when you look at donors and implementing partners and the like. And then the WHO and CDC and USA and Global Fund and World Bank are all looking at, where is the need, you know, unfortunately money is not unlimited. And so they have to decide where they're going to invest and where who needs the money the most and where is the problem most. And this is where all this helps make those decisions. Leaders need to have information to understand how to invest their funding. Thank you as kind of quick tell end of it. The important part is that that we understand the importance of both the current surveillance work that's been done through the University of Oslo and the HIST and the countries to support the COVID response. We also have to have to think about what comes next, you know, what's what's the system like for the next outbreak we shouldn't be building systems during outbreaks, the system should be there. And so how do we move toward planning these systems is to support day to day work that then also support a response. Oftentimes we're saying I want to build a system for response. Well, in my mind, we're not, we shouldn't be building systems for a response. We should be building systems to support day to day work to relieve the burden as much as possible on the people at the end of the at the end of the road, either from the collect data collection side of it or the people sitting in the national level, trying to put that data together into some usable form to inform leadership that day to day work should inform a response to you can do. Thank you so much. That's an excellent way to end this session. Carl, thank you so much to you and to Michelle and Karen. And I'm just going to hand it over to to Rebecca to wrap up the whole day on the COVID and packages. Thanks. Thanks, Knut. And thank you so much, Carl and Karin and Michelle. I know you guys have very busy days. As many of our presenters have as well. Many of those who are focused on countries and really focused on supporting the response. So we wanted to thank you so much for taking time out of your schedules to learn and share with our global community. And we have so much great work to look forward to together with the support of great partners that want to help countries be able to achieve their own goals and and also align ourselves at a global level. So we will wrap up the day today. We continue to encourage you to look up sessions you might have missed on our YouTube channel. Keep our conversations going on the community of practice thread. There was a lot of learning and asking of questions where I think there are many use cases around our community that we couldn't cover today. And just give you a little bit of a heads up that tomorrow morning. The WHO will open off our conference with the plenary session to share a little bit more about this collaboration around data standards that that has been running through as a theme today. It was one of the ways that we're really able to strengthen these routine health systems to make sure as as Carl reminds us that they're actually getting used. It's not just a reporting tool.