 Okay, so we're already a little bit late and we have great presentations, so I am going to fly through this first part and just give you a little bit of an introduction over the last couple of years of where we've been working in DHIS too in the space of- We have several presentations, I started with this presentation that you see at the So here it is where several countries have started with DHIS as a basic indicator for surveillance because you are naturalistic, apart from all the information. So here it is, how did it start? There are a little bit of 41 countries at the moment, we started to socialize, there were 21 for COVID and there are 40 in total after COVID-19. Several of you know the OMS tool box that includes soy, the alarm, and also the metadata from OMS that is taken into account, 15 countries for the standardization. Also, there are several other modes, countries use a combination of these to see who needs them. But now when we go back to the guide, we see that there are some pilots who have been forgotten. Regarding the emergency, in 2019, the countries began to reinforce their foundation. They began to call on the digital and they said that the SIMR is very important. The countries are here and they can say how many fresh air conditioners are effective for what is the emergency in the countries. And now the air pressure, as it says here, is very difficult to replace a continental system for emergency data. This is in line with the other systems and tools that are called the EUS of the United States. It is the epidemic intelligence for open source. All the countries work together. Regarding the preparation and the emergency, in the case of emergency, there is a colleague who is in charge of this. We have been talking for years, but there is not always a difference between the routine and the following. Because the routine is the following before we are concerned to be able to detect the cases quickly. The question of knowing how well we have used the IHS-2 is going to do well in the response. There will be nine countries that have adopted the IHS-2 as a response strategy of COVID-19 and this also takes into account the variable of vaccination to be able to respond to the good moment. There are also people who have adopted the IHS-2 as the national SIMR and recently, in 2022, they have used this system of SMS reporting for community workers and the public who are in power to be able to manage the signs, to have signs very fast and make sure that there is a proper triage so that each person can know the information as they should so that maybe the ambulance agents can be able to detect the cases and isolate them to treat them better. There is something very important that has been done with COVID-19 and IHS-2. They started tracking. They used IHS-2 as an extensible system to be able to incorporate other variables and to be able to be on the web and we can also help new actors to collect data and integrate them into the system. We have several kilometers from Fondiers to Thérèse so we had to find a way to solve the problem because it was a chance to prevent people from bringing diseases. The IHS-2 for the tracking of rumors that is the Mozambique case. I understand that tracking rumors is a very sensitive question. In this specific case, it is a question of understanding to do the tracking of rumors to understand the type of communication that we need with the different actors. Now there is the question of perspective. The IHS-2 for the tracking of rumors is very important for surveillance based on these tools. So we try to see the generic tools and think how to manage them in the best way. Now we have new actors like the CDC from the United States and others who work to see what other countries can help the workers at the community level. So we are testing our rope on the old one at the end of the old one, sorry. So we work with the FAO, the countries that understand the questions of human health, animal health, etc. And we have initiatives in relation to the climate and the surveillance of the diseases that have a link with the climate. And everything that concerns us is a question of triangulation in the system. It's to be very efficient and efficient. When you have a hundred platforms you don't have the resources to manage the hundred platforms, it means that you have data to fragment a little bit. So we see with the different actors on the side of triangulation and making campaigns. Sometimes when we try to manage the situation we start to launch the campaigns. So everything is complicated in relation to surveillance, mortality is part of the surveillance system because it was used during COVID-19 to calculate deaths. You don't have to think about acting alone but you always have to work in collaboration. So I try to say I think I can manage to continue. Thank you Rebecca. I will start with this big theme because we can't go without a human to talk about surveillance. To talk about follow-up etc. Thank you Rebecca for the introduction. I would like to ask the assistant who will give the presentation in relation to the surveillance system in relation to the virus. Thank you very much. It's good to be here. Thank you for the presentation. It's good to be here in the United States for the protection of world health as Rebecca said. We are working with several other agencies for surveillance in the DHSU which is part of our AUTI box and I will talk about it today. So as a little bit of a background we have a five-year plan. We have five cooperation agreements with the University of Slovakia to find the tools we need for surveillance. So the goal is to integrate the surveillance of human health and animal health by formalizing the tools in the domain. The goal of these tools is to be able to give different animal resources of surveillance and resources for what is infrastructure which is also available for the human sector in different countries. We are working on a surveillance structure in all countries. We don't want different things in all countries. So that's why we are putting this surveillance structure in all countries that are harmonized. And we have seen gaps and needs that we have put in place on this project the informal communication between the sector, the investigation and there are few reports in terms of the epidemic. And so with this project we hope to see the communication that already exists so that it is more formal and take into account the communication between the sectors. And hopefully we can also share the data with the one and the other for what is the investigation. You know, this project for the moment is focused on the integration of human health and animal health but there are several other sectors that are still as important as the health of all beings in the entire world but we first focus on these two sectors for the moment and what we are learning the tool box is a project that is running, the project is not yet finished so the tool box is not yet available, we are working for the moment to ensure, sorry, the table, the visualization, the cards, the analysis the minimum data elements the requirements in terms of reporting the notifications and the sharing of data, so we try to focus on the verification and sharing of data which is very important in the sectors and also we are going to add the data and the tools of the investigation in this tool box. So this is a diagram to visualize how this tool box will enter the systems of humans in the countries to orient the animal sector and you are familiar with the other tools that are used for me and the other organizations and on the right we have the human sector and the human health sector and you see that there is the DHS2 and its module which is taken into account all this corresponds to the requirements of the DHS2 and what the DHS2 already supports in other countries or what the DHS2 already takes into account for all the countries so it is not something new that we are looking for and additional reporting So the idea is that we can take care of the animal and human health taking into account the requirements of the reporting and taking into account the devices that the DHS2 already offers us the goal of this tool is to be able to use the surveillance system at the national level and at the international level to share the data with all the actors As I said we collaborate with the FAO and there are surveillance systems that we want to integrate and that is maintained by the FAO It is the FAO system you can see the page which is just on the right they have an infrastructure similar to the DHS2 and there is also a national surveillance system and national database which is owned by countries so here are the events which are taken into account which are made on the screen in relation to the data of all the countries and the places where we need intervention So we collaborate also with them with the FAO and the projects of all the countries So they also have technical expertise in relation to animal health for those who their presence is crucial for this project and also our collaboration with University of Slovakia and the RISP organization to be able to put in place a global network to be able to put in place a software that we can modify also we are able to take into account the tool box and the package of the DHS2 and make it accessible on the page of the DHS2 we collaborate with other developers to create these software that are available to all countries so that we can implement this and with the projects of the countries earlier we want to put in place something that is useful to all countries it is for those who need to understand the local needs instead of creating something from offices without knowing the reality of the field it is for this that we started in project countries like the one in Tanzania it started in a year and we are seeing the results so the mission of these project countries is to understand the procedures of the countries in relation to the situation of health in the countries to see the LACUN identify the best practices also and as I said, use the sound to be able to create a worldwide that will be effective in the countries so last year we visited in Tanzania in September to understand their needs they used the tools of the DHIS2 to see the structure of health in the country and see the relationships with the offices of the country the partners in the countries and the different organizations or governments that are involved we applied that first the country continental has a surveillance platform and we did not want to interfere with what they already had on site so since it was beautiful we supported them but for the Zanzibar they also expressed their needs for what they had to share and the interoperability between the HIS2 tools and the FAO and in Zanzibar we understood that these FAO tools and the officers of the FAO the officers of the country are formed in relation to the use of the FAO of the HIS2 for the human and surveillance and animal health so they were first communicating by phone so we tried to digitize this communication system so our HISP partners we continue the next steps with the different systems to be able to create software that is available and understand the interactions between the different tools because it is very important to develop software that is useful for the different actors right now you have to pilot a notification for the information for the information of a world utility company so recently the last month we had a workshop with several agencies I think there are some participants here we worked to conceptualize the use of the architecture of the HIS2 so we are working on and we are working on the mechanism of sharing information of these different tools to be able to make sure this dialogue is displayed the goal of this workshop was to be able to develop the parameters for sharing information first of all to be able to have the information of the same that the national officials and this mechanism that was created by our developers is sharing unidirectional notifications based on the events and the information that is shared is who is involved are the animals, the humans what are the contact information so is it a disease is it a unique event what is the event what are the questions of jurisdiction where is it taking place and when is it taking place the goal number 2 is to set up a reporting system and it is different from number 1 it is also a question of sharing information but if it is bidirectional it is to allow joint investigations between the animal health sector and also the human health sector and it is a question that is taken into account in the future so to add what is in the new number 1 we also work to develop the bidirectional system and to have a tool that is reliable for everyone now for those who are interested even if some countries are not yet concerned with these countries it is to organize inter-sector conversations to identify the issues that they have to share as an inter-sector which is ideal so when we know the data we can continue to know how to better monitor the health issues and how to respond in a more effective way I think that will help your countries and when you receive this tool in the future you can implement effectively in your country thank you very much the next presenter is from Indonesia who will present their experience at the level of the country hello everyone my name is Taofi from Indonesia I want to share something with the DHKS2 especially on the impact of animal follow-up on integration we would like to talk about the zone here especially how we used the software for the national level and the national infrastructure since 2016 we have received support from several donors regarding how to implement a zone surveillance system in Indonesia in 2016 we have three ministers first the Ministry of Health Ministry of Agriculture Ministry of Environment and Forestry to manage the zones next we take into account the functionality of the three applications regarding the zones so this is very important for the activities between one and the other to enter the data of the animals of human health and the other factors to take into account since 2018 we have received support from the University of Slovakia to be able to implement the system we work with the University of Slovakia to implement the DHS2 and it will be the base application of the national system you must know that the DHS2 in Indonesia is aggregated in the national system since 2020 it has been difficult for us not only in Indonesia but in the world so we have the zones which have been taken into account it was difficult to be able to implement the system of training in relation to the zones and we have seen that to be able to trace the contact cases it was larger in the domain of the zones to have access to the data what we have for at the moment is that in 2021 we have gone ahead compared to what existed on the field we have made additional efforts you know there is an old valley behind which uses a system that we have used this application all in this area it is the DHS2 obviously we have used Zono6 which is our system not only for the Ministry of Health but also for several other ministers so there are 268 interactive applications that use the application Zono6 or the application of Zono6 what are the points that are taken into account there are 8 boards for 8 cases of use for the Entrax among others sorry I do not know the sector of health here are the information that you can see on the screen there are several areas that are taken into account we have done the tests in these different areas since the end of Indonesia in a city of Jakarta and several other areas in the country we have the summary of the data which accounts more than 100,000,524 data elements it is only 3 indicators 9 data packages there are more than 13,000 organizations the unit of organizations that we can see on the screen so the package, the DHS2 should be used for the local sector because the national elements are really large compared to the data elements it was necessary to take into account the local context and also the local languages here is an example that you see on the screen on the right compared to the data elements you see health the point of activity also in the DHS2 we try to validate the different domains here are the data sets there are several as you can see on the screen and we have done the tests of Bali now here is the history of the indicators compared to the DHS2 in Indonesia the challenge is that we have data sources limited to public health so our concern since last year is that we have used people who come from local universities who who are interested in public health and health so we have involved them to use our system and we have done everything to feel the importance of this system for their work you can see here when you put an article like the indicators we would need to do the translation in Indonesian it is very important for the metadonesis and in Indonesia and in Southeast Asia in general since 2020 I think we have planned to improve the application of the DHS2 in Indonesia there are several provinces 34 more than 500 districts more than 12,000 health establishments to take care of different patients and also our villages 347 villages here you can't imagine it's not easy in Indonesia but we have done everything to see the best in Indonesia we have used Denpasar Denpasar is a province of Bali and we are going there to implement the health information system especially for the one health that is the health for all here is the interface with the user interface of the DHS2 and here is how it is displayed here is the information that we got from the DHS2 we have several information in relation to the rage for example the types of animals the cases the genres and the different cases of people animals that are in rage here are the information that you can see below but now on the screen you can see the reality in the country so what is our regulation precisely Denpasar we have put in place particular areas where it would be necessary to focus there is the question of the disinfection in 2020 in 2024 we will try to focus not only on the area but also on the paludism the flu and other diseases that you see on the screen so the Indonesian team has put in place that are put in place in the country now the rage program Denpasar will explain how we use the DHS2 also for the use at the local level here we use the information in relation to the population the animals also to track the positive animals in the rage and also to consider the vaccination now another thing in Indonesia is the question of the integration of data and the integration of data for example the fact that there are several applications that have been taken into account for several years apart from donors like the UMS the USID the organization that supported us so we try to see how we can integrate data in the application with the information system how we can categorize them according to the domain so we used the information system for the rage in the DHS2 and we tried to group the surveillance activities in different units I think I can stop here for Indonesia here are the numbers the site that is displayed in red and that's what happens at the local level at home thank you for your attention thank you for sharing your experience now we are going to see the evaluation of the surveillance process of the part of our colleague of Sierra Leone thank you very much good morning everyone hello everyone I'm going to talk about the difference is not the implementation of the system but rather its evaluation I'm a PhD student I'm a scientific an academic in the health sector in the Department of World Health Protection what we do is to promote the objectives of our department to collect the data as quickly as possible to interpret the data and to analyze them and to do the rest of the epidemic we work with many countries and especially the health ministry and the health centers to help to use the tools available in the countries and to collect the data very quickly and to improve the availability of data in real time I'm going to be very quick I'm going to give you a little context you already have this map if you are used to working with DHS2 I'm going to I'm going to talk about health units in the country we have over 2,400 public health units a public laboratory national and then why DHS2 as I already indicated we help the countries to use the tools with which they are already available Sierra Leone they started to use DHS2 in 2008 as a system of health management the desire is of course there were some challenges but more important after the Ebola epidemic 2013-2015 we have noticed that there was a need to reinforce the systems in 2016-2019 there is a collaboration and we have personalized the national system to collect data on 27 diseases and it was a base for us to start a surveillance system based on cases many countries used electronic systems but in Sierra Leone we have started to use the tablets to collect this data and we have developed a personalized application with which we can send SMS, DHS2 to adopt this system and then in 2017 we have introduced this surveillance system based on the cases of diseases it was based on the South African model and the Tracker model and after the Ebola pandemic there was a collaboration with ISP to help the countries to improve the data system so Sierra Leone was part of the countries that benefited from this collaboration with 2020-2020 during the COVID-19 pandemic we have the advantages of this surveillance system based on the case and the country adopted in the context of the repost against COVID-19 for data management analysis but also with the management of the vaccination system the ISP developed a generic package and Sierra Leone was really an advance compared to other countries we didn't compare we didn't have to personalize so it's the same concept there is the stage notification program Tracker we talked about the option in 2017 and 2018 there was an announcement about the Tracker system and it's in Uganda that we have piloted an implementation activity we conducted this pilot study and it helped to improve the functionality of our Tracker system in 2018 we started with pilot studies we developed the concept and we improved the initial system and then in 2018 we improved the system which was in place and it's the advantage and improved the functionality we tested them in 4 districts and then we started planning the deployment in 2020 unfortunately we were affected by the COVID-19 pandemic but the system was adopted in the context of the rest compared to COVID-19 and it helped the national development between August 2022 and January 2021 today it's used not only to send notifications but also to reach other objectives so I'm talking about the evaluation here are the objectives we had to evaluate the measurements of the system of surveillance based on the case the electronic system we had to determine the performance of the system its utility some attributes and here I have to say that it was not at all a system an intensive evaluation of the information system it was not really an evaluation of cross analysis it was just to help us in the context of the work we tried to improve we tried to elucidate the factors that worked or facilitated the integration of surveillance systems based on the case and we also had to the role of DHST in the surveillance of diseases opportunities and improvements as I have already indicated it's a map with which you are used we have selected yes and district based on the ratio there are districts that do good work some do not do good work and there are five health establishments that regularly use electronic surveillance of diseases and then the ratio between January, July and 2022 of diseases and then there was also the implication of regional and national laboratory of reference the data collection there were many methods quantitative methods and qualitative methods so the two methods were used the data collection took place in August 2022 I will talk about the results, the challenges that we have there are a lot of results I will focus on the key results that could be useful to you now in relation to the skills of human resources we talked about the use of data of resources before the deployment how will you form more than 1,500 participants we have adopted a three-plane approach we have we have formed the first participants who formed the other who formed the second and what was at the level of health there was a formal training more or less and there was no training of this health establishment because the person who should train people was absent and was not even to do it and we have noticed that their capacity of teams and districts is really a good thing because it brings support at all levels especially at the district level so the establishments have been previously addressed at the central level and first contact with what is found at the district level and then the cost and the time so before asking for funding the address is first at the district so we have had really rich information and there are people who really appreciate appreciate the data that have been collected, the quality we used the board tables and to generate the reports not only for health purposes but also for other objectives infrastructure and so after the Ebola pandemic there are a lot a lot of a lot of infrastructure there were tables because of the Ebola pandemic and it facilitated the implementation with the surveillance based on the cases so there are 39 sanitary establishments that used the tables there are 7 that did not use there was no electricity because there are establishments that were connected to the national electricity network and others that were connected not to the power group so electricity did not really create a problem compared to the internet and it was not good because around half of the sanitary establishments really had access to a stable internet connection and there are also sanitary establishments that did not have access to the internet and there are some who had access to a bad quality internet so there are data that were sent manually with the tables and the problem is that there are some who received the data and others who did not receive the data so here is the overview of the attributes there are many people who indicated that the system is very easy to use and easy to navigate there are staff who do not really have information there is no problem of charging or charging there are people who have learned very easily to use this system so it was easy to use easy to navigate the access was easy but here for for me there are some colors that are a little different so now there are really a lot of reports how the system helped to send notifications we have selected a lot of diseases we have analyzed them with the health settings as much as they use the system there are health settings that maintained this system and that connected about 70% we send reports on the same day 17% we send reports between 2 and 7 days later in general more than 76% of the diseases that we had to do a report the reports did not come to the destination in 7 days there are certain elements that were not that did not do the report and there are some who did the report and less of the sensitivity of the reports I would say that the data of the system we use NMS and the rate was 77% if you remove the month of January you know it's after the holidays after the month of January so here if we remove the month of January the sensitivity was more than 80% so here are the challenges are usual challenges internet connection problems skills problems so on the lessons that we have learned electronic systems and surveillance have an important role and it sends notifications to the port to make the work easy and then it's also a a sharing platform of data of data use at all levels and the staff of the health establishments have embraced and understood the value of the use of electronic tools and the people who benefited in the process of capacity have tried to form the others on the surveillance of diseases on the crisis and the other factors that affect the use of digital tools it's much more at the level of government policies sometimes there are no plans to have tablets and another thing even if we put in place systems training management we have to say that we need auxiliary systems for example a system to follow the tablets follow the staff of health and see if they have changed the opposite if you have sent someone who is trained you have to go to another to see if everyone is trained so it's difficult to follow the different problems of health establishments so if you have a system that helps to follow this kind of problem it helps a lot in decision making WhatsApp plays an important role we try to take advantage of technologies like WhatsApp and it helps a lot sometimes there is the district staff that tells us that there are screenshots that are taken that help to understand the problems that prevailed in these districts so we would like to thank the Ministry of Health and the management of Sierra Leone we would also like to thank the network of epidemiology African network of epidemiology but also the program of health training and thank you to everyone thank you very much George so continuing line with the event base we will continue with the electronic surveillance I will invite our presenter who will talk to us thank you very much Hello my name is Mkomo I am a developer unfortunately I have to I have to apologize I am not in the surveillance field but in the name of my colleagues who have joined the work that we have built to improve the electronic systems on the surveillance of the events so it is here electronic surveillance of the events which do not use DSS2 so in Tanzania we have already started an electronic surveillance system which is based on indicators and we had to collect data to support the efforts of Repost but we have started to migrate the surveillance based on the events it was to to have reports which are passed in the community and contributed for the Precoce and Repost so the news of the community of health establishments but also other sources like ScanMedia and CallSenta so there is SAC99 Tanzania the center of APED so very recently we did not have any surveillance based on the events in the system there were alerts and rumors which were collected manually from community and establishments now with the year 2020 the minister of health of Tanzania with the University of Alessalam the laboratory started to implement the surveillance based on the events to align with the directives of the OMS in summary here the the component which shows how it works and we call members of the community to send reports to health establishments and then these last we will try to check if the data are good and then they will notify the superior level the data also come from districts or regions there are also APED centers now in APED centers there is another system which collects messages and calls from the public so we have integrated the component of the surveillance system based on the events of the APED centers so it is complete and there is also the crisis management which includes the follow-up of contacts so on so what we have done with this system we have integrated with APED centers messages sent by the public if there is a problem and then the message is sent to the component of the system but also for the community we use the android application which includes surveillance indicators rather surveillance based on the indicators surveillance based on the events but also surveillance based on the palidism there is also DHS2 a personalized application web which can be used to produce reports and also check for the account of this system so you are used to these different aspects and so there is we have to detect the alerts and we have to try and see if we can keep the most important alerts and there is also the verification and they make a communication with the health and we also have to conduct an investigation so here here we have to call in case of surveillance based on the indicators it has already been deployed in six regions first in Gorongoro where a pilot was hired maybe we will see the animals here the lions we welcome you to visit us so the pilot was hired in Gorongoro and when part of the activities were carried out on the animals more than 300 users to produce reports on the rumors the alerts and the other health events health so they were formed to be able to use the android application so to conclude we can see that the surveillance system based on the events has the potential to reinforce the fact of having information during especially for the detection of the crisis and dissemination of the information it also supports the crossing of data with surveillance systems other surveillance systems for example the surveillance of the animals to be able to reach the health objectives for example a large part of the alerts in Gorongoro are linked to animal health so that could be the case so the future perspective is the same the system can be integrated with health initiatives in the area we also try to deploy this system on all areas of the territory and so we would also like to reinforce the capacity to protect the reports to use the data to analyze the district and regions and at the same national level so it is a component of the whole ecosystem it covers cases which are reported at the level of the states and today they are not enough to be able to finish the management the component on the management of the crisis so to be able to manage the crisis the following of the cases is the ecosystem which uses DHI so I have to thank my colleagues from the University of Aslam from the University of DHS2 my colleagues from the Ministry of Health my colleagues from MDH but also my colleagues from CDC the control center from the University of DHS2 thank you very much so there is a technical problem with so now we will invite you to ask the questions I will invite the presenters to come here to be able to answer the questions that have been asked I thank you we can also check at chat to see if there is any questions if not shy so thanks for the presentation my question is on the last presentation on even best surveillance because it's my area so you mentioned most of the rumors that you receive at least for the time being is animal related so once you collect that data from the android phone is there a way currently where you can relay it to the next level because you said the triaging and verification is done by the community health worker so most of our community health workers don't have training specifically for animal health related alerts so I just want to know how you relay the alerts which are considered related to animal health goes to the next level oh ok thank you I will try to answer that I will try to answer the question concerning the transition of the alerts to the superior level now in relation to the pilot there are alerts on the human health but a large part of the alerts is in relation to animal health and at the moment of expertise in relation to surveillance and animal and especially human surveillance so there is the potential for the alerts so that these alerts are transferred to animal surveillance now in relation to the verification in my presentation I said that the triage is not done by the community health workers and the objective of the community health workers the product and the reports now it is at the level of the sanitary establishment that the triage is done now how this is done and so the alerts are there and then the sanitary staff at the level of the establishment tries to verify and then there are notifications at the superior level but I think there are initiatives to be able to link this to our aspects to respond to the alerts on animal health to continue and there is a presentation that comes from Uganda which will maybe give us more information so all the presentations are available so next question the question is for Joe I have the evaluations that you have done in Sierra Leone if a country would like to do a similar evaluation are these tools available can we really access these tools and how can we do this evaluation why? Uganda is a pilot but we really need to extend what we have done but first we need to evaluate the pilot before being able to extend this at the national level so you can ask a second question before continuing thank you very much for your presentation I would like to ask a question to the presenter Sierra Leone in relation to a real time the proportion is still very low in relation to a real time so I would like to know what you have in mind to be able to improve your work so that people can produce reports at the right time thank you very much for the questions first in relation to the availability of tools thank you thank you thank you thank you I know something in relation to the implementation of this system in Uganda we have we have developed the tools based on the directives of the patient to be able to evaluate the information systems in the context of the report we have developed our tools from scratch but we also implemented the ideas so we have shared this with a country located in Central Asia we are ready to develop a tool to give a lot more standardization there are also lessons that we have learned from the evaluation that will help us to improve the tool how I work with Uganda it will be really easy there will be no problem of sharing so we really have something to share the second question was about the reason of the price that is low the price of the opportune report that is really low so the reports that arrive at an important moment so I will try to explain they have then produced reports at the level of 60% the same day and then 70% of reports in a week it is only 3% of patients who have not done the report at the moment so the reasons to explain this there is a factor in the month of January you know in the month of January it is just after Christmas after the holidays so if we put aside the month of January the rate rises compared to the exhaustivity of reports the rate becomes very 20% of the exhaustivity of reports so it is really satisfying so it is not at all low it is a time that is not low compared to the health of patients for us we would like to send the notifications now it depends on the type of disease now if you take 7 days for me I think it is not positive now if beyond 7 days it is not enough so we want to have much faster reports send the notifications quickly it is maybe because of our aggregations so I think if we change the method we can really have the data it is not 100% yet but I think it is not at all bad it is it is my opinion thank you for the presentation it is the good news is that there will be a lot of sessions so I will ask a question to Bill we have talked about sharing data in pre-sector now I would like to know what it looks like I would like to know if it happens at a national level and if the systems are integrated and if the sharing of data is at a national level how can all sectors have access to data for example of DHS2 I would like to know how the information is shared is it only from a national level and it can also be at the district level please try to share with us in a way in which the information is shared at a different level the mechanism that we have developed during the workshop it is the unidirectional mechanism it is either an initial user of DHS2 or in another tool a check box it will be a closed case in the report documents and with this closed case they will ask whether this disease should be notified and then it will be a notification that is sent only once to the sector with all the information that is asked by the countries and then the unidirectional notification is different for all sectors it is more complicated especially with the use of data from one country to another but the objective is to have something when there is a closed case there is a notification that is sent and then with the results that confirm this case there will be a lot of notifications but it is a platform that we can access including the community level but for the moment it is the unidirectional infrastructure that is something that is a mechanism that was created and it is the pilot and we hope that it will be used to achieve the second objective and then we have there is something if you enter in DHS2 with scenarios it must correspond to any country there is a risk with information that does not correspond to the national context so there must be its process to see what constitutes an alert that should be notified in another sector there are countries where there are surveillance systems based on indicators as it was presented in Tanzania I think that in the DHS2 we can share the information the information can be sent to other systems but we have lived in some architecture as in any other way there are really USID initiatives there are DHS2 tools especially we have Ministry of Agriculture Ministry of Elevation Ministry of Environment Ministry of Agriculture tries to share the data but it is still at the level where I have an opportunity to continue to exploit we will see how we can really continue to support them I am not trying to add something but I would like to say that the reason that I wanted to give is with the cases that have been reported so far in January there was a problem on the internet it does not want to say that this disease has never been reported phone calls were done and it took time but the cases were but without without the access to the internet agents who still called and the staff of the health districts and then the staff came and tried to investigate these cases I come from the west from the MS and I will ask a question representing the health centers and regarding the topic that you are proposing since 2017 we have tried to develop an integrated surveillance especially human and animal we have tried to respect what had been done at the level of the international organization for the animals but with integrated work I think it is very beneficial now if the workshop will be next week I would like to know if you will use the tool that you have proposed there was a workshop I would like to know if the same tools or other similar initiatives will be used in the next occasion I hope to have understood the question I will give a short answer of the initiatives parallel a short answer to your question no one of our team will participate in this workshop at the end of June with the same tool there are parallel initiatives that are in progress perfect thank you very much for your participation if you have any questions you can always meet the presenters and ask your questions thank you very much