The Pandemic Fund

Background

Tunisia received US$25 million from the Pandemic Fund to upgrade the country’s prevention, preparedness, and response (PPR) function and prevent public health threats. The grant leveraged an additional US$871 million in co-investment from the government and US$29 million in co-financing. The Implementing Entities (IEs) for this project are the Food and Agriculture Organization of the United Nations (FAO), the World Bank, and the World Health Organization (WHO).

Tunisia enjoys strong public health infrastructure, but several factors keep its people vulnerable to health risks. The country is a migration hub for both people and animals, which, along with climate change, elevates the risk of infectious disease. Tunisia’s population is also the oldest within the Middle East and North Africa (MENA) region, and antimicrobial resistance has surged in recent years, sapping the effectiveness of treatment options. COVID-19 exposed gaps in Tunisia's PPR abilities, too, with the country recording one of the highest mortality rates in MENA. Other common communicable diseases in Tunisia include avian influenza, leprosy, measles, neonatal and other tetanus, typhoid and paratyphoid fever, yellow fever, and more.

Tunisia’s project embodies the multisectoral approach that the Pandemic Fund advocates. The country’s Ministry of Health leads the charge, alongside the Ministry of Agriculture and the project’s IEs. Civil society organizations also play a critical role in the project, including a new consortium comprising the Tunisian Society of Clinical Biology, the Tunisian Society of Infectious Pathology, the Tunisian Society of Microbiology, the Tunisian Society of Emerging Tropical Diseases, and the Tunisian Red Crescent.
 

Project objectives

Tunisia aims to minimize the impact of future public health threats in the long term. In doing so, it aims to provide equal access and benefits for all and address the specific needs of marginalized groups. 
 

Implementation arrangements and key components

Tunisia’s project aligns with the Pandemic Fund’s three priorities: surveillance, laboratory systems, and workforce development. Activities within each of these areas follow.

• Improving disease surveillance and early warning systems. This work focuses on operationalizing a One Health surveillance strategy and implementing the Southern African Treatment Resistance Network system for integrated disease surveillance. It includes standardizing disease investigation systems, mapping disease vectors and public health threats, updating lists of notifiable diseases, and conducting simulation exercises for various outbreak scenarios.
• Strengthening human and animal health laboratories. The focus in this area is on readying 20 human health and seven animal health reference laboratories for accreditation by the International Organization for Standardization. It includes activities such as developing an integrated sample transport system, creating a One Health laboratory integration strategy, and enhancing biosafety and biosecurity, including at biobanks.
• Scaling-up the public health and community workforce. Activities in this area include producing an integrated human resource management information system (HRMIS) for human and animal health, running simulation exercises with emergency response teams, and providing competency-based education for medical and agricultural workers, incorporating the One Health approach. 

FAO focuses on surveillance and early warning within the agriculture sector. The World Bank fosters effective coordination and assists with procurement for both human and animal health laboratories. The WHO provides technical support and assists with surveillance and early warning systems, laboratory strengthening, human resources, and risk communication and community engagement. 

Expected outcomes

The Pandemic Fund grant will enable Tunisia to boost its prevention, detection, and response capacity. The country expects to:

• Improve disease surveillance and early warning systems
• Strengthen human and animal health laboratory systems, and
• Scale-up the public and community health workforce.