AT DNLM 2022-2026 and 2030

Context:

The Republic of Guinea faces an epidemiological profile dominated by a high burden of communicable diseases, whilst experiencing a gradual increase in non-communicable diseases (NCDs). The country remains vulnerable to recurrent epidemics (cholera, measles, yellow fever, meningitis, haemorrhagic fevers), against a backdrop of a fragile health system, structural poverty and adverse social determinants. Although between 2016 and 2021 the number of doctors rose from 0.8% to 2.08% per 10,000 inhabitants, and that of midwives from 0.58% to 0.69%, the number of health workforce (HWF) remains largely insufficient. Furthermore, the number of health facilities has actually declined, notably with the ratio rising from 6,966 to 7,362 inhabitants per health centre. Maternal mortality also remains high, estimated at around 553 deaths per 100,000 live births, reflecting persistent challenges in terms of access to obstetric care, antenatal coverage and the quality of services (USAID, 2024).

Several diseases remain priorities and recurring public health issues in Guinea:

·        HIV/AIDS: With a prevalence of 1.5% in 2022, HIV is considered a generalised and concentrated epidemic, particularly among key populations and their networks, who remain difficult to reach due to numerous socio-cultural, structural, economic, political (legal framework) and/or stigma-related barriers.

·        Tuberculosis: With an estimated incidence of around 175 cases per 100,000 inhabitants in 2023, Guinea is classified as a country with a high intermediate TB burden in West Africa. The country faces challenges of under-testing and under-reporting. TB/HIV co-infection and multidrug-resistant tuberculosis (MDR-TB) represent major challenges.

·        Malaria: Malaria is the leading cause of morbidity in Guinea, with 100% of the population at risk. The incidence is estimated at around 181 cases per 1,000 people at risk, with high prevalence among children under five and pregnant women.

·        Vaccine-preventable diseases: Prevention of these diseases remains a major public health priority. Despite the progress made, low vaccination coverage in certain regions, stock-outs and socio-economic barriers continue to limit access to services.

·        Neglected tropical diseases: Guinea remains endemic for several of these diseases, particularly in poor rural areas, communities living near watercourses, and school-age children.

·        Diseases with epidemic potential: Guinea is highly vulnerable to epidemics (cholera, yellow fever, measles, meningitis, viral haemorrhagic fevers and COVID-19) and to the rise in NCDs (hypertension, diabetes, cancers, etc.), with structural risk factors and gender-specific impacts.

In this context, integrating the response to priority diseases is a central pillar for building a resilient, sustainable health system capable of withstanding health shocks. The review and update of the DNLM’s 2026–2030 National Strategic Plan (NSP) is therefore a strategic prerequisite for ensuring the quality, credibility and competitiveness of the future Round 8 funding application, by ensuring alignment between national priorities, the results of reviews and evaluations, and the Global Fund’s programmatic and budgetary requirements.

Overall objective: To review the DNLM’s 2022–2026 National Strategic Plan and update the DNLM’s National Strategic Plan for the period 2026–2030, along with its annexes (monitoring and evaluation plan, budget)