An Epihack event was organized and held at the Mount Meru hotel located in Arusha city of Tanzania on December 8^th-12^th 2014. The event was co-hosted by the Southern African Centre for Infectious Disease Surveillance (SACIDS), Eastern African Integrated Disease Surveillance Network (EAIDSNet), Connecting Organizations for Regional Disease Surveillance Network (CORDS) and Innovative Support to Emergencies, Diseases and Disasters (InSTEDD). It was funded by the US-based Skoll Global Threats Fund. The objectives of organizing this event were:

i)               To bring together health experts (animal and human health sectors) and software developers to collaborate in providing solutions to challenges facing disease surveillance and response in Southern and Eastern African region.

ii)             To build and strengthen cross-border working relationships between six countries (Burundi, Kenya, Malawi, Tanzania, Uganda and Zambia) in one health disease surveillance.

iii)            To collaboratively prototype fit for purpose digital solution to detect infectious disease outbreaks through strengthened inter-sectorial and cross-border disease surveillance.

The following were achievements of the Epihack Tanzania event:

i)               The Epihack Tanzania successfully brought together a total number of 66 participants (Figure 1). In order to ensure that the participants were fully engaged, the ratio of facilitator to participants was 1: 3.5.

ii)             Participants were from 14 countries as summarized in Figure 2. This mixture allowed intense interaction as well as sharing information and experiences from different disciplines (computer software developers, public/animal health specialists, community human/animal health workers and pastoral community leadership); countries, continents and international organizations. Through such experience, it is anticipated that closer working relationship between neighboring countries as well as CORDS networks (SACIDS, EAIDSNet and MBDS) will be strengthened. Furthermore, bringing together key people from East and Southern African countries that constitute geographic scale of a proposed project on ‘Enhancement of the Disease Surveillance Network with Digital and Mobile Technology for Earlier Detection and Quicker Response in Southern / Eastern Africa’ paved way for future collaboration between countries (cross-border disease surveillance and response) as well as between software developers and health experts.

iii)            Epihack Tanzania event attracted participants from different organizations and institutions. These included: SACIDS (10), EAIDSNet (1), InSTEDD (4), Skoll Global Threats Fund (3), MBDS (1), OpenDream (2), NIMR (2), KEMRI (1), AU-STRC (4), FAO-Rome (2) and CDC-Atlanta (1). The majority of health experts were from ministries responsible for public health (7) and animal health (4) in the East and Southern African regions. Software developers from southern and East Africa included those non-governmental institutions (13) and academic institutions (6).

iv)            Out of 59 targeted Epihack invitees (i.e. invited IT and health officials; facilitators and funders excluding logistic support staff and invited dignitaries), 29 (49.2%) were developers while the rest were either from human health (28.8%) or animal health (domestic and wildlife- 16.9%) sectors (Figure 3). Three other participants were of other specializations including fund raising (1), economics (1) and engagement (1) expertise. This distribution created an appropriate atmosphere that helped invited developers to design and develop digital solutions for public and animal health sectors under close guidance of the health experts.

v)             Organization of a field trip (Figure 4) on day 2 of Epihack provided an opportunity to the participants to interact directly with pastoral communities and community human and animal health workers and to observe and experience challenges faced by the public and animal health sector in Tanzania. This trip contributed to improving design of digital solutions for official reporting, community-based participatory surveillance, feedback and contact tracing.  The field trip was also crucial in promoting engagement with fellow team members. Group members congregated in one vehicle during the field trip providing ample time and good atmosphere for them to get to know one another personally and brainstorm on plans and activities throughout the event

vi)            During Epihack event four prototypes were designed and presented. Although these prototypes are not fully developed, they were admired by the Guest of Honor, i.e. the Deputy Permanent Secretary, Prime Minister’s Office of the United Republic of Tanzania, who recommended deploying them to the field.

vii)          Participants were exposed to SACIDS technologies (SMSCollect and ODK-based app) as well as FAO EMA-i application used for collection and reporting of disease surveillance data in Southern African region (Ngorongoro, Kagera River basin and Zambezi River basin) and Uganda, respectively. The participants were also exposed to InSTEDD applications (Verboice, Resource Map, MBuilder & Reporting wheel) as well as DoctorMe application from the OpendDream.

viii)         Print, TV, electronic media engagement was successfully carried out as summarized in Table 1. This provided opportunity to engage the public using different pathways and languages.

During the five-day period of Epihack Tanzania, four prototypes relevant to improving disease surveillance and response were developed. These include:

i)               Official data collection from facility-based disease surveillance reporting system (targeting submitting real-time disease reporting data).

ii)             Contact tracing (digital solution to support official tracking of potential disease outbreaks including identification of affected households or livestock herds and their locations to aid outbreak investigation).

iii)             Community-based participatory disease surveillance through a feedback of expert opinion on likely diagnosis to trigger focused follow up investigation.

iv)            Feedback: two-way communication to facilitate prompt feed-back to health facilities/communities and enhance interaction between community and sub-national (district) health systems.

·       Demos for the four prototypes developed were presented on the final day of Epihack.

·       The Government of United Republic of Tanzania, through the Deputy Permanent Secretary- Prime Minister’s office commended the Epihack outputs and recommended deployment of these prototypes in strategic sites to contribute to the Big Results Now (BRN) initiative in Tanzania and to facilitate cross-border disease information exchange between the countries represented at the EpiHack event.

·       Post-Epihack Tanzania discussion with the funder (Skoll Global Threats Fund) proposed:

1.     To develop a short-term project aimed at finalizing the prototypes developed and pilot deployment of them in selected field sites of East and Southern African countries.

2.     To write an abstract that will be submitted for consideration of oral presentation at the 3^rd GRF One Health Summit scheduled in Davos, Switzerland on October 4-7, 2015, more information is available at http://onehealth.grforum.org/submission/.

·       It was discussed and agreed to visit FAO Headquarters to learn more both about the EMA-i system (being deployed in Uganda) and the EMPRES-i, especially its regional hub component that could be provide some lessons for SACIDS as a regional hub in the proposed projects.

·       The meeting of Health (Animal and human sectors) experts held on Day 4 (December 11^th 2014) agreed on the following matters:

1.     That cross-border and cross-sectorial collaboration in East and Southern African regions is key to improved disease surveillance and response to disease epidemics in human and animal populations.

2.     For short-term solution, cross-border collaboration should start at local cross-border areas. This will generate evidence for cross-border collaboration at national level.

3.     That there is a need to set-up of appropriate structures to promote cross-border collaboration through East African Community (EAC) and Southern African Development Community (SADC) regional blocs.

4.     That there is a need to agree and develop frameworks for sharing information (both technical and administrative).

The following are lessons learnt during organization of Epihack Tanzania event:

·       A collaborative effort between SACIDS, InSTEDD, CORDS and Skoll GTF in organizing Epihack was instrumental for the success of Epihack Tanzania.

·       Participatory planning and identification of challenges between facilitators and Epihack participants generated appropriate challenge list which ensured constant interest and engagement of all participants.

·       The field trip on day 2 provided opportunity to appreciate the ‘real world’ facing human and animal health sector and contributed to better design of digital solutions.

·       There was little time for facilitators to meet before the event. In future, it is recommended to identify specific Epihack objectives as well as understanding the participants well in advance. It was further recommended to organize a pre-hack engagement/orientation of all facilitators e.g. by Webnar, to discuss and agree on objectives.

·       Time set for the developers to design and develop prototypes was not enough. It is recommended to organize a field trip on day 1 and allocate ample time to the developers (including minimal interruptions during dinner time).

·       Due to limited time, it was difficult to have maximum interactions between participants. It was recommended to have bigger letters on name tags so that the names are readable from the distance.

Epihack is a convening that brings together IT programmers and health experts to jointly plan and develop together some digital solutions (prototypes) to health challenges facing the animal and public health sectors.