According to situation report by the CDC /Center for Disease Control and Prevention/ The virus that causes COVID-19 is infecting people and spreading easily from person-to-person. Cases have been detected in most countries worldwide and community spread is being detected in a growing number of countries. On March 11, the COVID-19 outbreak was characterized as a pandemic by the WHO
Ethiopia is strengthening surveillance, diagnostics and medical care and public health information in readiness for a potential coronavirus outbreak.
Until Now, four new cases were confirmed in the Country over the past 24 hours, raising the total to five.
Ethiopia on Monday closed schools across the country and banned all public gatherings, including sports events, for 15 days.
The decision was announced by Prime Minister Abiy Ahmed after consultations with top officials on measures to avert a COVID-19 outbreak in the country.
So whose power is to close schools and public places during an epidemic? Following is a brief overview of the law quarantine, isolation and the taking of appropriate measure of control
The Power of Quarantine and Regulation of Communicable Disease at port of entry and exit was entrusted to the then Ethiopian Food, Medicine and Health Care Administration and Control Authority now renamed as Ethiopian Food and Drug Administration Authority by Food, Medicine and Health Care Administration and Control Proclamation No. 661-2009
Following the repeal of this law by Food and Medicine Administration Proclamation No. 1112-2019 such powers are now transferred to Ethiopian Public Health Institute.
This proclamation under article 72/2/ specifically mentions three provisions of the previous law affecting the transfer of power. These are Articles 3/2/ g, 4/14/ and 4/15/
Here is the full content of these articles /These are now within the powers of Ethiopian Public Health Institute/
Proclamation No. 661/2009 Food, Medicine and Health Care Administration and Control Article:
- 3 /2/ (g) undertaking quarantine service with concerned bodies at entry and exit ports
- 4/14/ undertake inspection on planes entering the country to ensure the protection of health and control of communicable diseases and undertake fumigation and give certificate for planes departing the country;
- 4/15/ undertake control of communicable diseases at entry and exit port on international travelers and, where necessary, prohibit them from entry or exit or subject them to be quarantined; ensure that necessary preventive and control measures are taken in the case of outbreak of trans-regional communicable diseases
Additional /related/ power is given to the institute in its establishment act Regulation No. 301-2013 Ethiopian Public Health Institute Establishment. Article 6/14/ of the regulation empowers the institute to conduct, during epidemics or any other public health emergency or public health risk, on sight investigation when deemed necessary, verify outbreaks, issue alert, provide warning and disseminate information to the concerned organs, mobilize or cause the mobilization of resources, support the response activities carried out at weredas, zones and regional levels as deemed necessary.
The Ministry of Health is given broad policy power under article 27/6/ of the Definition of Powers and Duties of the Executive Organs of the Federal Democratic Republic of Ethiopia Proclamation No. 1097-2018.
Accordingly, The Ministry is empowered to devise and follow up the implementation of strategies for the prevention of epidemic and communicable diseases
Duty to cooperate and Duty to report
Following the occurrence of wide spread communicable diseases including epidemics and Zoonosis any person suspected of epidemic disease shall cooperate for medical examination, treatment or vaccination.
Health professional who happen to know the existence of any of the diseases are also under a duty to report immediately to the nearest health service
Here is the full content of articles 26-28 of Proclamation No. 661-2009 detailing the duty of cooperation and reporting.
/Given the fact that this proclamation is now repealed, it is not clear how these duties will be enforced./
Proclamation No. 661-2009
- Health Control at Entrance and Exit Ports
1/ Any passenger coming to or leaving Ethiopia shall be obliged to take vaccination required for international passengers in accordance with international public health requirements adopted by Ethiopia and to show, at ports of entry and exit, his certificate whenever requested by the relevant health authority and, where suspected of any communicable disease, to cooperate for medical examination.
2/ Any person without having an appropriate health certificate or coming from an epidemic area may not be allowed to enter Ethiopia.
3/ The appropriate officer at any port of entry or exit shall have the duty to report any suspected passenger of any communicable disease to the nearest health office.
4/ It shall be prohibited to transport animals together with passengers without valid health certificate and protection.
- Communicable Diseases
1/ Any health professional who happens to know the existence of communicable disease in his vicinity shall have the duty to report immediately to the nearest health service institution. The institution which has received such report shall take the necessary measures and report same to public health emergency control body.
2/ The appropriate health professional shall quarantine a person infected or suspected of epidemic disease for a limited period of time.
3/ Any person suspected of epidemic disease shall cooperate for medical examination, treatment or vaccination.
4/ Parents or guardians shall have the duty to cause the vaccination of children for the protection of communicable disease.
1/ Any person who is infected or suspected of zoonosis or has come from the area where such disease occurs shall have the duty to cooperate for any control activity.
2/ Every health institution shall have the duty to render the appropriate service for zoonsis in accordance with its level of competence and immediately refer to the appropriate health institution where it is not capable of providing the service.
3/ Every health institution shall observe zoonosis prevention and control directives to be issued from time to time.
Article 48 of Regulation No-299-2013 also imposes the duty to respond to quarantine inspection on an international entry passenger
- Suspected Person and Duty to Report
1/ An international entry passenger shall be obliged to respond to quarantine inspection through verbal or written request for protection of public health,
2/ In the course of travel, if a passenger is suspected to be infected with any communicable disease, the conveyance operator shall inform the head of the nearest or destination frontier port about the type of the disease, principal symptoms and any other relevant information.
3/ The head of the frontier port receiving information in accordance with sub article (2) of this Article shall immediately report the in formation to the inspector at the port.
4/ For the purpose of this Article “head of frontier port” means the head of the frontier port aviation or Revenue and Customs Authority station.
Quarantine and Isolation
Regulation No-299-2013 Food, Medicine and Health Care Administration and Control Council of Ministers Regulation defines Quarantine as separation of persons who are suspected to be exposed or infected with emergent communicable disease until the infection is confirmed.
Article 47 of the regulation provides suspected person shall be quarantined immediately. He shall immediately send the suspected person to the public health emergency management body for quarantine.
Upon confirmation of his infection he shall be transferred to an isolation room in a health institution and provided with the necessary curative and rehabilitative treatment. Following quarantine, the public health emergency management body shall organize quarantine centres in the main frontier ports or designate the nearest health institutions as isolation centres.
Public health emergency management is defined in the establishment act of Ethiopian Public Health Institute /Regulation No. 301-2013/ as the process of conducting health surveillance, anticipating, detecting, preventing, preparing for, responding to, and recovering from consequences of public health threats in order that health risks are minimized
Power of closure of public places
Power of taking measures such as closure to control communicable and epidemic disease was under the jurisdiction of the previous Ethiopian Food, Medicine and Health Care Administration and Control Authority.
Under Article 48 of Regulation No-299-2013 the Authority is empowered to take the following measures to control communicable diseases
- Ordering the closure of schools and other public places for a certain period
- Establishing temporary controlling posts in any part of the country; and
- Taking any other necessary measures.
The new Food and Medicine Administration Proclamation No. 1112-2019, as its name indicates has taken away power of public health administration from the Authority. However, the power of closure and taking other measures outlined under article 48 of the regulation have not been transferred to the institute.
Article 53/1/ of Proclamation No. 661-2009 imposes imprisonment of not exceeding six months or fine of not exceeding Birr 3,000 or with both for violation of the duty to report communicable diseases or the duty to quarantine a person infected or suspected of epidemic disease. However, this provision is now repealed and no similar provision is to be found in the repealing law /Proclamation No. 1112-2019/