The World Health Organization (WHO) and the Syrian Ministry of Health have recently completed a joint evaluation of the country’s main disease surveillance system, the Early Warning, Alert and Response System (EWARS). Throughout the ongoing crisis in Syria, EWARS has played a crucial role in detecting outbreaks of measles, cholera, and other diseases and preventing their further spread.

Health facilities across Syria submit weekly surveillance data to the Ministry of Health in Damascus for consolidation, analysis, and response. An evaluation team comprising experts from the WHO Regional Office for the Eastern Mediterranean, WHO Country Office in Syria, and national counterparts assessed 46 health facilities and laboratories in 13 Syrian governorates. Preliminary findings suggest that EWARS is working effectively with high levels of timeliness, completeness, and acceptability – particularly at field level.

The evaluation team recommended several improvements to strengthen EWARS’ capacity to detect and respond to disease outbreaks and emerging threats. These include revising the list of diseases under surveillance to include case definitions, reviewing disease thresholds, strengthening staff capacity, data quality, and feedback loops.

Dr Iman Shankiti, Acting WHO Representative in Syria, stated that this recent assessment was timely: “The last evaluation of EWARS dates back to 2017. This latest assessment is critical to help us ensure that EWARS remains agile and fit for purpose. We are committed to work with the Ministry of Health to strengthen EWARS and make it even more effective.” Dr Sherein Elnossery from the Infectious Hazards Prevention and Preparedness unit at the Regional Office added: “EWARS is a lifeline for people in Syria facing ongoing conflict and uncertainty.”

“EWARS has proven resilient even amidst the devastating earthquake that hit the country this year,” said Elnossery. “By providing early warnings of outbreaks