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Summary

Senegal has contained many disease outbreaks and has been particularly credited for keeping its HIV/AIDS epidemics and, recently, the Ebola pandemic at bay.  Keys to this success include the involvement of government authorities from the national level to the local level, through a decentralized public health structure; measures aimed at early detection; an extensive use of the media and public information campaigns; and collaboration with the WHO and health-related NGOs for surveillance, immunization, and crisis management.

I. Introduction

Senegal, a West African nation, became independent from France in 1960 and inherited a legal and institutional system that was almost identical to the system prevailing in France.  Senegal is a republic with a democratic government.  It is regarded as one of the most politically stable countries in Africa.[1]  A new Constitution was adopted on January 22, 2001, which guarantees the right to health.[2]

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II. Structure of Public Health Crisis Management System

A. The Ministry of Health

Two directorates of the Ministry of Health are primarily involved in the fight against communicable diseases.  The Directorate of Health has the task of formulating, implementing, and monitoring health policy and programs.  To this end, it is responsible, among others, for the control of communicable and noncommunicable diseases.  The Directorate of Prevention formulates, implements, and monitors prevention policy.  It is responsible for immunization, monitoring and managing of epidemics, and communicating with the public.[3]  In addition, the Ministry of Health maintains partnerships with several international or foreign organizations including the World Health Organization (WHO), USAID, and the World Bank.[4]

B.  Medical Regions

Senegal has eleven medical regions,[5] each divided into sanitary districts, which are operational zones comprising at least one health center around which several health posts have been established.  The districts’ boundaries do not necessarily coincide with the boundaries of other territorial entities such as municipalities or départements.[6]  Each district is supposed to cover a population of between 100,000 and 150,000.[7]  Each medical region is headed by a doctor and has several bureaus, one of which is specifically in charge of immunization for and the management of epidemics.[8]

C.  National Service of Sanitary Information

The National Service of Sanitary Information, attached to the Health Minister’s cabinet, collects and analyzes sanitary information.  It centralizes and updates all information concerning the sanitary system of Senegal and compiles health statistics.  These data are available to other services, researchers, and the Ministry of Health’s partners.[9]

D.  Notification Requirements

The Public Health Code requires that doctors report to the public health authorities any case that they may come across of a disease listed in a regulation established by the Ministry of Health.[10] Additionally, the head of family, spouse, nearest relative, or any other person residing with or taking care of a sick person is required to report the illness to the public health authorities if they are aware that the patient is suffering from one of the listed diseases.[11]  Failure to notify authorities of the disease is punishable by a fine from 9,000 to 18,000 Francs CFA (approximately US$17 to US$35), imprisonment from five to eight days, or both.[12]

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III. Powers of Public Health Authorities

A.  Mandatory Immunization of Health Care Personnel

All personnel working in public or private health establishments in a capacity where they risk being exposed to certain specified diseases are required to get vaccinated.  The Ministry of Health sets forth the list of these establishments and the conditions under which this immunization takes place.  The diseases in question are tuberculosis, diphtheria, tetanus, typhoid and paratyphoid fevers, and poliomyelitis.[13]

B.  Disinfection Measures

Disinfection measures are mandatory for any of the diseases that must be reported.  The Ministry of Health decides which measures should be implemented.  The National Hygiene Service carries out the disinfection process.[14]  It is unlawful to oppose such measures.  The penalties for failing to take such measures are identical to the penalties set forth for failing to notify authorities of a listed disease.[15]

C.  Sanitary Controls at the Borders

Sanitary controls at the borders are governed by the World Health Organization’s (WHO) International Health Regulations, and any bilateral or multilateral agreement and national regulations in this field, aimed at preventing the spread of communicable diseases by air, sea, or land.[16]  Violations of these provisions are recorded either by public health doctors, doctors or officers from the National Hygiene Service, or by other agents specifically commissioned for such a task.[17]

If a civil servant, public agent, or commanding officer of a ship or airplane falsifies or voluntarily conceals information that may compromise the health of the population, he may be punished by a fine of 20,000 to 260,000 Francs CFA (approximately US$39 to US$500), imprisonment from two months to two years, or both.[18]

Senegal, for example, stepped up its vigilance against Severe Acute Respiratory Syndrome (SARS) and took special measures to protect itself when the WHO issued its alerts.  Surveillance was reinforced at the Dakar International Airport and at other points of entry.  Airport personnel were trained and given the necessary knowledge to be able to identify suspected SARS cases.[19]

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IV. Transparency of Public Health Crisis Management System

The Constitution of Senegal recognizes a right to a plurality of information.[20]  The government of Senegal has extensively used the media to fight public health crises.  In 2003, it launched a radio campaign to heighten public awareness of SARS.[21]  Currently, the Senegalese Ministry of Health provides information on the Ebola virus on its website and through a toll-free number.[22]

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V. Cooperation with the WHO

Senegal is a member of the WHO.  As noted above, it abides by the WHO International Health Regulations dealing with notification of certain communicable diseases and measures to be taken at entry points to avoid the spread of such diseases.  Senegal  worked with the WHO on  precautionary measures to protect its people from SARS.  Through the years, the WHO has provided epidemiological, clinical, and logistical support to Senegal.  The WHO  and the Ministry of Health have worked together in the areas of surveillance, immunization, and coordination with respect to yellow fever.[23]

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VI. Recent Crises

A.  HIV/AIDS

Senegal also stands as one of the few countries in the region to have succeeded thus far in containing the spread of HIV/AIDS, thanks to a strong surveillance system; an aggressive focus on treatment and support of high-risk groups; extensive information to the general public; and a high level of involvement of local authorities, teachers, soldiers, religious leaders, nongovernmental organizations, and the media to achieve a greater mobilization of the community.  Its long democratic experience and the relative freedom of its national press have also resulting in freely debating the problem and publishing information concerning the disease.[24]  Senegal has also scaled up access to anti-retroviral treatment and encouraged voluntary counseling and testing.  As a result, the country has Africa’s lowest HIV prevalence rate, at 0.7%.[25]

B.  Yellow Fever

Due to its climate, Senegal is prone to periodic yellow fever epidemics.  One such epidemic caused twelve deaths in 2002.[27]  In response, the Senegalese authorities organized mass vaccination campaigns, gradually covering the entirety of the country over the next several years.  Since 2007, inoculation against yellow fever is routinely given throughout Senegal.[27]

C.  Ebola Virus

Senegal has largely been spared by the current Ebola pandemic, despite sharing a border with Guinea, one of the hardest-hit countries.[28]  Senegal’s response to the Ebola threat has focused on four types of measures: quick testing of individuals suspected of being infected, identifying and monitoring anyone who has been in contact with infected patients, increased monitoring at the country’s entry points, and national public awareness campaigns.[29]  After Senegalese authorities identified a young man who had arrived from Guinea as being infected, they tracked down seventy-four people with whom he had had contact and screened them for the virus.[30]  Additionally, Senegal closed its border with Guinea, and has prohibited aircraft and ships from Guinea, Sierra Leone, and Liberia from landing in the country.[31]

From early on, the Senegalese government has been working closely with the WHO and NGOs such as Doctors Without Borders, both of which have provided Senegal with teams of doctors and epidemiologists to help deal stave off the pandemic.[32]

Prepared by Nicolas Boring
Foreign Law Specialist*
February 2015


* This is a revised and updated version of a 2003 report authored by Senior Foreign Law Specialist Nicole Atwill (retired).

[1] Senegal, CIA World Factbook, https://www.cia.gov/library/publications/the-world-factbook/geos/sg.html (accessed on Oct. 30, 2014).

[2] Constitution de la République du Sénégal du 22 Janvier 2001 (Constitution) art. 8, Journal Officiel de la République du Sénégal [J.O.], Jan. 22, 2001, http://www.gouv.sn/-Constitution-du-Senegal-.html.

[3] Décret No. 2003-466 du 24 juin 2003 portant organisation du Ministère de la Santé, de l’Hygiène et de la Prévention [Decree No. 2003-466 of June 24, 2003 Organizing the Ministry of Health, Hygiene, and Prevention] arts. 1–7 (June 24, 2003), http://www.jo.gouv.sn/spip.php?article284.

[4] Partenaires [Partners], Ministère de la santé et de l’action sociale [Ministry of Health and Social Action] (Aug. 21, 2013), http://www.sante.gouv.sn/index.php?option=com_content&view=article&id=1298& Itemid=764.

[5] Les Régions Médicales [The Medical Regions], Ministère de la santé et de l’action sociale, http://www.sante.gouv.sn/index.php?option=com_content&view=article&id=1294&Itemid=636 (last visited Oct. 31, 2014).

[6] Félix Atchadé, Radioscopie d’un système de santé africain: le Sénégal [Radioscopy of an African Healthcare System: Senegal] 67, 74 (2013).

[7] Col. Massamba Diop, La santé au Sénégal de 1960 à 2010 [Health in Senegal from 1960 to 2010] at 22 (2011).

[8] Décret No. 2003-466 du 24 juin 2003, arts. 22, 23 & 24.

[9] Id. art. 29.

[10] Code de l’Hygiene, Loi No. 83-71 du 5 juillet 1983 portant Code de l’Hygiène [Law No. 83-71 of July 5, 1983, Establishing the Hygiene Code] art. L3 (July 5, 1983), J.O., Aug. 6, 1983, http://www.servicepublic.gouv.sn/ assets/textes/code-Hygiene.pdf

[11] Id.

[12] Id. art. L75.

[13] Id. art. L1.

[14] Id. art. L4.

[15] Id. art. L75.

[16] Id. art. L5.

[17] Id. art. L6.

[18] Id. arts. L7 & L77.

[19] Africa Steps Up Vigilance After Continent’s First Probable SARS Case Dies, Agence France Presse (Apr. 30, 2003), available at Lexis, News Group File.

[20] Constitution art. 8, http://www.gouv.sn/-Constitution-du-Senegal-.html.  The concept of a “right to a plurality of information” is similar to the principle in the European Union Charter that the “freedom and pluralism of the media shall be respected.”  Charter of Fundamental Rights of the European Union art. 11(2), 2000 O.J. (C 364) 1, http://www.europarl.europa.eu/charter/pdf/text_en.pdf.    

[21] Agence France Presse, supra note 19.

[22] Ministère de la santé et de l’action sociale, http://www.sante.gouv.sn/ (last visited Oct. 31, 2014).

[23] Country Cooperation Strategy at a Glance, WHO (May 2014), http://www.who.int/countryfocus/cooperation_ strategy/ccsbrief_sen_en.pdf; Senegal to Launch Pan West-African Campaign to Prevent Yellow Fever, WHO (Dec. 5, 2007), http://www.afro.who.int/fr/ghana/press-materials/item/74-senegal-to-launch-pan-west-african-campaign-to-prevent-yellow-fever.html.

[24] Mamadou Mika Lom, Le Sénégal, un modèle de réussite, 15(1–2) Afrique Relance 24 (June 2001).

[25] Senegal: A Success Story of AIDS Investments and Impact, UNAIDS (Oct. 11, 2012), http://www.unaids.org/ en/resources/presscentre/featurestories/2012/october/20121011senegal/.

[26] Atchadé, supra note 6, at 206.

[27] Id.; Senegal to Launch Pan West-African Campaign to Prevent Yellow Fever, supra note 23.

[28] Karen Weintraub, From Senegal and Nigeria, 4 Lessons on How to Stop Ebola, National Geographic (Oct. 24, 2014), http://news.nationalgeographic.com/news/2014/10/141024-ebola-nigeria-outbreak-lessons-virus-health/.

[29] Press Release, WHO, WHO Congratulates Senegal on Ending Ebola Transmission (Oct. 17, 2014), http://www.who.int/ mediacentre/ news/statements/2014/senegal-ends-ebola/en/.

[30] Id.; Weintraub, supra note 28.

[31] Jacque Wilson, Borders Closing Over Ebola Fears, CNN (Aug. 22, 2014), http://www.cnn.com/2014/08/22/ health/ebola-outbreak/.

[32] Ebola: le Sénégal sort de la liste rouge de l’OMS [Ebola: Senegal Comes Off the WHO’s Red List], Les Echos (Oct. 17, 2014), http://m.lesechos.fr/industrie-services/ebola-le-senegal-sort-de-la-liste-rouge-de-l-oms-0203868882831.htm.

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Last Updated: 06/09/2015