The OCEAC (Organisation de coordination pour la lute contre les endémies en Afrique Centrale) is an organization of coordination and cooperation to fight major endemic diseases in Central Africa. Created in 1963, in Yaounde, by the determination of the health ministers of Cameroon, Congo, Gabon, CAR and Chad, it was originally known as the OCCGEAC until 1965. The Equatorial Guinea joined later the OCEAC. Its goals are to (1) coordinate public health policies and actions in Central African region, (2) participate in the training of the medical staff of member countries of the organization, (3) coordinate applied research projects undertaken by national institutions, (4) implement missions of expertise in the different areas of health sciences, (5) contribute to the public health promotion in the member countries and (6) support the actions undertaken in response to health emergencies. Today OCEAC is in charge of regional health programs and projects like the Sub Regional Program against HIV/AIDS, the Harmonization Program for Pharmaceutical Policy, the Regional Program to fight human African trypanosomiasis and research projects on malaria. The CEMAC (Communauté É conomique des É tats d'Afrique CentraleFEconomic Community of Central African States) is an economic community of the African Union for promotion of regional economic co-operation in Central Africa. Member countries include Gabon, Republic of Congo, Equatorial Guinea, CAR, Cameroon and Chad. It 'aims to achieve collective autonomy, raise the standard of living of its populations and maintain economic stability through harmonious cooperation'. It was established in 1983 and its ultimate goal is to establish a Central African Common Market. However CEMAC may have a role in the public health systems in Central Africa: in 2009, CEMAC signed a memorandum of understanding with Germany, which donated a 23 million euro grant for the prevention of HIV in Central Africa. The CIESPAC (Centre inter-états d'Enseignement en Santé Publique pour l'Afrique centrale) is a sub-regional public health training institution, originally located in Brazzaville. It was created to provide Central African countries with qualified health service staff and managers. It offers several courses, the most recent of which is recognized with a professional diploma in public health and targets mainly potential health district managers. 64 The civil war events that occurred in Brazzaville in the late nineties provoked the transfer of the institution to Yaoundé, Cameroon. The CAMES (Conseil Africain et Malgache pour l'Enseignement SupérieurFAfrican and Malagasy Council for Higher Education) exists to (1) promote and encourage the understanding and the solidarity between member States, (2) establish a permanent cultural and scientific cooperation between member states, (3) collect and diffuse all academic and research documents, (4) prepare agreement drafts between states concerned by Higher Education and Research and contribute to their implementation and finally (5) develop and promote dialogues to coordinate the higher education system and research so as to standardize programs and recruitment levels. This means that Gabonese university lecturers and researchers (in particular health researcher) are assessed by CAMES before obtaining a promotion.