Prioritization and Risk Ranking of Epidemic-Prone Diseases for Emergency Preparedness and Response in Northern Africa | Cairo, Egypt 20 – 22 May 2025

Executive Summary:

Amidst a fragile health emergency landscape and limited resources, the Africa Centres for Disease Control and Prevention (Africa CDC) adopts continuously scientific, evidence-based approaches to guide resource allocation for effective preparedness and response.

Northern Africa faces a wide array of health challenges, including increases in post-acute sequelae of SARS-CoV-2 infection (long COVID 19) as well as confirmed outbreaks of mpox, measles, rabies, diphtheria, and Crimean-Congo Haemorrhagic Fever (CCHF) etc. Climate-related events such as droughts and floods further exacerbate food insecurity in several areas, while the rising burden of non-communicable diseases (NCDs) continues to strain already fragile health systems. To address these complex threats, and in line with its mandate, the Africa CDC applied an expert-driven methodology combining Multi-Criteria Decision Analysis (MCDA) and the Delphi technique to prioritize major epidemic-prone diseases in the region. The framework used for prioritization was built around 17 criteria grouped into four categories: risk trajectory, epidemic potential, disease severity, and preparedness and response measures.

A multidisciplinary panel of public health professionals from across the six countries of the Northern Africa Regional Coordinating Centre, namely the People’s Democratic Republic of Algeria, the Arab Republic of Egypt, the State of Libya, the Islamic Republic of Mauritania, the Kingdom of Morocco, and the Republic of Tunisia, convened for a structured consensus building workshop held in Cairo, Egypt, from 20 to 22 May 2025.

The top five priority diseases identified were coronavirus diseases, rabies, measles, bacterial meningitis, and influenza (with pandemic potential). West Nile Fever received the lowest ranking among the diseases assessed. Notably, the lowest preparedness and countermeasures scores were reported for unknown disease, Marburg Virus Disease (MVD), Ebola Virus Disease (EVD), and Crimean-Congo Haemorrhagic Fever (CCHF). In contrast, the highest perceived preparedness and countermeasures levels were observed for rubella, followed by measles.

These results underscore the urgent need for coordinated regional strategies, enhanced cross-border collaboration, and sustained investments in surveillance systems, laboratory networks and diagnostics, and overall public health infrastructure to address priority epidemic threats in Northern Africa effectively.

The evidence generated serves as a strategic resource for Africa CDC and regional stakeholders to align priorities, ensure the rational allocation of resources, and strengthen emergency preparedness and response efforts across Northern Africa.