Emergency Preparedness and Response in Africa | Prioritization and Risk Ranking of Epidemic-Prone Diseases

Executive Summary

Africa continues to face recurrent emergence and re-emergence of high-impact infectious diseases, amplified by climate change, fragile health systems, socio-economic instability, and increasing population mobility. Persistent response gaps, limited resources, and shortages of skilled personnel further exacerbate vulnerabilities. In such a context, systematic prioritization of epidemic-prone diseases is essential. This process is critical for guiding strategic planning, optimizing preparedness options, and ensuring efficient allocation of scarce resources.

In 2024-2025, Africa CDC, in consultation with public health emergency managers, directors, and specialists from 27 (52%) out of 55 Member States, as well as with key partners, updated the continent’s list of priority epidemic-prone diseases to align with evolving health threats. A robust methodology integrating multi-criteria decision analysis (MCDA) and the Delphi approach was employed, and triangulated evidence from literature review, outbreak data from the Africa CDC Event-Based Surveillance system, and extensive expert consultations. A total of 27 diseases were prioritized for risk ranking, spanning vaccine preventable, vector borne, waterborne, zoonoses, acute hemorrhagic fever and unknown disease. In parallel, an assessment of general health- system capacities was undertaken to contextualize the coping capacity of Member States.

The risk ranking exercise identified Cholera, Malaria, and Ebola Virus Disease (EVD) as the highest risk threats, with Measles and COVID-19 also ranked prominently for both risk and preparedness capacities. By contrast, Plague and “Unknown disease” scored lowest in preparedness and countermeasures. Health-system capacity assessments showed relative strength in early warning and detection, but persistent weaknesses in research and innovation, response capacities at points of entry, and infection prevention and control.

These findings underscore the urgent need for routine, context-specific risk assessments to strengthen preparedness investments and operational planning. Translating prioritization outcomes into costed, implementable action packages covering procurement, training, simulation exercises, and systematic monitoring will be critical to achieving measurable improvements in preparedness. Ultimately, such investments are expected to enhance resilience, improve routine health indicators, and reduce morbidity and mortality across the continent.