Prioritization and Risk Ranking of Epidemic-Prone Diseases for Emergency Preparedness and Response in Southern Africa | Gaborone, Botswana 25 – 27 November 2024

Executive Summary:

Since its establishment, Africa CDC has played a crucial role in improving public health across Africa by providing strategic direction, building institutional capacities, and deploying healthcare workers to address various disease threats. As part of its mandate and in accordance with the International Health Regulations (IHR 2005), Africa CDC, has been conducting prioritization of epidemic-prone diseases at continental and regional levels, to guide effective resource allocation for managing mitigation and response actions to public health emergencies.

The Southern Africa region, including Angola, Botswana, Eswatini, Lesotho, Malawi, Mozambique, Namibia, South Africa, Zambia, and Zimbabwe, has experienced significant climatic and public health emergencies, leading to substantial infrastructure damage and a considerable economic impact. The region’s vulnerability to climate-induced emergencies and disease outbreaks underscores the need for enhanced preparedness and coordination among Member States, given the limited resources available.

In collaboration with the European Centre for Disease Prevention and Control (ECDC), Africa CDC initiated a regional prioritization exercise for epidemic-prone diseases in Southern Africa. The objectives were to identify priority diseases for effective emergency preparedness planning, guide resource allocation and build Member States’ capacity in utilizing risk ranking tools. A working group composed of experts from Africa CDC, ECDC, and UK Health Security Agency (UKHSA) planned and prepared the exercise, employing a methodology based on Multi-Criteria Decision Analysis (MCDA). Data from the Africa CDC Event-based Management System (EMS) and Member States (MS) were used to identify priority diseases.

The exercise concluded with a consensus workshop held in Gaborone, Botswana from 25-27 November 2024. The workshop brought together experts from all ten Member States and from the Common Market for Eastern and Southern Africa (COMESA). Experts were invited to finalize the list of selected diseases and score them based on 17 predetermined criteria. The criteria focused on risk (risk trajectory, epidemic potential, disease severity) and preparedness and countermeasures. The scores were then used to rank the diseases according to the assessed risk. Among the final list of 18 diseases, the top five diseases ranked by the country experts were cholera, rabies, influenza, malaria and measles.

The findings from this prioritization exercise can guide resource allocation and inform emergency preparedness activities within Southern Africa. Since these findings may not align with country-specific priority diseases, we also recommend national risk prioritization exercises to help countries tailor their preparedness activities.