Intended for healthcare professionals


How African countries can prepare for the next pandemic

BMJ 2023; 383 doi: (Published 23 November 2023) Cite this as: BMJ 2023;383:p2762
  1. Jean Kaseya, director general,
  2. Shingai Machingaidze, acting chief science officer
  1. Africa Centres for Disease Control and Prevention (CDC)

To achieve health security in African countries, we must build resilience and collaboration in health systems and prioritise pandemic preparedness, prevention, and response, write Jean Kaseya and Shingai Machingaidze

The resilience of African countries to disease outbreaks such as Ebola, cholera, malaria, and, recently, the covid-19 pandemic have shown the world what the continent is capable of in the face of health emergencies. But these experiences have underscored the vital need for an approach to pandemic preparedness that is continuous and multisectoral by establishing mechanisms for response and resource mobilisation and allocation.

To achieve health security, Africa must prioritise pandemic preparedness, prevention, and response. The Africa Centres for Disease Control and Prevention's new Public Health Order1 provides a framework to strengthen public health systems and health security across the continent. Health security is especially important because the African continent accounts for a significant proportion of the global burden of disease.2 It bears the highest malaria burden in the world, with approximately 95% of malaria cases and 96% of malaria deaths.3 Moreover, outbreaks of infectious diseases such as Ebola, cholera, chikungunya, Lassa fever, and mpox have had severe health and socioeconomic consequences. The continent is also disproportionately affected by health crises linked to climate change—between 2001 and 2021, 56% of public health events in the African region were climate related.4 These statistics highlight the urgent need for a proactive and coordinated approach to health emergencies in Africa.

It is encouraging that some collaborative efforts are already under way, including the partnership between Africa CDC and the World Health Organization to launch a Joint Emergency Preparedness and Response Action Plan.5 This aims to improve the capacity of African countries to prepare for, detect, and respond to health and humanitarian emergencies. Over the next five years, actions will be implemented across six key areas including workforce development, surveillance, response readiness and coordination, country preparedness assessment, logistic and institutional strengthening, and coordination. On a global level, negotiations are ongoing concerning the International Health Regulations and an international treaty on pandemics. African countries must engage with and collectively advocate for a unified position to influence future pandemic preparedness, prevention, and response instruments.

Broad initiatives like these are important, but African member states must also take critical steps to accelerate and ensure progress within their countries. For example, in Senegal and Rwanda having comprehensive pandemic preparedness, prevention, and response strategies in place allowed them to swiftly implement measures to contain covid-19 and mitigate its effect on public health, including rigorous testing, contact tracing, and isolation measures.67 Comprehensive, regularly tested preparedness and response plans are essential to managing health emergencies. These plans should cover several workstreams, including surveillance and early detection systems, rapid response mechanisms, risk communication and public awareness plans, data management systems, and resource mobilisation strategies.

Comprehensive plans alone are futile without adequate planning and resources to support their implementation. African governments must commit to investing in public health infrastructure, workforce training, and locally led research and innovation. Investing in these will help to ensure that, when a health emergency arises, the required systems, people, and technologies are in place to respond. This commitment goes beyond immediate crisis response as it builds the foundation for resilient healthcare ecosystems that can withstand future health crises.

Investing in African-led research can give rise to sustainable and relevant solutions to regional and country specific health challenges. Historically, global health systems and resources have been inequitably distributed, leaving African countries facing systemic disadvantages as they struggle to access international assistance and resources during health crises. African countries experienced this stark inequality in the rollout of covid-19 vaccines: by October 2022, for instance, only 24% of Africa’s populations had completed their primary covid-19 vaccination series, compared with 64% globally.8 This is a painful reminder that investing in home-grown solutions—including local innovation and manufacturing of health products—is an important step to strengthening autonomy in African countries.

African-led research can avoid falling into silos by strengthening regional collaboration. This involves African nations coming together to exchange knowledge and experiences, share resources, and disseminate best practices in pandemic preparedness, prevention, and response. Past outbreaks have reminded us that diseases do not respect borders, and our collective health security depends on countries working together to build robust defences against threats to public health.

Regional conferences offer important opportunities to bring together African leaders and partners to strengthen collaboration to build more resilient health systems—the upcoming third International Conference on Public Health in Africa (CPHIA)9 in Zambia is one such platform. Public health policymakers, scientists, researchers, and academics will convene to discuss the challenges and opportunities and develop actionable pathways to improve the health and wellbeing of African people.

African countries have gained important momentum in driving public health progress since the covid-19 pandemic, and we must seize this opportunity for action to avoid returning to business as usual. This includes taking proactive steps to safeguard health and building resilience against future health threats within the framework of the global health architecture. To fully realise our commitment to health security, we need equitable access to global funding mechanisms to support inclusive and carefully considered proposals that protect the health of African populations. Governments across the continent should work together in developing comprehensive pandemic preparedness plans to enable allocation of resources, including investments in health infrastructure, workforce, research, and innovation and work across borders and institutions to strengthen collective efforts. In doing so, African countries can effectively respond to health crises and mitigate their impact on communities and economies, ultimately leading to a healthier, more resilient, and prosperous continent.


  • Provenance: not commissioned, not externally peer reviewed.

  • Competing interests: The authors declare no conflicts of interest with this opinion article.