Title : One health governance and its impact on strengthening epidemic preparedness and response in Sierra Leone

The increasing frequency and impact of zoonotic and emerging infectious diseases across Africa have reinforced the need for integrated governance mechanisms that bridge human, animal, and environmental health sectors. Recognizing these challenges, the African Union (AU) and the Economic Community of West African States (ECOWAS) as well as the regional cross-border Manor River Union of Guinea, Liberia, and Sierra Leone have prioritized One Health as a cornerstone of regional health security, promoting multisectoral coordination, cross-border collaboration, and joint preparedness for public health threats. Sierra Leone, a country repeatedly affected by Ebola, Lassa fever, rabies, avian influenza, Mpox, and other zoonotic diseases, aligned its national efforts with the AU One Health agenda and the ECOWAS Regional One Health Coordination Mechanism established following the Dakar (2016) and Abuja (2017) ministerial commitments. This presentation examines how institutionalizing One Health governance has strengthened Sierra Leone's capacity to prepare for, detect, and respond to emerging and re-emerging disease threats.

Sierra Leone operationalized One Health through the establishment of a National One Health Platform and Secretariat within the National Public Health Agency, the appointment of One Health focal persons in all sixteen districts, and the progressive operationalization of chiefdom-level One Health committees. Through the Platform, ministries responsible for health, agriculture, livestock, wildlife, environment, and disaster management jointly developed and implemented key governance instruments, including the National One Health Policy, Strategic Plan, and Governance Framework. Technical working groups facilitate joint planning, risk assessment, policy development, and resource mobilization, while governance mechanisms support zoonotic disease surveillance, antimicrobial resistance (AMR) coordination, epidemic preparedness, and emergency response.

The institutionalization of One Health governance has significantly enhanced multisectoral coordination and research, data and information sharing, and emergency response capacity. Governance reforms have improved collaboration across sectors, strengthened district-level ownership, and enabled more timely detection and reporting of zoonotic disease events. Chiefdom One Health committees have expanded community participation in surveillance, preparedness, and gender-responsive risk communication, while facilitating cross-border collaboration with neighboring countries.

The value of these governance investments was demonstrated during the 2024 Mpox preparedness and response. The One Health Secretariat played a central role within the national Incident Management System by harmonizing surveillance approaches, supporting resource mobilization, contributing to monitoring and evaluation systems, and strengthening transparent reporting mechanisms. These integrated approaches contributed to more efficient outbreak management, improved surveillance performance, and strengthened preparedness capacities. Governance reforms have also advanced implementation of the national AMR agenda, improved resource mobilization, and promoted evidence-based decision-making through integrated risk assessments.

Despite these achievements, challenges remain, including limited domestic financing, dependence on donor support, insufficient laboratory capacity, weak digital interoperability, and uneven community engagement. Sierra Leone's experience demonstrates that strong governance is a critical enabler of effective One Health implementation and health security. The lessons emerging from this experience offer valuable insights for other low- and middle-income countries seeking to institutionalize One Health and strengthen resilience against future health threats across West Africa and beyond.

Rachel Regina Sandi holds a Master’s in Global Public Health degree, and is currently the Deputy National One Health Technical Coordinator in Sierra Leone, leading cross-ministry collaboration to strengthen disease prevention and control, especially zoonotic diseases and AMR. She is a Public Health and Community Specialist Practitioner with over 28 years in the UK’s NHS, focusing on adult nursing, community practice, and public health. She has served as a Specialist Community Nurse, Clinical Lead, and Lead Care Coordinator, and contributed over five years to humanitarian work in Sierra Leone with AEMRN and Serve United. During the COVID-19 pandemic, she advanced health promotion, education, and vaccination in Brent.