Abstract:
Background: Recent Marburg virus disease (MVD) outbreaks in Rwanda, Tanzania, and Ethiopia during 2024–2025 highlighted the continuing threat posed by emerging zoonotic diseases and exposed persistent challenges in translating the One Health approach into operational practice during public health emergencies. Although One Health is widely recognized as a critical framework for preventing, detecting, and responding to zoonotic disease outbreaks, evidence regarding its practical implementation during real-time Marburg outbreak responses remains limited. This narrative review assessed the extent to which One Health principles were operationalized during recent MVD outbreaks and identified key barriers affecting multisectoral collaboration and response effectiveness.
Methods: A structured narrative review was conducted using World Health Organization (WHO) outbreak situation reports, national Ministry of Health updates, technical reports, and peer-reviewed literature published between 2024 and 2025. Evidence was systematically synthesized to evaluate the operationalization of One Health across surveillance systems, laboratory networks, outbreak investigations, risk assessment processes, emergency coordination mechanisms, and collaboration between human, animal, and environmental health sectors.
Results: Across all three countries, outbreak response activities were predominantly led by the human health sector. Key interventions included enhanced surveillance, case detection, contact tracing, infection prevention and control measures, laboratory confirmation, risk communication, and community engagement. While multisectoral coordination meetings and technical consultations were reported, operational implementation of One Health remained limited and largely reactive. Real-time integration of animal health surveillance, environmental risk assessment, and joint human–animal outbreak investigations were minimal. Coordination mechanisms were generally activated in response to outbreaks rather than functioning as sustained preparedness platforms. Furthermore, interoperable surveillance systems and routine cross-sector information sharing were insufficiently developed. Major barriers included fragmented surveillance architectures, weak integration between human and animal health information systems, delayed information exchange, limited institutionalized collaboration mechanisms, and the absence of formalized joint outbreak investigation protocols.
Conclusions: The findings indicate that although the One Health approach is strongly endorsed within national and international policy frameworks, its operationalization during recent Marburg virus disease outbreaks remains inconsistent. Strengthening preparedness and response capacities requires institutionalized multisectoral coordination platforms, integrated surveillance and laboratory systems, routine information sharing, and formal joint outbreak investigation mechanisms. Advancing these capacities will be essential for improving the prevention, detection, and control of future zoonotic disease threats and strengthening global health security.
Keywords: Marburg virus disease; One Health; outbreak response; zoonotic diseases; surveillance; global health security; East Africa
Biography:
Dr Tedros Fikru is an Africa Epidemic Service (AES) Fellow in the Epidemiology Track at the Africa Centres for Disease Control and Prevention (Africa CDC). He is a public health professional with interests in infectious disease epidemiology, outbreak preparedness and response, disease surveillance, One Health, and global health security. Through the AES Fellowship, he contributes to strengthening epidemiological capacity and public health emergency preparedness across Africa. His work focuses on emerging and re-emerging infectious diseases, evidence synthesis, outbreak investigation, and strategies to enhance multisectoral collaboration for effective prevention and control of zoonotic disease threats.
