KEY LESSONS FROM PREPARATORY AND EARLY IMPLEMENTATION PHASE OF A REGIONAL MPOX RESPONSE WITHIN A MULTI-SECTORAL PREPARE PROJECT FRAMEWORK

Abstract

Background: Outbreaks of viral and zoonotic diseases are increasingly frequent, with Sub-Saharan Africa representing a significant global source of emerging infectious diseases. Health security threats posed by the pandemics and epidemics call for regional, multi-stakeholder, and multi-sectoral approaches.
Objectives: To examine and document events' chronologies and critical lessons during the preparatory and early implementation stages of a three-year Preparedness for Pandemic Response (PREPARE) project in the Intergovernmental Authority on Development (IGAD) region.
Methods: This narrative review synthesizes the evolution of the mpox outbreak, the regional and country level response considerations, and the key lessons learned during the initial implementation phase of the regional PREPARE project from 2024 to 2025.
Discussion: The regional PREPARE project was fast-tracked to respond to the mpox outbreak in IGAD region from November 2024, at a time when Uganda was the only IGAD country that had reported active cases. Lessons from the preparatory and early stages of the initiative arose from: IGAD's vulnerable geo-location in respect to the pandemics epicenters; the sporadic yet important paradigm shift from predominantly single-sector (health) response to a multi-sector approach; the adjustment from the initial ‘regional preparedness for response to pandemics and epidemics’ to ‘securing regional impact through supporting country-level mpox response’; the unpredictable trajectory of mpox transmission and spread; perplexing observations during the initial phase of the mpox outbreak; administrative challenges arising from the new partnerships; and opportunity presented for policy and strategy reviews, and harmonization across countries.
Conclusions and Recommendations: Regional mpox response presents increased relevance and draw support for expedited implementation when particularly initiated in proximity to the outbreak epicenter. Insights from the initial phase of the PREPARE project provide critical lessons applicable to regional responses to infectious disease outbreaks and other public health emergencies; and may inform refinement of context-specific health security policies and strategic frameworks.