By Doris Omao and Johnstone Kotut
Contributors: Dr. Eric Nzeyimana and Alison Kaitesi Gichohi
Background
The COVID-19 pandemic revealed significant gaps in emergency preparedness and health systems resilience worldwide, and East Africa was no exception. (Bwire et al., 2022) The East African Community (EAC) stakes were higher, ranging from overwhelmed healthcare facilities to disruptions in essential services. The region has experienced several infectious disease outbreaks during the last decade, the most recent being the Mpox outbreak of 2024. Others include cholera and yellow fever epidemics, as well as Rift Valley, Dengue, Marburg, and Ebola virus fevers (see Table 1). When COVID-19 hit, some hospitals in the region ran out of basic supplies such as oxygen. Cross-border trade was also disrupted, affecting millions of livelihoods. The crisis highlighted an urgent need for robust pandemic preparedness strategies to ensure that EAC Partner States can swiftly and effectively respond to future health emergencies to safeguard its population of 331+ million people (EAC Quick Facts, n.d.).
The EAC Secretariat in collaboration with EAC Partner States with technical and financial support from the African Population and Health Research Center (APHRC) embarked on a journey to develop a pandemic preparedness and response policy framework for the region. This initiative seeks to address the existing gaps in health policies and design an integrated approach to addressing pandemics, emphasizing the importance of regional collaboration in building resilient health systems.
Formulating this policy has been a collaborative effort. It began with a situational analysis conducted by expert consultants and was followed by in-depth country consultations across the EAC Partner States. This collaborative process ensures that the framework reflects the diverse needs and experience of all Partner States, positioning the EAC to enhance the protection of its citizens in times of health outbreaks; epidemics and pandemics.
Consultative Meetings
Following the analysis, experts from all the Partner States gathered in Bujumbura, Burundi, in July 2024 for a three-day meeting to review the findings and create a zero draft of the policy framework. The zero draft was reviewed and discussed with each partner state to ensure regional ownership. Between August and September 2024, consultations were held in each Partner State, facilitated by the ministries responsible for EAC affairs in collaboration with the ministries of health. These meetings brought together critical stakeholders, including epidemiologists, pharmaceutical supply chain experts, environmental specialists, data and health system experts and gender focal persons, ensuring a holistic approach to policy shaping.
During these sessions, the draft framework was discussed, with stakeholders working in groups based on their areas of expertise, reviewing specific document sections. Feedback was gathered through plenary sessions, and consolidated comments were documented for further framework refinement.
Key Lessons from the Consultation Process
- A comprehensive review of existing frameworks is essential to thoroughly examine the legal structures and practice of Partner States before initiating consultation. This step ensures countries interests are considered and accurately represented.
- When countries’ practices and policies conflict, it is imperative to reflect and agree on the most effective and efficient model to apply as a region based on evidence.
- Experts contribute a wide range of perspectives, and harmonizing these viewpoints necessitates a meticulous process that upholds and values diverse expertise where each input is acknowledged and documented.
- How the draft is presented significantly influences its effectiveness in gaining approval. Partner States must be assured that their contribution will have a direct impact on shaping the final policy, with some requiring immediate integration of their feedback rather than subsequent amendments.
- Country consultations are indispensable for ensuring the successful execution of strategies and initiatives. Partner States must recognize that their input and participation are valued and embedded in the decision-making process. Engaging stakeholders in substantive dialogue promotes ownership, builds mutual trust, and enhances the relevance and application of proposed actions.
After country consultations; a regional validation meeting was convened. The meeting was an opportunity for the heads of disease surveillance programmes from Partner States to review the draft policy framework and ensure that all inputs from country consultations are well captured.
Moving forward
The collaborative development of this pandemic preparedness framework has reinforced the importance of regional collaboration and highlighted the complexities of policy development in a diverse community like the EAC. The next steps involve refining the draft policy framework and presenting it to the EAC Sectoral Council of Ministers of Health. After this comes the implementation stage and governments, healthcare professionals, civil society organizations, and international partners can join forces in advocating for the adoption and execution of this framework for preparedness of the region. This will involve championing and securing the necessary investments to enhance East Africa’s ability to respond to future health emergencies.