Functionality of One Health Platform (Coordination Mechanism, Policy, Strategy, National Bridging Workshop) and Response Capacity to COVID-19 in West Africa

Daniel Yota, Anderson Latt, Christian Massidi, Tieble Traore, Freddy Banza M, Landry Cihambanya, Vatsiharizandry Mandrosovololona, Hermann Tchiyane, Allan Mpairwe, Lala Moulaty, Dick Chamla, Omer Njajou T, Marie Roseline Belizaire.

Abstract

Background: The COVID-19 pandemic exposed critical weaknesses in multisectoral coordination across West Africa, a region highly vulnerable to zoonotic disease emergence. Despite widespread advocacy for One Health approaches and the Quadripartite’s stepwise capacity-building pathway (Assess–Plan–Implement–Optimize), empirical evidence linking platform functionality to pandemic response outcomes remains sparse. We evaluated the association between One Health platform functionality, including coordination mechanisms, policies, strategies, and National Bridging Workshops (NBWs), and COVID-19 response capacity across all 15 Economic Communities of West African States (ECOWAS).

Methods: This mixed-methods retrospective study (January 2020–December 2022) used quantitative indicators (testing capacity, response timeliness, mortality) from WHO, Africa CDC, and Humanitarian Data Exchange, and qualitative data from national One Health documents, NBW reports, and peer-reviewed literature. One Health functionality was assessed using four binary indicators: functional coordination committee (≥2 meetings 2020–2021), ratified/costed policy, integrated zoonotic surveillance, and NBW participation. Analysis employed bivariate comparisons, multivariate regression, Spearman’s correlation, and directed content analysis.

Findings: Among 15 countries, only three (20%), namely Ghana, Nigeria, and Senegal—demonstrated high coordination functionality. Only two (13%)—Nigeria and Senegal—had fully ratified, costed One Health policies integrated into National Action Plans for Health Security. Nine countries completed NBWs, but only two designated national NBW Catalysts and conducted follow-up meetings, achieving action plan implementation rates of 78% and 69% versus 23% in countries without these mechanisms (p<0·01). NBW participation was the strongest predictor of response timeliness (r=-0·67, p<0·01), reducing response plan activation from 24 to 12 days (p=0·04). Higher One Health functionality was associated with greater testing capacity (4·2 vs. 1·8 PCR labs per 10 million population, p=0·01), superior contact tracing (58% vs. 41%, p=0·03), and shorter sample-to-result times (2·1 vs. 4·3 days, p=0·02). No significant association was found with COVID-19 mortality (β=-0·52, p=0·42). Environmental sector exclusion occurred in 80% of countries; legal mandates were absent in 87%; donor funding dependency affected 93%.

Interpretation: One Health functionality in West Africa is highly variable and associated with faster, more efficient pandemic response processes but not with COVID-19 mortality in this low-mortality context. The Quadripartite pathway provides a useful diagnostic: most countries complete the “Assess” step (NBWs) but stall at “Plan” and “Implement”. NBW Catalysts and follow-up meetings are critical but routinely omitted. Without legal mandates, domestic budgets, environmental sector inclusion, and mandated follow-through mechanisms, One Health platforms risk producing documents rather than outcomes. The process gains observed, though not mortality-reducing during COVID-19, could prove decisive in a future high-fatality zoonotic pandemic.